Name 1 (Print)... Name 2 (Print)... Money Village Number...



Similar documents
Debt Management Plan. Terms of Business

Terms and Conditions

CHURCHWOOD FINANCIAL LIMITED Terms and Conditions of Business

keyfacts About our debt management plan services About this document

Clients Copy. Terms and Conditions of Business

Please complete the Account Details page of our pack and ONE Letter of Authority for each company you want to claim against.

This booklet sets out Our Terms of Business in conjunction with the Debt Management Agreement that You have signed.

Money Management Team Limited Limited Service & Fee Agreement

PPI Claim Form. Easy steps to claim back your money. 1. Fill in all the required details and questionnaire.

Mis-Sold Payment Protection Insurance (PPI) Claims Pack

Debt Management Plan Protocol

PPI Customer Information Handbook

Please read and sign the following. This is to confirm you have received and read all of the. Client ID: EDS <<ClientID>> Version 2.5.

TERMS OF BUSINESS AGREEMENT - INSURANCE BROKING

Payment Protection Insurance Claim Form

Claim Forms. Please print, complete and return to (no stamp needed):

Your account will be transferred to our Collections department if you fail to make the repayments due under this agreement.

Have you been mis-sold a Packaged Bank Account? We are dedicated to dealing with claims where you have been mis-sold a packaged bank account

CLAIMLINE UK LTD GENUINE NO WIN NO FEE CLAIMS

How Do You Get Your Money? Simply fill in the enclosed claim pack and send it back to us in the pre-paid envelope provided.

Terms and conditions

T&Cs for GUARANTOR Instalment & Bond Loans

Terms of Business. Murray & Spelman Ltd. Name: T/A Murray # Spelman Insurance & Finance. Name & Contact Details:

UK Money Solutions Client Support Guide

Filling in the Form of Authority. Please ensure you have the lenders name in order to pursue the claim.

l Our Client Charter l Our Complaint Procedure l Glossary of terms to help you understand your Debt Management Agreement (DMA)

G&T Brokers Limited. Terms of Business Agreement ( TOBA )

Please enclose a copy of your loan/credit agreement if available. For credit cards, please enclose a copy of your statement.

Terms of Business. Who we are? Whose policies do we offer? Which service will we provide you with?

tel: Fighting Your Corner

Your rights when buying on credit

Claim Forms Please print, complete and return to:

Personal Debt Solutions (Dealing With Debt) An Essential Guide by Debt Advisory Services (Scotland)

T&Cs for NON-GUARANTOR Instalment & Bond Loans

Commercial Terms of Business Agreement

MoneySmartCo Limited Terms of Business MoneySmartCo Limited (Company Number ) is a claims management company authorised and regulated by the

Information Form. Personal Information. 2nd Applicant. First Names. Surname. Address

Post Office Personal Loans Terms & Conditions

Please enclose a copy of your loan/credit agreement if available. For credit cards, please enclose a copy of your statement.

AToM Debt Solutions. Debt Management. Call AToM Debt Solutions now on or visit

Mortgages, Equity Release and Protection Planning

Terms of Business. Who we are? Whose policies do we offer? Which service will we provide you with?

Client Information and Checklist

Debt Management Plan

Residential and Buy to Let Mortgages Supplementary application form

Client Agreement. Investment, Protection and Financial Planning

Money Boomerang Limited Adamson House, Towers Business Park, Didsbury, Manchester, M20 2YY Tel:

Saffron Building Society Mortgages Savings Investments Insurance Loans. Residential mortgage conditions.

LEGALLY ENTITLED PPI CLAIM PACK

Trustees and Liquidators in Bankruptcies and Compulsory Liquidations

Standard terms of business

3.6. Please also note, unless your policy confirms otherwise, the rights under your policy may only be pursued in an English court.


TT ELECTRONICS INTEGRATED MANUFACTURING SERVICES LIMITED CONDITIONS OF PURCHASE

Personal Instalment Loan - Express Loan Application Form

Windsor Thompson Financial Claims

Debt Solution Overview 2

If you are unclear about the implications of Auto Enrolment you will find our Guide to Auto Enrolment a good starting point.

