Debtmerica Relief - Debt Settlement Company

WFG Rep. Name	WFG Rep. Code #
WFG Rep. Phone # ( ) -	WFG Rep. Email
WFG Mktg. Dir. Name	WFG Mktg Dir. Email

Client First Name	Client Last Name
Spouse First Name	Spouse Last Name
Client Phone ( ) -	Client Alt. Phone ( ) -
Client Email	Marital Status
State	Unsecured Debt
Monthly Income	Is client current or past due?
Is client experiencing financial hardship? Yes No We respect your privacy and do not share your information with third parties. Privacy Policy	(Also note if you have a preferred Debtmerica agent) Comments:
FOR EXPEDITED SERVICE: Please FAX current statements (within 60 days) for ALL unsecured debt accounts over $500. We will contact you to schedule your Free Personalized Debt Analysis with a Senior Debt Consultant ASAP.

Debt Presentation

*Estimates are based on historical results and individual results may vary, including the ability to save sufficient funds to complete your program, the creditors in your individual portfolio, and underwriting guidelines. Statements made are examples of past performance, which are not intended to be a guarantee of any future settlement results. When you contact Debtmerica, LLC we will attempt to understand your situation and determine whether you are qualified for our debt resolution programs. Debtmerica, LLC assists with unsecured debt only and any use of “debt free” only applies to accounts that are successfully enrolled and upon program completion. While our programs work aggressively to reduce your debt balances, creditors are under no contractual obligation to negotiate or accept settlement offers. Debt reduction percentages do not include program fees; guarantee that your debt balances will be lowered by a specific amount or percentage, or that you will be debt free within a specific time period. However, if at the completion of your debt resolution program your total debt reduction equals less than two (2) times the amount of fees paid, we guarantee to refund a portion of those fees. This refund is calculated so that your fees will never equal more than one-half (1/2) of your total debt reduction. This fee guarantee does not apply to consumers referred to debt resolution programs utilizing attorney-based negotiations. We do not assume consumer debt, make monthly payments to creditors or provide tax, bankruptcy, accounting or legal advice and we do not provide credit repair services. Please contact a tax professional to discuss tax consequences of debt settlement. By providing your contact information, you agree to receive return telephone calls, emails or other communications from Debtmerica, LLC and/or its affiliates and expressly waive any “No Call” preference or registration. Photographs used are not actual clients. Debtmerica, LLC is not affiliated with MSNBC, Fox, CBS, MarketWatch, USA Today, INC. 5000 or OCBJ and logos used are registered trademarks of their respective owners. Not available in all states. Read and understand all program materials prior to your enrollment.