INTAKE PACKET SACRAMENTO LAW GROUP

Transcription

1 INTAKE PACKET SACRAMENTO LAW GROUP Contents: 1. Intake Sheet 2. Free Consultation Agreement (a) Disclosure (b) Disclosure (b) Disclosure Please take a few moments to complete the intake sheet, free consultation agreement and 3 disclosures. Once you have completed and signed these documents either (1) scan and the documents to bankruptcy@sacramentolawgroup.com or (2) fax the documents to (916)

2 Intake Sheet PERSONAL INFO Date Married, Single, Divorced, Separated? Name Spouse Date of Birth Date of Birth Address City, State, Zip Home Phone: ( ) Cell Phone: ( ) Address: Why are you considering bankruptcy? TOTAL DEBT Credit Card Debt: Payday Loan Debt: Student Loan Debt: Back Alimony/Child Support: Other Debt: Personal Loan Debt: Medical Debt: Owed From Repossession: Tax Debt: Other Debt: 2

3 INCOME Husband Gross Monthly Income: Net Monthly Income: Other income Other income: Total Monthly Income: Wife Gross Monthly Income: Net Monthly Income: Other income: Other income: Total Monthly Income: CA Median Income NUMBER OF PERSONS IN HOUSEHOLD: 1 4,035 mo. / 48,415 yr 3 5,617 mo. / 67,401 yr 2 5,253 mo. / 63,030 yr 4 6,305 mo. / 75,656 yr 5 6,980 mo. / 83,756 yr 6 7,655 mo. / 91,856 yr APPROXIMATE MONTHLY EXPENSES House payment* or rent (include lot rental) $ Utilities: Electricity and heating fuel (gas/propane company) Water and sewer. Telephone (including cellular phone and long distance) Recreation and Miscellaneous. Other:. Home Maintenance $ Food $ Clothing $ Laundry and Dry Cleaning $ Medical and Dental Expenses (not already taken out of paycheck) $ $ $ $ $ $ 3

4 Transportation and Car Expenses (gas/repairs/mantenance) $ Insurance: House or Renter s (if not included in house payment).. $ Life or Disability. $ Health or Dental $ Car/Truck.. $ Property. $ Other:.. $ Taxes: Income tax or withholding tax payments.. $ Current real estate taxes $ Estimated income tax payments (quarterly).. $ Overdue real estate taxes. $ Installment payments: Motor vehicle*: $ Motor vehicle*: $ Motor vehicle*: $ Rental Property. $ Furniture $ Jewelry $ Boat / Recreational Vehicles $ Other:.. $ Child Support/Alimony $ Child Care* $ Student Loan(s) $ Total Monthly Expenses $ 4

5 DEBTS Yes No Office Are your debts primarily consumer debts (incurred primarily for personal, family, or household purposes) Do you owe back child support, alimony, or maintenance 523 payments? Do you owe money under a marital settlement agreement? Ch. 13 If you are married, were most of your debts incurred before 523 marriage? Do you have student loans? 523 Have you stopped using credit cards? Do you have any payday loans? In the last 90 days, have you charged on a single credit card or received a loan for more than $650? What did you spend the money on? In the last 70 days, have you received a cash advance totaling more than $925? Do you owe any debts that could be considered fraudulent? Do you owe any court fines or penalties? Do you have cosigners for any debts, or have you cosigned for another s debt? Do you owe money to a friend or relative? Is the IRS or California Franchise Tax Board collecting back taxes? Has the IRS or California Franchise Tax Board put a lien on your property or garnished your wages? Is a creditor taking deductions from your paycheck or bank account for loans, car payments, etc.? 523(a)(2)(C) 523(a)(2)(C) Lux. goods/serv. 523(a)(2)(C) 523(a)(2)(C) Codebtor stay TRANSFERS Yes No Office Have you paid more than $600 to any creditor who is not a friend or relative within the past 90 days? Have you sold or transferred any property to a friend or relative you were/are in debt to within the past year? (365 days) Have you paid any money to a friend or relative in the past 2 years? Have you sold or transferred any property to anyone in the past 2 years? Have you sold or transferred any property to a relative within the past 2 years? In the last year did you use a credit card or borrow money to pay your taxes? 547 PP new value ord. course bus domestic supp ACF HDDC

