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    <!-- BOF: ./personal-templates/simple/businessnew/form/style_l51.wait -->

 
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  <!-- BOF: ./personal-templates/simple/business/layout/l51.wait -->


<!-- EOF: ./personal-templates/simple/business/layout/l51.wait -->


<HTML>

<HEAD>


<META NAME="description" CONTENT="Changing Negative Credit One Report At A Time.">
<META NAME="Keywords"    CONTENT="credit, repair, bad, reports, scores, raise, high, ">


<!-- business -->


<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=UTF-8">
<META NAME="Generator" content="">
<!-- BOF: ./personal-templates/simple/themes.show -->


<!-- EOF: ./personal-templates/simple/themes.show -->


<!--<BASE HREF="http://d19273.d24.allusionentertainment.com/form.html">-->
<TITLE>Request Credit Report ($40 fee)</TITLE></head>
<BODY  BGCOLOR="#FBEBE7"
 TEXT="#000000"

LEFTMARGIN="0" TOPMARGIN="0" RIGHTMARGIN="0" BOTTOMMARGIN="0"

 onLoad=""
 
 LINK="#000000"
 VLINK="#000000"
 ALINK="#F99450"
>

  
      <!-- BOF: ./personal-templates/simple/business/layout/l51.layout --> 

<!-- html -->
<TABLE WIDTH="100%" HEIGHT="100%" BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
   <TR>
       <TD WIDTH=274 HEIGHT="100%" VALIGN="top">
           <TABLE WIDTH="100%" HEIGHT="100%" BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">
               <TR>
                   <TD COLSPAN=2 WIDTH=274 HEIGHT=324 VALIGN="top">
                          <img src="widgets/gen_738.1.gif" border=0 width=274 height=324 alt=""></TD>
               </TR>
               <TR>
                   <TD WIDTH="48" HEIGHT="100%" BACKGROUND="widgets/gen_732.1.gif" BGCOLOR="#FFCC99" VALIGN="top">
                        <img src="widgets/spacer.gif" height=1 width=1 alt=""></TD>
                   <TD WIDTH="226" BACKGROUND="widgets/gen_19.1.gif" style="background-repeat: no-repeat;" VALIGN="top">
                       <img src="widgets/spacer.gif" height=20 width=1 alt="">
                       
                      <a href="index.html" onMouseOver="document.images['img6'].src='widgets/gen_746.1.gif'" onMouseOut="document.images['img6'].src='widgets/gen_486.1.gif'"><img src="widgets/gen_486.1.gif" alt="Home" name="img6" border="0"></a><br>
                      <a href="gpage.html" onMouseOver="document.images['img7'].src='widgets/gen_953.1.gif'" onMouseOut="document.images['img7'].src='widgets/gen_952.1.gif'"><img src="widgets/gen_952.1.gif" alt="About Our Service" name="img7" border="0"></a><br>
                      <a href="form.html" onMouseOver="document.images['img22'].src='widgets/gen_926.1.gif'" onMouseOut="document.images['img22'].src='widgets/gen_925.1.gif'"><img src="widgets/gen_925.1.gif" alt="Request Credit Report" name="img22" border="0"></a><br>
                      <a href="Download.html" onMouseOver="document.images['img56'].src='widgets/gen_924.1.gif'" onMouseOut="document.images['img56'].src='widgets/gen_923.1.gif'"><img src="widgets/gen_923.1.gif" alt="Start Credit Repair Today" name="img56" border="0"></a><br>
                      <a href="contact.html" onMouseOver="document.images['img9'].src='widgets/gen_753.1.gif'" onMouseOut="document.images['img9'].src='widgets/gen_500.1.gif'"><img src="widgets/gen_500.1.gif" alt="Contact Us" name="img9" border="0"></a><br>
                      
                      
                      <a href="form1.html" onMouseOver="document.images['img62'].src='widgets/gen_754.1.gif'" onMouseOut="document.images['img62'].src='widgets/gen_502.1.gif'"><img src="widgets/gen_502.1.gif" alt="Survey" name="img62" border="0"></a><br>
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                      <a href="gpage1.html" onMouseOver="document.images['img77'].src='widgets/gen_1017.1.gif'" onMouseOut="document.images['img77'].src='widgets/gen_1016.1.gif'"><img src="widgets/gen_1016.1.gif" alt="Our Prices" name="img77" border="0"></a><br><a href="mailto:gtcredit@yahoo.com" onMouseOver="document.images['img_email'].src='widgets/gen_755.1.gif'" onMouseOut="document.images['img_email'].src='widgets/gen_504.1.gif'"><img src="widgets/gen_504.1.gif" alt="Email Me" name="img_email" border="0"></a><br><br></TD>
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                              <TD VALIGN="top">
                               <img src="widgets/spacer.gif" height=1 width=1 alt="">
                           <!-- BOF: ./personal-templates/simple/businessnew/form/style_l51.html -->

