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: OR WA 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? 1 2 3 4 5 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

5. How Did You Hear About Pacific Bankruptcy? Google AOL Search MSN Yahoo Ask Jeeves Craig's List City Search Yellow Pages BankruptcyAction.com Findlaw.com Attorney Referral Personal Referral Other Saw Building Other Search Engine: Other Website:

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. Month: January February March April May June July August September October November December Day: Mon Tue Wed Thu Fri Sat Date: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Time: 8:00 A.M. 9:00 A.M. 10:00 A.M. 11:00 A.M. 12 Noon 1:00 P.M. 2:00 P.M. 3:00 P.M. 4:00 P.M. 5:00 P.M. 6:00 P.M. 7:00 P.M. Please enter the phone number you would prefer to be contacted at:

Beaverton (Main Office)

SE Portland

Hillsboro

Hackett & Harris
1500 NW Bethany Blvd., Suite 288
Beaverton, OR 97006
[directions]

Hackett & Harris
6400 SE Lake Road, Suite 440
Portland, OR 97222
[directions]

Hackett & Harris
165 SE 26th St.
Hillsboro, OR 97123
[directions]