Answer the following 9 questions. One of our consultants will review your submission and follow up with you with a more detailed assessment. If you would prefer to be contacted by telephone, please indicate the best time to call and your time zone (see the comments box below).

Before completing this form, please take a moment to review our (frequently asked questions page).

1. Have you reviewed our frequently asked question page? Yes No 2. Are your creditor payments up to date? Yes No 3. Your total monthly take home pay is: 4. Your total monthly basic living expenses ie: mortgage/rent, utilities, groceries, transportation, insurance, etc. are: 5. Total of all outstanding balances owing:(i.e. credit cards, personal loans, lines of credit, overdrafts. Please do not include mortgage, and household utility bills):  (Required) 6. If you could consolidate your debts into one monthly payment, what do you feel you could reasonably afford?  (Required) 7. If you are a home owner, what is the current market value of your home? 8. How much is owing on your mortgage? 9. Do you own your home? Your Contact Information Name:  (Required) Street Address: City: Province: Postal Code: E-mail Contact:  (Required if no Phone Number provided) Telephone Contact:  (Required if no E-mail provided) (indicate best time to call and time zone) Please tell us why you need help now: How did you find out about mydebtsolution.com? Unspecified superpages.ca Newspaper Radio Television Billboard Referral Internet Search mybc.com