Bankruptcy Consultation Form | DVBW Law West Michigan

Name*

First Last

Email*

Phone

Best Day & Time to Connect*

Marital Status

Number of People in Household

My Annual Income

Number of Creditors

Approximate Value of Assets

Vehicles, Home, Retirement Accts, etc.

Total Secured Debt

Mortgage, Lien on Car, etc.

Approximate Total Debt

Any Prior Bankruptcies?*

If Yes, Which Chapter?

Prior Bankruptcy File Date

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