If you think one or more of the HFS services might be of help to you and you would like to speak to a counselor or attorney, please fill out the form below.  They will get back to you within 24 to 48 hours.

*First Name:
*Last Name:
*Address 1:
Address 2:
*Zip Code:
*Please enter a preferred contact number:  
*Best time to contact you:
*Total unsecured debt: $  

A secured debt is one where the creditor has rights in the property being purchased or other property the debtor has pledged. For a house, the rights the creditor has are to foreclose on the property or collect on a note that was signed. For a car, the creditor typically has a right to repossess the vehicle. Certain furniture purchases are secured by giving the creditor the right to take the furniture. You can usually tell if a debt is secured by looking at the underlying agreement you signed when the goods were purchased. Generally, if the creditor has some right to reacquire the goods, the debt is secured. If not, the debt is unsecured.

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Please complete each question that pertains to your situation.
1. Are you currently employed?  
2. Marital status?
3. What is your age?   
4. What is the value of your 401(k)?
5. What is the current value of your home?  
6. What is your current home loan balance?  
    (Include all money owed where your home is the lender's security.)
7. Number of mortgage payments delinquent:  
8. Are you currently looking for a home loan?  
9. What is the value of your automobile(s)?  
10. What is the balance on your auto loan(s)?  
11. How much do you owe in student loan(s)?  
12. How much do you owe the IRS in delinquent taxes?   
13. Do you have any judgments?  
14. Is a Pension, Social Security, Disability, Veteran's Benefits, Worker's Compensation, Public Assistance, Child Support or Alimony your main source of income?