top of page

QUESTIONNAIRE

TAX & CREDIT BLITZ!

Date Of Birth
Are you a member or former member of the U.S Armed Forces (active, reserve, or National Guard)?
Yes
No

Address*

What was your marital status on December 31, 2023?
Single
Married
Divorced
Legally Separated
Widowed
Do you have any dependents
Yes
No
Filing Status
Single or Married (filing separately)
Married (filing jointly)
Qualifying Surving Spouse
Head of household (Choose ONLY if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)
Did you or a previous preparer sign you up for a IP PIN number for the previous year?
Yes
No
Not Sure
Did you receive any stimulus checks?
Yes
No
Did you file a tax return from the previous year (2022 Tax Year)?
Yes
No
Are you interested in filing for that year (or any other previous years) as well?
Yes, Help Me!
Not At The Moment
Not Applicable
Have You Used A Credit Repair Service Before?
Yes
No
Are you struggling to qualify for any of the following? (select all that apply):

We need a 3 bureau credit report in order to give you an estimate on the cost to remove the negative items from your credit report. Click the link below to receive your 3 bureau credit report for only $1. Download the credit report on a laptop or computer which you will submit on the following page.


$1 CREDIT REPORT CLICK HERE

Do You Have The Most RECENT copy of your CHEXSYSTEMS Consumer Disclosure Report?
Yes
No, Not Yet
Do You Have The Most RECENT copy of your EARLY WARNING Consumer Disclosure Report?
Yes
No, Not Yet

POWER OF ATTORNEY - AGREEMENT

By signing this, I hereby grant my full consent and authorization, appointing Blui.Ink, LLC ‘doing business as “BLUI.INK Credit Blitz”’ as my Agent (Attorney-in-Fact) with limited power and authority to act on my behalf, as specified below.

  1. Prepare, draft, electronically sign, transmit, dispatch, or lodge documents with any Credit Reporting Agency, Creditor, Collection Agency, Government Taxing Agency, or any other relevant party for the following purposes:

  • Prepare, sign, and submit documents and disputes to any credit reporting agencies via mail, fax, or online channels.

  • Obtain information or documents from any creditor, its agencies, or taxing agencies, both State and Federal.

  • Exercise my rights under the Fair Credit Reporting Act, Fair and Accurate Credit Transaction Act, Health Insurance Portability and Accountability Act, and Fair Credit Billing Act.


I hereby authorize my Agent to undertake all necessary or advisable actions regarding the aforementioned powers, as fully as I could if personally present and acting.

This Power of Attorney is to be interpreted as a Special Use and/or Limited Power of Attorney. The enumeration of specific powers aims to restrict and delimit the powers granted herein. This Power of Attorney remains unaffected by any subsequent disability or incapacity of the principal. My Agent shall not be held liable for any loss resulting from a judgment error made in good faith, nor for willful misconduct or failure to act in good faith while acting under this Power of Attorney. A Successor Agent shall not be held liable for the acts of a prior Agent. I authorize my Agent to indemnify and hold harmless any third party who accepts and acts under this document on my behalf. This Power of Attorney takes effect immediately and shall remain effective until revoked by written notice to my agent.

Date
bottom of page