BIG BIZZNEESSS CLIENT SUPPORT REQUEST

BIG BIZZNEESSS CLIENT SUPPORT
This form is designed to assist in addressing and mitigating potential outstanding business matters with Greg "Big Bizzneesss" Parker, Danielle "Nikki" Parker, and entities they represent. Please complete the form below regarding your claim. To assist in expediting the resolution of your concerns/claim, please complete the information below in its entirety and attach any documentation that supports your claim. This claim must be completed by the potential impacted party - NO EXCEPTIONS. You will receive a confirmation email once the claim has been submitted. Your claim will be processed in the order in which it is received by our legal and financial teams. Thank you in advance for your submission and cooperation in resolving these matters.

Please make sure all provided information is accurate and your data will be kept safely
Claimant Information

Please make sure all provided information is accurate and your data will be kept safely
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Claim Information

Please make sure all information is accurate
Please select the options that best apply to your situation?*

This is regarding a property purchase/real estate matter.This is regarding a joint venture agreement.
Date of Transaction*
If exact date is unknown, you may enter the month and year
Address of Property (if Real Estate Related)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount of Claim*
Upload Supporting Documentation*

Upload a scanned copy of your supporting documents here. This includes any contracts, agreements, receipts, confirmation of payment, and the like that can substantiate your claim. Failure to upload supporting documents may delay resolution of your claim.
Cancelof
Comments*
Please provide any additional information that may assist in resolving your claim and/or you would like to be noted in your initial claim. This may include more information about the claim, specific information about the transaction, any other parties/persons involved in the deal, or anything that will assist in our review of your claim. If you have no additional comments, please type "None".
Acknowledgment & Consent
I declare that I am the impacted party in the abovementioned claimed and that the information above is my direct account. I confirm that I am 18 years or older, and that all information provided above is true and is given with my full consent, of my own free will, and not under duress.

I understand that the information provided will be used to address the matters identified herein in an attempt to bring resolve to my claims. I understand that failure to provide all of the information requested herein may prevent or delay the resolution of my claim. I understand that additional information may be requested by the Parkers and/or their legal and financial team and I agree to comply with their discovery process and any requests made of me.

I further understand that, any person with intent to defraud, falsely makes, alters, forges or counterfiets information or documentation is in violation of state law and could be liable for criminal and civil penalties.
Date*

MonthDayYear
Date
Claimant Signature*

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BIG BIZZNEESSS CLIENT SUPPORT

Claimant Information

Claim Information

Acknowledgment & Consent