NEBRASKA DMP AGREEMENT

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Client(s) understands and agrees they have enrolled in the Debt Management Program (DMP) through Pioneer Credit & Debt Consolidation Services (PCDCS), 1644 Concourse Drive, Rapid City, SD 57703, a 501(c)(3) non-profit, bonded, consumer credit counseling and educational agency and client(s) hereby authorizes PCDCS to receive any information regarding client(s) accounts and/or creditors. Client(s) agrees to pay a Commitment Fee equal to $ (not to exceed $25 and is included in the total fee charged over the initial 36 months). Client(s) hereby authorizes creditors to send any additional information needed to PCDCS. This release agreement for information on my account may be copied and the copy of the signature may be deemed to be equivalent to the original and may be used as a duplicate original. Client(s) understands original will be stored in laserfiche.


1. * PCDCS will act upon the information received by client(s) in client(s) best interest. PCDCS will use discretion when disclosing any information or amount of income, living expenses and debt as necessary when negotiating with client(s) creditors. Should client(s) default on payment to the DMP, the rights and interest of client(s) creditors will not be jeopardized.


2. * In order for client(s) debt to be repaid as quickly as possible, client(s) requests that all creditors waive or reduce finance charges/interest rates and fees wherever possible if allowed in their companies' policies for DMP's. Client(s) understands once PCDCS has sent initial inquiry letters, client(s) creditors may continue to contact client(s) personally. It is client(s) responsibility to pleasantly discuss their accounts with them. Client(s) will encourage creditor who calls to contact PCDCS at 605-348-1608. However, if the creditor is unwilling to contact PCDCS, it is client(s) responsibility to notify PCDCS of the name and phone number of creditor to whom called. Client is also responsible for calling PCDCS with any questions on statements received from creditors and will monitor statements monthly to ensure proper concessions. PCDCS can make no guarantees of creditor policies or time of concessions.


3. * PCDCS does not guarantee that collection efforts, legal action, judgments, or garnishments will not be entered against client(s) for any creditor listed on DMP.


4. * Client(s) understands PCDCS is a non-profit third party administrator and is not representing itself as a loan company or insurance company. Client(s) also understands that no promise, warranty, or guarantee has or will be made on the part of PCDCS to clear client(s) of any debts or make client(s) payment(s) on client(s) behalf. Client(s) understand that by enrolling in the DMP with PCDCS, client(s) credit report may reflect a consumer credit counseling status and in some cases may cause a negative effect on client(s) credit report. PCDCS cannot repair or prevent any ratings that may appear on my credit report past, present, or future. Client(s) hereby authorizes PCDCS to obtain client(s) credit report solely for the purpose of Consumer Credit Counseling when needed by applicable creditors and in order to meet their proposal requirements. Client(s) understand this will appear as a soft inquiry on their credit report.


5. * Client(s) understands he/she must disclose to PCDCS all credit accounts. Client(s) wishes not to charge any further goods or services until my debts are paid in full. Client(s) hereby attests to the fact they have personally destroyed all charge card(s) and any accompanying cash-advance checks and request that my creditors close my charge accounts until further notice. Failure to comply with this agreement could result in cancellation of the DMP.


6. * Client(s) understands they are responsible for their debts and when client makes monthly deposit, for a period no longer than 36 months, at which time agreement may be renewed, client(s) agree that creditors will be receiving payments on client(s) behalf through the PCDCS Client Trust Account (held at BankWest, maintained and managed by PCDCS). Client(s) first payment is due on or before 30 days after the date of client(s) enrollment. PCDCS will contact client(s) regarding scheduled monthly payment and payment due date to PCDCS in Rapid City, SD. If, for any reason, client(s) payment will not be received at PCDCS office by the scheduled due date, client(s) will contact PCDCS to inform us of the situation. PCDCS disburses to all creditors no later than 15 days from receipt of valid funds or as scheduled. When necessary, client will maintain payments to creditors during initial process.


7. * Client(s) understands it is their responsibility in making payments on time. If client(s) does not make payments for two consecutive months, and does not communicate with PCDCS's phone calls or letters, a letter will be sent to client(s) creditors stating client(s) has defaulted on the DMP. Client(s) understands the following communication methods will be used by PCC; US Mail, E-mail, Telephone and Text Messaging.


8. * Client(s) understands that due to regulations governing PCDCS's Trust Account, client(s) scheduled payment must be in one of the following forms of payment: money order, cashier's check, checking debit card, western union, automatic payment from checking/savings. Client(s) will include client number, name, address, phone number on any payment sent. PCDCS will not be held liable for late fees or other service charges caused by posting payment to wrong client(s) account due to client(s) failure to identify form of payment.


9. * Client(s) understands when extra income is available to apply to debts, client(s) shall direct PCDCS where to apply the extra funds, however, PCDCS may have final discretion on disbursement of funds to debts and the application of all client funds will be disclosed to the client on the current Monthly Activity Report.


10. * PCDCS is a nonprofit agency and receives support from voluntary contributions. Most of our funding comes from voluntary contributions made by creditors who participate in DMP's. Creditors help PCDCS with contributions to continue the educational programs offered by PCDCS.


11. * Client(s) understands by paying a monthly counseling fee, which is included in scheduled monthly payment to creditors and is equal to $ (not to exceed 15% of the total debt, which is equal to $ / per list of creditors, which is then amortized over the initial period not longer than 36 months and not to exceed $50), will make available to them the following benefits: 800 number available, on-going consultations with Certified Counselors for review of debts, educational material pertaining to basic credit and budgeting, consulting with client(s) creditors and arrange for new payment plan, requesting creditors to re-age client(s) account, following up with creditor correspondence sent to client(s). Client(s) understands that fees are nonrefundable.


12. * Nothing herein shall apply to actions or claims under the provisions of the United State Bankruptcy Code, 11 U.S.C. § 101 et seq.


13. * Client(s) agrees that any dispute between us that cannot be amicably resolved, and all claims or controversies arising out of this agreement, shall be settled solely and exclusively by bind arbitration in the Nebraska county in which the debtor resides, administered by, and under the Commercial Arbitration Rules then prevailing of, the American Arbitration Association (it being expressly acknowledged that I will not participate in any class action lawsuit in connection with any such dispute, claim, or controversy, either as a representative plaintiff or as a member of a putative class), and judgments upon the award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. The interpretation of this agreement will be governed by the laws of the State of Nebraska.

If client(s) wishes to cancel, PCDCS must receive request in writing.

CREDITORS FOR "COUNSELING & DEBT MANAGEMENT PROGRAM"

Counselor & Home Office Use Only Creditor's Name Total Balance Owed Current Monthly Payment Past Due Payment (If Applicable) % RATE DATE DUE APPROX PAY OFF*
$ $ $
$ $ $
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$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
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$ $ $
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Client's Preferred Method Of Payment:
     

(not to exceed 36 months)

I (we) testify that the information provided by me (us) is truthful and correct. I have read, understand and agree with all of the conditions of the Debt Management Program.




*Primary Applicant Electronic Signature (Please enter your full name)



Co-Applicant Electronic Signature (Please enter your full name)

**Approximate or Anticipated Pay-Off Date for each creditor is based on information provided by client.


PCDCS USE ONLY:    





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