Doan Law Bankruptcy Intake

Doan Law Group
California's Largest Family of Attorneys
Tel 888-362-6529 | www.doan.law

Easy Online Intake - Your Fresh Start starts here!

We are delighted to help you begin your fresh start! The information you provide below will help us determine your bankruptcy options.

We only need estimates at this time. If you encounter any problems or have questions while completing the form, please call us! After submission, we will contact you to schedule your free telephonic consultation. We look forward to speaking with you!

Privacy: We do not share your information with anyone. Your Social Security Number is only used to search PACER for prior bankruptcy case information and has no effect on your credit.
Today's Date*

MonthDayYear

About You
Your Name*

First NameLast Name
Best Phone Number*
Email*
example@example.com
Date of Birth (optional)
SSN (optional)
(Enter SSN if you had a prior bankruptcy)
Address

Street Address

Street Address Line 2

CityState

Zip Code
Marital Status
Dependents
Number
Filed Bankruptcy before?

YesNo
Year(s) of Prior Case(s)
Year & Chapter
Spouse's Name

First NameLast Name
Spouse's Phone Number
Spouse's Email
example@example.com
Spouse's Date of Birth
Spouse's SSN (optional)
Enter SSN if spouse had a prior bankruptcy.
Spouse filed Bankruptcy before?

YesNo
Year(s) of Spouse's Prior Case(s)
Year & Chapter

Real Estate
Do you own Real Estate?

YesNo
I/we purchased the home in month & year purchased for $purchase price.
Real Estate Value
See Zillow.com for help
Real Estate Debt
Total Mortgages, Liens, Unpaid Taxes
Are you current on all of your payments?

YesNo
If late, how much are you behind?
Have you received a Notice of Default?

YesNo
Notice of Default Date
Have you received a Notice of Trustee Sale?

YesNo
Trustee Sale Date
Do you have any concerns about your real estate?
Describe any other real estate or time share you own.

Other Assets, Bank Accounts, Stock, Retirement
How much cash do you have on you or in the bank?
Enter 0 if none
How much of a tax refund are you expecting (or recently received)?
Enter 0 if none
Describe any other valuable assets you own:
ie, Stocks, Bonds, Retirement, 401K, Cryptocurrency, etc. Enter NA if none.

Income & Expenses
Estimate your YEARLY GROSS INCOME (before deductions) for this year-to-date (YTD), and last year. Please round to the nearest dollar, and do not use commas or decimals.
Estimate your AVERAGE MONTHLY INCOME (before taxes/deductions). Include spouse's income if married. Please round to the nearest dollar, and do not use commas or decimals.
How many people live at your household? (Disregard Median $ number)
Number of people living at your home.
Estimate your AVERAGE MONTHLY LIVING EXPENSES. Please round to the nearest dollar, and do not use commas or decimals.

Final Questions & Concerns
Describe any recent cash advances, loans, or major purchases you made within the last six months.
What else do you think Attorney Doan needs to know? Include any questions or concerns you may have.
How did you hear about the Doan Bankruptcy Attorneys?
That's it! Click the SUBMIT button below. We will email you a copy of this form, review the information you submitted, and contact you to discuss your options.

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