Stand Sure Credit Counseling Enrollment Form Welcome! Please use the form below to enroll in our online credit counseling course. Disclosures and Fee Waiver Policy* MANDATORY CLIENT DISCLOSURES Biblical Financial Concepts, Inc. d/b/a 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 (EQUST) to issue certificates in compliance with the Bankruptcy code for Pre-Bankruptcy Credit Counseling course. EQUST has reviewed only those counseling and education services related to bankruptcy, but has not reviewed or approved any other counseling services provided by Stand Sure Counseling Services. 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: Biblical Financial Concepts, Inc. dba Stand Sure Counseling Services 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: Biblical Financial Concepts, Inc. d/b/a Stand Sure Counseling Services 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 2019* Annual Basis Persons in family unit 48 Contiguous States and D.C. Alaska Hawaii 1 $18,735 $23,400 $21,570 2 $25,365 $31,695 $29,190 3 $31,995 $39,990 $36,810 4 $38,625 $48,285 $44,430 5 $45,255 $56,580 $52,050 6 $51,885 $64,875 $59,670 7 $58,515 $73,170 $67,290 8 $65,145 $81,465 $74,910 For each additional person add $6,630 $8,295 $7,620 * 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. AcceptDeclineTelephone Clients ONLY To receive a credit briefing via Telephone, please download the packet using the link below. Print the packet and follow the enclosed instructions. If you wish to receive your credit briefing via Internet, please use the form on this page to provide us with your information. Click here to download TELEPHONIC CREDIT BRIEFING PACKETPersonal InformationName:* First Middle Last UsernamePassword Enter Password Confirm Password Strength indicator Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Social Security Number:*Telephone Number:*Spouse Name:(If filing jointly) First Middle Last Date of Birth:Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Social Security Number:Telephone Number:Fax Number:Email Address:* Address*Student Mailing Address (not the Bankruptcy Court address) Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Judicial District*Northern District AlabamaSouthern District of AlabamaMiddle District of Alabama – MontgomeryDistrict of Alaska - KetchikanDistrict of Alaska - AnchorageDistrict of Alaska - JuneauDistrict of Alaska - NomeDistrict of Alaska - FairbanksDistrict of Arizona - PhoenixDistrict of Arizona - TucsonDistrict of Arizona - YumaEastern District of Arkansas - HelenaEastern District of Arkansas - Pine BluffEastern District of Arkansas - BatesvilleEastern District of Arkansas - JonesboroEastern District of Arkansas - Little RockWestern District of Arkansas - Ft. SmithWestern District of Arkansas - El DoradoWestern District of Arkansas - FayettevilleWestern District of Arkansas - HarrisonWestern District of Arkansas - Hot SpringsWestern District of Arkansas - TexarkanaCentral District of California - Santa AnnaCentral District of California - Los AngelesCentral District of California - San Fernando ValleyCentral District of California - RiversideCentral District of California - Northern DivisionEastern District of California - FresnoEastern District of California - ModestoEastern District of California - SacramentoNorthern District of California - OaklandNorthern District of California - Santa RosaNorthern District of California - San JoseNorthern District of California - San FranciscoSouthern District of California - San DiegoDistrict of Colorado - DenverDistrict of Connecticut - BridgeportDistrict of Connecticut - New HavenDistrict of Connecticut - HartfordDistrict of Columbia – Washington D.C.District of Delaware - WilmingtonMiddle District of Florida- OrlandoMiddle District of Florida - TampaMiddle District of Florida - Fort MeyersMiddle District of Florida - JacksonvilleNorthern District of Florida - TallahasseeNorthern District of Florida - GainesvilleNorthern District of Florida - Panama CityNorthern District of Florida - PensacolaSouthern District of Florida - Miami</option>Southern District of Florida - West Palm BeachSouthern District of Florida - Fort LauderdaleMiddle District of Georgia - ThomasvilleMiddle District of Georgia - AlbanyMiddle District of Georgia - ColumbusMiddle District of Georgia - AmericusMiddle District of Georgia - ValdostaMiddle District of Georgia - MaconMiddle District of Georgia - AthensNorthern District of Georgia - RomeNorthern District of Georgia - AtlantaNorthern District of Georgia - NewnanNorthern District of Georgia - GainesvilleSouthern District of Georgia - DublinSouthern District of Georgia - AugustaSouthern District of Georgia - WaycrossSouthern District of Georgia - BrunswickSouthern District of Georgia - SavannahSouthern District of Georgia - StatesboroDistrict of Guam – GuamDistrict of Hawaii – HonoluluDistrict of Idaho - PocatelloDistrict of Idaho - Twin FallsDistrict of Idaho - MoscowDistrict of Idaho - BoiseDistrict of Idaho - Coeur D’AleneCentral District of Illinois - PeoriaCentral District of Illinois - DanvilleCentral District of Illinois - SpringfieldNorthern District of Illinois - Rockford/SterlingNorthern District of Illinois - ChicagoSouthern District of Illinois - East St. LouisSouthern District of Illinois - AltonSouthern District of Illinois - EffinghamSouthern District of Illinois - BentonNorthern District of Indiana - HammondNorthern District of Indiana - South BendNorthern District of Indiana - Ft. WayneNorthern District of Indiana - Hammond at LafayetteSouthern District of Indiana - EvansvilleSouthern District of Indiana - New AlbanySouthern District of Indiana - Terre HauteSouthern District of Indiana - IndianapolisNorthern District of Iowa - DubuqueNorthern District of Iowa - Mason CityNorthern District of Iowa - WaterlooNorthern District of Iowa - Ft. DodgeNorthern District of Iowa - Cedar RapidsNorthern District of Iowa - Sioux CitySouthern District of Iowa - Des MoinesSouthern District of Iowa - DavenportSouthern District of Iowa - Council BluffsDistrict of Kansas - Kansas CityDistrict of Kansas - WichitaDistrict of Kansas - TopekaEastern District of Kentucky - LondonEastern District of Kentucky - AshlandEastern District of Kentucky - LexingtonEastern District of Kentucky - FrankfortEastern District of Kentucky - PikesvilleEastern District of Kentucky - CovingtonWestern District of Kentucky - PaducahWestern District of Kentucky - LouisvilleWestern District of Kentucky - Bowling GreenWestern District of Kentucky - OwensboroWestern District of Louisiana - MonroeWestern District of Louisiana - Lake CharlesWestern District of Louisiana - LafayetteWestern District of Louisiana - AlexandriaWestern District of Louisiana - ShreveportEastern District of Louisiana - New OrleansMiddle District of Louisiana - Baton RougeDistrict of Maine - BangorDistrict of Maine - PortlandDistrict of Maryland - BaltimoreDistrict of Maryland - GreenbeltDistrict of Massachusetts - WorcesterDistrict of Massachusetts - BostonEastern District of Michigan - DetroitEastern District of Michigan - Bay CityEastern District of Michigan - FlintWestern District of Michigan - MarquetteWestern District of Michigan - Grand RapidsDistrict of Minnesota - St. Paul]District of Minnesota - DuluthDistrict of Minnesota - MinneapolisDistrict of Minnesota - Fergus FallsNorthern District of Mississippi - BiloxiNorthern District of Mississippi - AberdeenSouthern District of Mississippi - JacksonEastern District of Missouri - Cape GirardeauEastern District of Missouri - HannibalEastern District of Missouri - St. LouisWestern District of Missouri - JoplinWestern District of Missouri - St. JosephWestern District of Missouri - Jefferson CityWestern District of Missouri - Kansas CityWestern District of Missouri - SpringfieldDistrict of Montana - BillingsDistrict of Montana - ButteDistrict of Montana - Great FallsDistrict of Nebraska - LincolnDistrict of Nebraska - OmahaDistrict of Nevada - RenoDistrict of Nevada - Las VegasDistrict of New Hampshire - ManchesterDistrict of New Jersey - CamdenDistrict of New Jersey - TrentonDistrict of New Jersey - NewarkDistrict of New Jersey - Atlantic CityDistrict of New Mexico - AlbuquerqueEastern District of New York - Central IslipEastern District of New York - BrooklynSouthern District of New York - White PlainsSouthern District of New York - ManhattanSouthern District of New York - PoughkeepsieNorthern District of New York - AlbanyNorthern District of New York - UticaWestern District of New York - BuffaloWestern District of New