Name
    Email
    Phone
    What type of debt do you have?credit card(s)line(s) of creditconsolidation loan(s)CRAmortgage debtcourt ordered paymentsother (please specify)
    How much debt do you have? less than $10,000$10k - $50K$50k - $150kmore than $150k
    Would you be interested in hearing about options in avoiding bankruptcy?yesno
    What is the best method of contact? emailphone
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