Board Certified in Consumer Bankruptcy
By the American Board of Certification
Home
|
About Us
|
Should You File?
|
Warning Signs
|
Types of Bankruptcy
|
Bankruptcy Process
|
BANKRUPTCY VIDEO
|
FAQs
|
CONSULTATION QUESTIONNAIRE
Please email us at
info@tampabaydebtrelief.com
or use one of the contact forms below.
*required information
*
Name:
*
Home/cell telephone number:
Alternative telephone number:
*
Email address:
What is the best time to contact you?
8 AM - 10 AM
10 AM - 12 NOON
12 NOON - 2 PM
2 PM - 4 PM
4 PM - 6 PM
6 PM - 7 PM
Questions or Comments:
Complete this online form or
print a form to fill out (click here)
.
*required information
General Information
*
Name:
Marital status:
Single
Married
Divorced
*
Home/cell telephone number:
Alternative telephone number:
*
Email address:
Children & Dependants
Children living at home:
None
1
2
3
4
5
6
7
8
9
10 or more
Home/Mortgage
Do you own your home?
Yes
No
Are you current on your mortgage?
Yes
No
Have you been served with a foreclosure?
Yes
No
Vehicle(s)
Do you own a car?
Yes
No
What year is your car?
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Please Select Below
Are you making payments?
Yes
No
Total Unsecured Debts
What is your total unsecured debt?
(credit cards, medical bills, repos, judgments, lease termination, etc.)
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Other Debts
Do you owe student loans?
Yes
No
Are you current with your income taxes?
Yes
No
Employment/Income
What is you employment status?
Employed
Social Security
Disability
Retired
Unemployed
What is your total household income?
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 - $60,000
$60,001 - $65,000
$65,001 - $70,000
$70,001 - $75,000
$75,001 - $80,000
$80,001 - $85,000
$85,001 - $90,000
$90,001 - $95,000
$95,001 - $100,000
$100,001 and up
Bankruptcy Status
Have you previously filed bankruptcy?
Yes
No
If you answered YES to the above question, what year did you file?
1961
1962
1963
1964
1965
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Please Select Below
Assets
Do you have any valuable assets?
Expensive jewelry:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Art collections:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Antiques:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Stocks:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Bonds:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Tools:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Classic cars:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Boats:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Motorcycles:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
RV's:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
Non homestead real estate:
Yes
No
$0 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
$4,001 - $5,000
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 or more
What is the best time to contact you?
8 AM - 10 AM
10 AM - 12 NOON
12 NOON - 2 PM
2 PM - 4 PM
4 PM - 6 PM
6 PM - 7 PM
Questions or Comments:
Law Office of
Thomas A. Nanna, P.A.
8910 N. Dale Mabry Hwy., Suite 1
Tampa, Florida 33614
Telephone: 813-935-8388
Fax: 813-935-3528
»enlarge map & get directions
©2005 All Rights Reserved
website design by SandyMeier.com