Please read the following statements carefully to understand CCCS of Greater Milwaukee procedures. Initial next to each statement to indicate understanding of that provision. For simplification the singular is used even when the plural may apply.

I understand the program will provide a confidential comprehensive personal money management review.

I understand the interview will be conducted by a Certified Consumer Credit Counselor or qualified Consumer Credit Counselor. All action plans not conducted by a Certified Consumer Credit Counselor will be reviewed by a Certified Credit Counselor.

I understand if I am dissatisfied, I can utilize the Complaint Resolution Process, outlined on the back of this service agreement.

I understand that most funding comes from voluntary contributions from creditors who participate in Debt Management Plans (DMP). Since creditors have a financial interest in getting paid, most are willing to make a contribution to help fund the agency.These contributions are usually calculated as a percentage of payments made through the DMP, which can be up to fifteen percent (15%) of each payment received. However, all accounts with creditors will always be credited with one hundred percent (100%) of the amount paid through CCCS. CCCS will work with all creditors regardless of whether they contribute to the agency.

I understand that DMPs serve a dual role of helping individuals and families repay debt and helping creditors collect the money owed them.

I further agree to hold CCCS, its employees, officers, directors, and agents harmless from any claim, suit, action, or demand of my creditors, myself, or any other person arising out of this agreement or resulting from advice or counseling. Nothing herein shall apply to actions or claims under the provisions of the United States Bankruptcy Code.11 U.S.C. ยง 101 et seq.

I understand that I will be given a written assessment based on the following options:

a) I may be advised to handle financial concerns on my own.

b) I may choose to enroll in the program's Debt Management Plan. Under the DMP the agency serves as a neutral third party in negotiating with creditors to liquidate financial obligations.

Your participation in a Debt Management Program will not change anything which is already on your credit report. If your credit report reflects that you have paid creditors as agreed in the past, a Debt Management Plan could have a negative impact on a creditworthiness decision by a potential creditor, landlord, or employer in the future. In addition, creditors may report that you are on a Debt Management Plan and are not paying as originally agreed although they have accepted the reduced payment.

c) A counselor may answer questions about bankruptcy, but not give legal advice. You should also be aware the debts to creditors you repay through the plan may be able to be discharged through bankruptcy.

d) I may be referred to other services of the organization or another agency or agencies as appropriate that may beableto assist with theproblems that have been identified.

At sometime in the future, my information may be used for confidential research and/or a neutral third party may contact me to request an evaluation of the agency's services.

I authorize the employees of Consumer Credit Counseling Service of Greater Milwaukee to discuss any and all aspects of my financial affairs with whom they deem necessary and obtain a consumer credit report in order to help me solve my financial problems.