[[[["field11","equal_to","Yes"]],[["show_fields","field12,field13,field23,field19,field16,field21,field20"],["show_fields","field17"],["show_fields","field18"]],"and"],[[["field11","equal_to","No"]],[["show_fields","field14"]],"or"],[[["field17","contains","Yes"]],[["show_fields","field29"]],"and"],[[["field18","contains","Yes"]],[["show_fields","field24"]],"or"]]
1
DO YOU QUALIFY FOR UP TO $1,500 PER CALL/TEXT?
Name
Phoneyour number
phone
City, Statewhere are you?
Are You Receiving Calls, Texts Or Faxes?check all that apply
Are the Calls and/or Texts being received on a cell phone, landline, or VoIP service (such as Google Voice)?check all that apply
Who Is the Company?
What Number or Numbers Are They Calling / Texting From?List all the numbers they use. We cannot review your claim without these numbers
0 /
Who Are They Looking For?
How Many Calls/Texts Have You Received?your best guess is fine
More Infoanything else you want to share with the attorneys?
0 /
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