<table border="0" cellpadding="0" cellspacing="10" align="center">

<tr>

    <td HEIGHT="35" valign="top" align="center">

    <img src="widgets/gen_929.1.gif" border=0 width=444 height=35 alt=""></td>

</tr>

</TABLE>

<TABLE DIR="LTR" WIDTH=90% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top" ALIGN="center">

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               <TD WIDTH=34 HEIGHT=8>

               <img src="widgets/gen_725.1.gif" border=0 width=34 height=8 alt=""></TD>

               <TD><img src="widgets/spacer.gif" height=1 width=1 alt=""></TD>

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              <TD BACKGROUND="widgets/gen_726.1.gif" VALIGN="bottom">

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<TABLE WIDTH=100% BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="top">

<TR><TD COLSPAN="2"></TD></TR>

<TR>

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<SCRIPT LANGUAGE="JavaScript">

var BUILDER = '/studio/servlet/psoft.masonry.Builder';
function validate(frm){

var i = 0;

if (frm.field_y_26.value=="") return error(frm.field_y_26);


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for(i = 0; i < frm.field_38.length; i++)

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var url = document.URL;
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}
frm.domain.value=url;
return true;


}

function error(field){ alert('You did not fill all required fields!'); field.focus(); return false; }

</SCRIPT>

<form name="questionary" action="http://66.232.105.244:8080/studio/servlet/psoft.customform.CustomForm" method="post">

<input type="hidden" name="domain" value="">

<input type="hidden" name="title" value="Request Credit Report ($40 fee)">

<input type="hidden" name="esubj" value="Submitted Form Report">
<input type="hidden" name="name" value="=GCh0WGxbU1bal4b">
<input type="hidden" name="submit_url" value="onsubmit1.html">
<input type="hidden" name="error_url" value="onerror1.html">


<input type="hidden" name="order" value="d26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 ">


        <TD VALIGN="top">

        <TABLE border="0" cellpadding="5" cellspacing="5" width="95%">

        <TR><TD colspan=2>&nbsp;</td></TR>

        <input type="hidden" name="name_26" value="Today’s Date">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Today’s Date
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><select name="field_m_26" size="1">

            <option>Jan<option>Feb<option>Mar

            <option>Apr<option>May<option>Jun

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            <select name="field_d_26" size="1">

            <option>1<option>2<option>3<option>4<option>5<option>6<option>7<option>8<option>9<option>10<option>11<option>12<option>13<option>14<option>15<option>16<option>17<option>18<option>19<option>20<option>21<option>22<option>23<option>24<option>25<option>26<option>27<option>28<option>29<option>30<option>31

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            <input type="text" name="field_y_26" size="4" maxsize="4">

            
            </TD>

        </TR>

        <input type="hidden" name="name_27" value="Name">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Name
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_27" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_28" value="Address">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Address
</b>
</font>


</td>

            <TD><input type="text" name="field_28" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_29" value="Previous Address">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Previous Address
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_29" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_30" value="SSN">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
SSN
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_30" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_31" value="DOB">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
DOB
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_31" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_32" value="Goal">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Goal
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_32" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_33" value="Estimated time to achieve your Goal">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Estimated time to achieve your Goal
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_33" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_34" value="Contact: (HM Phone)">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Contact: (HM Phone)
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_34" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_35" value="WK">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
WK
</b>
</font>


</td>

            <TD><input type="text" name="field_35" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_36" value="Cell">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Cell
</b>
</font>


</td>

            <TD><input type="text" name="field_36" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_37" value="Do You Have a Credit Report">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Do You Have a Credit Report
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="text" name="field_37" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_38" value="Additional information for Home & Car Loans Only">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Additional information for Home & Car Loans Only
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="radio" name="field_38" value="Yes">


<font face='Verdana' size='3' color='#000000'>
<b>
Yes
</b>
</font>


 <input type="radio" name="field_38" value="No">


<font face='Verdana' size='3' color='#000000'>
<b>
No
</b>
</font>


            </TD>

        </TR>

        <input type="hidden" name="name_39" value="Place of Employment">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Place of Employment
</b>
</font>


</td>

            <TD><input type="text" name="field_39" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_40" value="How Long">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
How Long
</b>
</font>


</td>

            <TD><input type="text" name="field_40" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_41" value="Income (Yearly)">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Income (Yearly)
</b>
</font>


</td>

            <TD><input type="text" name="field_41" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_42" value="Amount of Loan">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Amount of Loan
</b>
</font>


</td>

            <TD><input type="text" name="field_42" size=35>

            
            </TD>

        </TR>

        <input type="hidden" name="name_43" value="Spouse Information">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Spouse Information
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="radio" name="field_43" value="Yes">


<font face='Verdana' size='3' color='#000000'>
<b>
Yes
</b>
</font>


 <input type="radio" name="field_43" value="No">


<font face='Verdana' size='3' color='#000000'>
<b>
No
</b>
</font>


            </TD>

        </TR>

        <input type="hidden" name="name_44" value="Additional Spouse information: Name, Address, Previous Address, SSN, DOB, Goal, Estimated time to achieve your Goal, Contact: HM Phone, WK phone, Cell phone.">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Additional Spouse information: Name, Address, Previous Address, SSN, DOB, Goal, Estimated time to achieve your Goal, Contact: HM Phone, WK phone, Cell phone.
</b>
</font>


