Wine Country Family Law
Lindsay Smith

Wine Country Family Law & Bankruptcy Office
P.O. Box 262 - 220 N. Cloverdale Blvd., Ste. B
Cloverdale, CA 95425
Phone: (707) 669-0841
Fax: (707) 669-0842

Northern California bankruptcy & family law attorney Lindsay R. Smith has the knowledge and skills necessary to help you resolve your financial and family legal difficulties. We are dedicated to offering guidance through the bankruptcy process and family law disputes.

Learn how the professionalism and experience of our family law and bankruptcy attorney can work to your benefit. Call to schedule your free consultation with our skilled Cloverdale divorce, child support and bankruptcy lawyer today, or contact us via the email form.

Please note... Although Cloverdale is a short and scenic drive from both Santa Rosa and Ukiah, we are happy to conduct your consultation over the phone, if requested.

After obtaining an appointment for your bankruptcy evaluation, please complete the questionnaire below. This must be submitted at least one business day prior to your consultation.

NOTE: The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

BANKRUPTCY CONSULTATION QUESTIONNAIRE

Your Name

Spouse's Name

Consultation date

How long at current address

Your E-Mail

Telephone

Marital status

Your employer and job title

Spouse's employer and job title

Your gross (pre-tax) income per month

Spouse's gross (pre-tax) income per month

How many dependants?

Dependant ages

How did you hear about Wine Country Family Law and Bankruptcy Office?

Have you or your spouse ever filed bamkruptcy before?

Approximate date filed

How many outstanding accounts do you have relating to credit cards, medical or personal loans (including collection agencies?)

Approximately how much is your total debt, not including vehicles, real estate, land or mobile homes

When did you last use your credit card(s) and for what purpose?

Have you transferred any balances/made any cash advances/used any convenience checks from your credit card account(s) in the last 12 months?

If you answered yes to the above, when did the transaction(s) occur and in what amount(s)?

Are your payments current on your credit cards?

Are you or your spouse required to pay child support?

Have you repaid any money owed to relatives in the last 12 months, or sold, transferred or given any assets to any family members in the last 12 months?

If yes answered above, please list the amount repaid or asset transferred and its value, your relationship to the person it was transferred to, and the approximate date.

List any real estate which you own, lease or are buying: (use www.zillow.com for market value estimate).
Address

Market value

Loan balance - First

Loan balance - Second

Monthly payment - First

Monthly payment - Second

Additional real estate you own, lease or are buying:
Address

Market value

Loan balance - First

Loan balance - Second

Monthly payment - First

Monthly payment - Second

If you have a 2nd mortgage, was it used to fund the purchase of your home?

Have you refinanced your mortgage?

Are property taxes/insurance included in your mortgage?

If not, how much are yout taxes per month?

If not, how much is your insurance per month?

How many months behind are your payments for the above property?

Do you want to keep or surrender the above proprty?

List ANY vehicles in your possession - incl. trailers, boats, RVs, jet skis, motorcycles, etc. Use www.kbb.com for private party market value. If you are not basing value on good condition, please note reason
Please list the Year, Make, Model, Mileage, Market Value, Loan balance and Monthly payment for each.

List all vehicles that you wish to surrender, if any.

Do you owe any back taxes (not including property taxes)?

If answered yes above, please list tax year(s) owed for

Have you owned or partially owned any other land/house/mobiles homes/or other real property in the last 2 years? If so, explain what happened to each and provide the month/year you ceased being an owner:

Have you owned or partially owned any vehicles/boats/trailers/motorcycles/airplanes, etc. not listed above within the last two years? Explain what happened to each and provide the month/year/owner

What did you do with the proceeds you received?

Are any creditors alleging that you have defrauded them?

Might you inherit any money or property within the next year?

If you own a business, select one of the following:

How much of the shares or voting power do you control?

Do you use the business account to pay for personal expenses?

Has anyone or is anyone suing you or are you suing anyone? (i.e. worker’s comp claims, personal injury, etc.)

If so, please provide the details:

List your major questions/concerns:

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