JRI S STANDARD TERMS OF PURCHASE. Business Day: a day (other than a Saturday, Sunday or public holiday) when banks in London are open for business.

Your PPI Reclaim Plan

HOME LOAN GENERAL OFFER CONDITIONS (Mortgage Broker Introduction) with effect from 14th March 2016

Information Form. No Win, No Fee. Personal Information. 2nd Applicant. 1st Applicant. Financial Status. Pension Comparison. Mis Sold Mortgages

Residential mortgages general information

Dear Customer, What to do now Follow these 4 simple steps:

General Mortgage Conditions

Adequate Explanations


to a bank account nominated by the undersigned, where I/We will pay Reclaim Experts the agreed Success Fee.

mumbles pier, swansea Client Agreement and Service Proposition

CUSTOMER COPY Credit Agreement

TERMS & CONDITIONS FULLY MANAGED SERVICE

Thompson Jenner LLP Last revised April 2013 Standard Terms of Business

FINANCIAL RESCUERS, LLC

Client Agreement Mortgages, Equity Release and Protection Planning

TEMPLE LITIGATION ADVANTAGE INSURANCE FOR DISBURSEMENTS AND OPPONENT S COSTS Certificate of Insurance

Personal Loan Agreement

Retail Client Agreement Investment, Insurance and Mortgage Services

Client Agreement Mortgages and Protection Planning

The Superannuation Clearing House Online Product Disclosure Statement

Client Agreement document

Application form Residential and buy-to-let secured loans

Leathes Prior Solicitors Terms of Business

CURRENT ACCOUNT SWITCH

SANLAM PERSONAL LOANS 3 (PTY) LTD ( SPL3 ) TERMS & CONDITIONS

Direct Debit Form & Pre-Contract Credit Information for Household policies. (Standard European Consumer Credit Information)

Initial Disclosure Document (IDD) and Terms of Business Agreement (TOBA)

A few minutes of your time could earn you thousands.

1 Title. 2 Full Name (Please include names of all policy holders) 3 Address. 4 Phone. 5 Mobile number. 6

Home Loan Agreement General Terms

Lending Terms & Conditions. Current as at 23 November 2015

Terms of business agreement - Commercial clients

Terms of Business. Regulated Activities Our principal business is mortgage lending and this activity is regulated by the Central Bank of Ireland.

ANZ Loan. Terms and conditions

Client Agreement

Loan Contract Terms and Conditions booklet with:

about our equity release services

International Payment Service Terms and conditions

REF: GRMWEB. What next?

mortgage loan terms 2011

UNIT TRUST INVESTMENT APPLICATION FORM Companies, Close Corporation and other legal entities

Transcription:

