First Name

Last Name

Phone *

Email *

Have you attempted dispute assistance in the past?

Yes

What is your credit score?

Below 500

501-550

601-650

I don't know

What is your level of interest or commitment to achieving your credit goals at this time?

I'm just curious about the process

I'm interested but nor likely to take action at this time

I'm 50/50

100% committed

Do you have any late payments in the past 12 months?

Yes

I'm not sure

What is your highest limit on a personal credit card?

How many primary accounts do you have?

Do you have any negative reporting?

Yes

What is your credit utilization percentage?

0%-10%

10%-20%

Over 20%

I don't know

Do you need funding?

Yes

If you need funding, how much?

$5,000 - $15,000

$15,000 - $45,000

$45,000 or more

Do you currently have an active business? (Corp, LLC, Sole-prop)

Yes

No, But I would like to start one

Do you have any pending legal action? i.e divorce lawsuit, active bankruptcy...

Yes

How much are you ready to invest in the process of repairing your credit?

$0-$300

$300-$600

$600-$900

Whatever it takes

What is the best time/way to contact you?

Phone - 9am-12am

Phone - 12pm-5pm

Phone - 5pm-9pm

Email only

If you were referred by someone, tell us who

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By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, and dispute assistance updates from Skyline Group Venture LLC at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.