Agreement for Services

Introduction for Preparing the Debt Management Coordination Agreement

Following this Introduction page is the Debt Management Coordination Agreement for your review and preparation.

Please read this Agreement carefully before executing it. Your execution confirms your understanding.

Your counselor will assist you in understanding and preparing this form. Please feel free to ask questions on any matter you feel uncertain about before submitting the form.

Please type in all requested information exactly as instructed by the counselor.

Upon your submission of this form, the Home Office will transfer a start up charge of $150.00 out of the bank account you have indicated and on the date indicated. This transfer must be successfully completed before continuing with your enrollment.

Your counselor will contact you immediately following receipt of the start up charge.

If you have any questions at any time, please call your counselor at 1-800-357-4223 or by e-mail at:

Thank you for considering the Debt Management Program. [Click Here] to begin your enrollment.