Home Introduction Information FAQ's Agreement Contact Us Tell a Friend
Application
I, the undersigned, give Power of Attorney to The Credit Repair Law Firm Chartered, Inc., for the sole purpose of acquiring, requesting verification and disputing any information in regards to my credit. I have read and I understand the agreement completely and I may cancel this agreement without penalty or obligation at any time before midnight of the 3rd business day after the date on which I signed the agreement. Payment Method: Credit Card Check Enter Your Contact Information: First Name Last Name Social Security Number Birth Date Address City State/Zip E-mail Customer Case Home phone Cell phone Work phone x Date Client Signature (type your full name) x Date Kevin L. Hagen Member Florida Bar, Ft. Lauderdale, FL AGREEMENT MUST BE SIGNED AND RETURNED FOR US TO RELEASE YOUR CREDIT REPORTS. Please send copies of the following: * Drivers License or other Picture ID Card. * Your Social Security Card (if you have) OR any document that shows your name and Social Security number (such as W-2 form, pay stub, bank statement or medical insurance card. * And any ONE showing your NAME and CURRENT ADDRESS: electric, gas, water, cable TV bill, voters or auto registration or top part of any bank statement. * Documentation that will assist the attorney in identifying any errors, misrepresentations or omissions. * Sign at Client Signature and follow above instructions or your application will be delayed. NEXT: Contact Us
I, the undersigned, give Power of Attorney to The Credit Repair Law Firm Chartered, Inc., for the sole purpose of acquiring, requesting verification and disputing any information in regards to my credit.
I have read and I understand the agreement completely and I may cancel this agreement without penalty or obligation at any time before midnight of the 3rd business day after the date on which I signed the agreement.
Payment Method:
Credit Card Check
Enter Your Contact Information:
First Name Last Name Social Security Number Birth Date Address City
State/Zip
E-mail Customer Case
Home phone Cell phone Work phone x Date Client Signature (type your full name)
x Date Kevin L. Hagen Member Florida Bar, Ft. Lauderdale, FL
AGREEMENT MUST BE SIGNED AND RETURNED FOR US TO RELEASE YOUR CREDIT REPORTS. Please send copies of the following: * Drivers License or other Picture ID Card. * Your Social Security Card (if you have) OR any document that shows your name and Social Security number (such as W-2 form, pay stub, bank statement or medical insurance card. * And any ONE showing your NAME and CURRENT ADDRESS: electric, gas, water, cable TV bill, voters or auto registration or top part of any bank statement. * Documentation that will assist the attorney in identifying any errors, misrepresentations or omissions. * Sign at Client Signature and follow above instructions or your application will be delayed.
NEXT: Contact Us
Home