*How would you like to receive your Correspondence or Paperwork: (Please check one)
Please complete the information below that has an asterisk*.
*Address:
*City:
*State:
*Zip Code:
*Home Phone Number:
*Daytime Number:
Cell Phone Number:
*Best time to call between 8:30 a.m. and 4:00 p.m. (Pacific Time):
Registration Form
*Spouses Full Name (First, MI & Last Name / Jr., Sr., I, II):
* Email Address
* Date of Birth SSN#
Additional Comments: (optional) Summary of Explanation, Valuable Information to support a dispute, etc. List information below.
Conference Call Request :
Date:
*Application Acknowledgement: Client must read/or Rep must read these instructions in their entirety.
SCORE SURVEY
Please complete each question below.
1. How many credit cards do you have?
a. Follow up: How long ago did you get your first credit card? 2.How long ago did you get your first loan?
How long ago did you get your first loan?{ i.e., auto loan, mortgage, student loan, etc.} 3.How many loans or credit cards have you applied for in the last year?
How many loans or credit cards have you applied for in the last year? 4.How recently have you opened a new loan or credit card?
How recently have you opened a new loan or credit card? 5.How many of your loans and/or credit cards currently have a balance?
How many of your loans and/or credit cards currently have a balance? 6. Besides any mortgage loans, what are your total balances on all other loans and credit cards combined?
As an example, let’s say you have two accounts:*One auto loan with balance of $7,000*One credit card with balance of $1,500Your total balances on all non-mortgage accounts would be: $8,500 ($7,000 + $1,500). 7.When did you last miss a loan or credit card payment?
When did you last miss a loan or credit card payment? a. Follow up: What is the most delinquent you have ever been on a loan or credit card payment? { includes repossessions, foreclosures, and accounts referenced to collection agencies } 8.How many of your loans and/or credit cards are currently past due?
How many of your loans and/or credit cards are currently past due? a. Follow up: What are your total balances on all currently past due? 9.What percent of your total credit card limits do your credit card balances represent?
What percent of your total credit card limits do your credit card balances represent? As an example, let’s say you have two credit cards:One with balance of $273 and limit of $1,000One with balance of $737 and limit of $4,000Your total credit card balances would be $1,010 ($273 + $737), your total credit limits would be $5,000 ($1,000 + $4,000), and the percent of your total credit limits that your credit card balances represent are: $1,000 divided by $5,000, or 20%. 10.Please indicate if you have ever gone through any of the following negative financial events in the last 10 years: bankruptcy, tax lien, foreclosure, repossession, or account referred to collection agency.
Please indicate if you have ever gone through any of the following negative financial events in the last 10 years: bankruptcy, tax lien, foreclosure, repossession, or account referred to collection agency. a. Follow up: If so, how long ago did the most recent negative event occur.*Check this box to indicate that you have successfully completed the Score Survey to the best of my knowledge, and confirm that all information is accurate and true.
*Your Full Name (First, MI & Last Name / Jr., Sr., I, II):
To see if you qualify for our Increase Credit Score Program, please complete survey and fax a copy of your credit report to (623) 687-9464
Client Understands Pre-Consultation Fee is non-refundable:
In registering, Client understands the purpose for the non-refundable Registration/Pre-Consultation Fee is not to pay creditors, debts, restore their credit, make phone calls, or fax transmissions, but only to verify and investigate debts. For Debt & Credit Management clients, after verification/Investigation have been completed, the Client will receive a separate proposal for services and recommendations based on your individual circumstances which reflects on your current credit report, through our interview, and investigation. You also understand that all Pre-Consultation forms are a part of this agreement. Fees for Registration/Pre-Consultation are NON-REFUNDABLE (including wire transfer fees, if applicable). Your registration constitutes your acceptance of these conditions. Please select one of the options below:
Do you require a Translator?
Determining Your Current DTI (Debt-To-Income Ratio):
*What are your total monthly expenses? Amount:
*Monthly Net Income Amount:
You must complete the registration fee process prior to completing the "Score Survey."
Enrollment Application Form
Check all that you think applies to your specific situation:
Late on Mortgage payments more than 30 days and unable to make next month’s.
I have lates reporting on my credit profile and/or unable to make my minimum payments.
I have collections/charge-offs/foreclosure/ or repossessions reporting on my credit profile/or Creditors are
calling my job, home, and are harassing me.
I previously filed bankruptcy.I am making monthly payments, but my monthly balance always seems higher.Debt Elimination: I have unpaid collections, charge-offs, or repossessionFraud/Identity Theft Services: My personal identification has been used by someone else without my knowledge or consent.ChexSystems Removal Services: I am unable to open a bank account or write checks, due to previous bounced checks.Home Loan Services: I want to purchase a home, refinance, or conduct home improvements.Asset Protection: I own real estate, am a business owner, own a boat, or have other assets and want to protect them.Income: I need to increase my income in order to reach my life and financial goals.Please provide TDMS the following documents:
1. Utility Bill, Payroll Statement, Bank Statement or other legal document showing name & address.
2. Copy of credit reports and Bankruptcy Papers (including Discharge and Schedules), if applicable.
3. Signed Frequently Asked Questions Certification Sheet, Completed Expense Management worksheet, this
Enrollment/Pre-Consultation Agreement, Completed & Signed Authorization to Obtain Information, Complete &Signed Authorization to Release Information, Signed Interview Disclosure Statement, Completed Prioritize Debt Worksheet, and Completed Confidential Statement. (All documents must be signed, completed, and faxed before proposal is provided.) Click to print below.a. d.g. b. e.c. f.Note: All Fields must be completed for Debts owed and Expenses. A Rep will will contact you for additional information, if required.
4. Reminder: Fax Receipt of payment/deposit. (Be sure to write your name on it so that you receive the credit).
I have read this Pre-Consultation Agreement and understand the conditions and agree to it. [Once forms are received, deposit made, and interview conducted, Contract Administration will provide proposal. Form & Fees are required within 48 hours of date prepared. Note: If not received, the file will be held for 24 hours. If client has not submitted forms and fees within that timeframe, file will be closed.]
*First Name(s) :
*Last Name:
My typed name below signifies my electronic signature acknowledges I have read and agree to the above Registration/Pre-Consultation Agreement. After typing your name, please select "submit" button.
* Spouses Date of Birth SSN#
*What do you hope to accomplish once you have completed our program? (Please explain)
*Has anyone previously assisted you in this matter?
If so, name: Phone:
NOTE: If you have more negative than positive accounts and if you do not have reserve cash available, you WILLNOT qualify for the Increase Credit Score Program. Please complete the Enrollment Application form below for Debt & Credit Management/ Debt Elimination Assistance. If you believe you qualify, please click here.
