Phone 1. Tick the debts you owe from the list below: checkbox Afterpay Bank of Melbourne ANZ CBA Cash Converters CashnGo Cashtrain Cigno Citibank Credit Corp Ferratum Humm Jacaranda Latitude Lumi Money3 Moneyme Moneyspot Moula Mypaynow NAB Nimble Panthera Prospa Quickcash Rapid Loans St George Sunshine Loans Swoosh Telstra Wallet Wizard Westpac ZipMoney ZipPay Others (Not Listed) 2. Add the amount you owe for each debt: Total Amount You Owe Total:$ Estimated Amount you Pay Back with Solve My Debt Now Total:$ Estimated Savings you Make Total:$ *These results are the average we have achieved for your debt type and are indicative only. Estimated Time Period * Please Select 1 Year 2 Years 3 Years 4 Years 5 Years When choosing a time period, please think about your current income and living expenses, and decide how much you can comfortably put towards your debts each fortnight. [Please remember that the payment plan is very strict, so you need to ensure that this is a manageable amount for you to pay each fortnight] Frequency * Please Select Fortnightly Estimated amount you will pay to resolve your debts within the estimated time period Estimated Amount: $ This is the estimated total amount you will need to pay from now to get your debts to zero as quickly as possible. As part of that we contact your creditors to stop your current payments and to renegotiate interest, fees and debt amount reductions, or waivers and freezes, as well as to negotiate affordable payment plans with your creditors within your affordability. *A minimum $100 payment amount is required; please adjust the Estimated Time Period accordingly 3. Your Details: Email Address * First Name * Last Name * Mobile * Terms Agreed I have read and accept the Terms and Conditions and I agree to be bound by them. User Acknowledgment I acknowledge that the payment plan options accepted by me today are based solely on the debt amount information I have provided to Solve My Debt Now on this form. I further acknowledge that should my actual debt amount be higher or lower than the amount I have listed today, my regular payment plan option that I signed up today for will become higher or lower to reflect that. I also acknowledge that an additional 25% debt reduction fee will become part of my payment plan depending on the reduction amount negotiated by Solve My Debt Now with my nominated institutions. At the time a reduction amount is negotiated, my plan will be recalculated and the period of my instalments will be reduced accordingly.