Credit Repair Application

Credit Restoration Application

Please read before submitting your information!
Thank you for choosing Memphis Tax Company & The Credit Builders Group to assist you with your credit repair needs.

There are a couple of things that you are REQUIRED to do while in our program. We also have certain rules that you will need to follow to be sure that you get the best results possible during our program.

*Credit Monitoring is REQUIRED in order for us to assist you. It allows us to pull all 3 credit bureaus monthly and provide you with updates. If you can't afford credit monitoring at this time we ask that you do not sign up for our services. The cost is between $21.99 - $29.99 a month billed to your debit card monthly. If you do not maintain this account your account will be canceled and no refunds on any fees will be given.

*If you currently have an active bankruptcy please do not enroll in our program at this time. Bankruptcies that are discharged or dismissed are ok pending a credit anaylsis.

*If you are currently behind on paying your monthly bills please do not sign up for our services at this time. If you have old accounts this is fine. (Preferably 2 years or older)

Once we receive your application for our program you will be sent an onboarding link to access your client portal. This is where you will sign up for credit monitoring, and order your credit reports prior to your credit analysis appointment. The initial credit monitoring is $1 for the first 7 days.

There are also other onboarding tasks that will need to be completed, such as, uploading identification and proof of address documents. If you can not complete your onboarding within 48 hours please do not sign up for our services at this time. It is imperative that you complete this as soon as possible. Our first disputes are typically sent out within the first 5 days.

Our credit repair program is first come, first serve. We currently operate on a waitlist taking a certain number of credit clients per month. Please be sure that you meet the requirements prior to submitting an application and payment.

We stress financial & credit literacy while maintaining a strong credit profile. If you aren't able to afford credit repair you'll need to enroll in our program at a later date.

We look forward to working with you!

Memphis Tax Company Staff
Date

MonthDayYear
Date
Name

First NameLast Name
Email address*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is you date of birth?
Last 4 of your SSN*
Phone Number*
Please enter a valid phone number.
Spouse Name

First NameLast Name
Spouse Email Address
Spouse's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Last 4 of spouse SSN
What is you date of birth?
Spouse Phone Number
Please enter a valid phone number.
What Plan are you signing up for?

Standard Monthly PlanGold PlanPay Per Delete
Which enrollment fee are you paying today?

Standard Monthly Plan Startup $ 199.00Gold Plan $ 1200.00Pay Per Delete Startup $ 249.00
Can you afford credit monitoring at $21.99 -$29.99 a month for the duration of the program? If no, STOP AND DO NOT ENROLL.

YesNo
Are you currently employed or have stable income? If NO, DO NOT ENROLL

YesNo
Are you behind on your current montly bills today? If YES, DO NOT ENROLL

YesNo
Are you currently working with or have worked with another credit repair company in the last 6 months?

YesNo
Select all credit issues you are currently having:

Collection/Charge-OffsMedical BillsBankruptciesRepossessionJudgementsLate PaymentsStudent LoansChild SupportPublic RecordsOther
Do you have a credit card?

YesNo
Are you planning on buying a home or making a major purchase soon?

YesNo
If yes, what purchase do you plan on making?
If you are planning to purchase a home in the future, would you like the help of a REALTOR and information on the homebuying process?

YesNo
What are you hoping to gain from the credit repair program?
I hereby certify that I have read and understood all of the information above. I also agree that I have provided information that is true and correct regarding my credit file and financial situation. I understand that false information will disqualify me from the program and if any services have been completed then I will lose my start up fee at that time.
Sign your name here if you agree*

Clear
Credit Card Authorization

By signing, I authorize MEMPHIS TAX COMPANY to automatically charge the card entered to pay for services I have purchased. I agree to notify MEMPHIS TAX COMPANY of any changes dealing with my credit card payment account within 3 days of any billing transaction. I certify that this credit card belongs to me and that I will not dispute the scheduled transactions with my bank or credit card company, provided that I have received the terms or services indicated in this authorization form.
Signature*

Clear

My Products

Standard Plan

$199.00

Gold Plan

$1,200.00

Pay Per Delete

$249.00

Enter coupon

Total

$0.00

Payment by credit card or PayPal

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Credit Restoration Application