Consumer Credit Counseling Service of the CSRA

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Below are listed the various forms used in assisting our clients. In order to view and print these forms, you will need to download the Adobe Reader software from Adobe's web site (http://get.adobe.com/reader/).

Privacy Notice
Details the circumstances under which CCCS will release clients' information to third parties.
New Client Welcome Letter
Introduces new clients to the agency.
Appointment Letter
Details what information is necessary for clients to provide.
Statement of Counseling Services (2 pages)
Every client should review and understand the various aspects of what CCCS does and how we do it. This two-page form provides the information you will need to make an informed decision.
Client Worksheet (3 pages)
Once a client understands what CCCS is and determines that they may need our help, we ask that the client disclose information relating to their financial situation. Completing these forms helps our counseling staff determine the level of assistance we may be able to offer.
Debt Management Agreement (2 pages)
Once it's determined and agreed by both the client and CCCS that assistance is necessary in developing a revised creditor repayment program, clients must read and agree to the terms disclosed in this written agreement.
Credit Card Closure Statement
In establishing a revised repayment agreement, and asking creditors for various concessions on interest, late fees, etc., it is sometimes necessary to provide affidavits that close various credit accounts.
Authorization for Debt Management Plans (DMPs) Exceeding 48 Months
Since it is the intent of our agency to help clients get out of debt as quickly as possible, we normally attempt to schedule repayment plans which last less than 48 months. Occasionally, clients request we make exception to this procedural policy, and in those cases, we ask that clients indicate this specific request by use of this form.
Authorization for Release of Records and Information
This form allows a client to authorize CCCS staff members to disclose confidential information to parties designated by the client.
AAFES Authorization
Authorizes the Army & Air Force Exchange Service to release financial information to CCCS.

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