Money Money Village Village Life Plan Plan Client Client Agreement Agreement This agreement This This agreement agreement is made is isbetween made between Us andyou You. Us andplease Us. You. Please ensure Please ensure that ensure that You You have that have read You read all have this parts read Agreement of the agreement all parts andof the and the the accompanying agreement and signing the accompanying below as accompanying Terms & Conditions before signing below. You will Terms be legally & Terms Conditions, & bound Conditions by which this before form Agreement you the sign basis by of signing the contract, it. before Name 1 (Print)... Name 1 (Print) Name 2 (Print).. Name 2 (Print)... Address. Reference. Money Village Number... Setting Setting up up your your Money Lifeplan Villageinvolves Plan involves undertaking undertaking an initial an assessment assessment of your of your income financial and expenditure position, carrying and general out financial a fact find position, of your preparing a Statement of Affairs for your creditors and making them offers of repayment. Money Village do not charge a fee for this. income and expenditure, preparing your Statement of Affairs and Offers of Repayment. MoneyVillage do not charge a fee for We do charge a monthly fee for the on-going administration of your plan. This fee is to cover the cost of processing your monthly payments and this. We do charge a fee for the on-going administration of the plan. disbursing to your creditors, providing a dedicated Personal Adviser to answer your queries and handle correspondence from your creditors and undertaking Our Monthly an annual Management review offee youris financial 14% of position your monthly (and more payment often should to MoneyVillage, this be required). subject to a minimum of 30.00 and a maximum of 80.00. Our monthly fee is comprised of an on-going management fee of 15 plus an amount of 3 per creditor included in your Money Village Plan. In alltherefore cases, ouryour maximum monthly monthly fee is fee... is cappedbased at 75. on Notwithstanding an initial monthly this, we payment will always of... ensure that We not will less advise thanyou 60% of ofany yourchanges monthly to payment this fee towhen Money your Village monthly is disbursed payment to your changes creditors. as your plan progresses. Based The Monthly the number Management of creditors Fee youis have to cover disclosed the to cost us, of your administering monthly fee will payments be. to /We creditors, have agreed dealing a monthly with queries fee of from (delete them and as appropriate). This may change if creditors are added to or removed from the plan or if your individual circumstances change and your existing providing a dedicated Personal Advisor to yourself. Your payments will be disbursed to your creditors within five working monthly payment becomes unaffordable. We will give you 30 days written notice of any changes. days of receipt of cleared funds subject to the plan terms and conditions (see What we do with your money ). Please This refer feeto isyour deducted personal fromillustration your monthly for payment our initial toestimate Money Village of the after duration the balance of your has plan been and distributed the total fees amongst that could your creditors be payable. on a pro-rata A further basis. estimate Your payments will be provided will be disbursed once we have to your received creditors confirmation within 5 working of the days outstanding of receipt balances of cleared from funds, your subject creditors. plan terms and conditions (see What we do with your money ). Please Before refer you to sign your this personal agreement, illustration please for our read estimate each of of the the duration following of and your initial plan and in the total box fees provided that could to be payable. confirm you have read and understood each point. Client Advisor Important information The advisor explained the other debt solutions that may be available. Money The advisor Village explained cannot guarantee that I have thata collections cooling off actions, period of including 14 days default from the notices date and you litigation, receive this cansigned be avoided and that default notices agreement may incur during costs which that time will I be can added cancel to the debt. agreement and receive a refund of any payment made. The following debts cannot be included in the plan: Mortgages and other secured loans, Council Tax and utility bills (including We normally wait until the cooling off period has elapsed before commencing negotiations with creditors. arrears), Inland Revenue debts and debts already subject to a County Court Judgement. Payments towards these priority debts If you need us to start work on your behalf immediately then please tick this box (please note any are not part of the plan and are to be maintained by you. payment taken during this period may not be refundable as per attached terms and conditions). The The Money advisor Village explained Plan isthat an MoneyVillage informal arrangement cannot guarantee with your creditors that collection and there actions, is no guarantee including default that they will agree to freeze interest notices and and charges litigation, orcan stopbe contacting avoided and you. that Entering default into notices a Money may Village incur costs Planthat maywill result be added in an increase to the debt. in the debt repayment period The advisor and theperformed total amount a fact to be find repaid. and noted down all of my income and expenses, and took details of the debts that are to be included within the plan. The advisor explained that the following debts could Entering not be included: into the Money Village Plan may result in Creditors notifying Credit Reference Agencies of this fact and this may affect the availability Secured of credit loans in the future, even after the debts have been repaid. Current Council Tax or utility arrears You are notinland applying Revenue for a loan overpayments and you must not apply for further credit (other than monthly instalment credit for household expenses such Debts as that Motor have and already Home had insurance). a County Court Judgement against them You I understand have a cooling there off is period a Monthly of 14Management days from thefee datepayable we receive as stated this signed above. agreement, during which time you can cancel the agreement and receive a refund of any fees paid. The advisor explained that a Debt Management Plan is an informal arrangement with my Creditors, Money and that Village there will is wait no guarantee until the cooling that Creditors off period will hasagree elapsed to before freeze commencing interest and negotiations other charges, or stop with contacting your Creditors. me, and If you that need a Debt us tomanagement start work on Plan your behalf may increase immediately, the length please of tickthe here debt repayment (please period note and that the total any fees amount paid to during be repaid. this period may not be refundable as per the attached terms The and advisor conditions). explained that entering into a Debt Management Plan may result in Creditors notifying Credit Reference Bureau of this fact and this may affect the availability of credit in the short and medium to long term, even after debts have been repaid. The advisor explained that I am not applying for a loan and I confirm that I will not apply for further credit (other than monthly installment credit for household expenses such as Motor and Home insurance). Client 1 Signature Date.. Client 1 Signature Date Client 2 Signature. Date. D ate Client 2 Signature Date Advisor Signature Debt Management Gallery Associates House, Limited, 3rd Floor, West ThePoint, Headrow, Westland LeedsSquare, LS1 5RDLeeds LS11 5SS TM MoneyVillage is a trading style of Debt Management Associates Ltd, 3rd Floor, Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 Tel: Tel: 5240 0330 022 022 Fax 5240 5240 Fax: 0113271 Fax: 308 5001 3888 0113 2713888 www.debtman.co.uk Founder members of DEMSA (Debt Managers Standards Association). Date

