Title:
|
|
FREE!!
Debt
Consolidation Help! |
|
Our Organization Provides
FREE Professional Help
and Relief From Too Much Debt.
Find out Why Our Debt- Management Program
is the
# 1 Way For Dealing With Too Much Debt.
We provide FREE
Professional Help To Instantly Reduce
Your Interest Rates and Minimum Payments.
"We Get Your Creditors Off Your
Back!"
With One Phone Call,
We Can Get Your Creditors To Do the Following:
 |
Lower your monthly payments
by 40-60%. |
|
Save thousands of dollars in
interest and late charges. |
|
End Creditor Harassment! |
|
Start improving your credit rating. |
|
Cut your bills in half. |
|
Consolidate your bills into
One Low
monthly payment. |
|
Eliminate interest and late fee charges. |
|
Improve your credit rating. |
From credit counseling to debt consolidation we have
the
FREE information and
resources to provide you with fast relief
from credit card and other debts.
FREE award winning
monthly Email Newsletter
containing powerful money saving credit and tax secrets.
All applications are confidential.
There is absolutely NO
obligation for filling out this form
and receiving a FREE
debt analysis.
** The form must be filled
out completely and you must be at least 18 years of age. **
| Name: |
|
| Address: |
|
| City: |
|
| State: |
|
| Zip: |
|
Day
Phone:
(please be sure to include
your area code) |
|
Evening
Phone:
(please be sure to include
your area code) |
|
Best Time of Day To Call:
(please
be sure to include your time zone) |
|
Email
Address:
(i.e. [EMAIL PROTECTED]) |
|
Subscribe
me to your FREE
award winning
debt consolidation email newsletter |
Yes
No |
| Approximate
total amount owed to creditors: |
|
Is
this business or personal debt?
(Either
is acceptable) |
Personal
Business
Both |
Name of creditor
or bank:
(do not give
account number) |
Creditor #1
Amount Owed to Creditor#1
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
Creditor #2
Amount Owed to Creditor#2
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
Creditor #3
Amount Owed to Creditor#3
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
Creditor #4
Amount Owed to Creditor#4
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
Creditor #5
Amount Owed to Creditor#5
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
Creditor #6
Amount Owed to Creditor#6
Monthly Payment
Type of Debt
Please Select One
Credit Card
Personal Loan
Loan
Line of Credit
Leased Equipment
Purchased Equipment
Overdraft Protection
Payday Loan
Unpaid Checks
Student Loan
Mortgage
How Many Months Are You Behind?
*********
|
| Please
enter a short description of your debit/credit problem: |
|
List
Removal/OPT-OUT Option
Click
Here
|
