CREDIT REPAIR

CLIENT ENROLLMENT FORM

Please complete this form to officially enroll with Capital Collective Group. The information collected allows us to begin your onboarding and provide personalized credit support.

First Name *

Last Name *

Date of birth *

Social Security Number *

Address

Street Address *

You will get better results providing an address that you have never been associated with. It helps the debt get removed easier.

City

State

Country

Postal Code

Email *

Phone *

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

Onboarding Items

Please provide accurate, up-to-date information. Failure to upload clear documentation can result in a delay in processing.

Drivers License/Identification Card *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Social Security Card *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Credit Monitoring Information

As an active client you are REQUIRED to keep the credit monitoring that we use ACTIVE. Being able to see all 3 of your credit reports monthly will keep your dispute schedule running as smoothly as possible. If you downgrade/cancel your credit monitoring you could be cancelled as a client. If you continuously allow your credit monitoring service to be inactive, you could be cancelled as a client.

CLICK HERE to pull your 3 bureau credit reports

Credit Monitoring Account *

Credit Monitoring Username *

Credit Monitoring Password *

Signature *

Clear