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Please Read Carefully - Creditor Inquiry Form
During the 30-day negotiation
period your creditors were sent proposals. This form should be submitted
only after this process is complete. It is important to check your
statements each month after negotiations are completed to insure payments
are posting with your creditors. It may take up to 3 months for some
creditors to reage your accounts and show benefits. If correct benefits
are not being given after 3 months, complete the bottom section of
this form immediately. If you are unsure when benefits should start
showing on your statements, call Client Services.
After your account has
been brought current, if you are receiving late fees, it may be necessary
for you to contact your creditor to adjust your due date 15 days after
your due date on the program. REMINDER: EARLY, LATE OR MISSED PAYMENTS
can cause problems with your creditors. Please make your payments
on or just before your due date each month.
Please fill out the form
below with a copy of your most recent statement. Your creditors require
us to have this information when contacting them. Your request can
either be faxed to (301) 515-6991 or mailed to 12850 Middlebrook Road
4th floor, Germantown, MD 20874 Attn: Creditor Inquiry Department.
Please allow 10 business days for mailed request and 7 days for faxes
to be processed before calling Client Services.
Client Name ___________________
Acct # __________________ Date ____________________
Home # ( )_______________
Work # ( )_____________________ Program due date _____________
*If your creditors are
not sending statements, please call to get current account information
from them. Request that they send monthly statements to you.
Creditor _________________
Last 4 digits of acct # ______________ Phone # ___________________
Type of problem: (Circle
all that apply)
*Late Fee *Incorrect APR
*Missing Payment *Creditor calling (date) ___________
*Current Statement info:
Due Date ________Amount past due $_______ APR ______% Finance Charge
$ ______
Comments: ______________________________________________________________
Creditor _________________ Last 4 digits of acct # _______________
Phone # _______________
Type of problem: (Circle
all that apply)
*Late Fee *Incorrect APR
*Missing Payment *Creditor calling (date) ___________
*Current Statement info:
Due Date ___________ Amount past due $_______ APR ______% Finance
Charge $ ______
Comments: ____________________________________________________________
PLEASE PRINT - Please make copies
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