T Your Personal Illustration (Based on the information you have provided us) Name 1 (Print)... Name 2 (Print)... Money Village Reference Number... Your Outstanding Debt... Your Monthly Payment to your Creditors... (Disposable Income minus Monthly Management Fee) Number of Months to repay your debt... (Outstanding Debt/Monthly payment to creditors) Monthly Management Fee to Money Village... Potential total fees payable... (Monthly Management Fee multiplied by the number of months to repay your debt) Potential total cost.. (Outstanding debt repayable plus potential total fees). We are required to provide you with this illustration of how long your plan may last and the total costs that could be payable as per Financial Conduct Authority rules and the DEMSA (Debt Managers Standards Association) Code of Conduct. We assume that interest and charges will be frozen by your creditors, which we cannot guarantee will happen, and that your current situation remains the same. Please note this is intended as a guide only and not a statement of what you must pay in total. Debt management is intended to be a short to medium term option to help you regain control of your finances. Your financial situation may improve, meaning you can make higher payments to creditors and repay debts quicker or you may have the funds available to settle some or all of your debts. If this is the case, Money Village can help you negotiate reduced settlement figures with your creditors. Client 1 Signature Date.. Client 2 Signature. Date. D ate Debt Management Gallery Associates House, Limited, 3rd Floor, West ThePoint, Headrow, Westland LeedsSquare, LS1 5RDLeeds LS11 5SS TM MoneyVillage is a trading style of Debt Management Associates Ltd, 3rd Floor, Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 Tel: 5240 Tel: 0330 022 Fax 5240 5240 0113 Fax: 0113 271 Fax: 308 5001 3888 0113 2713888 www.debtman.co.uk Founder members of DEMSA (Debt Managers Standards Association).

T Action List Reference No... WHAT TO DO NEXT Check List Please send us the following paperwork and/or complete the relevant actions as soon as possible (Tick where relevant) New Bank Account Details Including account number sort code and name and address of your new bank. Make first monthly payment Forward missing Creditor account numbers to Money Village Wage Slips/Salary Proofs - minimum 1 months wage slips Creditor Statements (one for each debt) Ensure Standing order is set up Inform Personal advisor of any change in circumstances Your Personal Illustration (Based on the information you have provided us) Any Other Your Instruction Outstanding Debt Your Monthly Payment to your Creditors Number of months to repay your debt Monthly Management Fee to Money Village Total Monthly Management Fees Paid Initial Set Up Fee Paid to Money Village Total Fees Paid to Money Village Months Every debt management company is regulated by the Office of Fair Trading ( OFT ), and is required to provide a tailored example of how long a plan will last for its customers. For illustrative purposes, we assume that interest and charges are frozen by the creditors. There is no guarantee that interest and charges will be frozen, and no company in the UK should state that this is the case. The time to repay your debt, as quoted above, also assumes that your monthly disposable income remains constant throughout the period and that you make all your monthly payments to us when they are due. As part of our service, we carry out regular reviews for our Clients to ensure their Statement of Affairs is up to date and reflects their circumstances at that time. Debt Management Gallery Associates House, Limited, 3rd Floor, West ThePoint, Headrow, Westland LeedsSquare, LS1 5RDLeeds LS11 5SS Debt Management Tel: 0330 Associates 022 5240 Limited, Fax 0113 West 271 Point, 3888 Westland www.debtman.co.uk Square, Leeds LS11 5SS TM MoneyVillage is a tradingtel: style of 0330 Debt Management 022 5240 Associates Fax: Ltd, 0113 3rd Floor, 2713888 Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 Tel: 0330 5240 022 5240 Fax: 0113 308271 5001 3888 www.debtman.co.uk Consumer Credit License Foundernumber members of473207 DEMSA (Debt Managers Registered Standards in England Association). number 3711687

