Credit Repair Applicaion

Credit Repair Client Intake Form

Congratulations for taking the next steps to bettering your financial situation. Complete the intake form and a credit analyst will contact you in 24- 48 hours with your results.
Name*

First NameMiddle NameLast NameSuffix
Current Mailing Address*

Street Address

Street Address Line 2 (Apt, Bldg, Suite)

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
(###) ###-####
What's your current credit scores?

Poor (300-579)Fair (580-669)Good (670-799)Excellent (800-850)
Have you filed bankruptcy in the past 2 years?

YesNoOther
Do you believe that you maybe a victim of identity theft?

YesNoMaybe
Have you worked with another credit repair company in the past?

YesNoOther
Credit Karma Username
Sign Up Link: https://www.creditkarma.com/signup
Credit Karma Passowrd
Example: bebetter850
Experian.com Username
Copy link if you do not have an account to sign up: https://usa.experian.com/registration/?offer=at_fcras100&br=exp&op=FRCR-LOG-PRI-100-RBT-XXXXXXX-XX-EXP-VWIN-DIR-XXXXXX-XXXXXX-XXXXX&dAuth=true
Experian.com Password
Answer to Security Question & Pin
Example: Blue & 1234
How Did You Hear About Us?

GoogleFamily/FriendFormer/ Current ClientOther
By signing below, you understand that Be Better Financials, LLC is not a law firm or providing legal advice
in anyway. Credit repair services may take 30-180 days to complete and if no results are provided
within 180 days a full refund will be granted to the client upon rquest within 7 business day. This intake form is not your credit application or contract. This form is only used by your credit anaylst to get a better idea of your credit situation from your prospective. A consultation is required before starting any credit services so you must have Experian and Credit Karma credit monitoring services. Please allow up to 48 hours to recieve a callback with your credit consultation results. If you have any questions contact us at (702)-900-2725.
Signature*

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Credit Repair Client Intake Form