Jefferson Financial Solutions
     Commercial Debt Negotiation

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Looking to
your bright financial future

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This form is no longer operational and is used as example of work done for this client whose business is no longer in operation.

Your Information Form: We will reply promptly by email or phone. 

First Name*   Middle Initial Last Name* Your Business Name* Email*
Primary Phone   (area code - xxx-xxxx)*  Ext
 
Alternate Phone (area code - xxx-xxxx)
 
Fax Phone         (area code - xxx-xxxx)
Comments and Information about your Financial Situation
 
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Our fees are based on productivity. No settlement, no cost - guaranteed in writing.