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What Debts Are You Struggling With?
(Check all that apply)
Garnishment
Repossession
Foreclosure
Lawsuit
Illness/Disability
Divorce
Job Loss
Please Estimate Your Total Unsecured Debt:
(Do Not Include your Mortgage, Auto
Loans, or Student Loans)
*required
Total Debt $:
- - - - -
$0 - $10,000
$10,000 - $20,000
$20,000 - $50,000
$50,000 - $100,000
$100,000+
*Comments:
(250 Max Characters)
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Fair Debt Collection Practices Act
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