BANKRUPTCY INITIAL INQUIRY FORM

KORB TUCKER PLLC is a debt relief agency under the Bankruptcy Code.
We help people and companies file for bankruptcy relief.

 

 

Completing and submitting this form does NOT obligate either you or the firm
and does NOT make you a client of the firm.


Please see How to Become a Bankruptcy Client of KORB TUCKER PLLC
on our website at www.KorbTuckerAttorneys.com.


Please fill out this form if you are seeking our help in working out debts or possibly filing for bankruptcy.  You may use our online form below, or you may print and complete this form instead, and then fax it to us at (970) 493-0516 or mail it to us at:

 

110 East Oak Street, Suite 220
Fort Collins, CO 80524


We will contact you within 2 business days.  We will only contact you once, unless you decide otherwise.  We will not share your information with anyone. 


The information you supply on this form will help us talk about some ways the firm might be able to help you and, if necessary, whether you can file a Chapter 7 bankruptcy case.
If a question does not apply to you, leave it blank.  Please do not send us any Social Security Numbers or account numbers yet.  Please provide reasonably accurate dollar amounts where requested. 


Bankruptcy Initial Inquiry Form

1. PREVIOUS BANKRUPTCIES

Have you filed for Bankruptcy before?
If yes, was the case for you? 
Or your business?
Did you receive a discharge?
If yes, what year?
   

2. ABOUT YOUR HOUSEHOLD
Counting yourself, how many people are in your household?
Adults   Children
Your Name    
  Last
Former name or a/k/a    
Address      
 
 
       
Spouses Name      
  Last
Former name or a/k/a    
Address      
 
 
       

3. HOW THE FIRM SHOULD CONTACT YOU

  Cell Phone
   
   
Best way to contact you
Best times to contact you

 

4. YOUR INCOME AND EXPENSES
Your monthly take-home pay $
Your spouse’s monthly take-home pay $
Current monthly expenses $
Your adjusted gross income (AGI) from your most recent tax return $
   

5. YOUR HOME AND PERSONAL DEBTS
Total debt on credit cards for consumer and household use $
Total of other household debts, other than home mortgage $
If you own a home, its current market value $
Total amount you owe on your home $
Personal income taxes you owe $
Amount of any overdue child support or spousal maintenance obligations $
Other significant debts you are concerned about (describe below) $
   

6. YOUR BUSINESS
Current market value of rental home or other business property $
Total amount you owe on your rental home or other business property $

What type of business do you own?
Total debt on credit cards for your business $
Total business debt on supplier accounts or loans $
Total debt for employee wages due, payroll taxes due, sales & unemployment taxes due, and business income taxes due $
   

7. YOUR CONCERNS

Please describe why you need our help:
   
110 East Oak Street, Suite 220, Fort Collins, CO 80524, 970-266-5156, info@KorbTuckerAttorneys.com