Community Credit Counseling Specialists, Inc.
5301 Southwyck Blvd., Suite 100
Toledo, Ohio 43614
419-865-2333 Toll Free 888-662-3313 Fax 419-868-0207 Website www.creditcounsel.org
Michigan Debt Management Plan and Authorization Agreement
Date: __________, 20____
In order to establish my Debt Management Plan (herein after referred to as DMP) with Community Credit
Counseling Specialists, Inc., (herein after referred to as CCC), I agree to the following:
I authorize CCC, its employees and agents as follows:
To plan the liquidation of my outstanding obligations listed in my DMP, and to undertake such steps as they
may deem necessary to this end and in cooperation with my creditors, and
To make any necessary arrangements with my creditors and others in order to reach a final satisfaction of all of
my debts, liabilities and obligations, together with obtaining all necessary information, including a credit report,
to determine my financial status, income, prospects and other data in attempting to achieve the ends for which I
have applies for these services.
I agree and understand fully, that:
The information that I have given to CCC, is, to the best of my knowledge, accurate and complete.
I will contact and inactivate ALL of my credit accounts, and request that my due dates be reset, if possible, to at
least 10 days after my monthly Repayment Date which I have chosen, to insure ample time for my creditors to
post my payments, and that after such notification, some or all of my creditors may report my participation in
this DMP to a credit bureau, which may have a negative impact on my credit report.
I will hold CCC, its employees, officers, trustees and agents harmless from any claim, suit, action or demand of
my creditors, ourselves or any other person arising out of my application herewith presented, with the
understanding that nothing herein shall apply to actions or claims under the provisions of th