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The Bodor Law Firm

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Blind Justice / no favoritism

 

Case Evaluation Form For 

Chapter 7 & 13 Cases

*Name, including middle initial
*E-mail address
*Phone Number
  
Does your spouse intend to file also?
YesNo
If yes, include information for both yourself and your spouse below:
Name of spouse, including middle initial
*Residence address, including county
Have you ever filed bankruptcy before?
YesNo
*Provide date filed, type of bankruptcy and result obtained.
Have you been a resident of Ohio for longer than 2 years?
YesNo
How long have you been at above address?
Other Address w/in 2 years How Long?
 
 
 
Other telephone number(s)
Work
Cell
Other
Have you used any other name(s) in the last six years?
YesNo
If yes, please list here
 SingleSeparatedMarriedDivorced
If married, how long?
If divorced, how long?
Ages of dependants living with you
Ages, and amount of child support paid:
Age Amount
  $
  $
  $
  $
Are you behind on your child support?
YesNo
Are you making payments on this child support arrearage?
YesNo
Amount of child support arrearage
$

Husband's employer:
How long at this job?
Husband's occupation
Husband's pay period:
weeklysemi-monthlymonthlyother
Husband's gross pay last year:
Husband's Net income per pay:

Wife's employer:
How long at this job?
Wife's occupation
Wife's pay period
weeklysemi-monthlymonthlyother
Wife's gross income last year:
Wife's net income per pay:
Income from other sources (contributions from other members of household, second job, cash-only jobs, unreported income, rental income, investments, social security, child support, worker's compensation, etc.) (state sources and amount):
Do you owe any income taxes?
YesNo
If yes, for what year(s)?
How much (total)?
$
Do you have any unpaid student loans?
YesNo
Amount
$

Do you pay anyone spousal support (alimony)
YesNo
If yes, to whom and how much?
Do you own or are you purchasing a home or other real property?
YesNo
County Valuation of Parcel # 1
$
Parcel #1: First Mortgage Loan Balance
$
Are you Current?
 
Amount Behind
   $
Monthly payment
$
Parcel # 1: 2nd Mortgage Loan Balance
$
Are you Current?
Amount behind
   $
Monthly payment
$
Parcel #1: 3rd Mortgage Loan Balance
$
Are you  current?
Amount behind  
$
Monthly payment
$
Has foreclosure been filed?
YesNo
Date filed or when papers were received?
County Valuation of Parcel # 2
$
Parcel #2: First Mortgage Loan Balance
$
Are you Current?
 
Amount Behind
   $
Monthly payment
$
Parcel # 2: 2nd Mortgage Loan Balance
$
Are you Current?
Amount behind
   $
Monthly payment
$
Parcel #2: 3rd Mortgage Loan Balance
$
Are you  current?
Amount behind  
$
Monthly payment
$
Has foreclosure been filed?
YesNo
Date filed or when papers were received?
Amount of liens against Parcel # 2          $
Amount of liens against Parcel # 2          $
List all vehicle loans (car, truck, motorcycles; boat, dentify vehicle type)
Vehicle Loan Balance Date of Loan Amount Behind
  $   $
  $   $
  $   $
List all vehicles you own outright (no loan balance)
Vehicle Est. Value
  $
  $
Have you purchased any items (electronics, boats, jet ski, appliances, etc.) in the last two years on which you still owe money?
YesNo
Have you taken out a loan from a finance company, credit union, bank or any other place and secured the loan by household items or other type of secured collateral?
YesNo
Creditors' Names
Estimate balances owed on all other types of debt listed below
$

Medical Bills

$

NSF Checks

$

Credit Cards

$

Family

$

Misc. Bills

When was the last time you used any of your credit cards? (approx. date)
How much new debt was added to the cards in the last 12 months?
Have you paid back money to relatives within the last 12 months?
YesNo
How much?
$
When was the money paid to such relative?
Do you anticipate receiving a tax refund?
YesNo
How much?
$
Are you eligible for the Earned Income Credit?
YesNo
How much?
$
List all judgments, lawsuits, liens, and garnishments against you.
If you have a business, please descibe it. Is it Incorporated?.
List all property transferred out of your name within last 24 months OR being held by someone for you (no time limit):
How did you learn about us?
 

NOTE: The use of this means of communication with the Bodor Law Firm will not establish an attorney-client relationship and messages containing confidential or time-sensitive information should not be sent.  If you do not hear from us within 5 working days, please call us.

Law Offices of Andrew Bodor 

Call us toll free at (800) 924-7403 to make an appointment

for that FREE CONSULTATION before it's too late.


Cleveland
5005 Rockside Rd.
Suite 600
Independence, OH 44131
Phone: (216) 476-1730
Fax: (330) 393-0855

Cleveland
1991 Crocker Rd.
Sixth Floor
Westlake, OH 44320
Phone: (216) 476-1730
Fax: (330) 393-0855


Cleveland
3401 Enterprise Pkwy. 
Third Floor
Beachwood, OH 44122
Phone: (216) 476-1730
Fax: (330) 393-0855

Akron
755 White Pond Dr.
Suite 403
Akron, OH 44320
Phone: (330) 253-0130
Fax: (330) 393-0855


Canton
116 Cleveland Avenue, NW 
Suite 709
Canton, OH 44702
Phone: (330) 453-4357
Fax: (330) 393-0855







Painesville
56 Liberty St.
Suite 309
First Merit Bank Bldg.
Painesville, OH 44077
Phone: (800) 924-7403
Fax: (330) 393-0855

Jefferson

 35 West Jefferson St.
Jefferson, OH 44047
Phone: (800) 924-7403
Fax: (330) 393-0855


Youngstown
565 East Main St. (Rt224)
Suite 225
Canfield, OH 44512
Salem Phone: (330) 332-5531
Phone: (330) 782-0799
Fax: (330) 393-0855

Warren
8256 E. Market Street
Suite 115
Warren, OH 44484
Phone: (800) 924-7403
Phone: (330) 393-4060
Fax: (330) 393-0855

        Empty House TV Commercial     Don't lock the door to your future

      As seen on TV:   "Don't close the door to your future. . . ."

Representing clients in the Youngstown, Warren, Salem, Jefferson, Cleveland, Akron, and Painesville, Ohio areas, including the neighboring cities and throughout the counties of Ashtabula, Trumbull, Mahoning and Columbiana, Cuyahoga, Lorain, Medina, Summit, Stark and  Lake.

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 All information you may obtain is not, nor is it intended to be, legal advice. You should consult an attorney for specific information relevent to your situation.