6 COLLECTION Yes No Office Are you currently involved in a lawsuit? Do you have a judgment against you? Are there any liens against your property because of the judgment? Has your property been subject to an execution sale within the last 90 days? Are your wages being garnished? Is your home in a Trustee s sale (foreclosure) Date of the Trustee s sale Is a lender trying to repossess your car? Are you in danger of being evicted? If so, has your landlord obtained a judgment (writ) of possession? ASSETS Yes No Office Are you expecting a refund for any past year including this year? How much? Do you have an insurance, stockbrokers, or securities license and do you expect commissions or renewals? Do you own any recreational vehicles worth more than $100? Are you expecting to receive money or property from an inheritance, life insurance, marital settlement agreement, or divorce judgment within the next 6 months? Are you expecting to receive an inheritance within the next 5 years? Do you expect money from anyone in the next 5 years? Have you filed federal and state income taxes for every year for the past 4 years? If no, were you required to? Even if you never expect to collect, does anyone owe you any money? Do you (or your spouse) have a right to sue anyone for anything? If so, please explain: Do you (or your spouse) have a personal injury claim that you can file, is pending or payable? Do you have an education IRA or qualified state tuition program? If so, were those funds deposited more than 1 year ago? Do you have any property in pawn? If so, has the redemption period expired? / (b)(5-6) 1-3 yrs/ 5,475 6

7 ASSETS CONT. Yes No Office Is there any property that you are concerned about loosing Describe property: Are you self employed? (own your own business) Value of equipment used in your business: 704-7,175(2) Stocks, Bonds, Mutual Funds Retirement Funds Life insurance with cash surrender value VEHICLES (automobiles, trailers, motorcycles, RV s, etc) Year, Make, Model Approximate Value Amount Owed Behind on Payments? Purchased within last 910 days? REAL ESTATE Yes No Office Do you own your own home? Approximate equity in home: 703: 22, : Are you behind on your mortgage payments? Are you behind on your HOA payments? 523(a)(16) Do you want to keep your home after bankruptcy? Do you (or your spouse) own any other real estate? Ex.) time shares, land, etc. If yes, describe: Do you (or your spouse) own any burial plots? 703: 22,075 7

8 FREE CONSULTATION AGREEMENT This agreement is entered into on by and between Adam Garcia (representative of Sacramento Law Group hereinafter referred to as Attorney ) and (referred to as I, We, Our, or Us. ) 1. I (We) have requested a consultation with the Attorney to obtain information and advice about debt issues and relief from debt, including the possibility of filing bankruptcy. The Attorney agrees to provide an initial consultation concerning these matters. There is no charge for this initial consultation. 2. The Attorney agrees to provide the following services at the initial consultation, based on the information I (we) have provided: (a) Analyze my (our) financial circumstances and advise me (us) of possible bankruptcy and nonbankruptcy options for responding to my (our) financial problems. I (We) understand that this analysis is only preliminary, because the Attorney does not have all of the information and documents that will be required to fully evaluate my (our) situation. (b) Describe the potential benefits and the disadvantages of filing bankruptcy, and explain the relief available under chapters 7, 11, 12 and 13 of the Bankruptcy Code. (c) Advise me (us) of the requirements, obligations and costs for filing a chapter 7 or 13 bankruptcy. (d) Inform me (us) of the additional information that I (we) will need to provide to enable the Attorney to more fully advise me (us) of my (our) potential options and legal rights 3. I (We) agree to provide at the initial consultation information and documents, if any, concerning my (our) income, expenses, assets, and liabilities. I (We) understand that in order for the Attorney to give meaningful advice, detailed financial information must be provided completely and accurately. 4. The Attorney will provide at this time only the services specifically stated in this Agreement. If I (we) retain the Attorney to represent me (us) and provide additional services, including the filing of bankruptcy or other bankruptcy assistance, I (we) and the Attorney will sign a separate retainer agreement detailing the services and their cost, and the other terms of such representation. 8

9 5. I (We) acknowledge that if I (we) decide to not hire the Attorney to represent me (us) then the Attorney is not obligated to provide any additional professional services to me (us) relative to proceedings pursuant to the Bankruptcy Code. I (we) understand that I (we) have no rights arising out of Section 526, 527, and 528 of the Bankruptcy Code. 6. I (We) understand that unless I (we) retain the Attorney, the Attorney cannot fully inform me (us) of the benefits and risks that may result if I (we) become a debtor in a case under the Bankruptcy Code because the Attorney will not have all the information needed to give me (us) such advice. 7. I (We) acknowledge that the Attorney gave to me (us) at the initial consultation copies of this agreement and several notices required by the Bankruptcy Code listed below. All of the following documents were given me (us): (a) Initial Consultation Agreement (b) Notice Required by Sections 342(b) and 527(a) of the Bankruptcy Code (c) Notice Required by Section 527(b) of the Bankruptcy Code Debtor Debtor Attorney Date Date Date 9

