Five Minute Debt Analysis
Answer the questions below and click on the submit button. Try to be as exact as possible. Do not guess. If you need to look up information to supply the answer, take the time to do so. The better information you provide to us, the better we can help you find a solution!
Your Name
Spouse Name
Address
City, State, Zip
Phone Number:
Cell Phone Number:
I am single
I am divorced
How long have you lived in the State of Washington?
How many people live in your household?
Have you cash advanced or charged more than $600 in the past 90 days?
June 11, 2008 - Tennessee - AP
Gas Prices Causing Bankruptcy
Amanda Shropshire
Consumer Credit Counseling Services is trying to help people in East Tennessee find relief in a struggling economy. Tennessee is number one for bankruptcy filings and the main constributor to that rank is gas prices.
Employer Name:
Job Positon/ Your title at work:
How often are you paid?
I/we am/are self-employed
Hourly Wage/Monthly Salary:
Length of Employment
Hours worked per week:
Have you been on unemployment in the past 6 months?
Have you worked for the past six months?
If yes, what was the monthly unemployment amount?
Do you work overtime?
You
Your Spouse
Overall, how much money do you think you earned in the past six months before taxes were taken out of your paycheck?
3. Real Property Information
Property Address:
City, State Zip:
When did you buy this property?
How much did you pay?
How much is it worth now?
What is your first mortgage balance?
I/We do not own a home, condo, duplex, vacant land or any other real property and I am not making any mortgage payments to a bank or other creditor.
Are you current on your payments?
www.zillow.com
What is your second mortgage balance?
What is your third mortgage balance?
Yes
No
Do you have an adjustable rate mortgage?
Yes
No
Need to know how much your home is worth?
Go online to www.zillow.com to find out what the value on your home is. Although it isn't perfect, it will give us a good estimate of the value of your home.
For a more exacting valuation of your home, we suggest an appraisal of your home or a comparable market analysis. Most real estate agents will provide a CMA for no charge.
What is your monthly payment?
How many months behind are you?
How much do you owe to catch up?
Have you received a notice of foreclosure?
Have you received a notice of default?
If you are in foreclosure, your time is limited. Severely.
Your home is your biggest investment and represents your slice of the American Dream.
If we can take action before the foreclosure date, well in advance of the foreclosure date, then we can most lkely create a plan that will stop the foreclosure and keep you in your home.
If you don't take action by the foreclosure date, then there is really very little we can do to get your home back. Unless there has been severe negligence or outright fraud, you are going to have to move out within twenty days of the foreclosure date.
If you are facing foreclosure, pick up the phone right now and set an appointment. Our number is 253 479 0241. You need to take action today on this.
Mortgage #1
What is your monthly payment?
How many months behind are you?
How much do you owe to catch up?
Mortgage #2
What is your monthly payment?
How many months behind are you?
How much do you owe to catch up?
Mortgage #3
If yes, when is the foreclosure date?
Yes
No
Yes
No
If your property is in foreclosure:
What is your monthly dues payment?
Are you current on your dues payments?
If no, how much do you owe to catch up?
Homeowners Dues:
I do not have any homeowners dues on my property.
How much are your annual property taxes?
Are you current on your property taxes?
If no, how much do you owe to catch up?
Property Taxes:
Property Taxes and Insurance are included in my mortgage payment.
Do you own other homes or land?
Yes
No
Other Real Property:
If yes, how many other pieces of real property do you own?
Year, Make and Model: (Ex: 2001 GMC Yukon)
What was the purchase date? (Ex: 01/01/2008)
How much is it worth today?
Do you owe any money for this vehicle?
How much do you owe?
Are you current on your payments?
I do not own a car, truck, SUV, motorcycle, boat or other motorized vehicle.
Yes
No
Yes
No
If no, how much do you owe to get current?
What is the interest rate on this loan?
Do you own any other motor vehicles?
Yes
No
Do you want to keep this vehicle or get rid of it?
Keep it
Get rid of it
What is the monthly payment amount?
Yes
No
Yes
No
Keep it
Get rid of it
Vehicle #1
Vehicle #2
What is the name of the lender?
How much is the monthly payment?
Are you current on your payments?
Yes
No
What is the loan for?
How much do you owe?
When did you get this loan? (12/10/2007)
Rent to Own / Home Improvement Loans
I do not have any secured/rent to own/home improvement loans.
If no, how much do you owe to get current?
What is the interest rate?
How much do you owe to the IRS?
How much do you owe to the State Tax Board?
Are any of these amounts more than 3 years old?
Tax Debts Owed to the IRS or State
I do not owe any money for taxes to the IRS or to any State.
What is your monthly support amount?
How much do you owe for back support?
