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					                                                                        9619 Chesapeake Drive, Suite 100
February 26, 2010                                                       San Diego, CA 92123
                                                                        Phone: 866-206-5574
                                                                        Fax: 866-206-5532



                                   DMP Cancellation Agreement


       ,


Dear        ,


Please use this letter to confirm your request to terminate the Debt Management Program. We cannot
process your request to cancel your program until we receive both pages completed and signed by you.

Please initial confirming you understand the terms below that will go into effect upon canceling your
Debt Management Program:

 ____ 1. My creditors will not be contacted or sent proposals to get the benefits quoted by my counselor.
         If proposals have already been sent, my creditors will be notified that I wish to discontinue the
         program.
 ____ 2. My interest rates will fall back to the rates they were before I spoke with my counselor or
         increase at my creditors’ discretion.
 ____ 3. I will not get the new payment quoted to me by my counselor.
 ____ 4. I will not get out of debt within 3-5 yrs (the time I was quoted by my counselor)
 ____ 5. Late fees and over limit fees may occur on my accounts
 ____ 6. My account will be listed as cancelled and will not be on a Debt Management Program.

If I wish to continue with any Debt Management Program in the future, it is possible that the creditors
will no longer offer the benefits I was previously quoted. All benefits are subject to change.

I have read and fully understand the above information. I wish to cancel my agreement with CBDC
Client Signature ___________________________________ Co-Client Signature_______________________________
Client's SS# ______________________________________ Co-Client's SS# ___________________________________
Date: ____________________________________________ Date: __________________________________________

Both pages must be initialed, signed, and completed in order for us to terminate your account.
Please fax or mail this completed form to the fax number or address listed above. This form must
be received and confirmed with Cancellation Department at least 5 (Five) business days prior to
debit date to stop future debits from taking place.




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                                             DMP Cancellation Agreement



As per your request to terminate the Debt Management Program, please complete the attached form and return it to the address
listed above.

1) What is the primary reason for discontinuing the program?
   Can afford payments on own                   Amount of First payment                   Bankruptcy
   Concerned with Credit Effect                 APS (Debit) error(s)                      Unhappy with the service
   Calls from collectors                        Cannot afford the Program                 Received a Unsecured Personal loan
   Refinanced Home (Secured loan)               Felt misled by counselor                  Paid account(s) in full
   Dissatisfaction with the Counselor           Do not want to close accounts             Getting help from family or friend
   Dissatisfaction with the service fees        Arranged settlement with creditors        Transferred balance to a lower interest card
   Enrolled with a Debt Settlement company
   Joined another Debt Management Program (Please Explain Why)__________________________________________________________
_________________________________________________________________________________________________________________
   Other (Please Explain) _________________________________________________________________________________________

2) What was your primary reason(s) for initially joining the debt management program?

   Stopping Over limit and late fees              Interest Rate Savings                      Improving Credit
   Lowering my monthly payment                    Convenience of Automatic Debit             Stopping Harassing calls from Creditors
   One Convenient Payment                         Time Frame of becoming Debt Free

   Other (Please Explain) _________________________________________________________________________________________

Comments:

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________


3) Would you recommend this program to anyone else?                           YES          NO


Please write your SS# (co-client if applicable), sign and date this letter.


Client Signature ___________________________________ Co-Client Signature_______________________________
Client's SS# ______________________________________ Co-Client's SS# ___________________________________
Date: ____________________________________________ Date: __________________________________________




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