This form is intended for creditors who have a claim against any debtor.
Please complete the applicable portions of this form. The more thorough job you do now the faster we can help.
Your Name:
_________________________________________________________________
Your Address:
_______________________________________________________________
State &
County where you live
_________________________________________________
Phone Number: ___________________ (office)
____________________ (home)
Fax Number: ______________________
E-mail address: _________________________
If you are a new client - who referred you to our office: _______________________________
Full Name of
the Debtor(s)
______________________________________________________________
Bankruptcy Case Number: __________________________ Has the debtor filed other bankruptcies? ( ) yes ( ) no
Check the
appropriate box if any of the following were pending a the
time the bankruptcy was filed:
___ a trustee's sale
___ judicial foreclosure
___ forcible entry and detainer
___ repossession
___ garnishment
___ law suit
If you know,
what you need our firm to do?
___ a motion for relief from the automatic stay
___ a proof of claim
___ objection to Plan of Reorganization
___ objection to discharge
___ general review of bankruptcy issues
___ attend creditor's meeting (341(a))
___ Other -
_____________________________________________________________________
If you are owed money:
Provide this office with a copy of the following:
Contract or agreement.
Demands for payment.
Law suit pleadings, including judgment, if any
Itemize amounts owed to you at the time the bankruptcy was filed.
Did you pay the debtor any money? 5 yes 5 no If so, how much $__________ Date:_______
Did you transfer any assets to the debtor (the person or company in bankruptcy)? 5 yes 5 no If so, what ____________________
Other Issues you deem
important:
___________________________________________________
_______________________________________________________________________________
After we receive this information we will prepare documents. We cannot start the process until we have received this information and a retainer. The more thorough you are in filling out this information the faster the process can be started.
If this is a motion for relief there will be a 5 day demand letter sent to the Debtor and Debtor's attorney.
VERY IMPORTANT NOTES:
IT IS EXTREMELY IMPORTANT THAT YOU DO NOT TALK TO THE DEBTOR or THEIR ATTORNEY.
IS IS ALSO EXTREMELY IMPORTANT THAT YOU DO NOT ACCEPT ANY MONIES FROM THE DEBTOR WITHOUT FIRST TALKING TO THIS OFFICE.
Make sure that you include the documents described in paragraph 1 when you send this form to our office.