Debt Assistance Questionaire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please answer the following questions to see if you qualify

Email *

Enter Your Full Name *

Question 1 of 9:
Are you currently Employed? *

Yes

Question 2 of 9:
What Is Your Currently Salary Per Month? *

Question 3 of 9:
How Much Debt Do You Owe In Total? (Please include all debt such as credit cards, personal loans, vehicle, bond, etc). *

R0 - R8000

R8000 - R15000

R16000 - R30000

More than R30000

Question 4 of 9:

Are you currently under debt review?

Yes

Question 5 of 9:
Your Marital Status

Single

Married (COP)

Married (Not COP)

Divorced

Clear selection

Question 6 of 9:

Do you consent to us pulling your credit report so we can assess how much we can reduce your debt by? *

Yes

Question 7 of 9:

If Yes, Please enter your ID number

Question 8 of 9:
When is the best time to call you? *

During Working hours

After hours

Whatsapp me anytime

Question 9 of 9:
Enter your best contact number and an alternative one (such work number, spouse, etc).
*

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of National Debt Experts. Report Abuse