About Us | Contact Us | 808.469.4300 

We are a debt relief agency. 

We help people file for relief under the Bankruptcy Code.

If you are in financial distress, contact the Law Office of Lars Peterson, LLLC for a free legal consultation.  We will determine whether bankruptcy is an advisable for you or whether alternatives to bankruptcy, e.g., debt settlements or tax workouts, are available for you.  We are a full-service consumer bankruptcy law firm and will help you through the entire proceeding.

Should I consider filing for bankruptcy? 

If you would like to know if bankruptcy or its alternatives are right for you, please fill in the information below and we will contact you as soon as possible to schedule an appointment.  The law firm will treat the information confidentially. Please feel free to call us to set up your free consultation anytime and complete the information section subsequently.  

To get a free copy of your credit report (once per year) go to www.annualcreditreport.com. 

 

Bankrupcty Questionnaire

* Required Fields

Date
yes
Do you have an appointment with our office?	yes   no
Name First, Middle, Last
Address
City, State, Zip
Employer/Position
Home Phone
Work Phone
Cell Phone
E-mail
Have you filed bankrupcty in the past?	yes   no
If so when?
How did you hear about us?	Internet search   Online Advertisement   Recommendation from friend or family?   Other
Have you lived at your current address (in the same county) for 2 years?	yes   no
If no, where did you live before and for how long?
Marital Status?	married   single   divorced   separated
What is your approximate take home income per month (not per pay period) after deductions for taxes, social security, and insurance? (Please include spouses income whether filing a case with you or not)
Are there any special deductions out of your pay? How much and for what?
What are your approximate expenses per month for the following items?
Mortgage/Rent
2nd Mortgage
3rd Mortgage
Maintenance Fees
Medical
Electrical
Laundry
Water
Hair Cuts
Gas
Cable
Telephone
Gas
Vehicles If more than one, combine them
Car Maintenance
Car Insurance
Child Support
Recreation
Pets
Other
Mortgages and Other House Related Debts
Name of Creditor, Balance and Real Estate Value Separate by commas
Name of Creditor, Balance and Real Estate Value Separate by commas
Name of Creditor, Balance and Real Estate Value Separate by commas
Name of Creditor, Balance and Real Estate Value Separate by commas
CAR DEBTS
Name of Creditor, Balance, type & year of car
Name of Creditor, Balance, type & year of car
Name of Creditor, Balance, type & year of car
CREDIT CARDS
Type and Total Balance Owed
Type and Total Balance Owed
Type and Total Balance Owed
Type and Total Balance Owed
SINGATURE LOANS with collateral
Creditor and Balance
Creditor and Balance
Creditor and Balance
SIGNATURE LOANS without collateral
Creditor and Balance
Creditor and Balance
Creditor and Balance
MEDICAL BILLS
Creditor and Balance
Creditor and Balance
STUDENT LOANS
Creditor and Balance
Creditor and Balance
OTHER LOANS
Creditor and Balance
Creditor and Balance
Back Tax Debt List by Type of tax with the balance
Do you own real estate, a house, a condominium? Yes/No; if yes, what is the current fair market value of your real property?
i. Do you own any of the personal property listed below:
Checking account?	yes   no
If yes what is the balance?
Savings account?	yes   no
If yes what is the balance?
Interest in other companies, stocks, bonds, other financial investments?	yes   no
If yes what is the balance?
401(k), IRA, or other retirement account?	yes   no
If yes what is the balance?
If you currently own a business, what type of business?
Are you paying or receiving child support or alimony payments?	yes   no
Paying – amount:
Receiving – amount:
Do you owe any taxes? (Federal taxes, State taxes, e.g., GE Tax, property taxes)? If yes, for what years and what kind of taxes?
Are you late or have missed payments for your house or car?	yes   no
House & number of months
Car & number of months
Car & number of months
Are you currently involved in a law suit or other legal or administrative proceeding?	yes   no
If yes what is the basis of the lawsuit?
Could you file a law suit at this time (e.g., following a car accident, worker’s compensation claim, etc.)	yes   no
If yes explain.
Do you have student loans?	yes   no
If yes, for what years? What type? Amounts?
Are you paying any loans from family members?	yes   no
If yes to whom and how much did you pay in the last 2 years?
Do you have any co-debtors, e.g., did anybody co-sign a promissory note (house, car), do you have joint credit card accounts, etc?	yes   no
If yes list the dates and who co-signed?
ADDITIONAL INFORMATION.
To disallow automatic submission and stop spam we must confirm you are indeed human. Please click on the submit button to transmit the above information about you to our office. Your information will be confidential. Read our privacy policy