Breeze Wealth Solutions

CLIENT INTAKE FORM

Thank you for trusting us to assist in improving your credit profile. To get started, please complete the intake form below with accurate and up-to-date information.

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Address

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Credit Bureau & Credit Karma Account Access

Full cooperation required

Timely progress on your file depends on your full cooperation and participation. Please provide complete and accurate login credentials, security question answers, and security PINs for each credit bureau below, and respond promptly to any requests for documents, verification codes, or additional information. Incomplete or inaccurate information, or delayed responses, may cause delays in the process.

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Equifax

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Experian

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TransUnion

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To verify your address, the only accepted documents are:
  • W-2 form
  • 1099 form
  • Pay stub
  • Lease agreement
  • Mortgage agreement
  • Utility bill
  • Bank statement
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Please review and sign the contract


Credit Solutions Agreement

1. Agreement

This Contract Agreement ("Agreement") is made effective as of , between Breeze Wealth Solutions ("Service Provider") and ("Client"), collectively referred to as "Parties."

2. Services Provided

Service Provider agrees to provide credit repair and consultation services to the Client within the Client's package. These services include analyzing the Client's credit report, identifying errors and inaccuracies, disputing inaccurate information, providing guidance on credit improvement strategies, and offering ongoing support during the credit repair process.

3. Payment

The Client agrees to pay the total fee of $ for the selected package. Prior to enrollment, the Service Provider performs a consultation, credit report review, negative item audit, strategy development, compliance review, and case preparation. Unless otherwise agreed in writing, payment is due upon enrollment.

4. Service Commencement

Services will commence immediately after this Agreement has been reviewed and signed by both Parties and payment requirements have been satisfied.

5. Timeframe for Results

The Parties acknowledge that results may vary. Initial changes may take a minimum of 30 business days and up to 180 business days depending on the complexity of the file and bureau response times.

5a. No Guarantee of Results

Credit repair outcomes depend on factors outside the Service Provider's control, including but not limited to the accuracy of information furnished by creditors, the policies and response times of the credit bureaus, and the Client's own credit activity during the engagement. The Service Provider makes no guarantee, promise, or warranty — express or implied — regarding specific outcomes, the deletion or correction of any particular item, score improvement, timeframes, or entitlement to a refund. Any discussion of possible results is illustrative only and not a representation of what will occur in the Client's case.

5b. Disclosure Regarding Late-Payment Accounts

The Client acknowledges and understands that when an account reporting late payments is disputed, the credit bureau or furnisher may be unable to verify the disputed information within the required reporting period, which can result in the account being deleted from the credit report in its entirety — not merely corrected. This may remove the account's full payment history, including any on-time payment history that had been reporting positively, along with the negative marks. The Client understands this is a possible outcome of the dispute process, is not guaranteed to occur, and is outside the Service Provider's control.

5c. Disclosure Regarding Re-Verified Accounts and Dispute Timelines

The Client acknowledges that if, after an initial round of disputes, an account is verified by the furnisher and remains on the credit report, the Service Provider may submit a new dispute for that same account. The Client understands that each new dispute submitted for an account restarts the credit bureau's applicable investigation and response timeframe for that account, and that the overall timeframes described in Section 5 apply separately to each new round of disputes rather than accumulating from the original dispute date.

6. Client's Obligations

The Client agrees to cooperate fully by providing all requested documentation and information required for the credit restoration process.

7. Limitations of Liability

The Service Provider cannot guarantee specific outcomes and is not responsible for decisions made by credit reporting agencies or creditors.

8. Confidentiality

The Parties agree to maintain strict confidentiality regarding personal and financial information exchanged during the course of this Agreement.

8a. Authorized Personnel

Client acknowledges that Service Provider may assign employees, contractors, or authorized representatives ("Authorized Personnel") to work on Client's file, including reviewing Client's credit report, preparing and submitting disputes, communicating with Client, executing correspondence, and receiving documentation on Service Provider's behalf. Client's file may not be handled exclusively by the Service Provider named in Section 1. All Authorized Personnel are bound by the same confidentiality obligations set forth in this Section 8. Any Authorized Personnel found to have misused, improperly disclosed, or accessed Client's information outside the scope of this Agreement will be subject to immediate termination and disciplinary action, and Service Provider reserves the right to pursue all available legal remedies. Nothing in this section limits any liability or penalty available under applicable federal or state law, including the Fair Credit Reporting Act (FCRA) and Georgia data privacy statutes, for unauthorized use or disclosure of consumer information.

9. Content, Testimonial, and Media Use

The Client acknowledges that Breeze Wealth Solutions may request testimonials, progress updates, before-and-after score comparisons, screenshots, written reviews, or other materials reflecting the Client's experience and results. Personally identifying information such as Social Security numbers, account numbers, dates of birth, addresses, and login credentials shall not be intentionally disclosed. Materials used for marketing or educational purposes may be reviewed and redacted where appropriate to protect client privacy. The purpose of such materials is solely to demonstrate client progress, transparency, and legitimate results.

10. Termination

Either Party may terminate this Agreement with written notice. For purposes of this Agreement, "services rendered" include consultations, credit report reviews, negative item audits, strategy development, case preparation, compliance review, dispute preparation, dispute submissions, follow-up communications, client support, and other documented work completed on behalf of the Client. The Service Provider shall retain payment attributable to services already rendered up to the termination date.

11. Entire Agreement

This Agreement constitutes the entire understanding between the Parties.

12. Governing Law and Jurisdiction

This Agreement shall be governed by the laws of the State of Georgia.

Service Provider: Breeze Wealth Solutions

Signature of Service Provider:

Date:

Client's Full Name:

Selected Package:

Signature of Client:

Date:

Agreement details

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Thank you

Your intake form has been received. Our team will review your information and follow up with next steps.