Initial Consultation Worksheet | Omaha Bankruptcy Lawyer

John T. Turco and Associates, P.C., L.L.O.

Attorneys at Law
2580 South 90th Street
Omaha, Nebraska 68124
(402) 763-8623
John T. Turco

jturco@johnturcolaw.com
Wesley H. Bain, Jr.

wbain@johnturcolaw.com
Erin M. McCartney

emccartney@johnturcolaw.com
Angela Y. Gruber-Gardner

agruber@johnturcolaw.com

As defined by federal law, we are a Debt Relief Agency. We help people file for bankruptcy relief under the Bankruptcy Code.

Initial Consultation Worksheet

* Denotes Mandatory entry

Applicant I	Applicant II
Name:	Name:
Address:	Address:
City:State:Zip:	City:State:Zip:
Phone numbers: Home:Work: Cell:	Phone numbers: Home:Work: Cell:
* Email:	Email:
Date: Sat Jan 10, 2026
How did you hear about us? Check the one that applies	Dex phone book Yellow phone book Letter from us Newspaper Internet Referral from
Please tell us about your financial problems by listing the major areas of trouble and providing us with approximate amounts:

Debts and Liabilities

Mortgage / Home Loan information

Do you own or are you purchasing any real estate (such as your house)?
If no, then do you rent?
How long have you lived at your present address: (in years)
Monthly rent: $
If you neither own or rent, then please tell us about your living situation and any money paid out here:
Do you own more than one property?How Many?
Is your main house in a state of foreclosure?
If the house is in foreclosure, what is the sale date? example: 12/31/2011
(if you are in foreclosure, remember to please ask one of our attorneys to help you fill out a special foreclosure information form.)

Home Value

What could you realistically sell your property (home) for in its present condition?
Please provide figures for any or all of the following:

Recent appraisal: $ County assessment: $ Comparable sales: $ Market analysis: $
Name of your primary real estate lender:
Address of lender:
if multiple please list properties and lender and outstanding amounts in this box:
Total loan amount (approx):$ Regular monthly mortgage payment $

Interest rate (best guess): %
Behind on payments?
If yes, how much? $
Are taxes and/or insurance included?
Do you own or are you on the deed (title) to any other real property?
This includes Rental Property, cemetery plots, Time Shares or just being on the title to a relatives property for any reason..

Credit Cards How many? Total Owed: $ Anything thing else we should know?

Unpaid Medical Bills: How many? Total Owed: $Anything thing else we should know?

Business debts : How many? Total Owed: $Anything thing else we should know?

Personal loans: How many? Total Owed: $Anything thing else we should know?

Auto loan(s): How many? Total Owed: $Anything thing else we should know?

ANY Other debts owed to anyone?: How many? Total Owed: $
Anything thing else we should know?

Marital status

What is your Marital status?
Total Alimony/Child Support Owed: $ Are you up to date on payments?
Please detail any debts owed, based on current or previous marriages (such as property settlements or alimony)

Relationship and age of each dependent (Ex: Son, age 2)
:
Dependents:
:
:
:
:
:
:
:
:
Total Household size:

Previously filed bankruptcy?

Year: Chapter: State:Attorney:
Year: Chapter: State:Attorney:

Vehicles

Vehicle 1
Yr:
Make:
Model:
Lender:
Type:
Total amount owed: $
Monthly payment: $
Interest Rate: (approx.)
Current Value: (approx.)
Behind on Payments?
Is vehicle insured?
Monthly premium?$
Approximate mileage:

Vehicle 2
Yr:
Make:
Model:
Lender:
Type:
Total amount owed: $
Monthly payment: $
Interest Rate: (approx.)
Current Value: (approx.)
Behind on Payments?
Is vehicle insured?
Monthly premium?
Approximate mileage:

Vehicle 3
Yr:
Make:
Model:
Lender:
Type:
Total amount owed: $
Monthly payment: $
Interest Rate: (approx.)
Current Value: (approx.)
Behind on Payments?
Is vehicle insured?
Monthly premium? $
Approximate mileage:

Assets

Please list all other property you own or have owned in the past 5 year including houses, vehicles, boats, motorcycles, RVs, trailers, campers, ATV’s, or any other valuable property.
Provide an approximate Value and the disposition of the property. (Example: 1985 Ford F-150 - $1,000 - sold to 3rd party in 2009 for $1,000)
Asset: Value: $ When Transferred? To whom? How much received? $
Asset: Value: $ When Transferred? To whom? How much received? $
Asset: Value: $ When Transferred? To whom? How much received? $
Asset: Value: $ When Transferred? To whom? How much received? $

Other major Assets that you may own? (please names/dollar amounts)
ex: (401(k), Mutual funds, savings, inheritance, trust funds, pension income etc.):

Taxes

Have you FILED all tax returns required by law as of this date?

Have you PAID all of your taxes that are due at this time?

If you answered “no” to either question, please provide the following information:

Type of tax: State (NE, IA, etc):

Tax year:

Return filed?

Amount due (est): $

Type of return: (1040, 941 or IRS):

Tax lien?:

Are you expecting a tax refund for the current tax year:

If Yes, How much? $

Lawsuits

If you are being sued, please provide the following information:

Name of creditor suing:

Amount owed $

Judgment entered?

Case number:

Which court, if known?

Employment / Current Income

(List all jobs worked-at in the last 7 months) ex:Date Range:Employer:Title:$Salary,Date Range:Employer:Title:$Salary

Name of current employer

Gross earnings per month: $ Do you have paystubs for last 7 months?

Any overtime or bonuses? $

Length of tenure: current employer: ( years )

Other Sources of Income: (list all sources within the last 7 months)

Please specify source:

Frequency:

Amount: $

Other Abnormal Income: (please list thoroughly):

Have you paid a relative any money in the past year? If yes, Please provide the names and amounts below:

Bank Account Information

List all Checking or Savings Accounts that could be under your name: ex. Checking : Wells Fargo Bank
1. name of bank:	2. name of bank:	3. name of bank:
4. name of bank:	5. name of bank:	6. name of bank:

Do you owe your bank for any loan, line of credit, or overdraft protection?

Have you closed any financial accounts in the past year?

Do you have a PayPal account?

Do you have a safe deposit box? If yes, list contents:

Are you a party to any contract or lease (including a cell phone contract)? Please provide details:

BUSINESS ONLY SECTION- Stop here if you do not operate a business.

Business Supplement

What is the name of your business?

In general, what does your business produce or provide?
Is the business a: 1) Sole proprietorship; 2) LLC; 3) C-Corp; 4) S-Corp; 5) Partnership; 6) Other:
What percentage of ownership do you and/or your spouse own? %
Name(s) of other owners:
%
%
%
%
%
Asset
Value $
Lienholder
Amount of lien $
Monthly payment $
Arrearage
What is the most URGENT PROBLEM with the business, if any?
Do you owe the state or federal government any tax liabilities?
If yes, please describe the nature of the debt and the amount:
What is the business monthly gross revenues? $ (typical amount) $
What is the monthly cost of doing business (employee wages, COGS, insurance, fuel, maintenance, etc)? $
* Denotes Mandatory entry