Tradeline Order Form

Tradeline Order Form
Are you placing this order for yourself, or for your client? *
Are you a first time buyer?*
Your First Name *
Your Last Name*
Your Email Address *
Your Phone Number *
Are you ordering a Tradeline Package, or are you ordering lines individually? (IF YOU ARE ORDERING A TRADELINE PACKAGE, IN THE SECTION RIGHT BELOW THIS, BE SURE YOU ENTER THE WORD "PACKAGE" IN THE NEXT TWO FIELDS, THEN ENTER THE DOLLAR AMOUNT OF YOUR PACKAGE IN THE "COST OF TRADELINE #1" FIELD.) *
Tradeline Order 1
Name of Tradeline *
Credit Limit of Tradeline *
Cost of Tradeline #1 *
CLIENT INFORMATION FOR TRADELINE #1
*If this line is for the same client, no need to fill out the client information again.
Please double check your accuracy!!
Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name *
Client's Last Name *
Client's Date of Birth *
Client's SSN/Credit File Number *
Street address as listed on credit file *
Address line two (apartment #, etc.)
City *
State *
Zip Code *
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Service Password
Tradeline Order 2
Name of Tradeline
Credit Limit of Tradeline
Cost of Tradeline #2
CLIENT INFORMATION FOR TRADELINE #2

Please double check your accuracy!!Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name
Client's Last Name
Client's Date of Birth
Client's SSN/Credit File Number
Street address as listed on credit file
Address line two (apartment #, etc.)
City
State
Zip Code
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Service Password
Tradeline Order 3
Name of Tradeline
Credit Limit of Tradeline
Cost of Tradeline #3
CLIENT INFORMATION FOR TRADELINE #3

Please double check your accuracy!! Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name
Client's Last Name
Client's Date of Birth
Client's SSN/Credit File Number
Street address as listed on credit file
Address line two (apartment #, etc.)
City
State
Zip Code
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Service Password
Tradeline Order 4
Name of Tradeline
Credit Limit of Tradeline
Cost of Tradeline #4
CLIENT INFORMATION FOR TRADELINE #4

Please double check your accuracy!! Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name
Client's Last Name
Client's Date of Birth
Client's SSN/Credit File Number
Street address as listed on credit file
Address line two (apartment #, etc.)
City
State
Zip Code
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Service Password
Tradeline Order 5
Name of Tradeline
Credit Limit of Tradeline
Cost of Tradeline #5
CLIENT INFORMATION FOR TRADELINE #5

Please double check your accuracy!! Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name
Client's Last Name
Client's Date of Birth
Client's SSN/Credit File Number
Street address as listed on credit file
Address line two (apartment #, etc.)
City
State
Zip Code
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Service Password
Tradeline Order 6
Name of Tradeline
Credit Limit of Tradeline
Cost of Tradeline #6
CLIENT INFORMATION FOR TRADELINE #6

Please double check your accuracy!! Being a digit or letter off can cause a non-posting issue. Don't let this be you!
Client's First Name
Client's Last Name
Client's Date of Birth
Client's SSN/Credit File Number
Street address as listed on credit file
Address line two (apartment #, etc.)
City
State
Zip Code
Credit Monitoring Service Name
Credit Monitoring Username
Credit Monitoring Password
Additional Tradelines
If you want to purchase more than 6 lines, list the line and price here:
TOTAL COST OF ORDER
Upload State ID/Drivers License/Passport*

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Upload SSN card

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Are you a member of our broker incentive program? *
Payment methods and instructions are below and will also be sent to your email after checkout.

Please use your email as the payment reference wherever possible. Your order won’t be processed until the funds have cleared in our account.
Payment Options:

ZellePay [zellepay.com]. Payment must clear before we can process your order. You simply send payment to info@drmimediagroup.com and email us confirmation.

Google Pay [can pay via Gmail account, app or we can send a payment request] Payment must clear before we can process your order. You can send payment to drmimediagroup@gmail.com and email us confirmation.

Western Union, Walmart 2 Walmart, Money Gram (Please send email if you are doing this option so that we can give you the name and state to send) Make sure you spell 100% accurately.
Choose method of payment*
How did you hear about us?
Comments:
I HEREBY CERTIFY THAT I HAVE READ THE TRADELINE CONTRACT/AGREEMENT AND THAT I UNDERSTAND AND AGREE WITH EACH OF THE TERMS SET FORTH ABOVE. *

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Tradeline Order Form

Tradeline Order 1

CLIENT INFORMATION FOR TRADELINE #1

Tradeline Order 2

CLIENT INFORMATION FOR TRADELINE #2

Tradeline Order 3

CLIENT INFORMATION FOR TRADELINE #3

Tradeline Order 4

CLIENT INFORMATION FOR TRADELINE #4

Tradeline Order 5

CLIENT INFORMATION FOR TRADELINE #5

Tradeline Order 6

CLIENT INFORMATION FOR TRADELINE #6

Additional Tradelines