Money Village Plan Terms & Conditions Definition Of Terms You Us,We Creditors Fees Services Pro-rata Full and Final Settlements The Client(s) whose name is recorded on the Client Agreement. Money Village, a trading name of Debt Management Associates Ltd., registered number 3711687. Registered address: Gallery House, 3rd Floor, The Headrow, Leeds, LS1 5RD. The organisations that You owe money to and in relation to which we have agreed to act on your behalf. The Fees as set out on the Client Agreement. Negotiating revised payment terms with your creditors, collecting an agreed monthly payment from You and distributing this amongst your creditors on a pro-rata basis. Money is divided proportionately among your creditors, after deduction of our monthly management fee, according to the value of the individual debt. A one-off lump sum payment agreed with your creditors which is less than the full balance you owe but which is accepted in full and final settlement of your debt. Our Agreement You appoint Us and We agree to act on your behalf as debt counsellors and debt adjusters in providing the Services. The Agreement will start when we receive the signed Client Agreement form, signed Letter of Authority form and your first monthly payment. This Agreement is governed by English law. Fees We charge a fee for our services. This is set out in the Client Agreement. What We Will Do We will use the information provided by You to calculate a monthly amount that We will believe You can afford to pay to your Creditors. We will provide an estimate of the total Fees payable by You to Us for the services which We provide under this Agreement and an estimate of how long it will take You to repay your Creditors. We will notify your Creditors that We act for You and will offer them revised payment terms on Your behalf. We will ask Creditors not to charge You interest on the amounts You owe, and to cease attempting to collect the money that You owe. We do not guarantee that your Creditors will agree to this. We will send You a schedule of how much we will pay every month to each of your creditors. We will update this schedule when we complete a review of your circumstances or when You let us know of a change in your circumstances (see below). We will also periodically issue a statement of account showing the payments you have made and the outstanding balance for each debt subject to the plan. We will contact You in order to review Your circumstances at least once every twelve months, or when You let Us know that there has been a change to Your circumstances. Where the amount that You can afford to pay to Your Creditors changes, We will offer them revised payment terms on Your behalf. We will keep You informed of all material communications between your Creditors and Us, and We shall deal with all communications from your Creditors to Us (or to You and provided by You to Us) appropriately and promptly.

