Forms

Below are the forms you are required to print and complete:

 

 

Income Verification & Certification

 

The Income Verification and Certification includes the fee schedule. Please select the correct fee based on your income then sign and date. This fee can be paid online by debit card, or money order.

 

Budget

 

Please complete this form to the best of your ability. A Budget worksheet guide is provided to assist you in completing the form.

 

Affidavit and Agreement for Credit Counseling

 

Please complete the Affidavit and Agreement for Credit Counseling.

THIS FORM MUST BE NOTORIZED OR SIGNED BY YOUR ATTORNEY

A copy of your state or government issued picture ID must accompany this form.

 

PreBankruptcy Counseling and disclosure

Please print and review this form it contains important information about Consumer Credit and Budget Counseling and our PreBankruptcy services.

 

Mail (or Fax) the forms to CC&BC:

 

1. Income Verification and Certification

2. Affidavit (with a copy of ID)

3. Budget Worksheet

4. Fee (If paying by Money Order it must be mailed - please mail forms along with your payment. )

 

Address:

CCBC - PREBANKRUPTCY
Post Office Box 866
Marmora, NJ 08223-0866

If you are paying by debit card online you can fax the forms to our toll free fax:

Fx: 1-888-738-8234