Financial Intake Form
Please complete the form below to receive your FREE analysis and savings report.
For the most accurate results, include all household income and debt and be as detailed as possible. If you have questions please reach out to us at 410-371-1351.
NOTE: We protect your privacy. We do not need nor require, nor will we ever ask you for any account numbers or Social Security numbers. There is no credit check. We use the information below to provide the best analysis possible. Your data will be kept strictly confidential and used for interoffice processing only.
See how much time and money you can save on your current debt!
- Afghanistan
- Albania
- Algeria
- American Samoa
- Andorra
- Angola
- Anguilla
- Antarctica
- Antigua and Barbuda
- Argentina
- Armenia
- Aruba
- Australia
- Austria
- Azerbaijan
- Bahamas
- Bahrain
- Bangladesh
- Barbados
- Belarus
- Belgium
- Belize
- Benin
- Bermuda
- Bhutan
- Bolivia
- Bosnia and Herzegovina
- Botswana
- Bouvet Island
- Brazil
- British Indian Ocean Territory
- Brunei Darussalam
- Bulgaria
- Burkina Faso
- Burundi
- Cambodia
- Cameroon
- Canada
- Cape Verde
- Cayman Islands
- Central African Republic
- Chad
- Chile
- China
- Christmas Island
- Cocos (Keeling) Islands
- Colombia
- Comoros
- Congo
- Congo, The Democratic Republic of the
- Cook Islands
- Costa Rica
- Cote D"Ivoire
- Croatia
- Cuba
- Cyprus
- Czech Republic
- Denmark
- Djibouti
- Dominica
- Dominican Republic
- Ecuador
- Egypt
- El Salvador
- Equatorial Guinea
- Eritrea
- Estonia
- Ethiopia
- Falkland Islands (Malvinas)
- Faroe Islands
- Fiji
- Finland
- France
- French Guiana
- French Polynesia
- French Southern Territories
- Gabon
- Gambia
- Georgia
- Germany
- Ghana
- Gibraltar
- Greece
- Greenland
- Grenada
- Guadeloupe
- Guam
- Guatemala
- Guernsey
- Guinea
- Guinea-Bissau
- Guyana
- Haiti
- Heard Island and McDonald Islands
- Holy See (Vatican City State)
- Honduras
- Hong Kong
- Hungary
- Iceland
- India
- Indonesia
- Iran, Islamic Republic Of
- Iraq
- Ireland
- Isle of Man
- Israel
- Italy
- Jamaica
- Japan
- Jersey
- Jordan
- Kazakhstan
- Kenya
- Kiribati
- Korea People's Democratic Republic
- Republic of Korea
- Kuwait
- Kyrgyzstan
- Land Islands
- Lao People's Democratic Republic
- Latvia
- Lebanon
- Lesotho
- Liberia
- Libyan Arab Jamahiriya
- Liechtenstein
- Lithuania
- Luxembourg
- Macao
- North Macedonia
- Madagascar
- Malawi
- Malaysia
- Maldives
- Mali
- Malta
- Marshall Islands
- Martinique
- Mauritania
- Mauritius
- Mayotte
- Mexico
- Federated States of Micronesia
- Moldova, Republic of
- Monaco
- Mongolia
- Montenegro
- Montserrat
- Morocco
- Mozambique
- Myanmar
- Namibia
- Nauru
- Nepal
- Netherlands
- New Caledonia
- New Zealand
- Nicaragua
- Niger
- Nigeria
- Niue
- Norfolk Island
- Northern Mariana Islands
- Norway
- Oman
- Pakistan
- Palau
- Palestinian Territory, Occupied
- Panama
- Papua New Guinea
- Paraguay
- Peru
- Philippines
- Pitcairn
- Poland
- Portugal
- Puerto Rico
- Qatar
- Reunion
- Romania
- Russian Federation
- Rwanda
- Saint Helena
- Saint Kitts and Nevis
- Saint Lucia
- Saint Pierre and Miquelon
- Saint Vincent and the Grenadines
- Samoa
- San Marino
- Sao Tome and Principe
- Saudi Arabia
- Senegal
- Serbia
- Seychelles
- Sierra Leone
- Singapore
- Slovakia
- Slovenia
- Solomon Islands
- Somalia
- South Africa
- South Georgia and the South Sandwich Islands
- Spain
- Sri Lanka
- Sudan
- Suriname
- Svalbard and Jan Mayen
- Eswatini
- Sweden
- Switzerland
- Syrian Arab Republic
- Taiwan
- Tajikistan
- Tanzania, United Republic of
- Thailand
- Timor-Leste
- Togo
- Tokelau
- Tonga
- Trinidad and Tobago
- Tunisia
- Turkey
- Turkmenistan
- Turks and Caicos Islands
- Tuvalu
- Uganda
- UK
- Ukraine
- United Arab Emirates
- United States
- United States Minor Outlying Islands
- Uruguay
- Uzbekistan
- Vanuatu
- Venezuela
- Vietnam
- Virgin Islands, British
- Virgin Islands, U.S.
- Wallis and Futuna
- Western Sahara
- Yemen
- Zambia
- Zimbabwe
- No elements found. Consider changing the search query.
- List is empty.
INCOME
Please list all of your sources of income for your household. You must enter at least one source of income. Please be sure to note the frequency of that income source.
If you more than three income sources, please enter them in the Additional Information field at the bottom of this form.
- Every Week
- Every Other Week
- Twice a Month
- Once a Month
- Every Three Months
- Twice a Year
- Once a Year
- No elements found. Consider changing the search query.
- List is empty.
- Every Week
- Every Other Week
- Twice a Month
- Once a Month
- Every Three Months
- Twice a Year
- Once a Year
- No elements found. Consider changing the search query.
- List is empty.
- Every Week
- Every Other Week
- Twice a Month
- Once a Month
- Every Three Months
- Twice a Year
- Once a Year
- No elements found. Consider changing the search query.
- List is empty.
MORTGAGES & HELOCS
Please enter the information for your mortgage(s) or HELOC(s) below. Please be as detailed as possible and do not round up the payments. Your monthly mortgage payment should be entered in Total Payment and then only the portion of that payment that is escrow should be entered in the Escrow Portion of Payment field.
If your HELOC has a variable rate, please use the current rate and make a note in the Additional Information section.
CREDIT ACCOUNTS
Please select the number of credit accounts/loans you have in addition to the mortgages you listed above. Please be as detailed as possible and do not round up the payments.
If you more than 10 credit accounts/loans, please enter them in the Additional Information field at the bottom of this form.
- None
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
- Credit Card
- Auto Loan
- Student Loan
- Personal/Other
- No elements found. Consider changing the search query.
- List is empty.
BANKING
Please enter information for at least two accounts. If you only have one account then enter Savings in the Account 2 field and 0.00 for the Account 2: Balance.
- Checking
- Savings
- No elements found. Consider changing the search query.
- List is empty.
- Checking
- Savings
- No elements found. Consider changing the search query.
- List is empty.
- Checking
- Savings
- No elements found. Consider changing the search query.
- List is empty.
- Checking
- Savings
- No elements found. Consider changing the search query.
- List is empty.
