Personal Consultation

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We will be able to do an initial evaluation of your case and determine if a bankruptcy is a viable option for you. We need to know about you and your finances to properly advise you. Spend five minutes now answering a few questions so we can provide you with advice specifically tailored to your situation.

By using our online form, your information is uploaded to our secure server, and we will either respond by e-mail or phone within two business days. Your answers here do not have to be exact, but they should be as close as possible.

Take your time! We look forward to working with you!

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Filing for Debt Relief under the Bankruptcy Code may help you keep your home or your vehicle, reduce your debt, consolidate your debts into an affordable payment.

Even eliminate some debts completely. Bankruptcy can stop foreclosures, prevent repossessions, stop wage garnishments, and end creditor harassment.

If you want to find out about what Bankruptcy Relief can do for you or if you are seeking to initiate possible representation by Keith Moskowitz we will need to obtain detailed information about your particular situation. Bankruptcy cases are different depending on the facts, and in order to properly assess your legal options you will be asked to complete our consultation worksheet on the following pages. All information you submit through our website will be kept strictly confidential. Such information will only be used to evaluate and assess your particular situation and may also be used in order to prepare your case should you be eligible for Bankruptcy Relief.

The term “free consultation” refers to the initial consultation only. The initial consultation to assess your debt relief options under the Bankruptcy Code is free. However, should you retain the The Law Offices Of Keith Moskowitz at a in person consultation should you be eligible for Bankruptcy Debt Relief and should the Attorney(s) choose to accept your case a fee agreement must be entered into with the Law Office of Keith Moskowitz. The fee agreement shall be for providing the agreed bankruptcy services including the initial consultation.

Please understand that that any response to email and/or our consultation worksheet is not equivalent to legal representation by an attorney of The Law Offices of Keith Moskowitz. To retain Attorney’s Services you must execute a written retainer agreement which may be provided to you at an in person consultation should you be eligible for Bankruptcy Debt Relief and should the Attorney(s) choose to accept your case. All information sent via e-mail does not create an attorney-client relationship. Moreover, Until you receive a written Attorney Fee Contract from The Law Offices of Keith Moskowitz you are advised that we do not represent you. The Law Offices of Keith Moskowitz is a Debt Relief Agency and we help people file for Bankruptcy Relief under the Bankruptcy Code.

Do not close browser until completed and Sent: The free consultation also is not linked to the first page. This needs to linked to Free Consolation next to contact us on the first picture.

Personal Bankruptcy Consultation Form

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Please confirm that you have read the above disclosure and type: "Yes" *required
Please Type in Yes
ANSWER EVERY QUESTION ON THESE FORMS TO THE BEST OF YOUR ABILITY. DO NOT LEAVE ANY SPACES BLANK. IF THE QUESTIONS DOES NOT APPLY, WRITE “N/A”. IF THE ANSWER IS ZERO, WRITE “0”.IN COMPLIANCE WITH BANKRUPTCY LAW, YOU MUST LIST EVERYONE YOU OWE MONEY TO. NO EXCEPTIONS. EVEN IF YOU INTEND TO PAY THE DEBT, LIST THE DEBT ON THESE FORMS.YOU MUST INCLUDE YOUR SPOUSES ASSETS & DEBTS EVEN IF HE/SHE IS NOT A PARTY TO THIS CASEAll the information requested in this questionnaire is necessary to prepare any potential Bankruptcy petition. Should you be eligible for Bankruptcy Debt Relief and should the Attorney(s) of The Law Offices Of Keith Moskowitz choose to accept your case this firm may utilize this information to prepare such a petition. A Bankruptcy petition is a legal document signed under penalty of perjury. Bankruptcy petitions are reviewed by a Bankruptcy Trustee, Bankruptcy Judge, and your creditors. It is important to be accurate and thorough when answering the questions and providing financial information.By Accurately providing the following information to The Law Offices Keith Moskowitz we will be able to properly assess you options under the Bankruptcy Code as well as make preparation of any potential Bankruptcy filing easier for you.The Law Offices of Keith Moskowitz is a debt relief agency. We help people file for bankruptcy relief under the Bankruptcy Code.Information requested below will help the attorney assess your situation and properly advise you. Failure to disclose debts, property, income, or ANYTHING, will prohibit us from giving you thorough advice and potentially result in unwanted consequences. If you do not have all the information requested below, estimate the answers to the best of your ability. List spouse's info even if not filing jointly.
Name *required
Company
Address *required
City *required
State *required
Phone *required
Fax
Email *required
Optional Message

