Fleming & Lowenberg Law Firm

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Assisted Person Analysis Form

Assisted Person Analysis Form

Contact Us

Name of Prospective Client

The Prospective Client Is (check one):

individual

sole proprietor

general partnership

limited partnership

limited liability company

S corporation

C corporation

other

Describe other

Free Text

Real Property Owner?

Type:

residence

2nd residence

office bldg

industrial bld

graw lan

Combined current market value(s): $

Combined 1st mortgage amount(s):$

Combined 2nd mortgage amount(s):$

Other tax, HOA, judgement lien $

Combined amount(s):$

Renter?

Renter?

type

residence

office

store

monthly rent amount: $

months left on the lease:

Business Personal Property

Business Personal Property

(use current liquidation value)

ff&e purchase money loan balance(s): $

seller-carried loan balance: $

bank/SBA loan balance: $

b. business vehicle(s) value: $

purchase money loan balance(s): $

vehicle lease payoff amounts: $

Free Text

Consumer Personal Property

(use current replacement/retail value)

furniture, equipment value: $

consumer all-vehicle loan/lease

furniture/equipment loan/lease

Free Text

Priority Debt Balances:

Employee Wages: $

Consumer Deposits: $

Payroll Taxes: $

Sales & Unemployment Taxes: $

Income Taxes: $

Income Taxes: $

Free Text

Unsecured Debt Balances:

Credit Cards - consumer use: $

Credit Cards - business use: $

Other Consumer (medical, student loan) Debt: $

Trade Creditors (business vendors): $

Name of Person to Contact?:

Free Text

How should we contact you?

By email at the sender's address:

At home telephone:

At work telephone:

On a cell phone:

Best time to contact you:

Why do you need our help?

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We will get back to you as soon as possible.

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Free Evaluation

Sound legal advice is based on years of training, hard work, and passion, as well as familiarity with legislation, precedent and sound consideration. You’ll find all that and more at Fleming, Lowenberg & Cooling.

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Contact info

Phone: (970) 240-2812

Fax: (970) 240-2860

Office Location

144 S. Uncompahgre Ave.

Montrose, CO 81402

Hours

Hours – 8:30am to 5:00pm

Monday thru Friday

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