</td>

            <TD><textarea name="field_44" rows="5" cols="30"></textarea>

            
            </TD>

        </TR>

        <input type="hidden" name="name_45" value="Do You Have a Credit Report">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Do You Have a Credit Report
</b>
</font>


<font color="red" size="-1">*</font></td>

            <TD><input type="radio" name="field_45" value="Yes">


<font face='Verdana' size='3' color='#000000'>
<b>
Yes
</b>
</font>


 <input type="radio" name="field_45" value="No">


<font face='Verdana' size='3' color='#000000'>
<b>
No
</b>
</font>


            </TD>

        </TR>

        <input type="hidden" name="name_46" value="Additional information for Home & Car Loans Only: Place of Employment, How Long, Income (Yearly), Amount of Loan.">

        <TR><TD>


<font face='Verdana' size='3' color='#000000'>
<b>
Additional information for Home & Car Loans Only: Place of Employment, How Long, Income (Yearly), Amount of Loan.
</b>
</font>


</td>

            <TD><textarea name="field_46" rows="5" cols="30"></textarea>

            
            </TD>

        </TR>

        
        <TR><TD colspan=2 align=center><input onClick="return validate(form)" type="submit" value="Submit">

            <input type="reset"  value="Reset"></TD>

        </TR>

        </TABLE>

        </TD>

</form>

    </TR>

    </TABLE>

    </TD>

</TR>

</TABLE>

</TD>

<TD BACKGROUND="widgets/gen_45.1.gif" VALIGN="top" width="4">

              <img src="widgets/gen_46.1.gif" border=0 width=4 height=9 alt=""></TD></TR>

              <TR>

          <TD WIDTH=34 HEIGHT=14>

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          <TD ALIGN="left" BACKGROUND="widgets/gen_43.1.gif">

          <img src="widgets/gen_42.1.gif" border=0 width=116 height=14 alt=""></TD>

          <TD WIDTH=4 HEIGHT=14>

          <img src="widgets/gen_44.1.gif" border=0 width=4 height=14 alt=""></TD>

        </TR></TABLE>

<!-- EOF: ./personal-templates/simple/businessnew/form/style_l51.html -->

                                                
                           </TD></TR>
                           <TR><TD valign="bottom" align="right">
                           <img src="widgets/gen_704.1.gif" border=0 width=105 height=99 alt="">
                           </TD></TR></TABLE>
                           </TD>
                       </TR>
                     </TABLE>
                    </TD>
                    </TR>
                   <TR>
                   <TD VALIGN="bottom" ALIGN="center">
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<a href="http://www.psoft.net" target="_blank"><img src="widgets/ss_button.gif" border="0"></a>

<br><font face="helvetica,verdana, arial" size="1">&nbsp;</font>

</td></tr></table></center>
</TD>
               </TR>
            </TABLE>
       </TD>
       <TD ROWSPAN=2 WIDTH=46 BGCOLOR="#FFCC99" BACKGROUND="widgets/gen_731.1.gif" ALIGN="right">
              <img src="widgets/spacer.gif" height=1 width=46 alt=""></TD>
   </TR>
   <TR>
      <TD COLSPAN=2 VALIGN="bottom">
          <TABLE WIDTH="100%" HEIGHT="100%" BORDER=0 CELLPADDING=0 CELLSPACING=0 VALIGN="bottom">
             <TR>
                 <TD WIDTH=121 HEIGHT=86 ALIGN="left" VALIGN="top">
                 <img src="widgets/gen_737.1.gif" border=0 width=121 height=86 alt=""></TD>
                 <TD BACKGROUND="widgets/gen_733.1.gif" VALIGN="top">

<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">Home</A>|</nobr>

<nobr>|<a href="gpage.html">About Our Service</A>|</nobr>

<nobr>|Request Credit Report|</nobr>

<nobr>|<a href="Download.html">Start Credit Repair Today</A>|</nobr>

<nobr>|<a href="contact.html">Contact Us</A>|</nobr>

<nobr>|<a href="form1.html">Survey</A>|</nobr>

<nobr>|<a href="faq.html">FAQ</A>|</nobr>

<nobr>|<a href="gpage1.html">Our Prices</A>|</nobr>
</center>
</font>

</TD>
                 <TD WIDTH=73 ALIGN="right" VALIGN="top">
                 <img src="widgets/gen_734.1.gif" border=0 width=73 height=86 alt=""></TD>
             </TR>
          </TABLE>
      </TD>
   </TR>
</TABLE>

<!-- end html -->
                
<!-- EOF: ./personal-templates/simple/business/layout/l51.layout -->

    
<!-- BOF: ./personal-templates/simple/themes.show.body -->


<!-- EOF: ./personal-templates/simple/themes.show.body -->

</body>
<!-- BOF: ./personal-templates/simple/themes.show.end -->


<!-- EOF: ./personal-templates/simple/themes.show.end -->


</html>


<!-- EOF: ./personal-templates/show.body -->