Free Online Evaluation

Contact Information
Please provide us with your contact information
First Name:
Last Name:
Email:
Address:
City:
State:
Zip Code:
Phone:	--
Types of Debt

Tell us about the type of debt you have.
	Credit Cards
	Judgments
	Tax Debts
	Personal Loans
	Medical Bills
	Student Loans
	Government Fines
Amount of Debt

How much debt do you have?
	Under $5,000
	$5,000-$10,000
	$10,000-15,000
	$15,000-$20,000
	$20,000-$30,000
	$30,000-$40,000
	$40,000-$50,000
	Over $50,000
Home
Tell us about your property

Do you own real estate?	Yes No

Are you up to date on your mortgage?	Yes No
Vehicle
Provide us information about your vehicle
Do you have a car?	Yes No
Are your payments up to date?	Yes No
Employment

Are you employed?	Yes No
Household Income

How often do you get paid?
	Every week
	Every 2 weeks
	Twice a month
	Monthly
	Net Pay (after taxes, medical, etc)
Spouse (Optional)

How often do you get paid?
	Every week
	Every 2 weeks
	Twice a month
	Monthly
	Net Pay (after taxes, medical, etc)

The law firm of Dionne & Dionne represents clients in Central and West Alabama including Birmingham, Tuscaloosa, Centerville, Fayette, Jasper, Moundville, Tuscaloosa County, Bibb County, Blount County, Fayette County, Greene County, Hale County, Jefferson County, Lamar County, Perry County, Pickens County, Shelby County, Sumter County and Walker County.

We are a debt relief agency. We help people file for bankruptcy relief under the Bankruptcy Code. No representation is made that the quality of legal services to be performed is greater than the quality of legal services performed by other lawyers.

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