Client Intake & Authorization

Complete this secure digital intake form to begin your credit restoration or funding process. All information is encrypted and visible only to you and authorized administrators.

Section 1 — Personal Information

Only the last 4 digits are collected — never the full number.

Section 2 — Current & Previous Address

Previous Address (if at current address less than 3 years)

Section 3 — Bureau Authorization & E-Signature

I authorize BEST BIZZ LLC / BO$$UP AKADEMI, acting through its consultant Jean Henry Bastien, to request my free annual credit report (consumer report) from the consumer reporting agencies marked below, on my behalf, for the purpose of preparing my credit evaluation and funding roadmap. This authorization is given under the Fair Credit Reporting Act (15 U.S.C. § 1681 et seq.). I understand the report is free to me once every 12 months at annualcreditreport.com, that approvals and funding amounts are never guaranteed, and that I may cancel this authorization at any time.

Download your free annual reports at annualcreditreport.com, then upload each bureau's report below.

Click to upload
Click to upload
Click to upload

Sign directly on the screen below using your finger or mouse. Your signature is captured securely and stored with your authorization.

Draw your signature here
Use your finger or mouse to sign

By typing my full legal name below, I agree this typed signature has the same legal effect as a handwritten signature (Electronic Signatures Act / E-SIGN).

Section 4 — Document Uploads

All documents are uploaded to encrypted private storage and visible to administrators only.

Click to upload
Click to upload
Click to upload
Click to upload
Click to upload
Click to upload

By submitting, you certify that all information provided is accurate. Your data is protected and visible only to you and authorized administrators.