Initial Eligibility Form for WNYLC Bankruptcy Clinic
Please fill out this form to help us determine your initial eligibility for WNYLC’s services. Please keep in mind that once you begin you must complete it in one sitting – if you exit out before submitting you will need to begin it again. You may find it helpful to take a look at all of the questions on the form before beginning so you can gather all necessary documents and information. If you have all your documents and information with you, the form should take approximately 45 minutes to complete. Please also note that WNYLC will not be able to determine your final eligibility for a Chapter 7 bankruptcy or our services until we have reviewed all your information.

Basic Information
Income Information
Do you or your spouse receive any income from sources other than employment? 
Prior Bankruptcies
Asset Information
What types of debt do you have?