Statement of Counseling
 
 
 
 
 
 
Statement of Counseling Service
• I understand that Consumer Credit Counseling Service of Northern Nevada (CCCCS) will provide a FREE confidential comprehensive money management interview.
• I understand that a certified credit counselor or qualified professional counselor will conduct the interview.
I understand that in the event, I/we are dissatisfied; I/we can utilize the Complaint Resolution Process.
• I hold CCCS, its employees, agents and volunteers harmless from any claim, suit, action or demand of my creditors, myself or any other person 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. Section 101 et seq.”
• I understand that if filing a Chapter 7 or a Chapter 13 bankruptcy that this will impact my credit report for 10 years from the date of discharge, and my impact obtaining credit, employment or housing.
• I understand that entering into a DMP DOES NOT guarantee maintaining the current status of the undersigned’s credit rating. Your participation in the DMP may change information which is already on your credit report. If your credit report reflects that you have paid creditors as agreed in the past, the DMP could have a negative impact on credit worthiness by a potential creditor, landlord, or employer in the future. Creditors may report that you are on a DMP and are not paying as originally agreed although they have accepted the reduced payment
• I will be given a written COUNSELOR ASSESSMENT outlining a suggested action plan, which will be based on the following options:
Assistance with managing financial matters on my own.
Assistance with budget development.
Enrollment in financial educational programs.
Referral for legal advice, a counselor may answer questions about bankruptcy but not legal advice. If I want legal advice, I will be referred for appropriate assistance.
 Referral to other services of the organization or another agency or agencies, as appropriate, that may be able to assist with particular problems that have been identified.
A recommendation to enroll in a Debt Management Plan (DMP). The DMP’s serve the dual role of helping you repay your debt and helping creditors to receive the money owed to them. Most of our 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 our agency. These contributions are usually calculated as a percentage of payments you make through your DMP, up to fifteen percent (15%) of each payment received. However, your accounts with your creditors will always be credited with one hundred percent (100%) of the money you pay thru us. We will work with all your creditors regardless of weather they contribute to our agency. I will receive complete details of the operation, requirements and responsibilities of the DMP if the option is recommended.
At some time 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 CCCS.

CLIENT BILL OF RIGHTS
We pledge that our clients have the right to:
• Prompt counseling services.
• Be treated with dignity and respect.
• Be actively involved in a comprehensive assessment of their financial situation including appropriate plan of action.
• Express dissatisfaction thru a Complaint Resolution Process.
• Discontinue their relationship with CCCS at any time.
• Ask questions and to have concerns addressed.

COMPLAINT RESOLUTION PROCESS
We are committed to providing you with high quality professional services. However, if you are not satisfied with the services provided or if you want to make a complaint, we ask that you follow the following guidelines:
• Step One – Try to resolve this issue with the staff member involved giving him/her specific information about your complaint. 
• Step Two – If step One is not possible or the issue is not resolved to your satisfaction, write CCCS at 575 East Plumb Lane Reno, NV 89502 or call 775-322-   6557.
• Step Three – CCCS may request a meeting with you (phone or face to face) or seek more information from a staff person
• Step Four – If your issue is not resolved to your satisfaction, you may appeal in writing or call directly to CCCS’s Manager. After additional fact finding, the Manager will provide a concluding to you within 15 days.

ACCESS AND AVAILABILITY POLICY
CCCS will provide services within a reasonable amount of time to the public for anyone regardless of age, race, color, creed, national origin or ancestry, physical, mental disability, medical condition, sex, sexual orientation, religion, employment, marital status, financial status or any other consideration made unlawful by federal, state or local law.

Please enter information below to confirm that you have read and understand this statement.

ONCE YOU HAVE ELECTRONICALLY SIGNED AND SUBMITTED THIS STATEMENT OF COUNSELING, YOU WILL BE RETURNED TO THIS PAGE.  CLICK "CONTINUE WITH APPLICATION" TO PROCEED TO THE NEXT STEP. WE WILL BE UNABLE TO CONTACT YOU OR HELP YOU WITHOUT THE REST OF THE APPLICATION.
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Thank you for your interest in credit counseling. Please read and sign the Statement of Counseling Form to continue the application process.
575 E. Plumb Lane
Reno, NV 89502
Toll free:  800-275-0137
FCS:  775-329-0623 
CCCS: 775-322-6557
Fax: 775-322-2059