Fair Debt Collection.com

Free Consumer Debt Test

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Please tell us about your situation

Are you (check all that apply):
Receiving collection calls from a creditor or debt collector
Receiving collection letters from a creditor or debt collector?
Finding debts on your credit report?

What bills are you behind on? (check all that apply) None
Credit Cards / Store Cards
Personal Loans
Child Support
Student Loans
Auto Loans
Income Taxes
Payday Loans
Medical Bills Other

Which of the following contribute to your current financial hardship (check all that apply) No Hardship
Garnishment
Creditor/Collector Harassment
Repossession
Foreclosure
Lawsuits
Illness/Disability
License Suspension
Divorce
Loss of Income Other

Do you receive any type of government financial assistance? Select all that apply.
None
Social Security
Unemployment
Disability Other

Do you think you could bring all of your debts current if you just had more time? Yes
No

Identify all sources of income Employed, Full-timePension/Retirement
Employed, Part-timeChild Support/Maintenance
Social SecurityNo Income Other

Are you: (check one)
Currently in Bankruptcy
Filed bankruptcy in the last 7 years
Never filed bankruptcy or have a bankruptcy older than 7 years
Opposed to filing bankruptcy

Do you own real estate? Yes
No

Rate your credit: Poor
Fair
Good
Excellent

Do you contest or dispute any of the debts on your credit report (i.e. do you think your credit report is inaccurate)? Yes
No

Do you care about your credit report? Yes
No

Have you been denied work or a loan because of your credit report? Yes
No

Have you ever subscribed to a credit score/credit monitoring service such as Freescore.com©, Triplescore.com©, etc.? Yes
No

Do you have dependents? Yes
No

Estimate Total Monthly Expenses:

Estimate Total Monthly Income:

Contact Information -- starred (*) information is required

First Name*

Last Name*

Email

Address*

City*

State of Residence*

Zip*

Home Phone: (999-999-9999)*

Work Phone: (999-999-9999)

Best Number to Call*

Best Time to Call*

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