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JS Assessoria
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Intake form
Help us serve you better
Name
*
Email address
*
What services are you interested in?
Please select at least one option.
Structured Consortium
Forex Investments
Solar Energy
Debt Clearance and Renegotiation
Financial Planning and Education
Insurance and Financial Protection
Credit and Financing
What is your current financial goal?
What is your preferred method of contact?
Select
Email
Phone
In-person
What is your estimated annual income?
Do you have any existing debts?
Select
Yes
No
If yes, please specify the type of debts you have.
What is your preferred time to be contacted?
Select
Morning
Afternoon
Evening
How did you hear about us?
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Social Media
Referral
Search Engine
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Event
Which service or services are you interested in?
Please select at least one option.
Structured consortium
Debt negotiation and credit recovery
Financial planning and education
Additional questions or comments
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