10 Notice to Assisted Persons This Notice Is Required by Section 527(a)(2) of the Bankruptcy Code The bankruptcy laws require that you be given the following disclosures: (1) the written notice required under section 342(b)(1); and (2) to the extent not covered in the written notice described in paragraph (1), and not later than 3 business days after the first date on which a debt relief agency first offers to provide any bankruptcy assistance services to you, a clear and conspicuous written notice advising you that-- (A) all information that you are required to provide with a petition and thereafter during a case under this title is required to be complete, accurate, and truthful; (B) all assets and all liabilities are required to be completely and accurately disclosed in the documents filed to commence the case, and the replacement value of each asset as defined in section 506 be stated in those documents where requested after reasonable inquiry to establish such value; (C) current monthly income, the amounts specified in section 707(b)(2), and, in a case under chapter 13 of this title, disposable income (determined in accordance with section 707(b)(2), are required to be stated after reasonable inquiry; and (D) information that you provide during your case may be audited pursuant to this title, and that failure to provide such information may result in dismissal of the case under this title or other sanction, including a criminal sanction. Print Name Date: Sign Name Print Name Date: Sign Name 10

11 Prescribed Language Notice Notice to Assisted Persons This Notice is Required by Section 527(b) of the Bankruptcy Code IMPORTANT INFORMATION ABOUT BANKRUPTCY ASSISTANCE SERVICES FROM AN ATTORNEY OR BANKRUPTCY PETITION PREPARER. If you decide to seek bankruptcy relief, you can represent yourself, you can hire an attorney to represent you, or you can get help in some localities from a bankruptcy petition preparer who is not an attorney. THE LAW REQUIRES AN ATTORNEY OR BANKRUPTCY PETITION PREPARER TO GIVE YOU A WRITTEN CONTRACT SPECIFYING WHAT THE ATTORNEY OR BANKRUPTCY PETITION PREPARER WILL DO FOR YOU AND HOW MUCH IT WILL COST. Ask to see the contract before you hire anyone. The following information helps you understand what must be done in a routine bankruptcy case to help you evaluate how much service you need. Although bankruptcy can be complex, many cases are routine. Before filing a bankruptcy case, either you or your attorney should analyze your eligibility for different forms of debt relief available under the Bankruptcy Code and which form of relief is most likely to be beneficial for you. Be sure you understand the relief you can obtain and its limitations. To file a bankruptcy case, documents called a Petition, Schedules and Statement of Financial Affairs, as well as in some cases a Statement of Intention need to be prepared correctly and filed with the bankruptcy court. You will have to pay a filing fee to the bankruptcy court. Once your case starts, you will have to attend the required first meeting of creditors where you may be questioned by a court official called a "trustee" and by creditors. If you choose to file a chapter 7 case, you may be asked by a creditor to reaffirm a debt. You may want help deciding whether to do so. A creditor is not permitted to coerce you into reaffirming your debts. If you choose to file a chapter 13 case in which you repay your creditors what you can afford over 3 to 5 years, you may also want help with preparing your chapter 13 plan and with the confirmation hearing on your plan which will be before a bankruptcy judge. If you select another type of relief under the Bankruptcy Code other than chapter 7 or chapter 13, you will want to find out what should be done from someone familiar with that type of relief. Your bankruptcy case may also involve litigation. You are generally permitted to represent yourself in litigation in bankruptcy court, but only attorneys, not bankruptcy petition preparers, can give you legal advice. Print Name Date: Sign Name Print Name Date: Sign Name 11

