Credit Wellness Intake Form

Dear Client,

Welcome to Clarity Unlocked LLC’s Credit Wellness Program.
Thank you for choosing Clarity Unlocked LLC to support you on your journey toward financial clarity and credit health. We understand that navigating your credit profile and financial records can sometimes feel overwhelming. That’s why we’re here—to help you gain confidence and clarity through education, strategy, and support.

To ensure we can assist you effectively, please read the following information carefully and complete this form with accurate details. Your full cooperation in providing the necessary documents is essential to moving forward.

By completing this form, you confirm that you understand your rights under the Credit Repair Organizations Act (CROA) and acknowledge the role you play in your personal financial growth. Please upload or send us copies of any correspondence you receive from Credit Reporting Agencies (CRAs) once you begin the program. This information is vital to help us analyze your credit profile and tailor your personalized improvement strategy.

We are honored to walk with you on this path toward greater confidence and financial freedom.

Warm regards,
Deonna Alston
Owner | Board Certified Credit Consultant | Certified Credit Score Consultant

This Consent and Release Agreement is entered into between the undersigned Client (“Client”) and Deonna Alston (“Consultant”) of Clarity Unlocked LLC.

By signing this Agreement, you acknowledge, understand, and agree to the following:

✅ Educational Credit Support
You are enrolling in a financial clarity program that includes credit wellness education, strategic planning, and support services. This is a paid program offered by Clarity Unlocked LLC, and your participation indicates your understanding of the associated service fees as outlined in your selected package.

✅ Authorization to Share Credit Reports and Scores
You agree to obtain and voluntarily share your credit reports and/or credit scores from credit reporting agencies such as Equifax, Experian, TransUnion, Innovis, NCTUE, and others as needed to support strategic review.

✅ Third-Party Access Disclaimer
Deonna Alston will not access your reports without your express written consent. She is not responsible for any breaches or misuse of your information by external agencies beyond her control.

✅ Scope of Services
You understand that this process involves reviewing and identifying inaccurate, outdated, or unverifiable information on your credit reports. If you choose to take action based on this review, you may be guided through appropriate next steps.

✅ No Guarantee Clause
You understand that results may vary based on individual credit history and financial behavior, and no specific outcomes are guaranteed.

✅ Identity Verification
You may be asked to provide valid proof of identity and documentation upon request (e.g., driver’s license, utility bill, Social Security card) to support service accuracy and compliance.

✅ Program Fees and Third-Party Costs
Your participation in this program includes paid services as outlined in your service agreement. You are also responsible for any additional third-party tools or services required to support your credit wellness strategy, such as credit monitoring subscriptions. These external costs are not included in your program fee unless otherwise stated.

✅ Service Agreement Acknowledgement
By proceeding, you acknowledge that you have selected a paid service package and agree to the terms, responsibilities, and fees outlined in your Clarity Unlocked LLC service agreement.

✅ Credit Behavior Acknowledgement
You agree to consult Clarity Unlocked LLC before applying for new credit or closing existing accounts, as these actions may impact your credit profile during the support process.

To ensure smooth communication and progress throughout your financial clarity program, please follow the guidelines below:

⚠️ Communication with Creditors and Credit Reporting Agencies (CRAs):

Please do not contact creditors or credit reporting agencies directly while enrolled in this program unless you are advised to do so. Doing so may interfere with the strategy or timeline we’ve established on your behalf.
If you choose to communicate with a creditor, do so only if you are prepared to resolve the account in full or as otherwise agreed upon.
Our team offers guidance on options that may include settling or addressing collection accounts strategically, but we do not guarantee specific outcomes such as account deletions.

📩 Handling Correspondence:

Send us copies (not originals) of any letters or communications you receive from Creditors or Credit Reporting Agencies.
If you do not receive any updates within 30–45 days, it is your responsibility to notify us. Timely access to this information is critical to your progress.
You may upload your documents directly to your secure client portal.

💼 Spousal Information:
Only provide your spouse’s information if they are also enrolling in services with Clarity Unlocked LLC.

📜 Client Agreement Terms:
This agreement confirms your intent to engage the support services offered by Clarity Unlocked LLC. By proceeding, you confirm that:

You have reviewed and accept the terms of this agreement.
Any changes or special conditions must be submitted in writing and agreed upon by both parties.
You understand that Clarity Unlocked LLC does not act as legal counsel and does not provide legal advice. You are responsible for seeking outside legal assistance if necessary.

⚖️ Document Handling Notice:
Please do not send original legal or court documents. Only submit clear copies of relevant records (e.g., proof of payment, dismissal notices, identity verification). These documents may be used to support your case and ensure accuracy in the review process.

(a) Disclosure Required. In accordance with the Credit Repair Organizations Act (CROA), you are entitled to receive the following disclosure before entering into any agreement for services. This document outlines your rights and protections as a consumer.

