INTAKE SHEET FOR MICHAEL J ROSE PC
4101 Perimeter Center Drive, Suite 120
Oklahoma City, OK 73112
(405) 605-3757 telephone
(405) 605-3758 facsimile
Information provided by you STAYS IN THIS OFFICE and will be kept ABSOLUTELY CONFIDENTIAL.
All information will be shredded after six months if you do not file a case with our office.
If you have one (or more) home mortgages, land or mobile home payments, list them here.
If you own cars, trucks, tractors, motorcycles, RV's, boats, jet skis etc. list them below.
Tax and Child Support Debts
If you owe taxes, or if you are past due on your child or spousal support, list below.