Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Loan Settlement Inquiry Form
Submit the details below and get a call back from our team to understand how we can help you in settling your loans at 50% or less.
Note: We do not provide any loans. We only assist in loan settlement and stopping harassment by lenders.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Mobile (10-digit)
*
Your answer
Email
*
Your answer
City
*
Your answer
Marital Status
*
Single
Married
Employment Status
*
Choose
Not Employed
Working as a Salaried Employed
Self Employed
Small Business (1-10 Employee)
Large Business (10 or more Employee)
Monthly income
*
Choose
Currently No Income
Less Than ₹15,000 per month
₹20,000 - ₹40,000 per month
₹40,000 - ₹60,000 per month
₹60,000 - ₹80,000 per month
₹80,000 - ₹1,00,000 per month
More than ₹1,00,000 per month
Your salary comes in which bank?
*
Your answer
Total personal loan amount
*
Choose
No Personal Loan
₹1- 2 Lacs
₹2- 3 Lacs
₹3- 4 Lacs
₹4- 5 Lacs
₹5- 10 Lacs
More than 10 Lacs
Are you staying in rented accommodation or own house?
*
Choose
Own House
Rented House
Payment Status
*
Choose
Paid Full amount but difficulty
Paying minimum amount with difficulty
Paying minimum amount for many months
Not paying minimum & Getting Collection Calls
Are you facing any harassment?
*
No
Yes
In the past,
have you done any settlement with any bank for any type of loan?
*
Yes
No
You can start settlement process with Rs.3,000 - Rs.5,000 and arrange additional funds towards first installment later. Is that manageable for you?
*
Choose
Yes I can Arrange
No Its not Possible
Anything else you want to mention (Optional)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
