Free Bankruptcy Screening by Bayer, Wishman & Leotta

Affordable Debt Relief
We offer reasonable rates and payment plans are available. Our attorneys are Certified Specialists in consumer and small business bankruptcy. Call 800-477-3111 for a free consultation.

Creditor threats and harassment
Calls from bill collectors
Wage garnishment
Foreclosure
Lawsuits
IRS action

Understand Your Rights
Your creditors employ aggressive legal teams to intimidate and confuse you. We can help ensure that you are not denied the full benefits afforded to you by the bankruptcy laws.
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Internet Discount
We offer a discount to those who have done their research and found us on the web. Learn more about our Internet discount.
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FREE INTERNET BANKRUPTCY EVALUATION!

Take 5 minutes to complete and email the following information. There is no obligation on your part, and we will give your our candid evaluation. (You are agreeing that nothing contained herein shall create any attorney-client relationship with us. An attorney-client relationship can only arise by mutual consent between us.)

If you prefer, we can also schedule a FREE in-office consultation. Contact us to setup your appointment today before the changes to the bankruptcy law take effect.

Your name(s):
Home address:		Apt./Unit#:
City:	Zip Code:
Home Telephone:	( )
Work Telephone:	( )
Email Address:


What is the best phone number to reach you at during normal business hours, so that we can provide your free evaluation?

HOW WERE YOU REFERRED TO US?

Internet site:

A lawyer sent me
     Lawyer’s name:
     Phone number:

Telephone book
     Which book:

Labor Union
     Which union

From a friend or relative
     Their name:

Newsletter in the mail:

Television:

None of the above. I heard about you through:

INTERNET CONSULTATION QUESTIONNAIRE

Please answer every question. If you prefer, you can stop now, and just call us on the phone! We do provide a completely free consultation in the office with an attorney who specializes in bankruptcy law. If you will fill this out completely we should have enough information to give you some good, basic advice. This is not intended by you nor by us to create any attorney-client relationship, and this is not a substitute for consulting in person with an experienced, competent attorney to obtain legal advice.

Have you been in business for yourself at any time within the past six years?

Are you in business for yourself at this time?

Have either you or your spouse ever filed any case in bankruptcy court?

During the past three months, have you lived ANYWHERE except in Los Angeles County?

Are there any lawsuits against you? Have you been served with lawsuit papers?

Do you have any earnings, wages or a car being held under attachment or garnishment?

Do you owe any taxes?

Do you owe any child suport?

What is your martial status?
if divorced...

How many minor children do you support?

What kind of work do you usually do?

Who is your present employer?

How long have you worked for your present employer?

Do you get paid weekly, monthly, or how?

When is your next pay day?

Each pay day you GROSS about how much?

Each pay day you BRING HOME about how much?

In addition to your pay checks, what other income do you have?

How much gross income does your spouse earn each month?

Is there anyone you think might die in the next six months and leave something to you?

Are you presently entitled to an inheritance and have not received it, or expect that you will become entitled to an inheritance in the next 12 months?

Have you, within the last 12 months, paid $1,000.00 or more to a relative, friend or any business associate?

Did you, within the past four years, sell anything of value to someone else or transfer anything of value (such as real estate, etc.) to someone else or put something of value in the name of some other person?

Give details below of all automobiles, trucks, motorcycles and other vehicles you have, whether free and clear, leased or owned:

Year	Make	Model	Terms	Owed

Are there any outstanding debts where you signed your name and co-signed for someone else?

Do you have debts that were co-signed for you by someone else, or made jointly with someone else?

How much money in the form of cash, checks (such as paychecks you haven’t cashed), money orders, cashier’s checks or travelers checks do you have?

Do you or your spouse have a checking account, savings account, credit union or other accounts?

Account Balance	Bank Name

Have you bought any “luxury goods or services” on credit within the past 60 days?

Have you received any cash advances on credit within the past 60 days? (This does not mean your regular paycheck from your job.)

Approximately how much money do you owe on credit cards and other similar debts?

Do you have a retirement plan at work?

If so, how much is it worth?

Do you have an IRA or other personal retirement monies?

If so, please list below:

Account Balance	Account Type

Is there any property of any kind, including bank accounts, money in a savings and loan association, money in a credit union, stocks or bonds, automobiles, real estate, or anything else of value, in your name or the name of your spouse or your children that you have not mentioned before? (Not including furniture and appliances)

If yes, please list below:

Property	Value

Do you have a claim against anyone for personal injury, property damage, breach of contract or for any other reason?

If yes, please list details:

Do you have any real estate such as a house or condo?

If so, what would it sell for?

Do you own any interest in any other real estate?

If yes, please list details:

About what would it sell for?

If you have some real estate, has anyone started a foreclosure against it?

If any of your real estate is in foreclosure, has a date of sale been set by the mortgage holder?

If so, when is the sale date?

By hitting the submit button on this form, you are agreeing that you have read all of the information contained in the DISCLAIMER at the bottom of this page, and that the submission of this form does not create any duty upon Bayer, Wishman and Leotta to provide you with legal representation.

Important notice required by Federal Law:
We are a debt relief agency pursuant to Federal Law §524 of Title 11 of the US Code. We provide legal assistance and help people file for bankruptcy relief under the Bankruptcy Code.

*DISCLAIMER: The information contained within this page and/or this site as a whole, including replies from Bayer, Wishman & Leotta to this PRE-CONSULTATION FORM, is not intended as legal advice, nor to create an attorney-client relationship yourself and Bayer, Wishman & Leota, PC and/or debt-relief-bankruptcy.com, it is informational in nature. Though bankruptcy is federal law, your particular state of domicile can impact the advice you receive. Furthermore, bankruptcy law is very complicated, therefore, an experienced bankruptcy lawyer within your state of domicile should be consulted for specific issues concerning your particular set of facts. Users of the internet should not rely on an e-mail message to Bayer, Wishman & Leota, PC and/or debt-relief-bankruptcy.com through this web site to create an attorney-client relationship. Said users should not act upon any information in this web site without first directly consulting legal counsel of their own. The hiring of a lawyer is an extremely important decision which should not be based solely upon advertisements, web pages, brochures, or other promotional materials. Unless a written retainer agreement has been signed by a member of Bayer, Wishman & Leota, PC, no attorney-client relationship exists between you and Bayer, Wishman & Leota, PC. This web site might be characterized as an ADVERTISEMENT. The responses and information are intended to be general and should not be relied upon for any specific situation. For legal advice, consult an attorney.

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