LIFE PROGRAM

OUR LIFELINE PROGRAM IS A SPECIAL EXCEPTION FOR CERTAIN PERSONS CURRENTLY UNDER A WAGE GARNISHMENT. PLEASE ENTER YOUR INFORMATION IN OUR LIFELINE APPLICATION BOX.

NAME :
PHONE NO :
EMAIL ADDRESS :
COUNTY OF RESIDENCE :
HOW LONG HAS GARNISHMENT BEEN GOING ON? :
HOW MUCH MONEY DO YOU LOSE EACH PAY? :
HOW OFTEN ARE YOU PAID? :
WHO IS THE CREDITOR GARNISHING YOUR WAGES? :

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