( Note: we will never share, sell, or abuse your information. )

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Martial Status
Husband's name ( Your name if not married)
First Last
Wife's name ( Your name if not married)
First Last
Maiden name, DBA, and or any other names used:
Husband's Street Address
Street Address Address Line 2 City State ZIP Code
If different, mailing address / spouse address
Street Address Address Line 2 City State ZIP Code
How long have you lived in this state?
If less than 2 years, where did you live before?
Husband's home phone
Husband's cell phone
Husband's work phone
Husband's email address
Wife's home phone
Wife's cell phone
Wife's work phone
Wife's email
Husband's employer
Occupation & how long at job
Wife's employer
Occupation & how long at job
Employer's phone
Name and Phone # of someone who will always know where to reach you and we can speak freely with:

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Home, rent or mortgage payment:
2nd Lein payment:
Property Taxes ( include school and county taxes)
Escrowed?
- Yes
- No
Insurance - Renter's or home
(if not escrowed with mortgage)
Escrowed?
- Yes
- No
Homeowner's / Community / Association dues:
Monthly or yearly?
Utilities (gas, electric, cable, water, sewer)
Phone ( Home, cell, internet)
Groceries and household items
For how many people?
Clothing
Laundry and cleaning
Newspapers, magazines and books ( including school books)
Childcare expenses (including daycare)
Medical & Dental expenses
(ie. prescriptions, Dr. visits, etc not covered by insurance)
Gas and vehicle maintenance
Recreation, clubs and entertainment
Insurance - Health or life ( if not payroll deducted)
Insurance - Car (must have for financed vehicles)
Car payment for year:
Make:
payment amount:
Car payment for year:
Make:
payment amount:
Rent to own installment payments
Other installment payments
Please specify:
Alimony, maintenance or child support:
- Payroll deducted
- Paid direct
Business expenses if self employed or own business:
Estimated income taxes if not W2 employee
Other living expenses:
Monthly amount:
Other living expenses:
Monthly amount:
Total Monthly Expenses:

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In bankruptcy, the law requires that you list every debt, and even potential debts, regardless of your intention to repay the debt. List debts of your spouse, even if he or she is not filing bankruptcy.
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Secured Creditors
(Debts that if you don’t pay, the creditor can foreclose or repossess)

Mortgage
Creditor's name:
When purchased:
Payoff date:
MIssed payments:
Regular payments
Total Arrears:
Next due date:
Interest Rates:
In the last year, did you make payments on your mortgage or to any other creditor greater than the regularly required payment?
- Yes
- No
Second Mortgage
Creditor's name:
When purchased:
Payoff date:
MIssed payments:
Regular payments
Total Arrears:
Next due date:
Interest Rates:
Balance Owed:
Are your Taxes and Homeowner's Insurance included in your house payments?
- Yes
- No

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Congress has made it clear that it does not trust that anyone can use the bankruptcy process without the necessity of lots of disclaimers and warnings. Some of these documents overload you with information - they should be given at later stages in the process, but in 2005 the credit card and banking industry wanted to make bankruptcy so complicated that people would not file bankruptcy, Congress drafted a law that front-loads far too much information on someone just trying to gain basic information, stop harassment by creditors and collection companies. It has always been my belief that my job as an attorney is to educate my clients so that they make good decisions based on knowledge and facts not half truths and rumors.Prior to this 2005 law I had always given all this information to my clients - but over a period of several meetings, not all at one time. Therefore, in order for me to comply with Congress's mandate, please read and sign the documents set forth below. Thank you for your patience and understanding.

