Celebrate's Dad with a New Home Contest

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Understanding Your Needs and Goals - Contact Form

Welcome to our Real Estate & Credit Repair Survey! This survey gathers insights into your real estate goals and credit repair needs. Your feedback will enable us to provide personalized assistance and solutions tailored to your unique situation. Your participation is greatly appreciated and will help us better serve you. Thank you for sharing your thoughts with us!
Date*

MonthDayYear
Date
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Why do you believe you need credit repair assistance? (Please provide details)*
PLEASE BE DETAILED AS POSSIBLE!
Did anyone refer you? If so, please place their name and/or referral code here;
Date of Birth*
Date of Birth
What steps, if any, have you taken to improve your credit score in the past?*
EQUIFAX SCORE blanks EXPERIAN SCOREblank
TRANSUNION SCOREblanks
Do you currently have any outstanding debts , collections, or student loans? If yes, please provide details:*
Have you faced any financial hardships recently that have impacted your credit score? If yes, please describe*
What do you hope to achieve by repairing your credit score?*
Are you willing to provide additional documentation if required to assess your credit situation?*

YesNoOther
Please go to linktr.ee/simmonstaxfinancialservice and get your credit score. Then enter below, or inbox your user name, password and last 4 ssn for free credit audit.user name password fields and text.
Last 4 of ssn for free credit audit and credit consultation:
What are your usernames on social media? Facebook, Instagram, Tiktok, Snapchat, Twitter? Please specify *
Are you paid weekly, biweekly or monthly?
Are you salary instead?*

YesNo
Where do work? *
How many hours you work at week? *
What is your hourly pay? *
How long have you work there? *
How did you hear about our contest?*

Social Media (Facebook, Twitter, Instagram, etc.)Word of Mouth (Family, Friends, Colleagues)
Are You Interested In Buying, Selling a Home, Or Both?*

Buying a HomeWord of Mouth (Family, Friends, Colleagues)Both - Selling A Home & Buying A Home
Should be Empty:

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Understanding Your Needs and Goals - Contact Form