Pacific Bankruptcy | Oregon Bankruptcy Attorneys

Free Case Evaluation!

Complete our confidential evaluation form below. Pacific Bankruptcy will make sure that you talk with one of our attorneys for free at your convenience. We are a local firm devoted only to helping people in Oregon.

If you prefer to simply have someone from our office call you directly regarding your specific situation, please use our quick contact form.

1. Personal Information
First Name:
Last Name:
Email Address:
Street Address:
City:	State:	Zip:
Phone:

2. Bills (check all that apply)
	Credit Cards	Personal Loans
	Home Mortgage	Judgments
	Tax Debts	Government Fines (i.e., parking tickets)
	Student Loans	Auto Loans
	Medical Bills
Credit Card balance:$
Home Mortgage balance:$
Student Loan balance:$
Tax Debt balance:$
Auto Loan balance:$

3. Property
Approximate Value of Home:$
Monthly Mortgage Payment:$
Are you behind on your mortgage payments?	yes	no
Vehicles you own or make payments on?
Monthly Car Payments:$
Are you behind on your car payments?	yes	no

4. Income
Monthly Household Income (after taxes and deductions):$
Other Monthly Income:	Disability	Part-Time Job
(check all that apply)	Social Security	Child Support
	Pension	Unemployment
	Rental Property	Workers' Compensation

6. Finish
We are a law firm and not a company that uses untrained operators to generate leads for other attorneys. Therefore, we request that you select a time Monday through Friday between 8 a.m. and 6 p.m. for one of our attorneys to contact you to review your case. Or, you can submit your questionnaire then call us during regular business hours at your convenience to talk directly to an attorney.
	Time:
Please enter the phone number you would prefer to be contacted at:

Eastside

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(503) 352-3690

Portland

Harris Law Firm, PC
10600 SE McLoughlin Blvd., Suite 203
Milwaukie, OR 97222
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Hillsboro

Harris Law Firm, PC
165 SE 26th St.
Hillsboro, OR 97123
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