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?

Would you want to sue a creditor or debt collector that violated your fair debt rights?
Yes
No

What bills are you behind on? (check all that apply) NoneCredit Cards / Store CardsPersonal LoansChild Support
Student LoansAuto LoansIncome TaxesPayday Loans
Medical Bills
Other

Which of the following contribute to your current financial hardship (check all that apply) No HardshipGarnishmentCreditor/Collector HarassmentRepossession
ForeclosureLawsuitsIllness/DisabilityLicense Suspension
DivorceLoss of Income
Other

Do you receive any type of government financial assistance? Select all that apply.
NoneSocial Security
UnemploymentDisability
Other

Do you think you could bring all of your debts current if you just had more time? YesNo

Identify all sources of income Employed, Full-timeSocial SecurityChild Support/Maintenance
Employed, Part-timePension/RetirementNo Income Other

Are you: (check one)
Currently in BankruptcyFiled bankruptcy in the last 7 years
Never filed bankruptcyOpposed to filing bankruptcy

Do you contest or dispute any of the debts on your credit report (i.e. do you think your credit report is inaccurate)? YesNo

Have you been denied work or a loan because of your credit report? YesNo

Have you ever subscribed to a credit score/credit monitoring service such as Freescore.com©, Triplescore.com©, etc.? YesNo

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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