Business Eclectics Client Questionnaire

1

Name* This field is required.

Prefix

First Name

Middle Name

Last Name

Suffix

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Would you like to opt-in to receive updates via text messages?* This field is required.

5

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

6

Date of Birth* This field is required.

Date

7

Last 4 digits of your SSN * This field is required.Social Security Number (NOT CPN)

Last 4 only

8

Last 4 digits of your CPNIf applicable

Last 4 only

9

Which of our services are you interested in?* This field is required.Select all that Apply

Credit Repair

Personal Funding

Business Funding

Start a Business

Rebrand Your Business

Add New Streams of Income

Other

11

Who is your Referral?* This field is required.If someone referred you to us, list their Name below.

First Name

Last Name

12

Are you ready to change your mindset? * This field is required.

13

Are you able to UNLEARN and relearn?* This field is required.

14

What are your current credit scores for Transunion, Experian, and Equifax? * This field is required.If you don't know, please check, then continue this questionnaire.

15

By providing your scores, this helps us gauge what route is best for you.

Some people have low scores but their credit needs minor adjustments.

For example, you may only have 3 accounts reporting on your credit. All or most of your accounts may be collections or charge offs. If the only things you have reporting on your credit are mostly negative items, this can make your scores low, 600s or less.

Some have high scores but their credit report isn't strong and could use a boost.

For example, you may only have 1 or 2 accounts reporting on your credit. These accounts are in good standing and your scores might be high 600s or higher. Your scores are high because they don't have anything negative to bring it down. This is still considered a weak credit report aka Ghost Report. You might find yourself getting denied or still needing a cosigner but don't understand why.

Although your scores give us a general idea, we will still need to view your personal credit report in detail. You will be asked to provide log in details for Credit Karma and Experian.

16

Are you currently in a financial crisis? * This field is required.If yes, please explain. If no, type NA

17

What do you plan to accomplish by having PERFECT CREDIT?* This field is required.No dream is too big!

18

Are you in check systems?Do you owe any banks due to check fraud or closed checking accounts with balances?

YESNO

19

Have you received credit repair in the past?

YESNO

20

Are you confident in yourself?* This field is required.

YESNO

21

What are your Short Term Goals?* This field is required.Goals to accomplish within 1 to 3 months

22

What are your Mid Term Goals?* This field is required.Goals to accomplish within 1 to 2 years

23

What are your Long Term Goals?* This field is required.Goals to accomplish within 2 to 10 years

24

Do you believe you can accomplish your goals?* This field is required.

YESNO

25

Are you a member of Navy Federal Credit Union? * This field is required.

YESNO

26

Have you ever applied for a credit card or loan from Navy Federal Credit Union?* This field is required.

YESNO

27

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