Child Support / Maintenance / Alimony
I do not owe any child support, maintenance or alimony.
How much do you owe in student loans?
Are your currently in forebearance?
Are you current on your payments?
Student Loan Debt
I do not owe any money for student loans
What is your monthly payment?
How much do you owe in traffic tickets?
How much do you owe in criminal fines?
Traffic Tickets, Criminal Fines, and/or Restitution
I do not owe traffic tickets, fines, or restitution
How much do you owe in restitution?
Is your drivers license presently suspended?
Yes
No
How much do you owe in credit cards?
How much do you owe in personal loans?
Credit Cards, Signature Loans, Medical Bills, Payday Loans, Collections, etc
I do not have any credit card debt, personal loans, medical bills, payday loans or any other type of unsecured debt.
How much do you owe for medical bills?
How much do you owe to collection agents?
How much do you owe in payday loans?
How much do you owe for other types of debt?
Click here to look up your Vehicle Value at www.kbb.com!
Employment Regular Gross Income:
You
Spouse
- Federal Taxes Paid
- Social Security Taxes Paid
- Medicare/Medcaid
- Union Dues
- 401(k) / Retirement / Pension
- Health Insurance
- 401(k) loan payment
- Other Mandatory Deductions
Employment Overtime Income
Other Monthly Income Source
Monthly Gross Income:
Paycheck Deductions from Income:
Rent:
Electricity
Water and Sewer
Telephone
Cell Phone
Cable
Internet
Gas Heat:
Home Maintenance:
Monthly Expenses:
Food
Clothing
Laundry/Dry Clean
Medical/Dental Exp.
Gas and Oil - Vehicle
License Tabs
Recreation
Charitable Contributions
Life Insurance
Health Insurance
Property Taxes
Other Tax Payments
Education expenses
Auto Insurance
Homeowners Insurance
Other Installment Pymt
Daycare
How much money do you think have earned in gross income in the past 6 months?
6 Months Income Information:
You
Spouse
The above information gives us a great start on knowing what direction you should take to work your way through this financial crisis. But we're not perfect, and there might be something you think we need to know. Take the time to type in your information below. It can be anything you like, from what brought you to this point, to other assets you think we should know about, to garnishments on your paycheck, etc. Let us know what is going on and we'll work it into our analysis.
REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACT MANDATED BY 11 U.S.C.§342(B)(1) AND 527(A). ------------------------------------------------------ A Brief Description of the Types of Bankruptcy: Chapter 7: Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. Under chapter 7 a trustee takes possession of all your property. You may claim certain of your property as exempt under governing law. The trustee then liquidates the property and uses the proceeds to pay your creditors according to priorities of the Bankruptcy Code. The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found to have committed certain kinds of improper conduct described in the Bankruptcy Code, your discharge m ay be denied by the court, and the purpose for which you filed the bankruptcy petition will be defeated. Even if you receive a discharge, there are some debts that are not discharged under the law. Therefore, you may still be responsible for such debts as certain taxes and student loans, alimony and support payments, criminal restitution, and debts for death or personal injury caused by driving while intoxicated from alcohol or drugs. Under certain circumstances you may keep property that you have purchased subject to valid security interest. Your attorney can explain the options that are available to you. Chapter 13: Chapter 13 is designed for individuals with regular income who are temporarily unable to pay their debts but would like to pay them in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar amounts set forth in the Bankruptcy Code. Under chapter 13 you must file a plan with the court to repay your creditors all or part of the money that you owe them, using your future earnings. Usually, the period allowed by the court to repay your debts is three years, but no more than five years. Your plan must be approved by the court before it can take effect. Under chapter 13, unlike chapter 7, you may keep all your property, both exempt and non-exempt, as long as you continue to make payments under the plan. After completion of payments under your plan, your debts are discharged except alimony and support payments, student loans, certain debts including criminal fines and restitution and debts for death or personal injury caused by driving while intoxicated from alcohol or drugs, and long term secured obligations. Chapter 11: Chapter 11 is designed for the reorganization of a business but is also available to consume r debtors. Its provisions are quite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney. Chapter 12: Chapter 12 designed to permit family farmers to repay their debts over a period of time from future earnings and is in many ways similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose income arises primarily from a family - owned farm. SERVICES AVAILABLE FROM CREDIT COUNSELING AGENCIES -------------------------------------------------- If you're not disciplined enough to create a workable budget and stick to it, can't work out a repayment plan with your creditors, can't keep track of mounting bills, or need more help with your debts than can be achieved by merely having a few of your unsecured creditors lower your interest rates somewhat, it makes NO sense to consider contacting a credit counseling organization. If, on the other hand, you meet all of those criteria, there are many non-profit credit counseling organizations are nonprofit that will work with you to solve your financial problems. But just because an organization says it is "nonprofit," there's no guarantee