Please Tell Rich About Your Financial Problems

Confidential Debt Evaluation Form

"I know it isn’t always easy to meet with a lawyer. So I designed this quick, convenient Confidential Debt Evaluation Form. Please fill in the information below and then click the Submit button. After I receive your information, I will contact you to discuss how I can help you." – Rich

If you don't want to send this information by e-mail, you're welcome to:

— FAX the information to my office at 312-624-7954

— MAIL the information requested below to:

Richard Fonfrias, J.D.
Fonfrias Law Group, LLC
70 West Madison Street, Suite 1400
Chicago, IL 60602

— CALL me at 312-969-0730 (Servicio en español 708-813-1696).

Please fill in the following information:





Please respond to these questions:


Debt levels:



Prior bankruptcy filings:

Yes
No

Yes
No

Income source:

Yes
No

Yes
No

Type of debt. Do you have any...

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

 

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