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    Name

    Email Address

    Phone Number

    Title

    Company

    Postal Code

    Industry

    Has your business been impacted by tariffs?

    What supports can the government provide?

      Full Name

      Email Address

      Phone Number

      Working with an Agent?

      Household Income

      Credit Score

      Preferred Location

        How much unsecured debt do you have?

        Min $5000

        0%

        Are you behind on payments?

        12%

        How many creditors do you have?

        What types of debt do you have?

        25%

        What is your credit rating?

        37%

        What is your employment status?

        50%

        Are you a home owner?

        62%

        What is your property value?

        Min $5000

        What is your mortgage balance?

        75%

        Are you currently in a bankruptcy or consumer proposal?

        87%

        What is your postal code?

        What is your name?

        What is your email address?

        What is your phone number?

        Briefly describe your debt problem

        100%