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Bankruptcy Debtor Education Registration

To register for AABC's Bankruptcy Debtor Education Class, please enter your contact and bankruptcy information in the form below. You will also need to read and sign the agreement at the bottom. This information is necessary for us to provide you a certificate of completion for your class

Your information will remain completely confidential, and we will not sell or give any of your personal information to anyone as stated in our privacy policy. Should you prefer to provide this information via fax, simply print this form, fill it out, and fax it to 719-599-7999.

Fees: Our fee for this service is only $45.00 per household, and includes both joint filers. If you take the course via telephone, there is an additional fee of $15 per person for postage and handling; howerver, this additional fee will be waived if you pick up the materials from our local office.
Available in these States only:
Select your course method:

If you select to take your course online, you may pay NOW online with a debit  card and begin your course immediately after registration.  If you select to pay LATER, then  your registration will be sent to us for processing and we will call you to finalize payment.

Schedule of Counseling Sessions: In-person classes are offered in Colorado only. Telephone and in-person counseling are available multiple times during the month on a first come first served basis and require you to call our office to confirm an available course date.

FILER'S INFORMATION
Enter Full Legal Name and Address:
First Name:
Middle Name:
Last Name:
Address:
City:
State:
Zip:
Home Tel:
Cell Phone:
Email:
Last 4 digits of SSN:
First Name:
Middle Name:
Last Name:
Address:
City:
State:
Zip:
Home Tel:
Cell Phone:
Email:
Last 4 digits of SSN:
Number of members in household
FILING INFO
Chapter filing:
Case Number:
Date Filed:

Judicial District:

ex: NY-Southern, PA-Western, CO, etc.

Judge or Trustee's Info:
Judge or Trustee's Name:
List two (2) Creditors:
Are you a self-filer?
ATTORNEY INFO (if not a Self-Filer)
Atty First Name
Atty Last Name
Atty Phone
Atty Email
Atty Fax
Atty Street:
Atty City:
Atty State:
Atty Zip:
Bankruptcy Credit Counseling
DISCLOSURES
FILER'S Electonic Signature
 

By checking the "I Agree" box below and entering my name, I have read, understand and agree with the above Disclosures, and this will serve as my legal signature.

If there is a joint-filer, I understand my spouse or joint-filer must personally read and sign this form by checking the box to the right and entering their own name under
"JOINT-FILER'S Electronic Signature"

My Full Name:
JOINT-FILER'S Electonic Signature
 

By checking the "I Agree" box below and entering my name, I have read, understand and agree with the above Disclosures, and this will serve as my legal signature.

I understand I must sign separately from my spouse or Joint-Filer.

My Full Name:
JOINT FILER'S INFORMATION
Enter Full Legal Name and Address:

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Upcoming Events

09.11.2010
Patriot Day

09.16.2010 2:30 PM - 5:00 PM
Personal Financial Management Telephone Class

09.20.2010 3:00 PM - 5:30 PM
Personal Financial Management

10.06.2010 1:30 PM - 4:30 PM
Personal Financial Management Class

10.11.2010
Columbus Day

Confused?

Do you need someone to talk to you about your situation?

Call today!  We’re here to help!

(800) 579-2414

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