Before making an appointment to come into my office I will want to review some basic information regarding your particular financial situation to determine how I might best assist you .

You are invited to call me to discuss your situation in person, or if you prefer, fill out the questionnaire below and press submit and I will contact you by phone.

Note: By providing the following information you are not retaining my services as your attorney.

What County do you reside in:

If you do not see your county in the list above then you are not in my area of practice which is limited to the South Florida Tri-County area. Please seek legal advice from your local bankruptcy attorney.


Full Name:

Phone Number:

Email Address:

Are You Employed?

Avg. gross monthly income over the past 6 Months:

If during a portion of the last six months you were unemployed, for example worked months 1,2,3 then unemployed months 4,5,6: Your total income divided by 6 = gross income per month.

Do you own your Home?

This means do you own your home, whether or not you have a mortgage.

When did you purchase your home?

What is your home estimated fair market value

Are you current on your mortgage:

Do you intend to keep your home:

Do you own any other real property other than your home?

If yes, do you hope to keep it after bankruptcy?

Do you Own or Lease a car:

If financed, how much do you owe on the car?

Do you want to keep it after the bankruptcy.

Estimated Fair Market Value of the Car:

How long have you resided in Florida?

If you have resided in Florida less than 180 days

Where did you live immediately before,

and for what period of time?


Financial Holdings:

Do you have any checking, savings, brokerage or other financial holdings that are not tax-exempt retirement plans such as IRAs or 401ks.
If yes, approximate value.

Other Assets:

Other than personal property such as clothing, personal accessories, and household furnishings, do you have any other assets which you hope to keep after your bankruptcy.

If yes, approximate value.

Other Debt:
Is your debt primarily consumer credit cards debt:

If yes how much do you owe in credit card debt:

What other kind of of creditors do you owe (other than consumer credit cards)

If so how much


By clicking Submit, I agree to be contacted by an attorney from The Law Offices of Robin L. Bodiford, and I hereby acknowledge that I have read the Legal Disclaimer and I agree to all of it's terms and conditions

LEGAL DISCLAIMER: The information on my website is intended as a general discussion of legal issues and not as a statement of fact, legal advice or a legal opinion. No attorney-client relationship is created by information provided herein. Do not act or rely upon information in this communication without seeking the advice of an attorney licensed to practice in your state.

This Web site is an advertisement by the Law Offices of Robin L. Bodiford, P.A., a debt relief agency helping people file for bankruptcy relief under the bankruptcy code.

The Law Offices of Robin L. Bodiford, P.A., is a Federally Designated Debt Relief Agency under the Bankruptcy Code. We assist consumers in need of bankruptcy relief and have been doing so since 1995.

IRS CIRCULAR 230 NOTICE: In order to ensure compliance with requirements imposed by the IRS: We must advise you that any U.S. tax advice contained in this communication (or in any attachment) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed in this communication, meaning any information in this website