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Name:

E-mail address:

Telephone number:

How much is your take home pay per month?:
(This is how much you have after insurance and taxes are deducted.)

Are you married?
Yes
No

Do you have dependent children?
Yes
No

How many dependent chldren do you have?:

Is your spouse employed?
Yes
No

Do you pay child support?
Yes
No

If you do pay child support, what is the monthly amount you pay?:

How much is your spouse's take home pay per month.
(This is how much is left after insurances and taxes are deducted.)


How much is your monthly house note or rent?


How much do you spend on food per month?


How much do you spend on utilities per month?


How much do you spend on insurance (not deducted from your pay)?


How much do you spend on gas and maintenance for your automobile?


How much is your daycare (if any)?


How much do you spend on medical expenses not covered by insurance per month?


How much is your monthly car payment?




If the total of these basic expenses exceeds your monthly take home pay or is within $200.00 of your monthly take home pay, you may want to consider some form of bankruptcy.


Please answer YES or NO to the following questions:


Are you behind on your mortgage payment?
Yes
No

Are you behind on your car or truck payments?
Yes
No

Are you behind on your child support payments?
Yes
No

Are your wages being garnisheed?
Yes
No

Have you been sued for a debt?
Yes
No

Are you behind on your taxes?
Yes
No

If you answered yes to any of the questions above, you should consider bankruptcy.

Debtor

If you live in the Middle Tennessee area and would like to have a consultation with me regarding filing bankruptcy, please submit this form to me, and I will keep it on file so that I will be well-informed about your situation when you arrive at my office.



IMPORTANT NOTICE TO ANYONE WHO IS CONSIDERING BANKRUPTCY

There is a bill currently pending and about to be passed in Congress which would limit the availability of bankruptcy relief sought by individuals such as yourself.  If you determined by this form or otherwise feel that you need to file bankruptcy, you should consult with an attorney immediately.
See Pending Bankruptcy Legislation Which May Affect You


Click here to read Disclaimer




Frequently Asked Questions/  Glossary/  Who Files Bankruptcy/ Do You Need to File Bankruptcy/  Pending Bankruptcy Legislation Which May Affect You/   Bankruptcy Court/ Make An Appointment/  Directions to My Office/   Rebuilding Your Life and Your Credit/  Links and Resources


Page Created and Maintained by: Faye Combs,fcombs@comcast.net
JMG Web Designs
Nashville, Tennessee
Page Last Updated: 04/05/2003
Copyright © 2001 J. Michael Combs, Attorney at Law, All Rights Reserved.