that its services are free, affordable, or even legitimate. In fact, some credit counseling organizations charge high fees, which may be hidden, urge consumers to make "voluntary" contributions that can cause more debt, urge consumers to enter "debt repayment plans" they simply cannot afford. Most credit counselors offer services through local offices, the Internet, or on the telephone. If possible, it probably best to find an organization that offers in-person counseling. Many universities, military bases, credit unions, housing authorities, and branches of the U.S. Cooperative Extension Service operate nonprofit credit counseling programs. Your financial institution, local consumer protection agency, and friends and family also may be good sources of information and referrals. Reputable credit counseling organizations can advise you on managing your money and debts, help you develop a budget, and offer free educational materials and workshops. Their counselors are certified and trained in the areas of consumer credit, money and debt management, and budgeting. Legitimate counselors will discuss your entire financial situation with you, and help you develop a personalized plan to solve your money problems. An initial counseling session typically lasts an hour, with an offer of follow-up sessions. If your financial problems stem from too much debt or your inability to repay your debts, a credit counseling agency may recommend that you enroll in what is knows as a "debt management plan" or "DMP". A DMP alone is not credit counseling, and DMPs are not for everyone. You should sign up for one of these plans only after a certified credit counselor has spent time thoroughly reviewing your financial situation, has offered you customized advice on managing your money, and has analyzed your budget to make sure that the proposed DMP is one you can afford. However, remember that all organizations that promote DMP's fund themselves in part through kickbacks from the creditors involved, which are called "fair share", so you have to be wary as to whose best interest the counselor has in mind. Even if a DMP is not appropriate for you, a reputable credit counseling organization still can help you create a budget and teach you money management skills. In a DMP, you deposit money each month with the credit counseling organization, which uses your deposits to pay your unsecured debts, like your credit card bills and medical bills, according to a payment schedule the counselor develops with your creditors. Your creditors may agree to lower your interest rates or waive certain fees, but it's always best to check with all your creditors, just to make sure they offer the concessions that a credit counseling organization is promising you. A successful DMP requires you to make regular, timely payments, and could take 48 months or more to complete. Ask the credit counselor to estimate how long it will take for you to complete the plan. You may have to agree not to apply for — or use — any additional credit while you're participating in the plan, and a DMP is absolutely useless if your problems stem from or involve your secured creditors holding your car, truck or home as collateral. DMP's are also useless if your problems stem from alimony, child support or overdue taxes. The bottom line is this: If all you need is a little lowering of your interest rates on some unsecured debts, a DMP might be the answer. However, if what you really need is to reduce the amount of your debt, bankruptcy may be the only solution. EXPLANATION OF MEANS TESTING ---------------------------- Before your case can be filed, it is subject to what is called "Means Testing". The Means Test was designed to determine whether or not you qualify to file a case under chapter 7 of the Bankruptcy Code, and if not, how much you need to pay your unsecured creditors in a chapter 13 case. For purposes of means test, you must state, after reasonable inquiry, your total current monthly income, the amount of all expenses as specified and allowed pursuant to section 707(b)(2) of the Bankruptcy Code, and if the plan is to file you in a Chapter 13 case, you must state, again after reasonable inquiry, your disposable income, as that term is defined. YOUR DUTY TO PROVIDE ACCURATE AND COMPLETE DISCLOSURE ----------------------------------------------------- Some or all of the information you provide in connection with your bankruptcy will be filed with the bankruptcy court on forms or documents that you will be required to sign and declare as true under penalty of perjury. All information that you are required to provide with the filing of your case and thereafter, while your case is pending, must be complete, accurate and truthful. All your assets and all your liabilities must be completely and accurately disclosed in the documents filed to commence your case. Some places in the bankruptcy code require you to determine and list the replacement value of an asset such as a car, or furniture. When replacement value is required, it means the replacement value, established after reasonable inquiry, as of the date of the filing of your bankruptcy case, without deduction for costs of sale or marketing. With respect to property acquired for personal, family or household purposes, replacement value means the price a retail merchant would charge for "used" property of that kind considering the age and condition of the property. Information that you provide during your case may be audited pursuant to the provisions of the Bankruptcy Code. Your failure to provide complete, accurate and truthful information may result in the dismissal of your case or other sanctions, including criminal sanctions. A person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of perjury in connection with a bankruptcy case shall be subject to fine, imprisonment, or both. All information you provide in connection with your bankruptcy case is subject to examination by the Attorney General. REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACT MANDATED BY 11 U.S.C.