What is Your Main Goal? (Select Maximum Two Choices)

Mortgage loan qualify or lower rate wanted Auto loan / lease qualify or lower rate Debt relief, unsecured debt balance is (comment box) Rent home/apartment Other

I’d Probably Hire The Company Which (Select Maximum Two Choices)

Guarantees results or I don't pay Doesn't guarantee results Is registered and bonded(like we are) Offers lowest cost



Household Income Range

under $40,000 $40,000 to $59,999 $60,000 to $84,999 $85,000 to $129,999 $130,000 or more

State I Live in (if the state isn’t listed I cannot do business with you)

AL AR AZ AK CA CO CT DE FL HI IL IN KY MA MI MT NC ND NM NJ NY OK PA RI SD WA WY

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