Credit Restoration Intake Form
About You
Employment status
Employed
Self-employed
Unemployed
Retired
Credit Profile
Have you reviewed your credit reports recently?
Yes
No
What is your primary credit goal? (Select all that apply)
Home purchase
Auto loan
Business funding
Credit cards
General credit improvement
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Have you disputed items before?
Yes
No
Not sure
Do you have any judgments, liens, or collections?
Yes
No
Any foreclosures, repossessions, or charge-offs?
Yes
No
Are you currently behind on any accounts?
Yes
No
Have you ever filed bankruptcy?
Yes
No
Have you ever been a victim of identity theft?
Yes
No
What is the biggest concern you have right now about your credit status?
SUBMIT
