Fowler and Fowler Credit and Debt Solutions, Inc.
Office Toll Free: 1-866-524-2328 Fax: 1-888-493-9631 e-mail: contracthelp@FowlerandFowler.net
HOME     PRIVACY POLICY     CONTACT US
 

 

CREDIT REPAIR SERVICE CONTRACT

Please fill out your personal information:

First Person Full Name 

Street Address

City  State Zip 

Telephone Number  E-mail Address

Social Security Number  Date of Birth 

 
Please enter the second persons information (if applicable):

Second Person Full Name 

Street Address

City  State  Zip 

Telephone Number  E-mail Address 

Social Security Number  Date of Birth 

Payment Information:

1. Payment Method      
2. Credit Card Account Number  Security Numbers from Back of Credit Card.  (Last three digits)
3.Expiration Date
4.Number of Persons and Plan

*billing provided by Fowler and Fowler, a St-Kitts corporation, C18, The Sands, Bay Road, Basseterre, St-Kitts.
5.Upgrade to Premium Mailings

Click HERE For More Information

 (If you do not want this option make sure you select NO!)

6.SELECT THE CORRECT  TOTAL:
7. Enter Your Name To Authorized Payment

**(You are also authorizing us to auto deduct or draft your 5 monthly payments.  This payment will be scheduled on the monthly anniversary of this contract.) i.e. 01/06/05, 02/06/05, 03/06/05, 04/06/05, 05/06/05
8.  Pay by check: If you would like to have these fees taken directly out of your checking account please enter your checking account information here, or simply tape a voided check to a piece of paper and fax it to our office at 863-655-2876.

Bank Name:

Bank Address:

Bank Address:

Bank Phone Number (if on check):

Routing Number (Usually the first nine numbers):

Account Number:


In this Agreement, the party who is contracting to receive services shall be referred to as "the client(s)", and the party who will be providing services shall be referred to as "Fowler and Fowler, we or us".

The parties agree as follows:

DESCRIPTION OF SERVICES.

I agree and understand what I am signing, and acknowledge that I have received a copy of the General Terms and Conditions by printing or saving this document.

I agree and understand what I am signing, and acknowledge that I have received a copy of Consumer Credit File Rights by printing or saving this document.


Signature #1  Date  (Month/Day/Year)

Signature #2  Date  (Month/Day/Year)
 

TO COMPLETE THE SIGN UP PROCESS PLEASE CLICK FINISHED AFTER YOU INDICATE THAT YOU
 UNDERSTAND AND AGREE TO THE ABOVE BY SIGNING AND DATING THE FOLLOWING.

Counselors or Representatives Name (If you have already spoken to someone.)

THANK YOU!

If you do not wish to submit over the Internet, print two copies of this contract one to mail or fax and one for your records.

 
-