Practice areas
About Our Firm
Laura Helps
Why Hire
Attorney Profile
Testimonials
RESOURCES
Video Center
CONTACT US
(614) 800-0262
FREE CASE EVALUATION
Free Case Evaluation
Free Case Evaluation
FULL NAME
Address
Phone
Email
Best Time To Contact You?
Best time to contact you?
AM
PM
Anytime
Marital Status
Marital Status
Single
Married
Divorced
Separated
Widowed
What type of unsecured debts do you owe? (Check all that apply)
All
Credit Cards
Tax Debts
Medical Bills
Government Fines
Judgments
Personal Loans
Student Loans
Repossession
Approximate amount owed on all unsecured debt (if married include spouse’s debt):
What type of property do you own? (Check all that apply)
House
Retirement savings
Rental Property
529 Plan savings
Business (ownership interest)
Life insurance policies
Vehicles
Boat(s)
Other (fill in blank)
Monthly mortgage or rent payment amount:
Are your payments up to date?
Yes
No
Do you own a vehicle?
Yes
No
Are you employed?
Yes
No
How often are you paid?
How often are you paid?
Every Week
Every 2 Weeks
Twice A Month
Monthly
What is your annual salary or hourly rate of pay?
Per Hour
Per Year
Is your spouse employed?
Yes
No
N/A
How often is spouse paid?
How often is spouse paid?
Every Week
Every 2 Weeks
Twice a Month
Monthly
What is your spouse’s annual salary or hourly rate of pay?
Per Hour
Per Year
What other types of income does your household have? (Check all that apply)
Disability
Child Support
Social Security
Unemployment
Pension
Workers Compensation
Rental Property
Roommate
Part Time Job
Family Contribution
Combined income for all other types of income:
What else would you like us to know ?
Get In Touch With Laura
FULL NAME
EMAIL ADDRESS
PHONE NUMBER
Tell us about your situation:
Input this code:
Send to Laura
Laura M. Nesbitt
Rated by Super Lawyers
loading …