Bankruptcy Education Course and Certificate Enrollment Form

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Disclosures and Fee Waiver Policy*

MANDATORY CLIENT DISCLOSURES

Stand Sure Counseling Services (SSCS) provides credit briefing services as its primary service. SSCS has been approved by the Executive Office for the United States Trustees (EOUST) to issue certificates in compliance with the Bankruptcy code for Pre-Bankruptcy Credit Counseling course. “UST has reviewed only the agency’s counseling services and has neither reviewed nor approved other services the agency may provide.” Approval does not endorse or assure the quality of an agency’s services. No other services SSCS may provide have been approved by the Trustee’s office.

Please read this disclosure policy carefully before using the Stand Sure Credit Counseling service. By using any such services, you are acknowledging that you have read and understand this policy and that you agree to be bound by its terms. If you do not agree to be bound by its terms, please exit out of this page without accessing our web site or any of our services.

Fees for services:

Individuals who take our Credit Counseling course will pay a one-time $29.95 fee for our service for an individual or a couple. Upon completion SSCS will email or fax a certificate to you and your attorney if requested.

Funding Sources:

Stand Sure Counseling Services (SSCS) is an Alabama non-profit organization that is funded by fees paid for counseling services and we do not receive funding from any other source.

Qualifications of credit briefing specialist:

All counselors, including respondents to student questions regarding course material have received debt briefing training and/or are under the supervision of a manager certified by the Association for Financial Counseling and Planning Education (AFCPE). Certification has been verified by SSCS and copies of their certifications have been provided to the US Department of Justice Executive Office for United States Trustees and the Bankruptcy Administrators in North Carolina and Alabama.

Impact on credit reports:

SSCS does not give legal advice nor are we attorneys. We make no promise, warranty, or guarantee that our services will improve your credit history. Client understands that by filing bankruptcy that the client’s credit report may reflect a consumer credit counseling status or that the client has filed bankruptcy. Completing our bankruptcy courses or receiving any other financial advice will have no impact on students’ credit reports.

Referral fees:

SSCS is prohibited from paying or receiving referral fees for the referral of clients.

Languages

This course is offered online in English only. If a client needs to take the course in Spanish or another language, then an appointment will be offered to accommodate.

Non-Discrimination Policy:

SSCS does not discriminate, withhold or condition service on the basis of gender, age, race, color, national origin, sexual orientation, physical ability, or any other protected class. We will also provide free bilingual counseling services or a professional interpreter to any limited English proficient client.

Fee Waiver Policy:

Stand Sure Counseling Services (SSCS) shall waive any fees if the client can adequately demonstrate that their income is less than 150 percent of the poverty guidelines as established by the United States Department of Health and Human Services (DHHS) or if the client is receiving pro bono legal representation for their bankruptcy filing. The standard shall be applied to the size of the client’s family for the 48 contiguous states, District of Columbia, Alaska, and Hawaii as shown below.

For more information, please call toll free 877-240-1398

150% of the HHS Poverty Guidelines for 2021*
Annual Basis

Persons in family unit	48 Contiguous States and D.C.	Alaska	Hawaii
1	$12,880	$16,090	$14,820
2	$17,420	$21,770	$20,040
3	$21,960	$27,450	$25,260
4	$26,500	$33,130	$30,480
5	$31,040	$38,810	$35,700
6	$35,580	$44,490	$40,920
7	$40,120	$50,170	$46,140
8	$44,660	$55,850	$51,360
For each additional person add	$4,540	$5,680	$5,220

* As required by section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35 - reauthorized by Pub. L. 105-285, Section 201 (1988)).

Length of Course

The Credit Counseling course should take an average of 60 to 90 minutes to complete satisfying the pre-filing requirement for individuals filing bankruptcy.

Credit counseling certificates:

The Executive Office for United States Trustees (“EOUST”) has established a web-based system for the issuance of Certificates of Course Completion. SSCS will comply with all EOUST standards and protocols for the issuance of Certificates. As such, students may receive the certificates via electronic mail, via fax, or via First Class Mail. SSCS is obligated to issue certificates promptly after successful completion of the Credit Briefing. A certificate will be issued only if client successfully completes the counseling course. SSCS shall not be responsible for certificates where the client fails to provide an accurate mailing address, email address or fax number. Clients may also request that certificates be sent directly to their attorney via email or facsimile.

Debt Management Plans:

SSCS does NOT provide “Debt Management Plans” or accept any payments for debt. The client has the opportunity to negotiate an alternative payment schedule with regard to each unsecured consumer debt under terms as set forth in 11 U.S.C. 502(k), but SSCS does not provide this service. SSCS may refer the client to another approved agency, and the client may incur additional fees in connection with such a referral.

Disclosure of Information:

We do not disclose (sell, rent or provide) the personally identifiable information you provide to us online to any third party for any marketing purposes. We do, however, disclose information you provide to the Executive Office for United States Trustees for use in issuing a Certificate of Completion, and your information may be matched against existing publicly accessible databases for identity verification purposes. Client’s information may also be used in connection with the United States Trustee’s oversight of the agency, or during the investigation of complaints, during on-site visits, or during quality of service reviews. Filing for bankruptcy is reported as a matter of public record and may impact your credit reports and scores as well as any other alternatives that we discuss with you. Please check with your legal counsel regarding this matter.

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Please provide the following information:*
- I need a Pre-discharge Bankruptcy Certificate for myself only (Single)
- I need a Pre-discharge Bankruptcy Certificate for myself and my spouse (Joint)
Select Course Type:*
- Internet (Single) $15.00
- Telephone (Single) $27.00
Name:*
First Middle Last
Username*
Password*
Enter Password Confirm Password

Strength indicator
Date of Birth:*
Social Security Number:*
Telephone Number:*
Spouse Name:
(If filing jointly)
First Middle Last
Date of Birth:
Social Security Number:
Telephone Number:
Fax Number:
Email Address:*
Address*
Student Mailing Address (not the Bankruptcy Court address)

Street Address Address Line 2 City State ZIP Code
CASE NUMBER NOTE: Your case number is a seven digit number such as 07-12345 or 06-98765. This number is issued to you by the bankruptcy court after you have filed for bankruptcy. If you do not have a case number, contact your attorney for assistance.
Some courts have unique numbering systems.

If your case number looks like this:
07-XYZ-12345
07-12345-XYZ
3:07-5K-12345

You should enter this:
07-12345
07-12345
07-12345

Entering an incorrect case number will delay receipt of your certificate.
Bankruptcy Case Number:*
Judicial District*
Attorney Information
Do you have an Attorney?*
- Yes
- No
** the following attorney fields are required if you answered yes above.
Attorney Name:*
Attorney Phone Number:*
Attorney Fax Number: