IntakeName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact Phone #*Cell, Home or WorkEmail* Date of Birth*Last 4 digits of Social Security #Are you married? Yes NoSpouse's Name First Last Do you have any lawsuits against you? Yes NoDo you have any judgments against you? Yes NoDo you own a business? Yes NoHave you ever filed for bankruptcy? Yes NoHave you filed all income tax returns for the last 4 years? Yes NoOutstanding debt to IRS? Yes NoIf yes, has the IRS filed a lien? Yes NoDo you have any outstanding payday loans? Yes NoFor your residence, do you Rent Own Other(choose one)Are you behind on rent or mortgage? Yes NoDo you have a car payment? Yes NoIf Yes, are you behind on the payments? Yes NoWhat is your estimated annual income/salary (gross, before taxes)?If married, what is your spouse’s estimated annual gross income?Briefly, what brought you to seek this legal advice?