Consolidate Questionnaire

Boostline Questionnaire

1) Marital Status *

• Single
• Married
• Divorced
• Widowed
• Domestic Partnership

2) How much credit card debt do you currently have? *

• $1,000 – $10,000
• $10,000 – $20,000
• $20,000+

3) What are your goals? *

• Buy a house
• Buy a car
• Refinance
• Get out of debt
• Consolidate
• Other

Other *

4) Reason for high credit card debt? *

• Lost job
• Student loans
• Divorce
• Making only the minimum payment
• Over spending
• Medical emergency
• Covid
• Other

Please list other reason *

5) Have you tried to fix your credit in the past? *

• Yes
• No

What did you do before to try and fix your credit? *

6) Have you recently been denied for any of the following: *

• Refinance
• Home Mortgage
• Credit Card
• Auto Insurance
• Auto Loan
• Apartment/Rental
• Other

Please list other credit products that you have been recently declined for *

7) What is your current employment status? *

• Employed
• Not working
• Laid off
• Medical/Disabled
• Retired
• Covid
• Other

Please explain other *

8) Is your significant other in a similar situation? *

• Yes
• No or N/A

Name of your significant other?

Please explain their situation

9) Please check any retirement/investment accounts that you have *

• 401k
• 403b
• 457
• Thrift savings/tsp
• Pension
• Roth IRA
• Other IRA
• Mutual fund
• Stock/Bonds
• Crypto
• Savings for a house
• None

Amount of savings? *

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Name of CreditBull analyst helping you *

When would you like to receive a follow-up call? *

How did you hear about CreditBull?

• Google
• Other search engine
• Television
• Radio
• Referral
• Facebook
• YouTube
• Called by CreditBull Analyst

I agree to communications from CreditBull *

• I agree

Submit