Clone of Free Credit Repair Intake Form

Free Credit Repair Client Intake Form
Welcome to the D Shine Bookkeeping Credit Restoration Program
Welcome to the D Shine Bookkeeping Credit Restoration Program.
We’re glad you’ve taken the first step toward improving your financial future.

Our program is designed to help individuals strengthen their credit profiles by reviewing credit reports, identifying items that may be inaccurate, outdated, or unverifiable, and challenging those items through a structured dispute process when appropriate.

⚠ Important Information

Improving your credit takes time and consistency — it is not an overnight process.
Results will vary depending on your credit history, participation, and the information reported by creditors and credit bureaus.

To participate in this program, clients must:

• Maintain active credit monitoring throughout the service period
• Participate in the process and respond when information is requested
• Practice patience while disputes and investigations are processed
• Communicate with our team during scheduled or necessary monthly updates

Clients who are committed to improving their financial standing, qualifying for better approvals, securing lower interest rates, and increasing their financial opportunities, will benefit most from this program.
Name

First NameMiddle NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Drivers License Identification Card

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Social Security Card

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Proof of address

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PROGRAM OVERVIEW

What to Expect After Enrollment
Once you join the program, our team will:

• Conduct a detailed review of your 3-bureau credit report
• Locate items that may be inaccurate, outdated, or unverifiable
• Prepare and submit dispute requests to the credit bureaus when applicable
• Monitor changes to your report and review progress on a monthly basis
• Provide recommendations and education to help you rebuild and strengthen your credit profile

Important Information

Accurate and verified accounts cannot be removed from your credit report.
Specific credit score increases cannot be promised or guaranteed.
All services are performed in accordance with federal consumer protection laws and regulations.
Client Acknowledgment

Active Participation and Credit Monitoring is required
By signing below, I acknowledge that credit repair is a process that requires time, patience, and active participation. I agree to maintain active credit monitoring ($29/month) throughout the duration of the service, as this is required for proper account review and dispute processing. I also agree to participate in monthly check-ins to review progress and provide any requested documentation or updates. I understand that results cannot be guaranteed and that my cooperation and patience are essential for the best possible outcome.

I further acknowledge that the services included in this package apply only to the accounts and items listed on my credit report at the time of enrollment and the initial credit report review. Any new negative accounts, collections, or derogatory items that appear after enrollment and the initial report pull are not included in this package. I understand that I am responsible for avoiding new negative accounts and that any newly reported items may require additional services or fees to address.
I acknowledge that after submitting this form, I will receive a link to activate required credit monitoring for $29.99 per month. I understand that enrollment must be completed before any credit repair services can begin.
By signing below, I confirm that I have read, understood, and agree to the terms and conditions described above.
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Date

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Free Credit Repair Client Intake Form

Welcome to the D Shine Bookkeeping Credit Restoration Program

PROGRAM OVERVIEW

Client Acknowledgment