Client Intake Form for Credit Repair and Funding Services

Client Intake Form for Credit Repair and Funding Services

Please fill out the following information to help us understand your needs and assist you effectively.
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Credit Score (If you don’t know put N/A)
Services Needed
What is your goal in repairing your credit ?And or needing access to funding.
Other
Please Upload the following MANDATORY documents ( Social Security, Drivers License and A Utility Bill with your CURRENT address)

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PLEASE READ! IMPORTANT INFORMATION!

In order to Repair your Credit ,Credit Monitoring is MANDATORY AND MUST STAY ACTIVE during the span of the dispute process. Click on the Link below to Signup and Please read the signup page in its entirety. Thank-you.

Credit Monitoring SignUp
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TAX CLIENT
FIRST ROUND FREE FOR TAX CLIENTS -IF YOU WOULD LIKE TO BECOME A TAX CLIENT PLEASE CLICK BELOW *Current Tax Clients please just check client box *

Free Quantity



PLATINUM PACKAGE
Basic Disputing (Late Payments, hard Inquiries, Charge Offs, Collections, Medical bills) Up to 3 months - additional rounds can be purchased later if needed*

$375.00 Quantity



Gold Package
Advanced Disputing (basic accounts + Repo,Bankruptcy,Eviction,Child Support) Up to 6 months - *additonal rounds can be purchased later if needed*

$575.00 Quantity



Rose GOLD Package
Basic + Advance+Chex System Disputing-*If you keep getting denied for bank accounts you are most likely flagged by Chex systems * FULL SWEEP

$695.00 Quantity



Monthly
Pay Per Round Sent Out

$149.99 Quantity



Total

$0.00

Client Intake Form for Credit Repair and Funding Services

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