Cell Phone:

Please continue to answer the questions below to pre-qualify.

	Are you currently having your paycheck garnished?	Yes No Please choose yes or no
	Are you currently having your tax refund offset?	Yes No Please choose yes or no
	Are any of your loans in default?	Yes No Please choose yes or no
	Comments:
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We will contact you within 15 minutes at the above phone number between 9AM-6PM Eastern Standard Time.