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Preliminary Questionnaire
Welcome to the Law Offices of Jill McDonald. We are a debt relief agency whose only practice is to assist our clients with their debt problems. We strive to be the best at what we do. To be able to better service our clients we ask that you fill out this form to the best of your recollection. This information will help determine your ability to file.

If there is anything that we can do better or could have done better after you have had your consultation, please let us know.

"When one door closes another door opens; but we so often look so long and so regretfully upon the closed door, that we do not see the ones which open for us." -- Alexander Graham Bell

Name       Today’s Date:  
Address   
City      State      Zip  
Home Number       Cell Number  
Email  

Spouse: (If Applicable)

Name      Same Address   Yes       No  
Address   
City      State      Zip  
Home Number       Cell Number  
Email  
Source of referral?    Letter    Google     Yahoo/Bing    Yellow Pages
Referred by or other source:



FINANCIAL INFORMATION
NUMBER IN HOUSEHOLD:       AVERAGE INCOME PER MONTH: $
1st MORTGAGE / RENT: $       AMOUNT BEHIND ON PAYMENTS: $
2nd MORTGAGE: $       AMOUNT BEHIND ON PAYMENTS: $
VEHICLES:
Vehicle 1 Own Making Payments Behind on Payments
Vehicle 2 Own Making Payments Behind on Payments
Vehicle 3 Own Making Payments Behind on Payments
Total Estimated Credit Card Debt $    Total Estimated Medical Debt $
Total Estimated Cash Advances in the Past Six Months $
Do you own a boat, motorcycle, ATV, etc?      Yes         No
Are you paying the following?       Child Support         Domestic Support
 
Initial Appointment Questionnaire

Please answer the following questions. Your answer should reflect answers from either of you or both of you.
 
Question Yes/No Comments
1.  Have you lived in Florida for more than three years? Yes
No
2.  Have either of you filed a bankruptcy before? Where and what were the dates? Yes
No
3.  Is your homestead or any other property (rental property, land, bank account, etc.) about to be seized or foreclosed? Yes
No
4.  Is your vehicle or any other property about to be seized or repossessed? Yes
No
5.  Besides your spouse do you have any co-signers on any note or account? Yes
No
6.  Have you filed your 2008,2009,2010,2011, 2012, and 2013 Income Tax Returns? If no, what years have NOT been filed? Yes
No
7.  Have you charged or borrowed more than $1000 on any single credit card in the last 90 days? Yes
No
8.  Have you purchased any appliances, furniture, electronics on credit in the past 90 days? Yes
No
9.  Have you paid a relative or friend
Yes any money on a loan or debt in the past 12 months?
Yes
No
10.  Have you been a party to a lawsuit in the past 12 months? (Including divorces) Yes
No
11.  Have you been sued? Yes
No
12.  Can you sue anyone due to accident or any other reason? Yes
No
13.  Any repossessions or foreclosures in the past 12 months? Yes
No
14.  Have you paid any income tax or property tax by credit card within the last 3 years? Yes
No
15.  Have you TRANSFERRED any property in the past 12 months? (Including cars, houses, stocks or bonds, ANY property.) Yes
No
16.  Have you SOLD any property in the past 12 months? Yes
No
17.  Have you GIVEN anyone a lien or mortgage on any of your property in the past 12 months? Yes
No
18.  Have you GIVEN ANYONE ELSE any other property in the past 12 months? Yes
No
19.  Have you sold or traded in any vehicles in the past 12 months? Yes
No
20.  Closed any bank, brokerage or financial accounts in the past 12 months? Yes
No
21.  Have you had any SETOFFS in the past 12 months? (You default on a loan & they take money out of your account) Yes
No
22.  Do you have any pay day loans? Yes
No
23.  Is your name on SOMEONE ELSE’S property? Yes
No
24.  Are you holding money or property IN TRUST for someone else? (Bank account for children or other relative) Yes
No
25.  Do you have any outstanding “Hot Checks”? Yes
No
26.  Are you a co-signer on any loans or has anyone co-signed for any credit purchases on your behalf? Yes
No
27.  Do you have any judgments against you? Yes
No
28.  Have you ever been divorced? Yes
No
29.  If you were divorced were you ordered to pay any credit cards, or other debts? Yes
No
30.  Have you been an OFFICER, DIRECTOR, PARTNER, and OR MANAGING EXECUTIVE of a corporation or partnership in the past TWO YEARS? Yes
No
31.  Have you been a sole proprietor or self-employed in the past TWO YEARS? Yes
No
32.  Do you own a business, or any part of a business, now? Yes
No
33.  If yes what type of business? Sole Proprietor
Partnership
Corporation
34.  Did you visit any other attorneys about filing bankruptcy before coming to see us? Why didn’t you hire them? Yes
No
Comments:
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Confidential