Client Intake Questionniare

If you are here that means that you believe your rights have been violated by a debt collector. The good news is, we are here to help you... and possibly get you a settlement of up to $1,000 per debt collector that violate your rights!

if you have been contacted by a debt collector, please complete the information below, but before we get started, please consent to the below:

I agree to Terms and Conditions provided by The Law Office of Lalisa Sweat, PLLC. The Terms and Conditions can be found on the officially website. By providing my phone number or email, I agree to receive text messages from the business regarding my legal matters.

Consumer Information

Please enter your information below.

First Name *

Last Name *

Title *

Date of Birth *

Telephone *

Email *

Mailing Address *

Currently, how many debt collectors are contacting you? *

1. Debt Collector

2. Debt Collector

3. Debt Collector

4. Debt Collector

5. Debt Collector

6. Debt Collector

7. Debt Collector

8. Debt Collector

9. Debt Collector

10. Debt Collector

Have you sent dispute letters to the debt collector(s)? *

This only applies if you sent dispute letters directly to the debt collector. This does NOT apply to the CREDIT BUREAUS or ORIGINAL CREDITOR.

Have you told any of the debt collector(s) that you refuse to pay the debt? *

Have you asked any of the debt collector(s) to stop contacting you? *

Do you currently have debt collector(s) contacting you? *

Upload Evidence

Dispute Letter Sent

How many debt collector(s) did you send dispute letters too? *

How did you send the dispute letters to the debt collector(s) *

Check all that applies

If you sent by mail, did you send the dispute letter by certified mail (with tracking)?

If you sent by mail, upload screenshot(s) of the certified tracking number or evidence the letters were delivered:

Only upload if applicable.

If you did not send the dispute letters by mail, upload copies showing that the debt collector received the dispute letters:

Upload copies of the dispute letters you sent to the debt collector(s): *

Please upload all the dispute letters sent to each debt collector

Please upload any additional information you wish us to review:

Are you ready to submit the form? *

Requested Debt Collector(s) to Stop Contacting You

Please fully complete the section below:

Type the names of the debt collector(s) and the dates you requested the debt collector(s) to stop contacting you:

1. Debt Collector | Date(s)

2. Debt Collector | Date(s)

3. Debt Collector | Date(s)

4. Debt Collector | Date(s)

5. Debt Collector | Date(s)

6. Debt Collector | Date(s)

7. Debt Collector | Date(s)

8. Debt Collector | Date(s)

9. Debt Collector | Date(s)

10. Debt Collector | Date(s)

Did the debt collector(s) contact you by (text, email, phone or mail) after you requested them to stop contacting you? *

Yes

If so, how many?

If you answered NO to the question above, Please keep an eye out for the debt collector contacting you again. If they contact you again, please send an email [email protected] with an attachment of the evidence showing of them contacting you.

Upload Evidence

Cease and Desist

Please label each document you upload. This will allow us to easily decipher through the documents.

Please upload screenshot(s) of you requesting the debt collector(s) to stop contacting you: *

Please upload screenshot(s) of the debt collector(s) continuing to contact you after you asked them to stop:

Please skip if this section does not apply to you.

Please upload any additional information you wish our firm to review:

This section is optional. If you have any additional documents you would like our firm to review, please upload it here.

Are you ready to submit this form? *

Please only select a option that you have not previously selected already

Advised Debt Collector of Refusal to Pay

Please fully complete the section below:

Type the names of the debt collector(s) and the dates you told the debt collector(s) you refused to pay the debt

1. Debt Collector Name | Date(s)

2. Debt Collector Name | Date(s)

3. Debt Collector Name | Date(s)

4. Debt Collector Name | Date(s)

5. Debt Collector Name | Date(s)

6. Debt Collector Name | Date(s)

7. Debt Collector Name | Date(s)

8. Debt Collector Name | Date(s)

9. Debt Collector Name | Date(s)

10. Debt Collector Name | Date(s)

Did the debt collector(s) contact you by (text, email, telephone or mail) after you told them that you refuse to pay? *

Yes

If yes, how many?

Upload Evidence

Refusal to Pay

Please label each document you upload. This will allow us to easily decipher through the documents.

Please upload screenshot(s) of you telling the debt collector(s) you refuse to pay the debt: *

Please upload screenshot(s) of the debt collector(s) continuing to contact you after you told them you were not paying the debt:

Please skip if this section does not apply to you.

Please upload any additional information you would like our firm to review:

This section is optional. If you have any additional documents you would like our firm to review, please upload it here.

Ready to submit this form? *

Upload Evidence

General Uploads

Please upload screenshot(s) of all communication you have received from debt collector(s) within the past year: *

Be sure to upload all screenshots (text, email, telephone calls and mail letters) received from the past year up until today.

I'm ready to submit this form: *

Submit the Form

Congratulations, you have made it to the end of the form! Please allow us 2-3 days to review the information and if we have any additional questions we will be in contact.

Please provide additional comments or concerns that you would like our firm to know about:

If you do not not have any additonal comments or concerns, please go to the secton below.

To expedite our review, please download all three copies of your credit report from FREE ANNUAL CREDIT REPORT:

To access your free credit reports, click on this LINK. Please be sure to access the reports from a computer (instead of your phone) as you will need to download PDF copies of each report. Please follow the prompts thoroughly.

Once you have the three PDF's from (TransUnion, Experian and Equifax) come back here to upload the documents.