Full & Final Settlements If you have the funds available, We can negotiate full and final settlements with Your Creditors on your behalf. There is a separate fee for this service which will be 15% of the amount that We save You, subject to a minimum fee of 100. What We Do With Your Money All payments that We receive from You in cleared funds will be paid directly into a Client Bank Account. After making payments from You to Your Creditors, We will deduct our fees from the Client Bank Account. We will normally make payments to Your Creditors within five working days of receipt of the Monthly Payment from You in cleared funds. We will deduct our Monthly Management Fee from your Monthly Payment to Us after making payment to Your Creditors on a pro-rata basis. Where We are unable to make a payment within five working days of receipt, we will make a payment at the first available opportunity and will ask Your Creditors to maintain any payment plans that have been agreed and to put you back into the financial position you would have been in had the delay not occurred. If a payment is returned to Us by a Creditor We will endeavour to find out the reason for this and if necessary, contact You for further information. Following completion of our enquiries, we will resend the payment at the first available opportunity. If You send less than the agreed monthly payment, your funds will not automatically be disbursed by our system resulting in delays in your creditors receiving payment. We will endeavour to contact you to discuss the shortfall but if we are unable to contact you or we do not receive an additional payment to make up the shortfall, we will have to send less than the agreed amounts to your creditors, which may result in your creditors cancelling any agreed payments plans and collections action being taken as well as additional interest and default charges being added to your debt. If You send more than the agreed monthly payment, our system will automatically pay Your creditors the agreed monthly amount only, and any monies remaining will be held on Your behalf and discussed with You when We have the opportunity to do so. What You Will Do You must provide Us with full, accurate and truthful details of income, expenses, Creditors and other relevant details that We ask for. Where We ask for evidence, You must provide this. You must make the agreed monthly payments. If You do not, we will not be able to send any payments to your creditors. This may mean that your creditors may cancel any payment plans to which they have agreed and collections action being taken as well as additional interest and default charges being added to your debt. Please advise us immediately if You are unable to make your payment. You must tell Us if your circumstances change. You must not apply for or take out further credit or incur further debts, other than those relating to your normal living expenses. Ending The Agreement You have a right to cancel our Agreement at any time. If you cancel within the first 14 days ( Days here include Saturdays, Sundays and public holidays) we will then refund to You in full any Fees already paid to us that are cleared funds unless you authorised us on page 1 of this agreement to commence work on your behalf immediately, in which case we will assess the cost of the work we have carried out before determining the amount of any refund. We will not refund any payments that have already been made to your creditors. If you wish to cancel, please write to us at the address below, send an email to dma.customerservice@moneyvillage.co.uk or phone us on the number below. The Agreement will end when You have repaid all agreed amounts owed to your Creditors, or if either You or We cancel the agreement.

T We may cancel the agreement if You fail to make payments to Us when due, file for bankruptcy (or enter any other insolvency arrangement) or are in breach of this Agreement in any other way. If We cancel this agreement, we will write to You 2 weeks before. When this Agreement ends, our duties and obligations under this Agreement will come to an end and You will be responsible for making payments to your Creditors, should any balances be outstanding. You may within 30 days of the end of this Agreement request Us to send You copies of all paperwork received from You or your Creditors that has been retained by Us as a scanned image. Data Protection Statement Please read this statement carefully as it explains how We use the information Your financial and personal circumstances that We have asked You for and You have provided. This information will be treated as confidential and will be stored and processed in line with the Data Protection Act 1998. It will only be passed to your creditors and such third parties (or made available to them by access to your records on our systems via an on-line portal) in order for us to be able to negotiate with them on Your behalf in accordance with the terms of this agreement. We may pass your information to Creditors who process your data outside the European Economic Area (EEA). It will also be used by us in order to for us manage, and to communicate with You about, your plan. We may contact You by the following methods: post, telephone, email or SMS text. You can advise us at any time if you wish us not to use any of these particular methods this will not affect the provision of the services or Our decision to provide You with the services. Your information may also be disclosed to a recognised auditing/regulatory body as part of the periodic audits to which we are subject. These are performed at least every 12 months in order to demonstrate compliance with the relevant regulatory guidance and the terms of the Debt Management Protocol. We may also use your personal information to contact You to provide You details of other products and services which We think may be of interest to You, including those offered by related companies and selected third parties. If you prefer not receive such details then please tick the following box. Electing not to receive such details does not affect the provision of the services or Our decision to provide you with the services. Other terms We may transfer our rights and obligations under this Agreement by giving You written notice of such transfer. This Agreement sets out the entire agreement and understanding between You and Us and supersedes all prior agreements, understandings or arrangements (whether oral or written) relating to the provision of the Services. We shall not be deemed in breach of this Agreement or otherwise liable to You if We are prevented or hindered from performing our obligations under this Agreement by reason of any event beyond our reasonable control. If any part of these terms and conditions is found to be invalid or unenforceable, that part shall be deemed severed from our agreement which will otherwise remain in full force and effect. Any failure on our part to insist on strict performance of any part of these terms and conditions will not be deemed a waiver of our rights and remedies in respect of any future breach. We may vary these Business Conditions from time to time and will write to give You at least 30 days prior notice of any changes. Complaints If you wish to complain about any aspect of our service, you may contact us either by telephone (0330 022 5240), or in writing by letter to Money Village, 3rd Floor, Gallery House, The Headrow, Leeds, LS1 5RD, or by email to customerservice@moneyvillage.co.uk. You can also refer complaints to the Financial Ombudsman Service. Please see www.financial-ombudsman.org.uk for further information. Debt Management Gallery Associates House, Limited, 3rd Floor, West ThePoint, Headrow, Westland LeedsSquare, LS1 5RDLeeds LS11 5SS Tel: TM0330 022 Tel: 5240 0330 022 Fax 5240 0113 271 Fax: 3888 0113 2713888 www.debtman.co.uk MoneyVillage is a trading style of Debt Management Associates Ltd, 3rd Floor, Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 5240 Fax: 0113 308 5001 Founder members of DEMSA (Debt Managers Standards Association).

