Julian Credit Management is a non-profit, nationwide debt consolidation and credit counseling organization, located in Central Florida. Our dedicated counselors can help you restructure your bills and make a payment plan that can cut years and thousands of dollars off your long-term debts like credit cards, mortgages, and other loans.
Our debt management program can help you repay your debts: We help you establish a spending plan, determine your financial options, save money on interest and late fees, get your creditors off your back, and provide you with useful information.
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A nation-wide non profit organization. Try our debt consolidation program!
18820 U.S. 19 North, Building 2, Suite 200,
Clearwater FL 33764		 Phone: 1-877-454-3328 (DEBT)
Fax: (727) 524-6744

Questionnaire: Budget Disclosure (monthly)
Client Name:
Spouse Name:
Mailing Address:
City:
State:
ZIP Code:
Home Phone:
Work Phone:
E-Mail:
Best time to reach you:

Net Income Sources:
Employment: $
Pension/Retirement: $
Child Support: $
Social Security: $
Other: $
Total Income: $

Household Expenses: (individual or joint)

Diverse Expenses:

Mortgage/Rent:		 $
Food: $
Clothing: $
Alimony: $
Other Expenses: $

Utilities:

Gas		 $
Electricity: $
Water/Sewer: $
Cable: $
Security: $

Auto Expenses:

Gasoline:		 $
Vehicle Maintenance: $
Automobile Payments: $

Child Expenses:

Child Support:		 $
Day Care: $

Insurance Payments:

Auto:		 $
Medical: $
Dental: $
Life: $
Homeowners: $
Total Expenses: $

Revolving Charge Debt (Credit Cards)
Total Balances: $
Total Minimum Payments: $

Any Other Secured or Installment Loans (Except Auto Loans)
Type of Loan:    
Monthly Payments: $
Type of Loan:    
Monthly Payments: $
Total Balances: $
   


Questionnaire   Agreement For Services

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