Credit Repair Application 1 Contact Info2 Address Info3 Personal Info4 Payment Info Name* First Last Email* By clicking 'Next' I agree to (1) be contacted by email about this service or other BullhornCreditRepair.com offers, and (2) the Privacy Policy and Terms of Use We just need a few more details to get your credit reports.Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneBy clicking "Next " I agree by electronic signature to: (1) be contacted about credit repair or credit repair marketing by a live agent, artificial or prerecorded voice, and SMS text at my residential or cellular number, dialed manually or by autodialer, and by email (consent to be contacted is not a condition to purchase services); and (2) the Privacy Policy and Terms of Use. Call (725) 261-0333 to sign up without providing consent to be contacted. The following information is used to obtain your credit information. Learn more...Social Security NumberYour BirthdayMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920By clicking "Next " I agree by electronic signature to: (1) be contacted about credit repair or credit repair marketing by a live agent, artificial or prerecorded voice, and SMS text at my residential or cellular number, dialed manually or by autodialer, and by email (consent to be contacted is not a condition to purchase services); and (2) the Privacy Policy and Terms of Use Call (725) 261-0333 to sign up without providing consent to be contacted. Almost done! Please choose a level of service and fill out your payment info.Credit Repair OptionsCredit Repair - $199.99/moTotal $0.00 ACHBy clicking ‘Submit’ I agree by electronic signature to: 1) authorize BullheadCreditRepair.com to charge the echeck/credit/debit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the amount indicated above only and is valid for 3 reoccurring payments of $199/mo for the total of $600. I certify that I am an authorized user of this bank account/credit/debit card and that I will not dispute the payment with my bank/credit/debit card company so long as the transaction corresponds to the terms indicated in the form. 2) be contacted by credit repair or credit repair marketing by a live agent, artificial or prerecorded voice,and SMS text at my residential or cellular number, dialed manually or by autodialer, and by email (consent to be contacted is not a condition to purchase services); and (3) the Privacy Policy and Terms of Use