You can always press Enter⏎ to continue
Welcome
Hi there, please fill out and submit this form.
19
Questions
START
1
What are your current concerns with your finances?
Previous
Next
Submit
Press
Enter
2
Do You Rent or Own Your Home?
Previous
Next
Submit
Press
Enter
3
Are you currently contributing to a retirement plan?
YES
NO
Previous
Next
Submit
Press
Enter
4
What are you contributing to your retirement plan monthly?
Previous
Next
Submit
Press
Enter
5
In order to get you out of debt how much extra a month can you contribute towards your debt elimination?
Previous
Next
Submit
Press
Enter
6
Enter DEBTS here. We have provided a few more rows for debts. If more is needed please upload the remaining debts on a spreadsheet you can upload below these rows.
DEBT NAME
AMOUNT OWED
INTEREST RATE
MINIMUM PAYMENT
ACTUAL PAYMENT
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
1
2
3
4
DEBT NAME
Row 0, Column 0
AMOUNT OWED
Row 0, Column 1
INTEREST RATE
Row 0, Column 2
MINIMUM PAYMENT
Row 0, Column 3
ACTUAL PAYMENT
Row 0, Column 4
DEBT NAME
Row 1, Column 0
AMOUNT OWED
Row 1, Column 1
INTEREST RATE
Row 1, Column 2
MINIMUM PAYMENT
Row 1, Column 3
ACTUAL PAYMENT
Row 1, Column 4
DEBT NAME
Row 2, Column 0
AMOUNT OWED
Row 2, Column 1
INTEREST RATE
Row 2, Column 2
MINIMUM PAYMENT
Row 2, Column 3
ACTUAL PAYMENT
Row 2, Column 4
DEBT NAME
Row 3, Column 0
AMOUNT OWED
Row 3, Column 1
INTEREST RATE
Row 3, Column 2
MINIMUM PAYMENT
Row 3, Column 3
ACTUAL PAYMENT
Row 3, Column 4
1
of 4
Previous
Next
Submit
Press
Enter
7
Enter DEBTS here. We have provided a few more rows for debts. If more is needed please upload the remaining debts on a spreadsheet you can upload below these rows.
DEBT NAME
AMOUNT OWED
INTEREST RATE
MINIMUM PAYMENT
ACTUAL PAYMENT
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
1
2
3
4
DEBT NAME
Row 0, Column 0
AMOUNT OWED
Row 0, Column 1
INTEREST RATE
Row 0, Column 2
MINIMUM PAYMENT
Row 0, Column 3
ACTUAL PAYMENT
Row 0, Column 4
DEBT NAME
Row 1, Column 0
AMOUNT OWED
Row 1, Column 1
INTEREST RATE
Row 1, Column 2
MINIMUM PAYMENT
Row 1, Column 3
ACTUAL PAYMENT
Row 1, Column 4
DEBT NAME
Row 2, Column 0
AMOUNT OWED
Row 2, Column 1
INTEREST RATE
Row 2, Column 2
MINIMUM PAYMENT
Row 2, Column 3
ACTUAL PAYMENT
Row 2, Column 4
DEBT NAME
Row 3, Column 0
AMOUNT OWED
Row 3, Column 1
INTEREST RATE
Row 3, Column 2
MINIMUM PAYMENT
Row 3, Column 3
ACTUAL PAYMENT
Row 3, Column 4
1
of 4
Previous
Next
Submit
Press
Enter
8
More Space To List Your Debts
DEBT NAME
AMOUNT OWED
INTEREST RATE
MINIMUM PAYMENT
ACTUAL PAYMENT
5
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
6
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
7
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
8
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
5
6
7
8
DEBT NAME
Row 0, Column 0
AMOUNT OWED
Row 0, Column 1
INTEREST RATE
Row 0, Column 2
MINIMUM PAYMENT
Row 0, Column 3
ACTUAL PAYMENT
Row 0, Column 4
DEBT NAME
Row 1, Column 0
AMOUNT OWED
Row 1, Column 1
INTEREST RATE
Row 1, Column 2
MINIMUM PAYMENT
Row 1, Column 3
ACTUAL PAYMENT
Row 1, Column 4
DEBT NAME
Row 2, Column 0
AMOUNT OWED
Row 2, Column 1
INTEREST RATE
Row 2, Column 2
MINIMUM PAYMENT
Row 2, Column 3
ACTUAL PAYMENT
Row 2, Column 4
DEBT NAME
Row 3, Column 0
AMOUNT OWED
Row 3, Column 1
INTEREST RATE
Row 3, Column 2
MINIMUM PAYMENT
Row 3, Column 3
ACTUAL PAYMENT
Row 3, Column 4
1
of 4
Previous
Next
Submit
Press
Enter
9
Upload document, Spreadsheet, with all of your debts here. Make sure all are Monthly numbers, Including interest rates, minimum payments, and actual payments. All money going out of your hands every month.
ONLY IF THERE ARE EXTRA DEBTS TO ADD - IF NONE, SKIP THIS SLIDE.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
Cancel
of
Previous
Next
Submit
Press
Enter
10
Information from your mortgage please:
1. Total mortgage payment Principle and interest only. 2. How many years left on your mortgage? 3. What is your interest rate?
Previous
Next
Submit
Press
Enter
11
Are you paying more than your minimum payments on your debts?
YES
NO
Previous
Next
Submit
Press
Enter
12
Total Amount of Overpayments on Debts
Previous
Next
Submit
Press
Enter
13
Who Referred You to Us?
Previous
Next
Submit
Press
Enter
14
Full Name
Previous
Next
Submit
Press
Enter
15
Date of Birth?
/
Date
Month
Day
Year
Previous
Next
Submit
Press
Enter
16
Phone Number
Previous
Next
Submit
Press
Enter
17
Email
example@example.com
Previous
Next
Submit
Press
Enter
18
What state do you live in?
Previous
Next
Submit
Press
Enter
19
Do You Smoke?
YES
NO
Previous
Next
Submit
Press
Enter
20
Tags
Todo
In Progress
Done
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
20
See All
Go Back
Submit