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Final Eligibility Questions for @program - Let's Go!

Checking requirements in @postal_code

src
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utm_source
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laminLid
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program
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nx_clid
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msclkid
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disclaimer_variable
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brand
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leadid_token
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s_src
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s_cid
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s_agid
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s_tid
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s_mt
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s_n
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s_d
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s_adid
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s_aid
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s_pos
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s_plc
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s_k
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Do you currently receive any government benefits?

FACT: The USA spends around TWO TRILLION dollars each year on programs like @program to help people like you and me!

Do you currently receive Social Security Disability benefits?

Do you expect to be out of work for at least a year due to your health?

FACT: If you are approved for SSDI benefits in 2023, you could receive up to $3,148/month to help cover your living expenses and provide financial stability.

Have you had a full-time job within the past 5 years?

Are you actively working with a disability advocate or attorney?

What describes your situation?

Are you seeing a doctor or taking prescription medication to help with your situation?

Have you or your spouse served in the US Military? 🇺🇸

Do you earn less than $1,000 a month?

Have you or a loved one been injured by one of the following, within 2 years?

Have you or a loved one been exposed to any of the following:

What is your current household credit card debt amount?

Describe your debt situation:

Estimate the value of your assets 

What is your monthly income?

Are you a homeowner?

What name will you use on your @program application?

First name
Please enter your first name
Last name
Please enter your last name

What is your zip code?

Zip code
Please enter a valid zip code
Example: 90210

Unlock Over $900/Month in Benefits by Meeting Certain Age Requirements

What year were you born, @first_name?

Birth Year
Please specify a valid birth year

What's your job status?

Where would you like your results sent, @first_name?

mail_outline
Email address
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phone
Phone number
Please enter a valid phone number
Example: 1112223333

Calculating eligibility for benefit programs...

Where would you like your results sent, @first_name?

mail_outline
Email address
Please enter a valid email address
phone
Phone number
Please enter a valid phone number
Example: 1112223333

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