Personal Case Assessment

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Personal Information
Bankruptcy Information
Have you lived in Central Illinois for over 2 years?
Have you ever filed a bankruptcy before?
Has a collection lawsuit been threatened or filed against you?
Is there a pending foreclosure action or repossession?
Are your wages currently being deducted to pay a judgment?
Do you currently have an accident claim or workers' comp case?
Are you going to inherit anything of value in the next 6 month?
Do you have any life insurance with cash surrender value?
Beside a spouse, do you have any co-signers on any of your debts?
Have you used a credit card for purchase of merchandise in the last 90 days?
Have you made a cash advance or balance transfer in the last 70 days?
Last Tax Refund Received

What did you use it for?


Assets









Debts
Income










Average Monthly Expenses
Comments

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