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* Terms and Conditions:	I acknowledge that I am submitting the request for bankruptcy consultation with an attorney of Nye & Associates, P.L.L.C, for the purpose of consultation only. I understand that no attorney-client relationship is established unless I sign a separate agreement with the attorney. For the consultation, the attorney will analyze my financial situation and explain my qualifications for relief under Bankruptcy Law. I understand that, unless I sign an attorney retainer agreement, the attorney will take no further action on my behalf regarding any matter. I realize the purpose of the consultation is only to make me familiar with possible rights, duties, liabilities, or other issues related to the matter I am seeking advice about. I realize that without actually retaining an attorney to represent me, there might be facts or other information which may affect any advice he or she may give me. I acknowledge that no representation or recommendations by the attorney during the consultation should be relied upon unless the attorney is retained in the matter. I understand that any information I tell or give the attorney is confidential and will not be disclosed without permission. I also understand that if a third party is present during any consultation, then that third party may record disclosed information which I have disclosed during the consultation. I acknowledge that the attorney has a separate legal duty to fully disclose my financial condition as required by Bankruptcy Law, and I will be truthful and candid during the consultation. I acknowledge reviewing the notice required by Section 527(a) and notice required by Section 527(b). I agree to the terms and conditions specified above.

We will use the information you provide us on this form to respond to your request and for no other purpose.