The following notices are required pursuant to 527(a)(2). By signing below you acknowledge that
1) You understand that all information that you are required to provide to complete any documents filed with the Bankruptcy Court must be complete, accurate and truthful;2) That you will fully and completely disclose all assets and all liabilities in the documents filed with the Bankruptcy Court.3) That the value of each secured personal property asset is the replacement value ("the price a retail merchant would charge for property of that kind considering the age and condition of the property at the time the value is determined.").4) Current Monthly income, the amounts specified in Section 707(b)(2), and, in a case under Chapter 13, disposable income (determined in accordance with Section 707(b)(2)) are required to be stated after reasonable inquiry.5) That you have fully disclosed all sources of income on any documents filed with this court.6) That you understand that any information set forth either in the documents filed with the Bankruptcy Court, or testified to under oath may be audited and that failure to provide accurate information may result in the dismissal of your bankruptcy case or other sanctions, including criminal sanctions.7) You agree that an electronic signature shall be sufficient to indicate agreement to these notices.

Mandatory Disclosures REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACT MANDATED BY 11 U.S.C.§342(B)(1) AND 527(A).------------------------------------------------------A Brief Description of the Types of Bankruptcy:Chapter 7: Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. Under chapter 7 a trustee takes possession of all your property. You may claim certain of your property as exempt under governing law. The trustee then liquidates the property and uses the proceeds to pay your creditors according to priorities of the Bankruptcy Code. The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found to have committed certain kinds of improper conduct described in the Bankruptcy Code, your discharge m ay be denied by the court, and the purpose for which you filed the bankruptcy petition will be defeated. Even if you receive a discharge, there are some debts that are not discharged under the law. Therefore, you may still be responsible for such debts as certain taxes and student loans, alimony and support payments, criminal restitution, and debts for death or personal injury caused by driving while intoxicated from alcohol or drugs. Under certain circumstances you may keep property that you have purchased subject to valid security interest. Your attorney can explain the options that are available to you.Chapter 13: Chapter 13 is designed for individuals with regular income who are temporarily unable to pay their debts but would like to pay them in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar amounts set forth in the Bankruptcy Code. Under chapter 13 you must file a plan with the court to repay your creditors all or part of the money that you owe them, using your future earnings. Usually, the period allowed by the court to repay your debts is three years, but no more than five years. Your plan must be approved by the court before it can take effect. Under chapter 13, unlike chapter 7, you may keep all your property, both exempt and non-exempt, as long as you continue to make payments under the plan. After completion of payments under your plan, your debts are discharged except alimony and support payments, student loans, certain debts including criminal fines and restitution and debts for death or personal injury caused by driving while intoxicated from alcohol or drugs, and long term secured obligations.Chapter 11: Chapter 11 is designed for the reorganization of a business but is also available to consume r debtors. Its provisions are quite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney.Chapter 12: Chapter 12 designed to permit family farmers to repay their debts over a period of time from future earnings and is in many ways similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose income arises primarily from a family - owned farm.SERVICES AVAILABLE FROM CREDIT COUNSELING AGENCIES--------------------------------------------------If you're not disciplined enough to create a workable budget and stick to it, can't work out a repayment plan with your creditors, can't keep track of mounting bills, or need more help with your debts than can be achieved by merely having a few of your unsecured creditors lower your interest rates somewhat, it makes NO sense to consider contacting a credit counseling organization.If, on the other hand, you meet all of those criteria, there are many non-profit credit counseling organizations are nonprofit that will work with you to solve your financial problems. But just because an organization says it is "nonprofit," there's no guarantee that its services are free, affordable, or even legitimate. In fact, some credit counseling organizations charge high fees, which may be hidden, urge consumers to make "voluntary" contributions that can cause more debt, urge consumers to enter "debt repayment plans" they