Credit Repair Application
The next step to revive your credit!
Your Full Name
*
First Name
Last Name
Your E-mail
*
example@example.com
Your mobile number
*
Work Number
Do you know your current credit score?
*
Yes
No
What items do you have on your credit report?
*
Collections
Repossession
Bankruptcy
Late Payments
Student Loans
None of the Above
Other
If you have chose “other”, please explain below.
Be as detailed as possible.
Back
Next
Agreement
(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms
*
I agree that I will be able to make a down payment of $299 to start credit repair services with a reoccurring payment of $99 per month, until credit is fully repaired.
I disagree.
Agreement and Terms
*
I agree that I have acknowledged I must use auto pay for all payments.
I disagree.
Agreement and Terms
*
I agree that my credit repair process will be done with Credit Dyno, so I am also required to pay their monthly subscription fee of $29.99.
I disagree.
Agreement and Terms
*
I agree that if I fail to make my payments to Richmond Enterprise Credit Repair Services, my services will be stopped.
I disagree.
Agreement and Terms
*
I agree that if I fail to make payments on Credit Dyno, I will not be able to move on with credit repair services.
I disagree.
Printed Signature
*
First Name
Last Name
Digital Signature Date
-
Month
-
Day
Year
Date
Signature
Submit
Submit
Should be Empty: