:: LEGAL FORM CONSULTATION QUESTIONNAIRE ::

Please fill out the corresponding three (3) sections of this questionnaire and then Click the Submit Button:

Please note that we do adhere to utmost principles of ethical responsibility and confidentiality...

DISCLOSURE FROM NON-LAWYER:

...By submitting this form, you are agreeing that we have informed you that our consultants are experienced legal documentation/form consultants who are nonetheless "non-lawyers"; i.e., although we are authorized to assist you in different capacities with various forms that are either pre-approved or not pre-approved by the Florida Supreme Court (i.e., Rule 10-2.1(a) and (b) of the Rules Regulating the Florida Bar) and comparable rules of other states and Federal entities, we cannot represent you in court, or tell you how to testify in court, or tell you what your rights or remedies are. Our job is simply to assist you in properly filling out your legal forms to the extent authorized by the aforementioned rules.

-- Thank you so much for using our service!

-------------------------------------------------------------

1) PERSONAL INFORMATION

PARTY#1/Petitioner (party bringing the action):

First Name:                  Last Name:   

Date of Birth (MM/DD/YYYY) :      Social Security #(XXX-XX-XXXX):

MARRIED? Please Enter the Following Information:

Marriage Date (MM/DD/YYYY) :      Separation Date (MM/DD/YYYY) :     

Divorce Date (MM/DD/YYYY) :

----------------

PARTY#2/Respondent/Defendant (party responding to/defending the action):

First Name:                  Last Name:   

Date of Birth (MM/DD/YYYY):      Social Security #(XXX-XX-XXXX)):

IF MARRIED? Please Enter the Following Information:

Marriage Date (MM/DD/YYYY) :      Separation Date (MM/DD/YYYY) :     

Divorce Date (MM/DD/YYYY) :

----------------------------------------------------

2) YOUR CONTACT INFORMATION

          Primary Phone#:           Emergency#:                            

Email Address(e.g., pete@petelorins.com):

                 Address:      Street:    

         City:        

                           State:        Zip Code:

Best Phone Contact Time:

How Did You Hear About Us?  News Paper Other Word of Mouth Flyer Recruiter Referral Consumer Referral The Internet Direct Mail Referred by a Friend Referred by an Acquaintance

----------------------------------------------------

3) NATURE OF YOUR ISSUE (OPTIONS)

               DIVORCE            CHILD SUPPORT          CUSTODY

               ALIMONY               BANKRUPTCY              FORECLOSURE

                  IMMIGRATION      TAX                                 INCORPORATION      

                COPYRIGHT         PATENT                         TRADEMARK  

               FRANCHISE           DOCUMENT REVIEW    RECORD EXPUNGEMENT

               GRANT WRITING   INTERNET/WEB            RESUME FORMATTING

----------------------------------------------------

                       FREE LAWYER REFERRAL                   NOTARY SERVICES

             OTHER ISSUE (Please Specify below)

< please enter your question or issue below and a CONSUMER BAILOUT LEGAL DOCUMENTATION consultant will get back to you within 24 business hours >