Settlement Offer - Giove Law Office, P.C.

Settlement Proposal
In order to assure that your settlement offer or payment plan proposal is properly received and accurately applied to your account you must fully complete the top portion of this form, as well as either the Settlement Offer or Payment Proposal section of your choice. Your e-mail address and phone numbers are critical to follow up should we need additional information from you. This firm is a debt collector. This is an attempt to collect a debt and all information obtained will be used for that purpose.

Please provide the following contact information.


	Name:
	Address:
	City:
	State/Province:
	Zip/Postal Code:
	Country:
	Work Phone:
	Home Phone:
	E-Mail
	File Number:
	Name Of Creditor:



Lump Sum Settlement Offer
This is an amount that you would like to offer our client as payment in full on your account. This offer is not yet accepted by our client. Please do not make payment until we advise that it has been accepted. If accepted, the amount will need to be paid in full to our office in one installment. We will advise you of the deadline for payment. If payment is not received in our office by that time, the full balance will become due, less any partial payment applied.

	Lump Sum Settlement:
	Settlement Date:

	Additional Information or Comments:

Payment Plan Proposal
This is a proposal for payments over time at an agreed amount per payment. Your proposal is not binding on our client or our office unless it has been accepted, and you keep the proposal by making all payments in a timely fashion. We will advise you if your payment plan proposal has been accepted, and when your payments are due.

	Payment Offer:
	Payment Start Date:
	Payment Frequency:	Monthly Bi-Weekly Weekly
	Additional Information or Comments:

Authorization: I understand that this offer of settlement or proposal for a payment plan is not effective until Giove Law Office, P.C. communicates acceptance of my offer or proposal. In addition, I understand that if my offer or proposal is accepted, that all payments must be made in the agreed amount, and must be received by Giove Law Office, P.C. by their due date, or Giove Law Office, P.C., at its option, can declare the settlement offer or payment proposal withdrawn. In that event, the full remaining balance will be due, and any payment made on the account thereafter will be applied against the full balance. Giove Law Office, P.C. may contact me by e-mail regarding this matter. NOTICE: Be advised that your offer to settle your account is not binding upon Giove Law Office, P.C. and Giove Law Office, P.C. reserves the right to reject and/or counter any and all settlement offers made.
YES I do understand and agree to all of the terms above. You may contact me by email regarding this matter.

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