Our business is granting wishes, so let's get started...
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First Name *

 
Last Name *

 
Phone Number *

 
Email Address *

 
Please upload an image of the bill you would like for us to pay.  Make sure all of the proper information is visible. 

 **This image will only be seen by us and not made public.

 
If we are able to grant this wish for you, how will this benefit your current situation? *

Thanks!  Happy Holidays!!
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