12 B201A (Form 201A) (12/12) Page 1 of 2 USBC, EDCA UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF CALIFORNIA NOTICE TO CONSUMER DEBTOR(S) UNDER 342(b) OF THE BANKRUPTCY CODE In accordance with 342(b) of the Bankruptcy Code, this notice: (1) Describes briefly the services available from credit counseling services; (2) Describes briefly the purposes, benefits and costs of the four types of bankruptcy proceedings you may commence; and (3) Informs you about bankruptcy crimes and notifies you that the Attorney General may examine all information you supply in connection with a bankruptcy case. You are cautioned that bankruptcy law is complicated and not easily described. Thus, you may wish to seek the advice of an attorney to learn of your rights and responsibilities should you decide to file a petition. Court employees cannot give you legal advice. Notices from the bankruptcy court are sent to the mailing address you list on your bankruptcy petition. In order to ensure that you receive information about events concerning your case, Bankruptcy Rule 4002 requires that you notify the court of any changes in your address. If you are filing a joint case (a single bankruptcy case for two individuals married to each other), and each spouse lists the same mailing address on the bankruptcy petition, you and your spouse will generally receive a single copy of each notice mailed from the bankruptcy court in a jointly- addressed envelope, unless you file a statement with the court requesting that each spouse receive a separate copy of all notices. 1. SERVICES AVAILABLE FROM CREDIT COUNSELING AGENCIES With limited exceptions, 109(h) of the Bankruptcy Code requires that all individual debtors who file for bankruptcy relief on or after October 17, 2005, receive a briefing that outlines the available opportunities for credit counseling and provides assistance in performing a budget analysis. The briefing must be given within 180 days before the bankruptcy filing. The briefing may be provided individually or in a group (including briefings conducted by telephone or on the Internet) and must be provided by a nonprofit budget and credit counseling agency approved by the United States trustee or bankruptcy administrator. A list of approved budget and credit counseling agencies that you may consult is posted on the United States trustee program's web site at It is also available in the bankruptcy clerk's office. Each debtor in a joint case must complete the briefing. In addition, after filing a bankruptcy case, an individual debtor generally must complete a financial management instructional course before he or she can receive a discharge. A list of approved financial management instructional courses is also available on the United States trustee program's web site ( and the bankruptcy clerk's office. Each debtor in a joint case must complete the course. 2. THE FOUR CHAPTERS OF THE BANKRUPTCY CODE AVAILABLE TO INDIVIDUAL CONSUMER DEBTORS a. Chapter 7: Liquidation. Total fee: $306 ($245 filing fee + $46 administrative fee + $15 trustee surcharge) Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. Debtors whose debts are primarily consumer debts are subject to a "means test" designed to determine whether the case should be permitted to proceed under chapter 7. If your income is greater than the median income for your state of residence and family size, in some cases, creditors have the right to file a motion requesting that the court dismiss your case under 707(b) of the Code. It is up to the court to decide whether the case should be dismissed. Under chapter 7, you may claim certain of your property as exempt under governing law. A trustee may have the right to take possession of and sell the remaining property that is not exempt and use the sale proceeds to pay your creditors. 12

13 B201A (12/12) Page 2 of 2 USBC, EDCA The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found to have committed certain kinds of improper conduct described in the Bankruptcy Code, the court may deny your discharge and, if it does, the purpose for which you filed the bankruptcy petition will be defeated. Even if you receive a general discharge, some particular debts are not discharged under the law. Therefore, you may still be responsible for most taxes and student loans; debts incurred to pay nondischargeable taxes; domestic support and property settlement obligations; most fines, penalties, forfeitures, and criminal restitution obligations; certain debts which are not properly listed in your bankruptcy papers; and debts for death or personal injury caused by operating a motor vehicle, vessel, or aircraft while intoxicated from alcohol or drugs. Also, if a creditor can prove that a debt arose from fraud, breach of fiduciary duty, or theft, or from a willful and malicious injury, the bankruptcy court may determine that the debt is not discharged. b. Chapter 13: Repayment of All or Part of the Debts of an Individual with Regular Income. Total fee: $281 ($235 filing fee + $46 administrative fee) Chapter 13 is designed for individuals with regular income who would like to pay all or part of their debts in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar amounts set forth in the Bankruptcy Code. Under chapter 13, you must file with the court a plan to repay your creditors all or part of the money that you owe them, using your future earnings. The period allowed by the court to repay your debts may be three years or five years, depending upon your income and other factors. The court must approve your plan before it can take effect. After completing the payments under your plan, your debts are generally discharged except for domestic support obligations; most student loans; certain taxes; most criminal fines and restitution obligations; certain debts which are not properly listed in your bankruptcy papers; certain debts for acts that caused death or personal injury; and certain long term secured obligations. c. Chapter 11: Reorganization. Total fee: $1,213 ($1,167 filing fee + $46 administrative fee) Chapter 11 is designed for the reorganization of a business but is also available to consumer debtors. Its provisions are quite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney. d. Chapter 12: Family Farmer or Fisherman. Total fee: $246 ($200 filing fee + $46 administrative fee) Chapter 12 is designed to permit family farmers and fishermen to repay their debts over a period of time from future earnings and is similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose income arises primarily from a family-owned farm or commercial fishing operation. 3. BANKRUPTCY CRIMES AND AVAILABILITY OF BANKRUPTCY PAPERS TO LAW ENFORCEMENT OFFICIALS A person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of perjury, either orally or in writing, in connection with a bankruptcy case is subject to a fine, imprisonment, or both. All information supplied by a debtor in connection with a bankruptcy case is subject to examination by the Attorney General acting through the Office of the United States Trustee, the Office of the United States Attorney, and other components and employees of the Department of Justice. WARNING: Section 521(a)(1) of the Bankruptcy Code requires that you promptly file detailed information regarding your creditors, assets, liabilities, income, expenses and general financial condition. Your bankruptcy case may be dismissed if this information is not filed with the court within the time deadlines set by the Bankruptcy Code, the Bankruptcy Rules, and the local rules of the court. The documents and deadlines are listed on Form EDC 2-035, Required Documents and Fees, which is posted on the court web site ( 13