Please read the following statement carefully: 

The following notice is required by federal law and must be provided before you enter into any agreement with a credit repair organization:

"You have a right to dispute inaccurate information in your credit report by contacting the credit bureau directly. However, neither you nor any 'credit repair' company or 'credit repair organization' has the right to have accurate, current, and verifiable information removed from your credit report. The credit bureau must remove inaccurate, negative information from your report. It may not remove accurate, negative information from your report unless it is over 7 years old. Bankruptcy information can be reported for 10 years."

"You have a right to obtain a copy of your credit report from a credit bureau. You may be charged a reasonable fee. There is no fee, however, if you have been turned down for credit, employment, insurance, or a rental dwelling because of information in your credit report within the preceding 60 days. The credit bureau must provide someone to help you interpret the information in your credit file."

"You have a right to sue a credit repair organization that violates the Credit Repair Organization Act. This law prohibits deceptive practices by credit repair organizations."

"You have the right to cancel your contract with any credit repair organization for any reason within 3 business days from the date you signed it."

"Credit bureaus are required to follow reasonable procedures to ensure that the information they report is accurate. However, mistakes may occur."

"You may, on your own, notify a credit bureau in writing that you dispute the accuracy of information in your credit file. The credit bureau must then reinvestigate and modify or remove inaccurate or incomplete information. The credit bureau may not charge any fee for this service. Any pertinent information and copies of all documents you have concerning an error should be given to the credit bureau."

"If the credit bureau’s reinvestigation does not resolve the dispute to your satisfaction, you may send a brief statement to be kept in your file, explaining why you think the record is inaccurate. The credit bureau must include a summary of your statement about disputed information with any report it issues about you."

The following terms apply to your participation in Clarity Unlocked LLC’s financial clarity program:

Clarity Unlocked LLC provides credit education, financial coaching, and document preparation services.
We do not offer legal advice or guarantee specific outcomes.
All services are fee-based, and your service package and pricing are detailed in your client agreement.
You are responsible for maintaining an active credit monitoring service throughout the program.
You may cancel services at any time with written notice.
Individual results may vary based on your unique credit profile and the responses of third-party reporting agencies and creditors.

I. Authorization
By signing below, you authorize Clarity Unlocked LLC and Consultant Deonna Alston to support you in matters related to your credit and financial wellness. This includes reviewing your credit reports, preparing dispute letters on your behalf, and communicating with credit reporting agencies and creditors as needed.

This authorization permits Clarity Unlocked LLC and Deonna Alston to:

Prepare and submit documentation related to credit report accuracy

Receive and review documents related to your credit file, including credit reports, collection notices, and creditor correspondence

Assist in follow-up communications related to disputes or verification requests

Access your credit monitoring account on your behalf in order to retrieve your credit reports and provide ongoing support

This authorization does not grant legal representation or power of attorney. It is strictly limited to providing document preparation and communication support in accordance with the Credit Repair Organizations Act (CROA) and the Fair Credit Reporting Act (FCRA).

You may revoke this permission at any time by providing written notice.

II. Effective Time
This authorization becomes effective immediately and will remain in effect on an as-needed basis unless revoked in writing via the mailing address or secure client portal listed above.

This Privacy Notice explains how Clarity Unlocked LLC collects, uses, and protects your personal information. It also outlines how you can direct us not to share certain information with third parties.

These practices apply to all current and former clients of Clarity Unlocked LLC.

Information We Collect
Clarity Unlocked LLC may collect non-public personal information about you from the following sources:

a. Information provided by you in this form or other onboarding documents
b. Information we receive from credit reporting agencies
c. Information received from affiliates or authorized third parties

Information Sharing Policy
Clarity Unlocked LLC does not disclose your non-public personal information to anyone without your express written authorization, except as permitted or required by law.

How We Protect Your Information
To protect your non-public personal information, we maintain strict physical, electronic, and procedural safeguards in accordance with federal and industry standards.

Monthly service fees are processed at the start of each billing cycle but are held in a separate internal business account and are not accessed by Clarity Unlocked LLC until after services have been completed for that period. This ensures compliance with the Credit Repair Organizations Act (CROA), which prohibits credit service companies from collecting payment for services that have not yet been fully performed.

Your first month’s payment includes a $99 non-refundable First Works Fee.

💼 First Works Fee – $99 (One-Time, Non-Refundable)

The First Works Fee is required for all new clients enrolling in credit wellness services. This one-time, non-refundable fee covers your initial onboarding and setup. It includes:

✔️ Full credit report analysis
✔️ Personalized credit improvement strategy
✔️ Education on your credit rights and responsibilities
✔️ Document preparation and dispute planning
✔️ Secure client portal setup

This fee must be paid before any services begin and is included in your first month’s payment.

After submitting this form and completing your payment, you will be redirected to schedule your free 30-minute consultation. Please be prepared to book your appointment.

🔒 Your information is secure and will be used only for the purpose of financial coaching, credit education, document preparation, and to comply with applicable legal and regulatory requirements.

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