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1
Credit Review Acknowledgment
I understand that this review is used to help identify an appropriate service path and does not guarantee deletion of credit-report information, a specific credit-score increase, or approval for credit, housing, vehicle financing, or a mortgage.
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2
What is your PRIMARY goal right now?
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Improve my overall credit profile
Prepare for a vehicle purchase or refinance
Prepare for better rental/housing opportunities
Prepare for future homeownership
I'm not sure — I need help determining my next step
Please Select
Improve my overall credit profile
Prepare for a vehicle purchase or refinance
Prepare for better rental/housing opportunities
Prepare for future homeownership
I'm not sure — I need help determining my next step
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3
What concerns are currently affecting your credit profile?
Collections
Charge-offs
Late payments
Repossession
Eviction/housing-related debt
High credit card balances
Maxed-out credit cards
Limited credit history
Student loans
Medical debt
Identity theft or accounts I don't recognize
Public records
Too many recent inquiries
Previous bankruptcy
I'm not sure what's affecting my credit
Other
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4
Have you reviewed all three of your credit reports recently?
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YES
NO
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5
Approximately where are your current credit scores?
Please Select
Below 500
500–549
550–599
600–649
650–699
700+
Scores vary significantly between bureaus
I don't know my current scores
Please Select
Below 500
500–549
550–599
600–649
650–699
700+
Scores vary significantly between bureaus
I don't know my current scores
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6
When are you hoping to reach your primary goal?
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As soon as reasonably possible
Within 3 months
Within 3–6 months
Within 6–12 months
More than 12 months from now
I don't have a specific timeline
Please Select
As soon as reasonably possible
Within 3 months
Within 3–6 months
Within 6–12 months
More than 12 months from now
I don't have a specific timeline
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7
Have you been denied recently for something related to this goal?
YES
NO
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8
What would make the biggest difference for you right now?
Address negative items on my reports
Rebuild positive credit history
Lower credit utilization
Understand what's hurting my profile
Recover from previous financial problems
Become more approval-ready
I'm not sure
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9
Have you previously attempted to address the negative items on your credit reports?
YES
NO
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10
What are you preparing for?
Please Select
Purchase a vehicle
Refinance my current vehicle
Replace a repossessed vehicle
Improve my financing options
I'm not sure yet
Please Select
Purchase a vehicle
Refinance my current vehicle
Replace a repossessed vehicle
Improve my financing options
I'm not sure yet
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11
Have you had a vehicle repossession?
YES
NO
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12
Have you recently been denied vehicle financing or offered terms you weren't comfortable with?
YES
NO
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13
When are you hoping to purchase or refinance?
Please Select
Within 30 days
1–3 months
3–6 months
6+ months
Unsure
Please Select
Within 30 days
1–3 months
3–6 months
6+ months
Unsure
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14
What are you currently working toward?
Please Select
Renting an apartment
Renting a house
Moving to a new community
Overcoming a previous rental denial
Addressing housing-related credit issues
I'm not sure
Please Select
Renting an apartment
Renting a house
Moving to a new community
Overcoming a previous rental denial
Addressing housing-related credit issues
I'm not sure
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15
Do your reports currently show an eviction, landlord collection, or housing-related debt?
YES
NO
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16
Have you been denied housing recently?
YES
NO
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17
When do you hope to move?
Please Select
Within 30 days
1–3 months
3–6 months
6+ months
Unsure
Please Select
Within 30 days
1–3 months
3–6 months
6+ months
Unsure
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18
Where are you in the homebuying process?
Please Select
Just starting to prepare
Planning to apply for a mortgage
Already spoke with a lender
Previously denied for a mortgage
Working on lender recommendations
Unsure where to begin
Please Select
Just starting to prepare
Planning to apply for a mortgage
Already spoke with a lender
Previously denied for a mortgage
Working on lender recommendations
Unsure where to begin
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19
Have you spoken with a mortgage lender within the last 12 months?
YES
NO
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20
Did a lender identify credit-related issues that need attention?
Yes
No
Unsure
I haven't spoken with a lender
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21
When are you hoping to purchase a home?
Please Select
Within 3 months
3–6 months
6–12 months
More than 12 months
Unsure
Please Select
Within 3 months
3–6 months
6–12 months
More than 12 months
Unsure
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22
1. Full Name
*
This field is required.
First Name
Last Name
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23
2. Email Address
*
This field is required.
example@example.com
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24
3. Mobile Phone Number
*
This field is required.
Please enter a valid phone number.
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25
4. Preferred Contact Method
Please Select
Text
Phone Call
Email
Please Select
Text
Phone Call
Email
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26
Typ6. Do you currently have access to reports from all three major credit bureaus?e a question
*
This field is required.
YES
NO
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27
7. How do you currently access or monitor your credit?
Credit monitoring service
Annual credit reports
Credit card/bank app
Credit bureau website/app
I have copies of my reports
I don't currently have access
Other
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8. Are you willing to provide current credit reports for a more detailed review?
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This field is required.
Yes
No
I need help accessing them
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29
9. What type of help are you looking for?
*
This field is required.
Please Select
I want professional assistance with my credit profile
I prefer a DIY option with guidance
I'm comparing my options
I'm not sure yet
Please Select
I want professional assistance with my credit profile
I prefer a DIY option with guidance
I'm comparing my options
I'm not sure yet
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30
10. Anything else you'd like me to know?
Share anything about your credit situation or financial goal that you believe would help me better understand what you're working toward.
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31
1. Information Certification
*
This field is required.
I certify that the information I provided is accurate to the best of my knowledge and understand that Fresh Start Relief Solutions will use this information to evaluate which service option may be appropriate for my stated goals.
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32
2. Credit Review Acknowledgment
*
This field is required.
I understand that this Credit Profile Review is an initial screening and is not a guarantee that any specific information will be removed or changed on my credit reports.
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33
3. Results Acknowledgment
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This field is required.
I understand that Fresh Start Relief Solutions does not guarantee a specific credit score increase, financing approval, interest rate, rental approval, mortgage approval, or completion within a specific timeframe.
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34
4. Consumer Rights Acknowledgment
*
This field is required.
I understand that I have the right to dispute inaccurate or incomplete information on my own and that I am not required to purchase services from Fresh Start Relief Solutions to exercise my rights under federal consumer protection laws.
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35
5. Communication Consent
*
This field is required.
I authorize Fresh Start Relief Solutions to contact me using the phone number and email address I provided regarding my Credit Profile Review, requested information, service options, and next steps.
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36
Primary Review Category
Please Select
Overall Credit Rebuild
Transportation
Housing
Homeownership
Needs Manual Review
Please Select
Overall Credit Rebuild
Transportation
Housing
Homeownership
Needs Manual Review
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37
Electronic Signature
*
This field is required.
By signing below, I confirm that I have reviewed the information and acknowledgments provided in this Credit Profile Review.
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38
7. Date Signed
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Date
Year
Month
Day
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