Thank You! Please complete this brief questionnaire.

Name
Address
Marital Status
Number of people living under your roof that you help support:
Please estimate your gross monthly income from the following:
Employment:
Self-employment:
Pension:
Unemployment:
Social security:
VA Disability:
Other:
 
If married, how much does your spouse earn per month from the following:
Employment:
Self-employment:
Pension:
Unemployment:
Social security:
VA Disability:
Other:
 
What is a rough estimate for the total amount of your unsecured debt (credit cards, debts, repossession, IRS and medical, but excluding student loans and real estate and cars that are currently in your possession)?
Check which types of debt you have
Are you current or behind on your payments to creditors?
Have you filed bankruptcy in the last 10 years?
Are you being sued?
Are your wages currently being garnished?

Our Locations

Gilbert

Elliot & McQueen
(480) 518-0154

North Phoenix

I-17 & Pinnacle Peak
(480) 518-0154

Scottsdale

94th St & Shea
(480) 284-5580

Peoria

N. 83rd Ave & W. Thunderbird
(480) 518-0154

Surprise

Bell & Reems
(602) 715-0856

Queen Creek

Ellsworth & Queen Creek
(480) 284-5581

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