Eddington Law Office Client Bankruptcy Questionnaire

Information About You

Your Name (First Name, Middle Initial, Last Name) *

What is the main reason you are considering filing a bankruptcy case? (e.g., "too many bills", "to stop a garnishment", "to stop a foreclosure," "to get a repossessed car back") *

Are you currently married? (check "YES" if you are legally married but separated from your spouse) *

Yes

No

Do you want to file your case JOINTLY with your spouse, or ALONE without your spouse?

Jointly (With My Spouse)

Alone (Without My Spouse)

Not Sure

Spouse's Name (if married) (First Name, Middle Initial, Last Name) *

Your Social Security Number (XXX-XX-XXXX) *

Your Date of Birth (MM/DD/YYYY) * +

Spouse's Security Number (if married)

Spouse's Date of Birth (if married) (MM/DD/YYYY) +

Your Street Address, City and State (e.g., 123 Main Street, Milwaukee, WI 53222) *

Your County *

Spouse's Street Address, City and State (if married but separated)

Spouse's County

Your Email Address *

Your Phone Number *

Spouse's Email Address

Spouse's Phone Number