simply cannot afford.Most credit counselors offer services through local Office, the Internet, or on the telephone. If possible, it probably best to find an organization that offers in-person counseling. Many universities, military bases, credit unions, housing authorities, and branches of the U.S. Cooperative Extension Service operate nonprofit credit counseling programs. Your financial institution, local consumer protection agency, and friends and family also may be good sources of information and referrals.Reputable credit counseling organizations can advise you on managing your money and debts, help you develop a budget, and offer free educational materials and workshops. Their counselors are certified and trained in the areas of consumer credit, money and debt management, and budgeting. Legitimate counselors will discuss your entire financial situation with you, and help you develop a personalized plan to solve your money problems. An initial counseling session typically lasts an hour, with an offer of follow-up sessions.If your financial problems stem from too much debt or your inability to repay your debts, a credit counseling agency may recommend that you enroll in what is knows as a "debt management plan" or "DMP". A DMP alone is not credit counseling, and DMPs are not for everyone. You should sign up for one of these plans only after a certified credit counselor has spent time thoroughly reviewing your financial situation, has offered you customized advice on managing your money, and has analyzed your budget to make sure that the proposed DMP is one you can afford. However, remember that all organizations that promote DMP's fund themselves in part through kickbacks from the creditors involved, which are called "fair share", so you have to be wary as to whose best interest the counselor has in mind. Even if a DMP is not appropriate for you, a reputable credit counseling organization still can help you create a budget and teach you money management skills.In a DMP, you deposit money each month with the credit counseling organization, which uses your deposits to pay your unsecured debts, like your credit card bills and medical bills, according to a payment schedule the counselor develops with your creditors. Your creditors may agree to lower your interest rates or waive certain fees, but it's always best to check with all your creditors, just to make sure they offer the concessions that a credit counseling organization is promising you. A successful DMP requires you to make regular, timely payments, and could take 48 months or more to complete. Ask the credit counselor to estimate how long it will take for you to complete the plan. You may have to agree not to apply for — or use — any additional credit while you're participating in the plan, and a DMP is absolutely useless if your problems stem from or involve your secured creditors holding your car, truck or home as collateral. DMP's are also useless if your problems stem from alimony, child support or overdue taxes.The bottom line is this: If all you need is a little lowering of your interest rates on some unsecured debts, a DMP might be the answer. However, if what you really need is to reduce the amount of your debt, bankruptcy may be the only solution.EXPLANATION OF MEANS TESTING----------------------------Before your case can be filed, it is subject to what is called "Means Testing". The Means Test was designed to determine whether or not you qualify to file a case under chapter 7 of the Bankruptcy Code, and if not, how much you need to pay your unsecured creditors in a chapter 13 case. For purposes of means test, you must state, after reasonable inquiry, your total current monthly income, the amount of all expenses as specified and allowed pursuant to section 707(b)(2) of the Bankruptcy Code, and if the plan is to file you in a Chapter 13 case, you must state, again after reasonable inquiry, your disposable income, as that term is defined.YOUR DUTY TO PROVIDE ACCURATE AND COMPLETE DISCLOSURE-----------------------------------------------------Some or all of the information you provide in connection with your bankruptcy will be filed with the bankruptcy court on forms or documents that you will be required to sign and declare as true under penalty of perjury.All information that you are required to provide with the filing of your case and thereafter, while your case is pending, must be complete, accurate and truthful.All your assets and all your liabilities must be completely and accurately disclosed in the documents filed to commence your case.Some places in the bankruptcy code require you to determine and list the replacement value of an asset such as a car, or furniture. When replacement value is required, it means the replacement value, established after reasonable inquiry, as of the date of the filing of your bankruptcy case, without deduction for costs of sale or marketing. With respect to property acquired for personal, family or household purposes, replacement value means the price a retail merchant would charge for "used" property of that kind considering the age and condition of the property.Information that you provide during your case may be audited pursuant to the provisions of the Bankruptcy Code. Your failure to provide complete, accurate and truthful information may result in the dismissal of your case or other sanctions, including criminal sanctions.A person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of perjury in connection with a bankruptcy case shall be subject to fine, imprisonment, or both.All information you provide in connection with your bankruptcy case is subject to examination by the Attorney General. REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACTMANDATED BY 11 U.S.C.