PLEASE READ THE FOLLOWING BEFORE SUBMITTING YOUR INFORMATION FOR ENROLLMENT.

1. When entering your information, please double check to be sure all of the information is correct before submitting your form.

2. You are required to keep monthly credit monitoring while in our program. It is an additional $27.99/month. This is so that we can update you with any changes, deletions/updates that have occurred. It is impossible for us to do our job without it. If you cannot agree to this, please do not sign up for our services. If you downgrade your plan during the program, we will cancel your account with us.

3. Please do not sign up if you are in an active bankruptcy. Dismissed/Discharged bankruptcies are OK.

4. We require clients to complete their onboarding process within 24 hours. Please do not sign up if you cannot complete this. It takes no more than 20 minutes to complete.

5. Please do not sign up if you are currently behind on your bills. We don't want our services to be another added bill. Old accounts are OK.

6. During the program, if your payment is missed, a $25 fee will be applied to your payment. This includes a declined payment. If you are more than 3 days late on your monthly charge, your services will be canceled and you will have to pay another document processing fee as a new client if you'd like to proceed with services.

7. If you wish to cancel services, you MUST send an email to [email protected] 7 days BEFORE your payment due date to avoid charges for that month.

8. You MUST check your email regularly so that you don't miss important updates.

Your signature *

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Full Name *

Address

Street Address *

City *

State *

Country *

Postal code *

Date of birth *

Phone *

Email *

Full SSN:

Please upload a copy of your social security card. *

Are you a victim of identity theft? *

Yes

No

I'm not sure

Which enrollment fee are you paying today? *

Single (document processing fee) $299

Couples (document processing fee) $499

Hard Inquiries ONLY- $250

I'm a current client and have already paid this fee.

I'm signing up for the One Time Fee below.

If you are signing up for the monthly option, the fees are: Monthly Fee- $149 Couples Monthly Fee- $249 If you are signing up for the one time fee option, there is no monthly fee. This is not charged until the following month. *

Yes, I understand and agree.

If you are signing up for the couples package, the other person must complete this form as well. They WILL NOT be charged. *

Yes, I understand and agree.

We also offer a One Time Fee package that includes up to 12 months of services.FULL payment is required upon sign up.This package does NOT have a recurring monthly fee.

Single (12 months included) $1000

Couples (12 months included) $1799

Neither, I am signing up for the Monthly option

Hard Inquiries ONLY

We require you to have credit monitoring during the duration of the program so that we are able to keep up with your progress. This is an additional $27.99/month. Will you be able to maintain credit monitoring? *

Yes

Consent to Receive Text Messages

By providing your phone number below, you consent to receive text messages (SMS) from Mend Financial Services. These messages may include account updates, reminders, notifications about your services, promotional offers, or other relevant information.

Message Frequency: May vary for Mend Financial Services LLC

Message & Data Rates: Standard messaging and data rates may apply based on your carrier's plan.

Opt-Out: You may opTextt-out of receiving text messages at any time by replying STOP to any message.

Support: For help, reply HELP or contact us at [email protected].

By signing below or checking the box, you confirm that:

You are the authorized user of the provided phone number.

You agree to receive text messages from Mend Financial Services.

You understand that your consent is not a condition of purchasing our services.

Consent for Text Communication

To improve communication, we offer the option to receive updates and reminders via text messaging.

Opt-In Requirements:

During the sign-up process, you will have the option to opt in to text communication for Mend Financial Services LLC by providing your phone number and checking the appropriate consent box.

By opting in, you agree to receive messages from Mend Financial Services LLC, including credit analysis updates, progress reminders, and important notices.

Required Opt-In Message:

When providing your phone number, you will see the following opt-in message for Mend Financial Services LLC:

By providing your phone number, you consent to receive automated text messages from Mend Financial Services LLC for updates, reminders, and notices. Message frequency varies. Message and data rates may apply. Reply HELP for assistance or STOP to opt out.

Opt-Out Message:

If you choose to opt out, you will receive a confirmation text from Mend Financial Services LLC:

Mend Financial Services LLC: You have successfully unsubscribed and will receive no further messages. For assistance, contact us at [email protected].

Message frequency varies. Message & data rates may apply

HELP Message:

If you reply HELP to any text message, you will receive a response from Mend Financial Services LLC:

Mend Financial Services LLC: For assistance, contact our support team at [email protected].

Message frequency varies. Message & data rates may apply.

*

I agree to receive text messages as outlined above.

I don't want to receive text messages as outlined above.

Privacy Policy

Commitment to Your Privacy, this form is owned and operated by Mend Financial Services LLC. Your privacy on the internet is of the utmost importance to us. We understand the importance of making sure that at all times your online experience is safe & satisfying and with us. It’s our top priority to make sure that happens. Please read to understand our policy terms, and conditions surrounding the capture and use of that information. This privacy statement discloses what information we gather and how we use it.

MONTHLY MEMBERSHIP AUTHORIZATION

By signing, I authorize Mend Financial Services LLC to automatically charge the card I have designated to pay for the services I've purchased from Mend Financial Services LLC in accordance with the payment schedule and terms of my new client agreement.

I agree and authorize Mend Financial Services LLC to adjust the payments to reflect any late fees that occur during the term of the service.

If I have designated a debit card, I acknowledge my responsibility to ensure that there are sufficient funds in my bank account at the time of each scheduled debit. If there are insufficient funds in my account, I understand Mend Financial Services LLC may charge me an NSF fee and that Mend Financial Services LLC may at its discretion, attempt to process the charge again within 30 days with avoid cancellation.

I also understand that my membership may cancel or expire due to nonpayment if an automatic payment is rejected.

I understand that this authorization will remain in full force and effect for the remainder of the membership or until Mend Financial Services LLC has received a written notice from me of its termination.

I agree to notify Mend Financial Services LLC of any changes to my credit/debit information or termination of this authorization at least 3 business days prior to the next billing date.

If my scheduled payment falls on a weekend or holiday, I understand that the payment will still be executed on the day I select in this agreement.

I acknowledge that the origination of transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute the scheduled transactions with my bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form. Mend Financial Services LLC reserves the right to terminate this authorization and cancel your membership at any moment.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

If you sign up for the Monthly option, this card will be used to set up your account for autopay. Your payments will be due every month on the same date that you sign this form. For example: 01/01/2023 Your payment will be due every 1st of the month.

I agree.

By signing, I authorize Mend Financial Services LLC to automatically charge the card I have designated to pay for the services I've purchased from Mend Financial Services LLC after I complete my enrollment form.

Signature *

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Client Enrollment Form

Mend Financial Services LLC

Important Links

Business Hours

Monday 9:00 am - 5:00 pm

​Client Enrollment Form

Mend Financial Services LLC

Important Links

Business Hours

Monday 9:00 am - 5:00 pm

Client Enrollment Form