Nease Law, PLLC
107 W. Miles Ave.
Kingfisher, OK 73750
(405) 252-0279
Contact information
Prefix
First name
*
Middle name
Last name
*
Emails
Email Address
*
Type
Upon submission, a copy of this form will be sent to the primary email.
Work
Home
Other
Primary
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Phone numbers
Phone number
Type
Work
Home
Mobile
Fax
Pager
Skype
Other
Primary
Default number false
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Preferred Method of Contact
Phone
Email
Text
County of Residence
Are you married?
Yes
What is your spouse's full legal name? (even if they are not filing)
No
What Do You Need Help With?
Describe your situation.
Credit Card Debt
Medical Debt
Personal Loans
Vehicle Loans/Repossession
Mortgage/Foreclosure
Tax Debt
Lawsuits or Judgments
Wage Garnishments
Collection Calls/Letters
Business Debt
Other
Are you currently being sued by a creditor or debt collector?
Yes
Who is suing you?
No
Unsure
Urgent Issues
Are any of the following happening now?
My wages are being garnished
My bank account has been garnished or frozen
My vehicle has been repossessed or is at immediate risk of repossession
My home is in foreclosure
I have received a summons or lawsuit
A creditor has a judgment against me
Utilities are scheduled for disconnection
None of these
Is there a court date, sale date, repossession date, garnishment date, or other deadline you know about?
Yes
No
Unsure
If yes, what is the date?
Bankruptcy Background
Have you ever filed bankruptcy before?
Yes
Approximately when did you file?
No
Unsure
What type of bankruptcy did you file, if known?
Chapter 7
Chapter 13
Other
I don't know
Are you primarily interested in:
Chapter 7
Chapter 13
I don't know - I need help determining my options
I'm not sure bankruptcy is right for me
Basic Financial Snapshot
Are you currently employed?
Yes
No
Approximate monthly household income
Under $2,500
$2,500-$4,000
$4,001-$6,000
$6,001-$8,000
More than $8,000
Unsure
Do you own a home?
Yes
No
Buying under a mortgage
Other
Do you own or finance any vehicles?
Yes
No
Approximately how much unsecured debt do you have?
Under $10,000
$10,000-$25,000
$25,001-$50,000
$50,001-$100,000
More than $100,000
I don't know
Opposing/Creditor Information
Please list the names of any creditors, collection agencies, attorneys, or other parties currently involved in lawsuits or legal proceedings concerning your debts. Please provide names only. Do not provide detailed or confidential information about your situation in this field.
Tell Us What You Need
In a few sentences, what is the primary problem you would like help resolving? Please provide only a brief description. Do not include sensitive or confidential details beyond what is necessary for us to understand the general nature of your matter.
I understand that submitting this form does not create an attorney-client relationship and does not mean that Nease Law PLLC has agreed to represent me. I understand that the firm must review my information and complete any necessary conflict check before representation can be accepted. I agree not to submit information beyond what has been requested on this form.
Yes