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(808) 426-2004

220 Imi Kala Street Suite 203 C
Wailuku, HI 96793

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(808) 426-2004

220 Imi Kala Street Suite 203 C Wailuku, HI 96793

 

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Blake Goodman – Bankruptcy Attorney
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Questionnaire

  • Would you like to know more about how our Maui bankruptcy attorneys can help you with your financial problems? Please take a moment to fill out the information on this page and click "submit" at the bottom. A Maui bankruptcy lawyer will reply as soon as possible. If there is not enough space to complete your responses, then please put carry over information in the "General Comments" section at the end of this questionnaire. Thank you for your kokua.
  • Name

  • Spouse's Name

  • Contact Info

  • Employer

  • Questionnaire

  • Late Payments

  • Income

  • What is your approximate take home income per month (not per pay period) after deductions for taxes, social security, and insurance? (Please include spouse's income whether filing a case with you or not)
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  • You

  • Your Spouse

  • Expenses

  • What are your approximate expenses per month for the following items?
  • (Ex: Diapers, Dog Food, Cigarettes)
  • Mortgages and Other House Related Debts

  • Name of CreditorBalance (Best Guess)Value of Real Estate 
  • Car Debts

  • Name of CreditorBalance (Best Guess)Type & Year of Car 
  • Credit Cards

  • Name of CreditorBalance (Best Guess) 
  • Signature Loans with Collateral

  • Name of CreditorBalance (Best Guess) 
  • Signature Loans without Collateral

  • Name of CreditorBalance (Best Guess) 
  • Medical Bill

  • Name of CreditorBalance (Best Guess) 
  • Student Loans

  • Name of CreditorBalance (Best Guess) 
  • Loans to Family and Friends

  • Name of CreditorBalance (Best Guess) 
  • Others

  • Name of CreditorBalance (Best Guess) 
  • Back Tax Debt

  • Name of CreditorType of TaxYearBalance 
  • General Comments



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Contact Us

  • Take The First Step Toward Stability. Time May Be Critical In Your Case.

    Give Us A Call Today or fill out the form below and we will contact you to set up a FREE consultation. We’ll talk you through your options. Most of my clients pay a fixed, reasonable fee for my service. And I guarantee you’ll be happy with my help.

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Coronavirus – Our Firm’s Response
The health and safety of our staff and our clients is our first priority.
Staff will stay home if they are sick. And, we recommend that client’s do the same. We will
be happy to reschedule any office meetings.

For our potential clients and existing clients:

We will be happy to offer all of our services online.

You may even have your free consultation by phone.

After retaining our office, we can work with you via phone and emails. We can even file your
case electronically. Therefore, we can both perform our duties to keep the members of our
families and community safe from the spread of Covid-19.

We are prepared to do everything possible to be proactive and safe.
We believe that our actions today will safeguard the health of our clients and staff, while
continuing to serve you with unsurpassed professionalism and support.