T 1. YOUR BANK DETAILS Please write clearly in the white spaces with capital letters or tick the box where appropriate All sections must be completed. Branch Name Sort Code Your full name and address Account Number 2. STANDING ORDER DETAILS Does this instruction replace any existing standing order or direct debit instructions? (please tick) Yes No Recipient's Name DMA Recipient's Bank and Branch Name Barclays Bank PLC, High Street, Skipton Recipient's Sort Code 20-78-42 Recipient's Account No 80756474 Usual Payment Amount Usual Payment Amount in words Your Payment Reference First Payment Date Payment Frequency Monthly Weekly Final Payment Until further notice 3. AUTHORISATION I authorise you to debit my / our account, in accordance with the details in Section 2. Your Signature (s) 1. 2. Date: Debt Debt Management Management Gallery Associates Associates House, Limited, Limited, 3rd Floor, West West The Point, Point, Headrow, Westland Westland Leeds Square, Square, LS1 5RD Leeds Leeds LS11 LS11 5SS 5SS Tel: Tel: TM 0330 0330 022 022 Tel: 5240 5240 0330Fax 022 Fax 0113 5240 0113 271 271 Fax: 3888 3888 0113www.debtman.co.uk 2713888 MoneyVillage is a trading style of Debt Management Associates Ltd, 3rd Floor, Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 5240 Fax: 0113 308 5001 Consumer Credit License Consumer Credit License Foundernumber number members473207 of473207 DEMSA (Debt Registered in England number 3711687 Registered Managers Standards in England Association). number 3711687

T To the Collection Department Please accept this signed document below as authority for MoneyVillage to act on behalf of the client(s) below. Authority to be signed by Client(s) To Whom it May Concern I/We hereby authorise my creditors to disclose to Money Village and/or their preferred providers of Insolvency Services any personal financial information (including personal data) they require concerning my financial affairs. I/We confirm that I/We have instructed Money Village to assist in my/our financial affairs. Please accept this authority as such. Print Full Name... Signed... Dated... Print Full Name... Signed... Dated... Reference No... Debt Debt Management Management Gallery Associates Associates House, Limited, Limited, 3rd Floor, West West ThePoint, Headrow, Westland Westland LeedsSquare, LS1 5RDLeeds LS11 LS11 5SS 5SS TM MoneyVillage Tel: Tel: 0330 0330 is a trading 022 022 Tel: style 5240 5240 0330 of Debt Management Fax 022 Fax 0113 5240 0113 Associates 271 271 Fax: 3888 3888 Ltd, 0113 3rd Floor, 2713888 www.debtman.co.uk www.debtman.co.uk Gallery House, The Headrow, Leeds, LS1 5RD. Tel: 0330 022 5240 Fax: 0113 308 5001 Consumer Credit License Foundernumber members of473207 DEMSA (Debt Managers Registered Standards in England Association). number 3711687