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*Name: Street Address: City: State: Zip: *Phone: Fax: *Email Address:

When would you like to be contacted (morning, afternoon, evening)? What day of the week works best for you?

Motivation

Why are you considering bankruptcy or consolidation?

Creditor Harassment Garnishment Foreclosure Illness/Disability Other Estimate Total Debt: $

Bills

What type of bills do you have?

Credit Cards/Store Cards Medical Bills Pay Day Loans/ Personal Loans Other Estimate Total Monthly Expenses: $

Income

Do you own real estate?	Yes No
Do you own a car?	Yes No
Do you own anything else worth more than $1,000.00?	Yes No

Income

Please identify all income sources for your household.

Employment Social Security Retirement/Pension Child Support/Maintenance No Income Other Estimate Total Monthly Income: $

If you are thinking about bankruptcy, do not consider this a matter of shame or despair. At Debt Advisors, S.C., we are career bankruptcy lawyers who are dedicated to helping our fellow Wisconsinites find their way to a fresh start and reestablishment of credit after bankruptcy. We have helped thousands of people before you eliminate or restructure consumer debt, and achieve their goals of living within their means. We are attorneys who understand that your out-of-control debt probably came about as a result of divorce, job loss, medical expenses, or other misfortunate twists and turns in life.

Get Your FREE Debt Evaluation Today! Click here to get started today!

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Debt Advisors - 2222 N. Mayfair Road, Suite 150 - Milwaukee, WI 53226-2208 - Phone: (414) 755-2400
2108 Kohler Memorial Drive, Lower Level, Sheboygan, WI 53081
We have 5 office locations throughout Wisconsin.

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Debt Advisors, S.C. is a Debt Relief Agency. We help people file for relief under the Bankruptcy Code. Our clients include people from throughout the Milwaukee, Wisconsin, metropolitan area and beyond, including clients from cities such as Waukesha, West Bend, Pewaukee, Brookfield, Delafield, Fond du Lac, Juneau, Menomonee Falls, Grafton, Germantown, Jackson, Madison, Racine, Kenosha, Appleton, Oshkosh, Beloit, Janesville, and New Berlin. Counties served include Milwaukee County, Waukesha County, Washington County, Dodge County, Sheboygan County, Fond du Lac County, and Ozaukee County.