Maselli Warren, P.C.

Schedule a Free Consultation - Bankruptcy

An attorney at Maselli Warren, P.C. would be happy to meet with you to discuss your present financial situation and assist with information about how we can put the law to work for you to solve your financial problems. Please complete the following questionnaire and submit it with your contact information and we will contact you to schedule your free consultation. Please be advised that the submission of your contact information and the submission of the questionnaire does not create an attorney-client relationship.

Contact Information (Required)

First Name:   Last Name:  

E-mail Address:

Telehone: ( ) -   Ext:

Address:   Suite/Apt/Rm:

City:   ST: -- NJ PA   ZIP:

Is Bankruptcy Right for Me?

Why are you considering bankruptcy? (Check all that apply)

Letters/Phone Calls from Creditors

Collection Lawsuit

Mortgage Foreclosure

Repossession

Utility Shut Off Notices

Garnishments

Unemployment

Loss of Income

Illness/Disability

Separation/Divorce

Other - specify:

What do you owe? (Check all that apply)

Estimated total debt owed (required): $

Credit Card Debt

Medical Bills

Garnishments

Student Loans

Taxes

Support Obligations

Mortgage

Car Payments

Other - specify:

Assets (Check all that apply)

Do you own a home? Yes No

Do you have a mortgage? Yes No

Are you behind on your mortgage? Yes No

Do you own a car? Yes No

Do you have a car payment? Yes No

Are you behind on your car payment? Yes No

Do you own other valuable assets greater than $1000?
Yes No

If yes, please describe asset:

Do you owe money on these assets? Yes No

Are you behind on your payments? Yes No

Income

Are you employed?

Full-time Part-time Seasonal only

What are your sources of income? (check all that apply)

No Income

Employment

Unemployment

Social Security (retirement)

Social Security-SSI

Social Security Disability-SSD

Pension/Retirement

Child Support/Alimony

Other Income - specify:

IMPORTANT: Please be advised that the submission of your contact information and the submission of the questionnaire does not create an attorney-client relationship. Please do not include any confidential or sensitive information when you email us or use our online forms. The forms sends information by non-encrypted e-mail which is not secure. Sending an email from a link on this website or using the online form does not create an attorney-client relationship.

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