NEW CLIENT CREDIT PROGRAM

Please read the information below before submitting.

Upon submission of this form, your client portal will be setup. Once your client portal is setup you will receive several emails with your client agreement and login instructions to your client portal. Your Client Agreement, which gives us permission to do work on your behalf, such as drafting and sending letters to the credit bureaus, creditors, secondary databases or agencies like the Consumer Financial Protection Bureau, which we cannot do without your permission.

1. If you are in an active bankruptcy, we cannot legally accept you as a client. If your bankruptcy has been dismissed or discharded then you are okay to be a client.

2. On any letter to the credit bureaus, they have to be able to identify the correct credit file. In this form you will be required to upload:

-valid state issued identification: unexpired Driver's License or State ID, Military ID or Passport

-and proof of address: Utility Bill, Insurance Statement, Bank Statement, something addressed to you at your home address. Credit Card Statements are not permitted

3. Credit Repair is a team sport, and we cannot do it by ourselves. We form a partnership with our clients with the understanding that while we are doing everything we can to help their score, they will be paying their bills on-tiime, building positive credit and paying their credit card balances (if any) down in order to also help their score. If you are not willing to consistently do these things, please DO NOT sign up for our services

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Cell Phone Number *

Last 4 of SSN *

Date of Birth * +

Email Address *

Photo ID Must be clear, close-up, no glare Not expired and showing entire ID. *

Proof of Address EX: Utility Bill, Bank Statement, Insurance Card, Phone Bill, Cable/Gas Bill *Please remove bills from envelope prior to taking picture.* *

*Social Security Card (Optional) Picture of SS Card, W2, or Tax Return *Not Required*, but makes the process more efficient and effective. Highly Recommended

Payment Information

Your card will NOT be charged until you complete your onboarding and we have completed all of our initial work, which includes processing your credit report, completion of the initial credit audit (sent by email), preparation of documents to update/remove any conflicting personal information from your credit report and from the secondary databases and preparing your file for challenges.

Payment Information: WE DO NOT ACCEPT PRE-PAID CARDS

Name on Card *

Credit Card Type *

Analysis/Audit Fee *

Credit Card Number *

Expiration Date (mm/yy) *

CVV Code *

Read and Agree to Terms Before Submitting

*

If you have not completed your enrollment requirements after 72 hours of receiving your enrollment email, your account will be cancelled. There is NO refund for cancellation of account due to non-compliance.

I UNDERSTAND that I am required to do my part while in the program, by keeping my bills paid on-time and lowering my account balances. There may also be a need for me to add some positive primary tradelines.

I UNDERSTAND that it is very important for me to maintain my credit monitoring while in the program. I also understand that if I do not maintain the credit monitoring, I risk having my account cancelled.

I am committed to improving my credit and I understand that credit repair is not an overnight process. The timing for credit repair vary for each individual.

I UNDERSTAND that my monthly payment is billed every 30 days from the date of enrollment.

I UNDERSTAND that there is no contract and I can cancel service at any time.

Upon submitting your enrollment form, you will be redirected to Revive Financial Consultants scheduling platform.

*Reminder*Your credit/debit card will NOT be charged until you complete your onboarding and we have completed all of our initial work, which includes processing your credit report, completion of the initial credit audit (sent via email), preparation of documents to update/remove any conflicting personal information from your credit report and from the secondary databases and preparing your file for challenges.

Your monthly payments for the previous work performed will be the same date every month. This date is determined by the date your first payment is processed.

Program Pricing as follows:

Individual: $247for setup/credit analysis/review workup and then $147 Monthly beginning 30 days after signup.

Upon submission of this form you will receive a text message with our Client Service Agreement that you can read and sign on your laptop or mobile device. This gives us permission to do work on your behalf.

NEW CLIENT CREDIT PROGRAM

Please read the information below before submitting.

Payment Information

Read and Agree to Terms Before Submitting

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