First Name *

Last Name *

Phone *

Email *

New or Returning Client? *

New

Returning

Do you have one or more dependents age 17 and under?

Do you plan on applying for the cash advance loan up to $7,000 starting Jan2. 2025?

Yes

Do you understand that if you are not local or do not wish to come in, your service will be completed virutally?

Yes

Please acknowledge that you understand this is just a VIP reservation form and you are under no obligation to file with KJ Financial Group, if you so choose.