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Credit Service Organizations Without Surety CSO-3 - West Virginia
| Credit Service Organizations Without Surety Form. This is a West Virginia form and can be used in Credit Service Organizations Business Organizations Secretary Of State . |
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Natalie E. Tennant Secretary of State 1900 Kanawha Blvd E. Bldg 1, Suite 157-K Charleston, WV 25305 CREDIT SERVICE ORGANIZATIONS WITHOUT SURETY Penney Barker, Manager Charities Division Tel: (304)558-8000 Fax: (304)558-8381 www.wvsos.com Hrs: 8:30 a.m. 5:00 p.m. ET Disclosure of Rights to Buyers of Services of Credit Service Organizations operating without surety registered in West Virginia as required by WV Code §46A-6C-6 Notice to Buyer: The registration of a credit service organization with the Secretary of State does not imply an endorsement of that organization by the Secretary of State or the State of West Virginia Section 1: Name of Credit Service Organization: Name of Person Acting as Broker or Agent for this Customer: Address of Broker/Agent: _____________________________________________ _____________________________________________ _____________________________________________ Broker/Agent: Section 2: Telephone: _______________________ Fax: __________________ _____________________________________________ The following is a complete and detailed description of services which will be provided to the buyer under this contract, along with the cost of each service: Description of Services: (Attach additional page if necessary) Cost of Service Total Cost Section 3: Notice to Buyer by Credit Service Organization Operating Without Surety Buyer: We hereby warrant that this organization and its agent(s) will not charge you or accept from you any money or other valuable consideration before completing performance of all services the organization has agreed to perform. Form CSO-3 WV Secretary of State American LegalNet, Inc. www.FormsWorkFlow.com Revised 02/11 Section 4: Buyer's Rights and Other Notices A "buyer" means an individual who is solicited to purchase or who purchases the services of a credit service organization. As a buyer, you have certain rights: You have a right to review any file maintained on you by a consumer reporting agency, as provided by the Fair Credit Reporting Act (15 U.S.C. Sec. 1681 et seq.) Your file is available for review at no charge on request made to the consumer reporting agency within thirty days after the date of the receipt of notice that credit has been denied, and your file is available for a minimal reporting charge at any other time. You have a right to dispute directly with your consumer reporting agency the completeness of accuracy of any item contained in a file on you maintained by that consumer reporting agency. ACCURATE INFORMATION CANNOT BE PERMANENTLY REMOVED FROM THE FILES OF A CONSUMER REPORTING AGENCY. No consumer reporting agency may make any consumer report containing any adverse item of information dating from more than seven (7) years before the report. Non-profit organizations which provide credit and debt counseling services are available. The WV Association of Consumer Credit Counseling Services (call 1-800-869-7758) or the National Foundation for Consumer Credit (call 1-800-388-2227) will connect you to a local organization, or check your yellow pages under "Credit Counseling Services" to find a non-profit service. Section 5: Acknowledgement of Receipt of Disclosure Statement I, the undersigned buyer of the services listed in Section 1, acknowledge that I have received a copy of this statement for my own records on this date, and that I understand that an exact copy of this statement, as signed below, will be maintained on file by this credit services organization for a period of two years after this date. Date Statement Signed and Received by Buyer: Printed name of Buyer: Signature of Buyer: ________________________________________ ________________________________________ ________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com
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