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    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%