Untitled Document


New Client Questionnaire


If you live in the Los Angeles area and are in financial trouble, we can help you.

At The Law Offices of Peter M. Lively, our attorneys provide legal assistance to businesses and individuals facing financial difficulties.

Often, we can design a plan of action which avoids bankruptcy and preserves your assets. If bankruptcy is necessary though, you should remember that bankruptcy is not the end of your financial life. In many ways it is a new beginning ? a fresh start.

As part of our intake process, please fill out this form with some basic information so that we can better serve you:

 

  Personal Information:  
       
  Name  
  Email address:  
  Home Phone:  
  Work Phone:  
  FAX:  
     
 
     
  Foreclosure Information:
     
  Property #1:  
     
  Property Location:
  Estimated Market Value:  
       
  Lender w/first td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/2nd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/3rd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  If no more properties, please skip down to the Auto section. Otherwise, enter the information for any additional properties below:
       
 
       
  Property #2:  
     
  Property Location:
  Estimated Market Value:  
       
  Lender w/first td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/2nd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/3rd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
 
       
  Property #3:  
     
  Property Location:
  Estimated Market Value:  
       
  Lender w/first td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/2nd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/3rd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
 
       
  Property #4:  
     
  Property Location:
  Estimated Market Value:  
       
  Lender w/first td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/2nd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
  Lender w/3rd td:  
  Loan Amount:  
  Payment Amount:  
  Total Arrears:  
       
 
 
       
  Car Loans / Leases
       
  Vehicle #1    
  Year  
  Make  
  Model  
  Mileage  
  Payment Amount:  
  Payee:  
       
  Vehicle #2    
  Year  
  Make  
  Model  
  Mileage  
  Payment Amount:  
  Payee:  
       
 
 
       
  Unsecured Credit Information:
       
  Credit Card Debt:  
  IRS/State Taxes:  
  Medical/Dental:  
  Other  
  Total Unsercured Debt:  
       
 
 
       
  Financial Ability:
       
  Client's Income:  
  Spouses Income:  
  Other Income:    
  Rent:  
  2nd Job:  
  Family Loans/Gifts:  
       
 
 
       
  Dependents:    
  Please list your dependents and their ages/sex here  
       
 
 
       
  Prior Bankruptcy Info:
  Chapter:  
  Case Number:  
  Attorney:  
  Attorney's Phone:  
       
 
 
       
  Assets and Exemptions Information:
  Life Insurance:  
  IRA Accounts:  
  Auto:  
  Checking Balance:  
  Savings Balance:  
  Stocks and Bonds:  
       
       
      

 

The Law Offices of Peter M. Lively
11268 Washington Boulevard
Suite 203
Culver City, California 90230-4647

Telephone: 310-391-2400
Toll Free: 800-307-DEBT (3328)
Fax: 310-391-2462
Email: Peter@PeterMLively.com

Map to Peter M. Lively's Office

 


 

We can help you start a new financial life.

 

The Law Offices of Peter M. Lively provide assistance in bankruptcies to businesses and individuals in the Los Angeles area, including Santa Monica, Santa Barbara, Santa Ana, Pacific Palisades, Marina del Rey, San Fernando, Burbank, Glendale, and Inglewood.