FILL OUT CREDIT INTAKE APPLICATION

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To ensure a smooth process, please complete this intake form with accurate details. Be prepared to make your payment upon submission to begin your service. If you have any questions before proceeding, we're happy to help-schedule a consultation to discuss your needs. Let's build a strong foundation for your business together!
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Name* This field is required.
First Name
Last Name
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Social Security Number* This field is required.
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Date of Birth* This field is required.
Date
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Day
Year
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Phone Number* This field is required.
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Email Address* This field is required.
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Address* This field is required.
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Were you referred by anyone?
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No
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Who referred you?
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Current Employer* This field is required.
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Job Title* This field is required.
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Monthly Income* This field is required.
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Are you Self Employed* This field is required.
Yes
No
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Have you reviewed your credit report recently* This field is required.
Yes
No
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Have you worked with a credit repair company before* This field is required.
Yes
No
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Do you have active credit accounts* This field is required.
Yes
No
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Do you have active credit accounts* This field is required.
Yes
No
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Do you have any credit cards?* This field is required.
Yes
No
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What are your biggest credit concerns? (Check all that apply)* This field is required.
Late payments
Collections
Charge-offs
Bankruptcies
Foreclosures
Judgements
Repossessions
Identity theft
Low credit score
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Financial Goals? (Check all that apply)* This field is required.
Buying a home
Buying a car
Getting a loan
Lowering interest rates
Improving credit score
Removing inaccurate items from credit report
Other (please specify)
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Mandatory > Sign up for credit Monitoring ✔️ (This is mandatory for me to fix your credit (I have 2 companies You can choose from ) pick 1* This field is required.
https://www.smartcredit.com/?PID=30398
https://myfreescorenow.com/enroll/?AID=ADTaxandFinancialServices&PID=79652
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Click on the below link to register for your preferred CREDIT MONITORING.

https://myfreescorenow.com/enroll/?AID=ADTaxandFinancialServices&PID=79652

NOTE: in order, for us to work on your credit, you need to keep the credit monitoring ON.

Once done, type in your USERNAME and PASSWORD below used in the credit monitoring login:
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Click on the below link to register for your preferred CREDIT MONITORING.

https://www.smartcredit.com/?PID=30398

NOTE: in order, for us to work on your credit, you need to keep the credit monitoring ON.

Once done, type in your USERNAME and PASSWORD below used in the credit monitoring login:
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Username* This field is required.
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Password* This field is required.
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Do you authorize us to pull your credit report? (Yes/No)* This field is required.
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Do you understand that credit repair is a process and results may vary? (Yes/No)* This field is required.
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Mandatory I cannot move forward with cleaning your credit without these documents File Upload (ID, SSN CARD, UP TO DATE UTILITY BILL or 1099 Tax Document )** This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Type a Question, Comment, or Concern* This field is required.
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By signing this document, you are giving permission to access your credit reports and any necessary documents/information in order to provide you the best advice.
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Signature* This field is required.
Clear
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Date* This field is required.
Date
Month
Day
Year
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ORDER SUMMARY
Total costUSD
6-Month Credit Boost Program 🚀✅ Full Credit Report Analysis – A deep dive into your credit profile to identify areas for improvement. ✅ Dispute & Removal Process – We work on challenging inaccurate, outdated, or unverifiable negative items. score. ✅ Credit-Building Resources – Get recommendations for the best credit cards, loans, and strategies to strengthen your profile.
$399.00Edit
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9 -Month The Ultimate Credit Comeback🚀🧨✅ Full Credit Report Analysis – A deep dive into your credit profile to identify areas for improvement.✅ Dispute & Removal Process – We work on challenging inaccurate, outdated, or unverifiable negative items.✅ Personalized Credit Strategy – Action steps tailored to your unique financial goals.✅ Debt Management Guidance – Learn how to reduce debt the smart way to boost your score.✅ Credit-Building Resources – Get recommendations for the best credit cards, loans, and strategies to strengthen your profile.✅ Monthly Progress Updates – Track improvements with regular check-ins and expert support.
$899.00Edit
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