Payment Plan Request

If you are represented by an attorney, you cannot submit this form. Instead, have your attorney submit this form on your behalf.

The payment plan cost is $325.00. The fee will be added to your ledger immediately upon approval and drafting of the payment plan. THE PAYMENT PLAN FEE IS NON-REFUNDABLE EVEN IF YOU CHOOSE NOT TO EXECUTE THE PAYMENT PLAN.

Submitting this form requests a payment plan, but IT IS ONLY A REQUEST. There is no guarantee that your request will be approved.

You will receive notification at the email address provided as to whether your requested payment plan is approved or denied. If your requested payment plan is approved you will receive a Payment Plan Agreement to be signed and retuned to our office. If you make a payment prior to receiving notification from our office that your request has been approved, your payment will be processed as a partial payment on the file.

Terms

By submitting this request I understand that $325.00 in attorney fees will be added to the account for the property indicated above. I understand that this charge is for the processing and drafting of the payment plan and will be charged regardless of whether I ultimately execute the payment plan.

I further understand that in the event my payment plan is approved there is an additional $150.00 charge for any plan exceeding 12 months.

I also understand that requesting a payment plan will NOT result in the cessation of collection efforts. Collection efforts will only be suspended when I return the signed Payment Plan Agreement along with my first installment payment.

I am not represented by an attorney.

NOTE: PURSUANT TO THE FAIR DEBT COLLECTION PRACTICES ACT YOU ARE ADVISED THAT THIS LAW FIRM IS DEEMED TO BE A DEBT COLLECTOR ATTEMPTING TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.

Property Information

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Your Contact Information

Requested Payment Terms

Down Payment

If prior to lien, request must be for at least 20% down.

Number of Monthly Payments

If prior to lien, request must be for no more than 12 monthly payments.

* I understand and agree to the terms.

 

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