Bankruptcy Solutions without Having to File Bankruptcy
For more info or to become a DCSD client
Call 800-992-3275 ext. 1304
Email Us or Enroll Now.

All your information
is confidential and
kept secure.

APPLY ONLINE - New Client Online Application

Please note: the Online New Client Application cannot be saved for later completion.

There is a $50 non-refundable Application Fee. Once application and fee are received, an attorney will review your application and you will be contacted by DCSD for an intake interview. If you qualify for our services and would like to become a DCSD client, we will then send you the required legal documents you will need to complete. At that time the ONE-TIME PROCESSING FEE balance ($100 - $200 depending on circumstances) is due.

 

Paying your $50 application fee. Please note, the one-time processing fee balance ($100 - $200 depending on circumstances) will be due upon application approval.

Pay by Credit Card Online. (option available once this New Client Online Application is submitted)

PRIMARY DEBTOR:

First Name:

SECONDARY DEBTOR:

First Name:

Last Name:

Last Name:

Date of Birth:  

Date of Birth:  

Street Address:

Street Address:

City:  

City:  

State:  

State:  

Zip:  

Zip:  

Home Phone:  

Home Phone:  

Cell Phone:  

Cell Phone:  

Email (required):  

Email:  

Relationship of Primary Debtor to Secondary Debtor

BANK INFORMATION

List the banks and credit unions where you have accounts. (checking, savings, cds, etc)
Do not write in account numbers.

#1.  

#2.  

#3.  

#4.  

Are you banking at an institution to which you owe money and are intending to provide to DCSD for representation?  

 

Primary Debtor

Secondary Debtor

Social Security

$

$

Pension

$

$

Disability

$

$

Veterans Benefits

$

$

Other

$

$

Do you have a job?:  

Employer:  

Hours worked per week:  

Hourly Rate:  

Do you have any Certificates of Deposit?  

401K?  

IRA?  

Stocks?  

Bonds?  

Mutual Funds?  

REAL PROPERTY INFORMATION

Do you own a home?  

Current value of home?  

How much is owed on all mortgages?

Is there another name on the title to this property?

Is your name on any other real estate?

Do you have any time share properties?

PERSONAL PROPERTY INFORMATION

Do you own any assets such as expensive jewelry, expensive artwork, Gun collection, coin or stamp collections, etc?  

VEHICLE INFORMATION

Year

Make

Model

Current Value

Loan Balance

List any recreational vehicles you have. (ie., motor homes, ATV, etc.)

#1.  

#2.  

CREDITOR INFORMATION

Approximately How many debts would you like us to handle for you?

Credit Card: 

Medical Bills: 

PayDay Loans: 

Student Loans: 

Please Note:
We cannot assist you with government backed student loans.

Unsecured Loans

Signature Loans:  

Line of Credit:  

Deficiencies (foreclosure/repossession)

Mortgage:  

Vehicle Loan:  

COMMENTS:

  

Note: Form may take a few minutes to submit.



The information you obtain at this site is not, nor is it intended to be, legal advice. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. Furthermore, the information on this website is for general purposes only and should not be interpreted to indicate a certain result will occur in your specific legal situation.