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URL:
https://www.bankruptcyresourcesusa.com/
Submission: On September 19 via automatic, source certstream-suspicious (September 19th 2021, 12:31:44 am UTC) — Scanned from DE

Form analysis
2 forms found in the DOM

POST /submit

<form id="benefitsform" method="post" action="/submit">
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    <div class="row">
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        <div class="input-box mr">
          <label>What is your total debt?*</label>
          <div class="select-box">
            <select class="form-control" name="debt" id="debt">
              <option value="">Please Select</option>
              <option value="0">Less than $5k</option>
              <option value="5">$5k - 10K</option>
              <option value="10">$10k - 20k</option>
              <option value="20">$20k - 50k</option>
              <option value="50">More than $50k</option>
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      <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="input-box mr">
          <label>What is your total monthly income?*</label>
          <div class="select-box">
            <select class="form-control" name="income" id="income">
              <option value="">Please Select</option>
              <option value="0">Under $1k</option>
              <option value="1">$1k - 2k</option>
              <option value="2">$2k - 3k</option>
              <option value="3">$3k - 5k</option>
              <option value="5">$5k - 7k</option>
              <option value="7">$7k – 10k</option>
              <option value="10">$10k – 15k</option>
              <option value="15">More than $15k</option>
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        </div>
      </div>
      <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="input-box mr">
          <label>Do You Own Real Estate?*</label>
          <div class="select-box">
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      </div>
      <div class="col-md-12 col-sm-12 col-xs-12">
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              <option value="">Please Select</option>
              <option value="0">Under $50k</option>
              <option value="50">$50k – 100k</option>
              <option value="100">$100k – 250k</option>
              <option value="250">$250k – 500k</option>
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      <div class="col-md-12 col-sm-12 col-xs-12">
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              <option value="1">Yes</option>
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      </div>
      <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="input-box mr">
          <label>Describe your case. What is the primary reason you're searching for a Bankruptcy lawyer?*</label>
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          <input type="checkbox" name="agree" id="agree">
          <label for="agree" id="agree_text">Check this box to confirm your understanding of and agreement with the <a href="/privacy" target="_blank">Privacy Policy</a> and <a href="/terms" target="_blank">Terms of Service</a></label>
        </div>
      </div>
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      <div class="col-md-8 col-sm-12 col-xs-12">
        <div class="continue-btn-box">
          <button type="button" class="next_btn1" onclick="validate()">FREE Evaluation<span><img src="images/right-yerro.png" alt="right-yerro"></span></button>
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      <div class="col-md-4 col-sm-12 col-xs-12 back-text-mobile-view">
        <div class="back-text">
          <a href="#first_step" class="back-link"><img src="images/left-yerro.png" alt="left-yerro">back</a>
        </div>
      </div>
      <div class="col-md-12 col-sm-12 col-xs-12" style="font-size:12px;padding:10px 10px 0px 15px"> By submitting this form as my electronic signature, I expressly give consent to Bankruptcy Resources USA as well as all sponsoring advocates or
        sponsoring attorneys to contact me via email messages, SMS messages and phone calls (including through automated and/or pre-recorded means), at any phone number I provide, even if that telephone number is a wireless number or on any federal,
        corporate or state do not call registry. I agree to the <a href="/terms" target="_blank">Terms of Use</a> and <a href="/privacy" target="_blank">Privacy Policy</a>. I understand that I am not required to submit this form to apply for
        Bankruptcy, and that consent is not a requirement of purchase. </div>
    </div>
  </div>
</form>

Name: flgxfrm_453 —

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Text Content

FILL OUT THE FORM BELOW TO
GET YOUR FREE EVALUATION




GET A FREE BANKRUPTCY CASE EVALUATION

Please answer a few questions to help us match you with a attorneys in your area

 * 1
   
   Qualify

 * 2
   
   Applicant Info

 * 3
   
   Results

What is your total debt?*
Please Select Less than $5k $5k - 10K $10k - 20k $20k - 50k More than $50k
What is your total monthly income?*
Please Select Under $1k $1k - 2k $2k - 3k $3k - 5k $5k - 7k $7k – 10k $10k – 15k
More than $15k
Do You Own Real Estate?*
Please Select Yes No
What is total value of your assets?*
Please Select Under $50k $50k – 100k $100k – 250k $250k – 500k $500k – 1MM More
than $1MM
Do you currently have an attorney representing your case?*
Please Select Yes No
Describe your case. What is the primary reason you're searching for a Bankruptcy
lawyer?*
Continue
First Name*
Last Name*
Email*
Phone* - -
Street Address*
City*
State*
Zip*
Date of Birth* MM 1 2 3 4 5 6 7 8 9 10 11 12 / Day 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 / Year 2021 2020 2019 2018
2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002
2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986
1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970
1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954
1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938
1937 1936 1935 1934 1933 1932 1931
MM 1 2 3 4 5 6 7 8 9 10 11 12 / Day 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 / Year 2021 2020 2019 2018 2017 2016 2015
2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999
1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983
1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967
1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951
1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935
1934 1933 1932 1931
Check this box to confirm your understanding of and agreement with the Privacy
Policy and Terms of Service
back
FREE Evaluation
back
By submitting this form as my electronic signature, I expressly give consent to
Bankruptcy Resources USA as well as all sponsoring advocates or sponsoring
attorneys to contact me via email messages, SMS messages and phone calls
(including through automated and/or pre-recorded means), at any phone number I
provide, even if that telephone number is a wireless number or on any federal,
corporate or state do not call registry. I agree to the Terms of Use and Privacy
Policy. I understand that I am not required to submit this form to apply for
Bankruptcy, and that consent is not a requirement of purchase.

FREE YOURSELF FROM DEBT

1

END CREDITOR
PHONE CALLS

2

STOP REPOSSESSION
EFFORTS

3

STOP LAWSUITS

4

FRESH START AT FINANCIAL
INDEPENDENCE

BANKRUPTCY MAY ELIMINATE

 * Credit Card Bills
 * Medical Bills
 * Foreclosure Process
 * Wage Garnishment
 * Creditor Harassment

BANKRUPTCY MAY PROTECT

 * Your Home
 * Your Car
 * Your Wages
 * Your Furniture

Get a FREE Bankruptcy Case Evaluation


Bankruptcy Resources USA is devoted to helping consumers who are having trouble
paying their bills and may qualify for Bankruptcy protection. THIS IS AN
ADVERTISEMENT. This is not a law firm or referral service and does not provide
legal advice. This is a free connection service only and there is no charge to
be connected with an attorney. Claim reviews will be performed by a third party
attorney and the attorney who receives your information may not offer a free
claim evaluation.

If you fill out the form, you are giving written consent to be contacted by an
attorney, law firm, or agent of the law firm, for the purposes of discussing
legal services. The contact may be in the form of a telephone call, an email, a
text message, or an auto-dialer system.

This is not a substitute for medical advice from your doctor, so never start or
stop taking medication without consulting a doctor first. We do not recommend or
endorse any attorneys that pay to participate in this advertisement. An
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