Please read the following statements carefully. For simplification the singular is used even when the plural may apply.

I understand that the purpose of the home ownership assessment, counseling and education programs offered by Consumer Credit Counseling Service of the Black Hills (CCCS) is to counsel and/or provide information to me regarding qualifying for a home mortgage and about the home purchase and financing process. I understand that CCCS may make recommendations to me regarding lenders or programs, which may suit my individual needs.

I understand that CCCS is not an agent for any lender. I understand that even if CCCS believes I may not qualify for a loan, I have the right to submit an application to any lender.

I understand that completion of CCCS home ownership assessment, counseling, and education programs does not guarantee that a lender will approve any loan application submitted by me to a lender.

I also understand that completion of CCCS home ownership assessment, counseling, and education programs, and CCCS referral to a lender is not a commitment by the lender to make me a loan. I understand that only the lender can make such a commitment after receipt of a loan application completed by me.

I understand that CCCS receives funding from various sources including HUD grants, Debt Management revenue, the United Way, Creditor Fair Share and community support.

I understand that CCCS provides various types of services including: financial assessments, a Debt Management Program, bankruptcy counseling and education, various financial literacy courses, and housing counseling and education to include: financial management/budget counseling, home improvement and rehabilitation counseling, mortgage delinquency and default resolution counseling, pre-purchase counseling, rental counseling, services for homeless counseling, pre-purchase homebuyer education, financial, budgeting, and credit education workshops, fair housing pre-purchase education, and predatory lending education.

I understand that if I choose to enroll onto a Debt Management Program (“DMP”) with CCCS and Navicore Solutions (collectively, the “Agencies”), that there are fees for this service:

South Dakota and Wyoming Residents:
CCCS charges a one-time setup fee between $50 and $95, which is determined using a sliding scale based on the client’s monthly gross household income and family size. Once enrolled on the DMP, Navicore Solutions charges a monthly fee of up to $60.

North Dakota Residents:
CCCS charges a one-time setup fee of up to $50. Once enrolled on the DMP, Navicore Solutions charges a fee of the lesser of 15% of the client’s payment to creditors, or $60.

Nebraska Residents:
CCCS charges a one-time setup fee of $25 that will be credited to your total fees charged. Once enrolled onto the DMP, Navicore Solutions charges the lesser of 15% of the client debt agreed to be paid or $60.00, amortized over the life of the plan.

I understand that I am not obligated to receive, purchase, or utilize any other services offered by the Agencies, or its exclusive partners in order to receive housing counseling services.

I understand that while the Agencies may partner with many other organizations, they have no business practices or partnerships that would constitute a conflict of interest. The Agencies each have Conflict of Interest Policies.

I understand that both Agencies are incorporated as non-profit 501 (c) (3) organizations and are each are governed independently by separate volunteer Boards of Directors. The Agencies’ services are not for the private benefit/interest of their Board, staff, or consultants. The Agencies have policies in place that prohibit the practice of steering or directing referrals of applicants or clients to a private practice in which Agency personnel, consultants, or immediate family members of personnel and consultants may be engaged.

I understand that the Agencies each have Business and Professional Ethics Policy. All personnel know and abide by the Code of Ethics that is posted in every office.

I understand that both Agencies have a Quality Control Plan and Quality Improvement Policies and Procedures for identifying, addressing, and mitigating any conflicts of interest and complying with HUD requirements.

I understand that in the event I am dissatisfied with any of the Agencies’ services I can utilize the Complaint Resolution Process.

At some time in the future, my information may be used for confidential research, quality assurance/training purposes, and/or HUD or a neutral third party may contact me to request and evaluation of the Agencies’ services.