Internal Network Intake

Your Info

Company Name *

Company Email *

CASE TYPE IDENTIFICATION

I confirm that I have the authority and permission to provide this information to Tariq Law and consent to its use for business and legal purposes.

Potential Client Email *

Potential Client Full Name *

Potential Client Phone *

PC's phone number

Case Type *

Intake Notes

DISPUTE HISTORY

How many dispute rounds have been completed?

Which parties were disputed?

Experian

TransUnion

Equifax

Other

EVIDENCE UPLOAD

Try to only capture pictures/docs of the exact issue.

Upload inaccurate credit report portion BEFORE disputes

PDF, DOCX, DOC, PNG, JPEG or JPG ( max 10 Files )

Upload ALL dispute letters sent

PDF, DOCX, DOC, JPEG, JPG or PNG ( max 10 Files )

Upload ALL bureau responses

PDF, DOCX, DOC, JPEG, JPG or PNG ( max 10 Files )

Upload inaccurate credit report portion AFTER disputes

PDF, DOCX, DOC, PNG, JPEG or JPG ( max 10 Files )

ALL Additional Evidence

JPEG, JPG, DOCX, DOC, PNG or PDF

Missing Items Summary