Why are you Considering Bankruptcy? (check all that apply) Garnishment Repossession Foreclosure Lawsuit Illness / Disability Divorce Job Loss Other: Go to Step Two Step 2 of 5 Please Estimate Your Total Unsecured Debt (Do Not Include your Mortgage, Auto Loans or Student Loans) Total Debt = - - - - - - - - $0 - $5,000 $5,000 - $10,000 $10,000 - $15,000 $15,000 - $20,000 $20,000+ Go to Step Three Step 3 of 5 Do you Own a Home? Yes No Monthly Mortgage: $ Approximate Mortgage Balance: $ Approximate Value of Home: $ Are Your Payments Current? Yes No Do you Have Any Other Important Assets? If so Please Describe: Go to Step Four Step 4 of 5 What is YOUR Net Monthly Income: $ What is your SPOUSE'S Net Monthly Income: $ Go to Final Step First Name: Last Name: Street Address: Zip Code: Email: Phone Number: -- By submitting my information, I agree to the Terms & Conditions. Get Your Evaluation!