This is to certify that I have chosen to give my testimonial as a client for The Law Office of Julio E Portilla, P.C. I understand that by submitting my testimonial it does not guarantee the use of my testimony. I understand that by submitting my testimonial I give The Law of Julio E Portilla, P.C., the right to use my testimonial for reproduction in any medium including but not limited to; websites, videos, broadcasts, prints, and electronic means for purposes of advertising, trade, display, exhibition or editorial use. The undersigned releases Mr. Portilla from all claims for libel, slander, invasion of privacy, infringement of copyright or right of publicity or any other claim. Mr. Portilla agrees to use only initials, first name/city or a pseudonym to reference the client’s testimonial.

I hereby agree to have my name appear as is in any posting or publication: (please choose one)

  • Basic Info

  • Estimated Total Debt

  • Estimated Total Debt*
  • Why are you considering bankruptcy?

  • Your Bills

  • What bills do you have? (select all that apply)

    What bills do you have? (select all that apply)
  • Estimate Total Monthly Expenses

  • Estimate your monthly expenses
  • Do you own real-estate?

  • Are you behind in these payments?

  • Do you own an vehicle (car, truck, van, motorcycle)?

  • Are you behind in these payments?

  • Do you own any other assets worth more than $1,000?

  • Please describe the other assets:

  • You Income

  • What types of income do you have? (select all that apply)

    What types of income do you have? (select all that apply)
  • Contact Info

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