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Thank you for choosing Clark & Washington, P.C. -  We are looking forward to meeting with you soon.

In order to simplify your meeting process with our staff, please take the time to complete and submit a brief list of your creditors.  Filling out this list can help us determine how we can help you, better assess your financial situation and give you the proper legal advice.  Please list all of your debts and simply scroll down to the bottom of the page and click SUBMIT.  You can also print your list out for your records to bring with you to your appointment. No problem if you can't List them all 
My Case Information
Name: *
Email: *
Phone Number: Cell Phone Number:
Message:
Creditor 1
Name of Creditor:
Address of Creditor:
Type of debt:
Amount Owed:
Finished? Click to Jump to Submit Button
Creditor 2
Name of Creditor 2:
Address of Creditor 2:
Type of debt 2:
Amount Owed 2:
Click Here to Submit
Creditor 3
Name of Creditor 3:
Address of Creditor 3:
Type of debt 3:
Amount Owed 3:
Click Here to Submit
Creditor 4
Name of Creditor 4:
Address of Creditor 4:
Type of debt 4:
Amount Owed 4:
Click Here to Submit
Creditor 5
Name of Creditor 5:
Address of Creditor 5:
Type of debt 5:
Amount Owed 5:
Click Here to Submit
Creditor 6
Name of Creditor 6:
Address of Creditor 6:
Type of debt 6:
Amount Owed 6:
Click Here to Submit
Creditor 7
Name of Creditor 7:
Address of Creditor 7:
Type of debt 7:
Amount Owed 7:
Click Here to Submit
Creditor 8
Name of Creditor 8:
Address of Creditor 8:
Type of debt 8:
Amount Owed 8:
Click Here to Submit
Creditor 9
Name of Creditor 9:
Address of Creditor 9:
Type of debt 9:
Amount Owed 9:
Click Here to Submit
Creditor 10
Name of Creditor 10:
Address of Creditor 10:
Type of debt 10:
Amount Owed 10:
Click Here to Submit
Creditor 11
Name of Creditor 11:
Address of Creditor 11:
Type of debt 11:
Amount Owed 11:
Click Here to Submit
Creditor 12
Name of Creditor 12:
Address of Creditor 12:
Type of debt 12:
Amount Owed 12:
 
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