Law Offices of Bruce R. Epstein

Areas of Practice:
Bankruptcy

Bankruptcy Case Evaluation

Name: *
Email: *
Telephone: *
Do you intend to file a joint petition with your spouse? Yes No
Include information for you and your spouse (even if not both filing)
Name(s), including middle initial:
Husband name Wife name
Residence address, including county:
How long at this address?
Have you used any other name(s) in the past 8 years?
If so, please list:
Marital Status:
Ages of minor children living with you:
Husband's occupation and employer:
Wife's occupation and employer:
List other sources of income (child support, social security, pension, etc):

AVERAGE MONTHLY EXPENSES:

Rent or mortgage:			Real estate taxes:
Electric:			Home insurance:
Gas or other heat:			Life insurance:
Water and sewer:			Health insurance:
Phone:			Food:
Cable:			Clothing:
Trash pick-up:			Medical expenses:
Home maintenance:			Gasoline and car maintenance:

If you own or are buying real estate, list your mortgage(s) and balances:
If behind on mortgages, how much?
List all vehicles you own or are buying:
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5500 Market Street, Suite 101, Youngstown OH, 44512 ph: (330) 782-7000

106 E. Market Street, Suite 507, Warren, OH 44481 fax: (330) 782-0483

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Law Offices of Bruce R. Epstein

Bankruptcy Case Evaluation

Disclaimer