4413 Spicewood Springs Rd, Suite 216 , Austin, TX 78759

HICKSON LAW, PC

Call Today! 512-346-8597

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Online Consultation Worksheet

Online Consultation Worksheet

Date

How did you hear about our firm, please check one

Phonebook (Yellow Pages)

Referral

Internet Search

Yahoo

Google

MSN/Bing

Other

If checked, please explain

Or did you hear about us by some other means, if so, please explain

Did you visit our website?

Yes

No

Email Address

Have you or are you about to lose any property due to Repossession Foreclosure or Levy?

Yes

No

Birthdate

Address

City/State

County

ZIP Code

Phone(s) Home

His WK

Her WK

His Cell

Her Cell

Marital Status

Number of Children/Dependents

Do you pay/receive Child Support?

Yes

No

Monthly Amount

Do you owe any taxes?

Yes

No

Type

AMT

Has a LIEN/LEVY been filed by the I.R.S?

Yes

No

Has anyone co-signed with you or have you co-signed for anyone on any loans, etc.?

Yes

No

Previous Bankruptcy? Chapter?

Year?

Where?

ASSETS

Vehicles

YR

Model

PMT

Current?

Lease or Purchase?

Leash

Purchase

YR

Model

PMT

Current?

Lease or Purchase?

Lease

Purchase

Real Property

Real Property

Mortgage Bal.

PMT. $

Value $

2nd LIEN Bal.

PMT. $

Value $

Do you own other Real Estate?

Yes

No

No. of Acres?

Other Assets: (Example: Rental Property, Land): $

Free Text

Debts

Total other secured Debts (Collateral) $

Total unsecured Debt (No Collateral) $

Gross and Net Monthly Income (After Taxes - Yours) $

Gross and Net Monthly Income (After Taxes - Spouse) $

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First Name

Last Name

Email

Phone

Message

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Home
The Firm
Practice Areas
Bankruptcy FAQs
Resources
Online Consultation Worksheet
Contact

Contact Information

Phone: 512-346-8597

Address: 4413 Spicewood Springs Rd, Suite 216, Austin, TX 78759

Email: info@hicksonlawpc.com

Service Areas

Austin,TX

Round Rock,TX

Cedar Park, TX

Business Hours:

Mon - Thu: 9:00 am - 5:00 pm
Friday: 9:00 am - 3:00 pm
Sat - Sun: Closed

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