§527(B). ----------------------------------------------------- IMPORTANT INFORMATION ABOUT BANKRUPTCY ASSISTANCE SERVICES FROM AN ATTORNEY OR BANKRUPTCY PETITION PREPARER. If you decide to seek bankruptcy relief, you can represent yourself, you can hire an attorney to represent you, or you can get help in some localities from a bankruptcy petition preparer who is not an attorney. THE LAW REQUIRES AN ATTORNEY OR BANKRUPTCY PETITION PREPARER TO GIVE YOU A WRITTEN CONTRACT SPECIFYING WHAT THE ATTORNEY OR BANKRUPTCY PETITION PREPARER WILL DO FOR YOU AND HOW MUCH IT WILL COST. Ask to see the contract before you hire anyone. The following information helps you understand what must be done in a routine bankruptcy case to help you evaluate how much service you need. Although bankruptcy can be complex, many cases are routine. Before filing a bankruptcy case, either you or your attorney should analyze your eligibility for different forms of debt relief available under the Bankruptcy Code and which form of relief is most likely to be beneficial for you. Be sure you understand the relief you can obtain and its limitations. To file a bankruptcy case, documents called a Petition, Schedules and Statement of Financial Affairs, as well as in some cases a Statement of Intention need to be prepared correctly and filed with the bankruptcy court. You will have to pay a filing fee to the bankruptcy court. Once your case starts, you will have to attend the required first meeting of creditors where you may be questioned by a court official called a ‘trustee’ and by creditors. If you choose to file a chapter 7 case, you may be asked by a creditor to reaffirm a debt. You may want help deciding whether to do so. A creditor is not permitted to coerce you into reaffirming your debts. If you choose to file a chapter 13 case in which you repay your creditors what you can afford over 3 to 5 years, you may also want help with preparing your chapter 13 plan and with the confirmation hearing on your plan which will be before a bankruptcy judge. If you select another type of relief under the Bankruptcy Code other than chapter 7 or chapter 13, you will want to find out what should be done from someone familiar with that type of relief. Your bankruptcy case may also involve litigation. You are generally permitted to represent yourself in litigation in bankruptcy court, but only attorneys, not bankruptcy petition preparers, can give you legal advice. REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACT MANDATED BY 11 U.S.C. §528(a)(1) ---------------------------------------------------- FREE INITIAL CONSULTATION AGREEMENT You (“Client”) are hereby requesting the opportunity to consult with and obtain information and advice from the Jump Law Group (“Law Firm”) regarding relief from debts, including relief from debts by filing bankruptcy under the United States Bankruptcy Code. This agreement is for purposes of that initial consultation only. If at the end of the Free 20 minute Initial Consultation, the parties agree that the Attorney is to provide any additional services short of being retained to file a bankruptcy, the parties shall attach an addendum to this contract setting forth the additional services the Attorney is to provide to the Client, the obligations of the Client, and the Attorney’s fees for such services. If the Client retains the Attorney to file a bankruptcy, the parties shall execute a separate contract setting forth the fees and other terms of such representations. With respect to the consultation, the parties agree as follows: There is no fee for the completion of the forms and discussion of your financial situation. In the event that Client wishes to hire Attorney for any purpose other than a Limited 20 Minute Free Initial Consultation then a separate agreement must be executed by all parties. Law Firm shall provide the Client the following services: Analyze the client’s financial circumstances based on information provided by the Client. To the extent possible, based on the information provided by the Client, advise the Client of the Client's bankruptcy options and non-bankruptcy options. Advise the Client of the requirements placed upon the Client to file a chapter 7 or 13 bankruptcy. To the extent possible, quote the Client an estimated fee for the Law Firm's services to provide bankruptcy assistance or other legal services to the Client. There is no obligation on the part of the client to tender any fees for the initial consultation.
I have read the above disclosure.
REQUIRED!
You are submitting a lot of personal information and we understand your desire for privacy. Your information is NEVER sold or disbursed to a 3rd party. While we do not have an attorney/client relationship yet, we agree that you are submitting this information in confidence and we will not reveal it to anyone, ever, without your permission.
Please contact me via EMAIL about setting up an appointment.
Please contact me via TELEPHONE about setting up an appointment.
1. Information about you and your family:
2. Employment Information
4. Motor Vehicle Information:
5. Information about people and companies you owe money to:
6. Income and Expense Information:
7. Other information you think we should know
8. Required Congressional Disclosure
9. Submit your information!
If yes, how many?
What is your takehome pay?
Net Income After Taxes
What is your gross income you have earned year to date? (Look on your latest paystub)
Year to Date Gross Income Information
You
Spouse
DO NOT INCLUDE payments to credit cards, collectors, or other unsecured creditors in this section.
Get your latest paystubs and fill in the requested information.
Use you latest paystub to provide this information.
Unemployed
Unemployed
Your Email Address: