Bankruptcy Credit Counseling Registration

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Pre-Filing Bankruptcy Credit Counseling

Bankruptcy Credit Counseling Registration

To register for AABC's Bankruptcy Credit Counseling, 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 counseling. Some additional financial information will be necessary from you at the time of your counseling session.

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 $50.00 per household, and includes both joint filers.

Available in these States only:

Select your course method:

Schedule of Counseling Sessions: At this time, counseling is offered in Colorado only. Telephone and in-person counseling are available by appointment only on a first come first served basis. After you register, you will need to call our office to confirm an available time and date for your appointment.

FILER'S INFORMATION

JOINT 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

Are you a self-filer?

Chapter filing:

ATTORNEY INFO (if not a Self-Filer)

Atty Street:

Atty First Name

Atty City:

Atty Last Name

Atty State:

Atty Phone

Atty Zip:

Atty Email

Atty Fax

Bankruptcy Credit Counseling
DISCLOSURES

FILER'S Electonic Signature

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.

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"

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:

I Agree

All About Bankruptcy & Credit (AABC) is committed to providing quality professional services with the ultimate goal of your long term financial success. AABC continually strives for relationships with our clients based on confidentiality, integrity, transparency and a personal touch. I/We desire to receive Credit Counseling services from AABC, and therefore understand and agree as follows:

AABC is a non-profit agency, organized and operating in accordance with Section 501(c)(3) of the Internal Revenue Service Code. AABC is committed to quality at the highest level, and is an ISO 9001:2001 accredited agency that is certified by Bureau Veritas Certification North America, an independent third-party organization.

Pre-filing bankruptcy credit counseling is $50.00 per household, and includes both joint filers.
Post-filing Debtor Education fees are: $45. If you take the course via telephone, there is an additional fee of $15.00 per person for postage and handling; however, this additional fee will be waived if you pick up the materials from our local office.

I will allow AABC, its employees, agents and volunteers to provide me with credit and debt management advice, recognizing that AABC does not give legal advice.
AABC counselors and instructors qualifications:

All are certified credit counselors. Certification is through an independent third party organization such as the Association for Financial Counseling and Planning Education (AFCPE). Instructors are trained in the Debtor Education course materials.

AABC is authorized to disclose to any bankruptcy attorneys I contact for services all the details of my counseling sessions with AABC, including, but not limited to my creditor names, assets, liabilities, expenses, income, and any proposed or past Debt Management Plan (DMP). Participation in a DMP may negatively impact credit scores.

Upon successfully completing counseling and/or an educational course, students will be provided a certificate of completion. If I have an attorney, my completion certificate(s) will be sent directly to them via fax or email.

The fees shown above include all materials, website access, and issuance of certificates, and are non-refundable. Fees are paid at the time of service and help offset the operating costs AABC incurs in providing these services. I understand that AABC will provide me counseling and educational services regardless of my ability to pay. Services are available for free or at a reduced rate based upon your ability to pay. Fee waiver requests are available by calling our office.

AABC may receive financial support from creditors, businesses, individuals & community organizations. I understand that the credit counseling industry, including AABC, relies on regular voluntary contributions from creditors. Support from creditors may be in the form of grants, or “fair share” contributions which may be calculated as a percentage of the payment amount of applicable Debt Management Plans.

AABC does not pay or receive fees or any other consideration for the referral of clients or students to or by the provider.

Payments must be by Debit Card, Certified Check, Money Order or Cash.

I expressly agree that any dispute between myself and AABC or its agents shall be resolved exclusively by binding arbitration in El Paso County, Colorado, through the National Arbitration Forum. Any award by the arbitrator may be entered as a judgment in any court of competent jurisdiction. Nothing herein shall apply to actions or claims under the provisions of the United States Bankruptcy Code, 11 U.S.C. Sec. 101 et seq. This agreement is governed by the laws of the State of Colorado.

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