York - RochesterNorthern District of New York - SyracuseEastern District of North Carolina - WilsonMiddle District of North Carolina - GreensboroWestern District of North Carolina - CharlotteDistrict of North Dakota – North DakotaDistrict of Northern Mariana Islands – SaipanNorthern District of Ohio - YoungstownNorthern District of Ohio - AkronNorthern District of Ohio - ClevelandNorthern District of Ohio - ToledoNorthern District of Ohio - CantonSouthern District of Ohio - ColumbusSouthern District of Ohio - DaytonSouthern District of Ohio - CincinnatiEastern District of Oklahoma - OkmulgeeNorthern District of Oklahoma – TulsaWestern District of Oklahoma – Oklahoma CityDistrict of Oregon - EugeneDistrict of Oregon - PortlandEastern District of Pennsylvania - ReadingEastern District of Pennsylvania - PhiladelphiaMiddle District of Pennsylvania - Wilkes-BarreMiddle District of Pennsylvania - HarrisburgWestern District of Pennsylvania - JohnstonWestern District of Pennsylvania - PittsburghWestern District of Pennsylvania - ErieDistrict of Puerto Rico – Hato ReyDistrict of Rhode Island - ProvidenceDistrict of South Carolina – ColumbiaDistrict of South Dakota - AberdeenDistrict of South Dakota - Rapid CityDistrict of South Dakota - Sioux FallsDistrict of South Dakota - PierreEastern District of Tennessee - ChattanoogaEastern District of Tennessee - GreenvilleEastern District of Tennessee - KnoxvilleMiddle District of Tennessee - CookvilleMiddle District of Tennessee - ColumbiaMiddle District of Tennessee - NashvilleWestern District of Tennessee - MemphisWestern District of Tennessee - JacksonEastern District of Texas - TylerEastern District of Texas - ShermanEastern District of Texas - BeaumontEastern District of Texas - ParisEastern District of Texas - LufkinEastern District of Texas - TexarkanaEastern District of Texas - MarshallNorthern District of Texas - Wichita FallsNorthern District of Texas - AmarilloNorthern District of Texas - Ft. WorthNorthern District of Texas - San AngeloNorthern District of Texas - AbileneNorthern District of Texas - DallasNorthern District of Texas - LubbockSouthern District of Texas - VictoriaSouthern District of Texas - GalvestonSouthern District of Texas - BrownsvilleSouthern District of Texas - LaredoSouthern District of Texas - McAllenSouthern District of Texas - HoustonSouthern District of Texas - Corpus ChristiWestern District of Texas - San AntonioWestern District of Texas - Midland-OdessaWestern District of Texas - AustinWestern District of Texas - El PasoWestern District of Texas - WacoDistrict of Utah - Salt Lake CityDistrict of Vermont – RutlandEastern District of Virginia - AlexandriaEastern District of Virginia - RichmondEastern District of Virginia - Newport NewsEastern District of Virginia - NorfolkWestern District of Virginia - LynchburgWestern District of Virginia - HarrisonburgWestern District of Virginia - RoanokeDistrict of Virgin Islands - St. CroixDistrict of Virgin Islands - St. ThomasEastern District of Washington - SpokaneEastern District of Washington - YakimaWestern District of Washington - TacomaWestern District of Washington - SeattleNorthern District of West Virginia - ElkinsNorthern District of West Virginia - WheelingNorthern District of West Virginia - MartinsburgNorthern District of West Virginia - ClarksburgSouthern District of West Virginia - HuntingtonSouthern District of West Virginia - BeckleySouthern District of West Virginia - ParkersburgSouthern District of West Virginia - CharlestonSouthern District of West Virginia - BluefieldEastern District of Wisconsin - MilwaukeeWestern District of Wisconsin - RothschildWestern District of Wisconsin - MadisonWestern District of Wisconsin - Eau Claire/SuperiorWestern District of Wisconsin - LacrosseDistrict of Wyoming - CheyenneDistrict of Wyoming - CasperAttorney InformationDo you have an Attorney?*YesNo** the following attorney fields are required if you answered yes above.Attorney Name:*Attorney Phone Number:*Attorney Fax Number:Payment Information$29.95 for Single / Joint (Online & Telephone Version)If your attorney will be covering the payment, please enter their Attorney Payment Code:Otherwise, please be prepared to pay online or over the phone. We accept Credit/Debit cards and checking account drafts.