Mail or Fax in your order
Print out this page Print out the following application form and either:

Option 1: Fax it to 888.774.5368
Option 2:
 Mail it to:
Credit Repair Department
Archer's Financial
PO Box 121193
Fort Worth, TX. 76121
     Step 1: Contact Information
About you:
 

First Name:____________________________
 
Middle:_______________________________
 
Last Name:____________________________
 
Email:________________________________
Your Address:
 
Street (1):_____________________________
 
Apt # ______
 
City:____________________
 
ZIP:_____________
 
State:_____________
Have you lived at your current address for more than 2 years?             yes no
If no, please provide previous address
 
Street (1):_____________________________
 
Apt # ______
 
City:____________________
 
ZIP:_____________
 
State:_____________
     Step 2: Confirm Your Identity
Please complete the following information in order for us to verify your identity:
 
Social Security #:_____-_____-______
 
Phone Number :______________________
 
Date of Birth:______________________
 
Drivers License #:_____________________ State:____
Payment Information
 
Credit Card Type:________________________
 
Credit Card #: __________________________
 
Expiration Date: __________________
Check or Money Order:
 
If you are paying with a check or money order please make the payment payable to Archer's Financial, for a total of $580.00
How did you hear about us ?
 
_____________________________________________________________________
Authorization/Disclosure/Disclaimer:
CONSUMER CREDIT FILE RIGHTS UNDER STATE AND FEDERAL LAW You have a right to dispute inaccurate information in your credit report by contacting the credit bureau directly. However, neither you nor any credit repair company or credit repair organization has the right to have accurate, current, and verifiable information removed from your credit report. The credit bureau must remove accurate, negative information from your report only if it is over 7 years old. Bankruptcy information can be reported for 10 years. Archer's Financial does not claim to remove accurate information from any credit report. You have a right to obtain a copy of your credit report from a credit bureau. You may be charged a reasonable fee. There is no fee, however, if you have been turned down for credit, employment, insurance, or a rental dwelling because of information in your credit report within the preceding 60 days. The credit bureau must provide someone to help you interpret the information in your credit file. You are entitled to receive a free copy of your credit report if you are unemployed and intend to apply for employment in the next 60 days, if you are a recipient of public welfare assistance, or if you have reason to believe that there is inaccurate information in your credit report due to fraud. You have a right to sue a credit repair organization that violates the Credit Repair Organization Act. This law prohibits deceptive practices by credit repair organizations. You have the right to cancel your contract with any credit repair organization for any reason within 3 business days from the date you signed it. Credit bureaus are required to follow reasonable procedures to ensure that the information they report is accurate. However, mistakes may occur. You may, on your own, notify a credit bureau in writing that you dispute the accuracy of information in your credit file. The credit bureau may not charge any fee for this service. Any pertinent information and copies of all documents you have concerning an error should be given to the credit bureau. If the credit bureau's reinvestigation does not resolve the dispute to your satisfaction, you may send a brief statement to the credit bureau, to be kept in your file, explaining why you think the record is inaccurate. The credit bureau must include a summary of your statement about disputed information with any report it issues about you. The Federal trade Commission regulates credit bureaus and credit repair organizations.
Limited Power of Attorney Disclosure. Be it known that I, the undersigned, am the individual and by submitting this form hereby grant a limited power of attorney to Archer's Financial, and any and all persons in there employ, as my agent, to have the necessary power and authority to undertake and perform the following on my behalf. I hereby give permission to Archer's Financial to sign my name on all documents written on my behalf as my agent for the purpose of disputing inaccurate, erroneous, and obsolete credit information held on my report by consumer credit reporting agencies. This "limited power of attorney" is given to Archer's Financial in compliance with section 611 of the Federal Fair Credit Reporting Act.
Please review the information you have entered for accuracy and completeness.
    
X______________________________                            _______________
              signature                                              date    

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