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Bankruptcy Intake Form

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Other Address: How Long?

Age Amount
$
$
$
$

$

$

$
Rent Real Estate Taxes
Electric Home Maintenance
Gas Life Insurance
Water Health Insurance
Phone Auto Insurance
Cable Homeowner/Rent Ins.
Trash House Payment

$

$

$

$

$

$

$

Vehicle:
Est. Loan Balance: $
Loan Current:
Amount Behind $
Vehicle:
Est. Loan Balance: $
Loan Current:
Amount Behind $
Vehicle:
Est. Loan Balance: $
Loan Current:
Amount Behind $
Vehicle Est. Value
$
$

$ Medical Bills
$ NSF Checks
$ Credit Cards
$ Misc. Bills

$

$

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Att James

James O.Cure

Board certified in Consumer Bankruptcy Law and Civil Trial Law by the Texas Board of Legal Specialization.

Bankruptcy

Probate

Att John

John R. Francis

Board certified in Personal Injury Trial Law and Civil Trial Law by the Texas Board of Legal Specialization.

Personal Injury

Business & Commercial Litigation