Initial Client Consultation Form

If you are interested in a free initial consultation, either by telephone or in person, the firm requests that you complete the Initial Client Consultation Form. You may either complete it online and return it electronically to the firm (preferable) or you may print the form, complete it offline and return it either by fax ((972)208-4603) or mail (101 E. Park Blvd., 600, Plano, TX 75074). If you are returning the Initial Client Consultation Form electronically, please be sure to indicate in the fields provided what dates and times are best to schedule an initial consultation and whether you wish the consultation to take place over the phone or in person.

NOTE: Do not enter dollar signs or decimals in any numeric field. Entering dollar signs will result in an error. All numbers entered after a decimal point will be truncated in any calculations.


Client Contact Information

Last Name*
First Name*
Address*
City*
Zip Code*
Home Phone*
Work Phone
Cell Phone
Email*



Spouse Contact Information (if applicable)

Last Name
First Name
Address
City
Zip Code
Home Phone
Work Phone
Cell Phone
Email



Real Property Information (if applicable)

Home

Do you own or rent your home?

Other Real Property

Do you own or lease this property?
Address

Other Real Property

Do you own or lease this property?
Address

Timeshare

Do you own a time share?
Address


Burial Plot

Do you own a Burial Plot?
Location



Personal Property Information

Vehicle 1

Do you own or lease your vehicle?


Vehicle 2

Do you own or lease your vehicle?


Vehicle 3

Do you own or lease your vehicle?


Boat

Do you own or lease a boat?


Trailer

Do you own or lease a trailer?


Mobil Home or RV

Do you own or lease a mobile home or RV?
Location


Miscellaneous






Do you own any property of a value of $1,000 or more? If yes, please list and value those items in the box to the left.



Secured Creditors

1st Mortgage Holder (name)

Amount Owed



2nd Mortgage Holder (name)

Amount Owed




3rd Mortgage Holder (name)

Amount Owed




Vehicle Lender (name)

Amount Owed







TOTAL SECURED DEBT



Unsecured Creditors
Creditor Name Amount Owed























TOTAL UNSECURED DEBT



Current Monthly Income

Salary Spouse Salary
Gross Wages
Gross Wages
Overtime


Overtime
Payroll Deductions

Spouse Payroll Deductions
Fed. Taxes
Fed. Taxes
Soc. Sec.
Soc. Sec.
Insurance
Insurance
401k
401k
Union
Union
Other
Other
Other


Other
NET SALARY


NET SALARY
Other Income

Spouse Other Income
Business
Business
Real Property
Real Property
Investment
Investment
Support
Support
Alimony
Alimony
Social Sec.
Social Sec.
Retirement


Retirement
GRAND TOTAL
GRAND TOTAL



Current Monthly Expenses

Rent
Life Ins.
Renters Ins.
Medical Ins.
Mortgage(s)
Car Ins.
Prop. Ins.
Child Support
Home Owners
Alimony
Prop. Taxes
Prof. Dues
Home Maint.
Car Payment
Electric
Car Payment
Gas / Oil
Car Maint.
Water
Vehicle Reg.
Garbage
Gasoline
Telephone
Bus / Train
Cable
Recreation
Food
Charity
Clothing
Other
Dry Cleaning
Other
Med. / Dental


Other
TOTAL EXPENSES



Disposable Income

MONTHLY DIPOSABLE INCOME



Schedule an Appointment

Day



Time



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