§527(B).-----------------------------------------------------IMPORTANT INFORMATION ABOUT BANKRUPTCY ASSISTANCE SERVICES FROM AN ATTORNEY OR BANKRUPTCY PETITION PREPARER.If you decide to seek bankruptcy relief, you can represent yourself, you can hire an attorney to represent you, or you can get help in some localities from a bankruptcy petition preparer who is not an attorney. THE LAW REQUIRES AN ATTORNEY OR BANKRUPTCY PETITION PREPARER TO GIVE YOU A WRITTEN CONTRACT SPECIFYING WHAT THE ATTORNEY OR BANKRUPTCY PETITION PREPARER WILL DO FOR YOU AND HOW MUCH IT WILL COST. Ask to see the contract before you hire anyone.The following information helps you understand what must be done in a routine bankruptcy case to help you evaluate how much service you need. Although bankruptcy can be complex, many cases are routine.Before filing a bankruptcy case, either you or your attorney should analyze your eligibility for different forms of debt relief available under the Bankruptcy Code and which form of relief is most likely to be beneficial for you. Be sure you understand the relief you can obtain and its limitations. To file a bankruptcy case, documents called a Petition, Schedules and Statement of Financial Affairs, as well as in some cases a Statement of Intention need to be prepared correctly and filed with the bankruptcy court. You will have to pay a filing fee to the bankruptcy court. Once your case starts, you will have to attend the required first meeting of creditors where you may be questioned by a court official called a ‘trustee’ and by creditors.If you choose to file a chapter 7 case, you may be asked by a creditor to reaffirm a debt. You may want help deciding whether to do so. A creditor is not permitted to coerce you into reaffirming your debts.If you choose to file a chapter 13 case in which you repay your creditors what you can afford over 3 to 5 years, you may also want help with preparing your chapter 13 plan and with the confirmation hearing on your plan which will be before a bankruptcy judge.If you select another type of relief under the Bankruptcy Code other than chapter 7 or chapter 13, you will want to find out what should be done from someone familiar with that type of relief.Your bankruptcy case may also involve litigation. You are generally permitted to represent yourself in litigation in bankruptcy court, but only attorneys, not bankruptcy petition preparers, can give you legal advice. REQUIRED DISCLOSURES UNDER THE BANKRUPTCY REFORM ACTMANDATED BY 11 U.S.C. §528(a)(1)----------------------------------------------------FREE INITIAL CONSULTATION AGREEMENTYou (“Client”) are hereby requesting the opportunity to consult with and obtain information and advice from the Jump Law Group (“Law Firm”) regarding relief from debts, including relief from debts by filing bankruptcy under the United States Bankruptcy Code. This agreement is for purposes of that initial consultation only. If at the end of the Free 20 minute Initial Consultation, the parties agree that the Attorney is to provide any additional services short of being retained to file a bankruptcy, the parties shall attach an addendum to this contract setting forth the additional services the Attorney is to provide to the Client, the obligations of the Client, and the Attorney’s fees for such services. If the Client retains the Attorney to file a bankruptcy, the parties shall execute a separate contract setting forth the fees and other terms of such representations. With respect to the consultation, the parties agree as follows: There is no fee for the completion of the forms and discussion of your financial situation. In the event that Client wishes to hire Attorney for any purpose other than a Limited 20 Minute Free Initial Consultation then a separate agreement must be executed by all parties. Law Firm shall provide the Client the following services: Analyze the client’s financial circumstances based on information provided by the Client. To the extent possible, based on the information provided by the Client, advise the Client of the Client's bankruptcy options and non-bankruptcy options. Advise the Client of the requirements placed upon the Client to file a chapter 7 or 13 bankruptcy. To the extent possible, quote the Client an estimated fee for the Law Firm's services to provide bankruptcy assistance or other legal services to the Client. There is no obligation on the part of the client to tender any fees for the initial consultation.

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With Our Online Consultation Form

Before You Begin Please Read: