Forms for Agreements containing Disclosures and Authorizations
On the following pages you will see our privacy policy and two agreements. Please review them carefully. Each of these contain important disclosures and authorizations that are required for Alliance to provide assistance.

You will receive a copy of each by email containing a PDF document.

Two forms require signatures. For these forms to be legally binding with signatures we adhere to ESIGN & UETA compliant practices. Among those practices you will see a notice that you are signing a electronic document and that your signature is legally binding. When signed, the IP address of the device used to sign the form and the time is recorded. Once signed, a timestamp and your user IP address are added to the contract. You are then provided a PDF copy with with the validation.

Counseling Agreement
Borrower(s) acknowledge that Alliance Credit Counseling, Inc. (“Alliance”) is a Department of Housing and Urban Development (“HUD”) approved housing counseling agency. Borrower(s) voluntarily seek Alliance’s assistance in maintaining homeownership. In doing so, borrower(s) will provide all of the requested/required documents associated with this homeownership counseling experience.

Borrower(s) agree to actively participate in homeowner counseling through required appointments, whether in- person or via telephone, and through the internet via email and web page forms, to provide requested documents within the established timeframe, and to supply Alliance with true and accurate information to the best of borrower(s) knowledge.

Borrower(s) understand that Alliance provides foreclosure mitigation counseling. During counseling, borrower(s) will receive a written action plan consisting of recommendations for handling personal finances. This counseling may also include referrals to other agencies as appropriate.
By initialing below, Homeowner (A) is indicating that he/she has reviewed the above content.*
By initialing below, Homeowner (B) is indicating that he/she has reviewed the above content.*

Services and Referral Disclosure
Alliance may make you aware of products and/or services that we believe offer value to our clients.

These products and/or services might be available directly from Alliance, lenders, developers, or other agencies with which Alliance has a working relationship. You are under no obligation to use the products and/or services identified by Alliance, whether by us or from industry partners.

Other Services provided by Alliance: Reverse Mortgage Counseling, Debt Management Program, Homebuyer Education Counseling, Bankruptcy Counseling.
By initialing below, Homeowner (A) is indicating that he/she has reviewed the above content.*
By initialing below, Homeowner (B) is indicating that he/she has reviewed the above content.*

Authorization to Obtain Information
Borrower(s) authorize Alliance to obtain, review and verify information concerning borrower(s) income/employment history, bank records, rental history, credit history, and any other items necessary as they relate to foreclosure mitigation and homeowner counseling.
By initialing below, Homeowner (A) is indicating that he/she has reviewed the above content.*
By initialing below, Homeowner (B) is indicating that he/she has reviewed the above content.*

Authorization to Release Information to Legal Services
Borrower(s) do hereby authorize Alliance to release any and all information from borrower(s) files to the Legal Services of Southern Piedmont. Borrower(s) further authorizes counselor to speak with any representative of the Legal Services of Southern Piedmont regarding all aspects of borrower(s) case.

The confidentiality of borrower(s) non-public personal information will be maintained in accordance with applicable federal and state privacy laws including N.C.G.S. 45-106. Borrower(s) acknowledge that this authorization will remain in effect until legal assistance ceases or until this authorization is withdrawn by written notice to Alliance.
By initialing below, Homeowner (A) is indicating that he/she has reviewed the above content.*
By initialing below, Homeowner (B) is indicating that he/she has reviewed the above content.*
Hidden
NFMC Funding Requirements Authorization
Borrower(s) understand that Alliance receives Congress- authorized federal funds through the National Foreclosure Mitigation Counseling (NFMC) program. Furthermore,
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I authorize Alliance Credit Counseling to submit client-level information to the Data Collection System for the NFMC grant.*
- Yes – Required
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I authorize NFMC to open files to be reviewed for program monitoring and compliance purposes.*
- Yes – Required
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I authorize NFMC to conduct follow-up with the client related to program evaluation.*
- Yes
- No
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Homeowner (A) Initials*
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Homeowner (B) Initials*

Privacy Policy
Alliance Privacy Policy – You are receiving this statement to comply with federal laws regarding the disclosure of nonpublic information. Alliance is committed to fully protecting and preserving the privacy of its clients. For your protection, please take a few moments to read this statement.

As part of our commitment to your privacy, Alliance will only disclose the information that it must in order to serve you in the most effective manner possible. Hence, Alliance will not distribute client information to third parties, except where it is necessary to perform quality services for its clients, as described below.

This Applies To – This statement applies to those individuals who have applied for counseling assistance, have gone through an initial budget consultation, or with whom there is a continuing relationship. Information Collected -Through telephone, fax, mail, and electronic communication, personal information will be gathered, including address, social security number, telephone number, email address, and other demographic information.

Through the aforementioned channels, financial information will also be collected, including information related to your debts, income, expenses, and checking/savings accounts on an as needed basis. Please be assured that we carefully train our advisors to protect all client information. In order to do this effectively we will ask for information that only you should know when you contact us. No one else can call in and access your account without your written authorization specifically placing their name on your account.

We strive to maintain complete and accurate information about you and your accounts. If you find at any time that our records contain inaccurate or incomplete information, please let us know immediately. Internal Sharing – Information will be shared within Alliance as needed to communicate with you, manage your accounts, and properly handle your disbursements. For the purpose of marketing research, portions of your information may be used to build an internal statistical report on our client base. However, these reports will not reveal any personal information.

Information Storage – The information you supply Alliance will remain in corporate files for as long as is necessary to provide services, and for a reasonable period of time following the completion or termination of services including time required to meet all Government regulatory requirements.

External Sharing – A necessary portion of your personal and financial information will be used to communicate with your creditors and/or bank to perform disbursements or to coordinate with them on your behalf.

Information will not be shared with corporations other than with Alliance and corporate entities contracted by Alliance to perform services and/or technology functions, your creditors, and your bank as needed. Alliance does not report any information to credit bureaus.

By law, third party financial institutions receiving information from Alliance may only use it in the ordinary course of business to carry out the activity for which it was received, and can only disclose it to affiliates of the originating institution or its own affiliates.

Notes – Alliance refers to Alliance Credit Counseling, Incorporated, and to unaffiliated, separate corporate entities contracted by Alliance, Inc. to perform service and/or technology functions on its behalf.

Other Applicable Laws – The practices described above are in accordance with federal privacy law. You may have other protections under applicable state laws. To the extent these state laws apply, we will comply with them when we share information about you.

Protections for Information Privacy and Security – Physical and electronic files are only kept within the confines of the Alliance corporate offices and at approved secure backup sites. Access is restricted to authorized personnel.

Opt-Out – Alliance fully complies with federal regulations regarding opting out in that disclosure is “made only in connection with servicing or processing a financial product or service that a consumer has requested or authorized.”

If your account is active, and you are not comfortable with this level of information sharing, please contact us to inactivate your account. If your account is inactive, your information is no longer used internally or externally, except for record keeping, governmental, and audit purposes as described above.

Online Privacy – Information may be gathered when you visit the Alliance web site, including Internet Protocol (IP) addresses, Uniform Resource Locator (URL) tags, and basic operating system and browser information.

Electronic security is maintained through the use of Secure Socket Layer (SSL) encryption and/or firewalls (which are designed to protect systems from intrusion). Fee Structure – Alliance may charge fees for education and counseling services, including Homebuyer’s Education, Reverse Mortgage Counseling, Bankruptcy Counseling, Payday Loan Counseling, Debt Management Services and Credit Counseling. Although there may be a fee associated with a Credit Counseling session, Alliance does not charge a fee for obtaining a credit report on behalf of our clients.

How You Can Help Protect Your Privacy
• Do not share your account information, passwords, user IDs, PINs, your SSN, code words or other confidential information with others.
• Do not provide confidential information to unknown callers.
• Do not provide confidential information online unless you initiated the contact, know the party with whom you are dealing, and can provide the information through a secure line (https://).
• When conducting business over the Internet, always use a secure browser and exit online applications as soon as you finish using them.
• If you believe you may be a victim of fraud or identify theft, please call the Social Security Administration Fraud Hotline at 800- 397- 0271 to report fraudulent use of your identification information.
• File a complaint with the Federal Trade Commission (FTC) by contacting the FTC’s Identity Theft Hotline: 877-IDTHEFT.
• File a police report in your local jurisdiction and retain the police report number and officers name who took the report.
Borrower(s) acknowledge reviewing of Alliance’s Privacy Policy and understand that a copy will be provided. Borrower(s) understand that their consent to policy may be revoked by providing written notice to Alliance.
Homeowner (A) Consent*
I have reviewed and I agree to the privacy policy.
Homeowner (B)*
I have reviewed and I agree to the privacy policy.

STATE HOME FORECLOSURE PREVENTION PROJECT- THIRD PARTY AUTHORIZATION AGREEMENT
I/We do hereby authorize servicer to release any and all information about any and all of my account(s) to any representative of the North Carolina Housing Finance Agency and Alliance Credit Counseling, Inc.,

Agency Address: 10720 Sikes Place, Suite 100, Charlotte, North Carolina, 28277

Telephone Number: 866-303-3328

Relationship to Borrower: Homeownership Counseling Agency

and its representatives. I understand that this information is needed so that I can receive counseling assistance. The information released by servicer may include, but is not limited to, information relating to my loan amount and payment transactions and/or provision of copies of any and all loan documents and communication history associated with my account(s) in the possession of servicer. Under no circumstances will I hold servicer responsible for any claims, liabilities or damages that may arise as a result of or in connection with servicer’s provision of information pursuant to the terms of this Agreement.
I/We further authorize servicer’s to speak with any representative of the North Carolina Housing Finance Agency and any third party authorized agency indicated herein and its representatives regarding all aspects of my account(s) and account history, including information provided by any prior servicer’s.

I/We also authorize servicer’s to notify the North Carolina Housing Finance Agency and any third party authorized agency indicated herein in the event that my/our loan payments become delinquent in the future, or if a loss mitigation workout is discussed, implemented, completed and/or results in default. The North Carolina Housing Finance Agency and any third party authorized agency indicated herein agrees to maintain the confidentiality of borrower(s) information in accordance with NCGS § 45-106.

I acknowledge that this authorization will remain in effect for the duration of time that servicer’s serves as the loan servicer’s for my account(s). I also acknowledge that should I wish to terminate this authorization, I will notify servicer’s in writing. This authorization will not be valid unless signed below by borrower and all co-borrowers named above.

I/We acknowledge that an electronic document is being electronically signed and is legally binding.
Please enter Homeowner (A) Full Name*
Please sign using a stylus, your mouse, or your finger below to authorize this agreement. By electronically signing this document, you agree to the terms established above. After the document is signed, you will be emailed a PDF copy.
Homeowner (A) Signature*
Please enter Homeowner (B) Full Name*
Please sign using a stylus, your mouse, or your finger below to authorize this agreement. By electronically signing this document, you agree to the terms established above. After the document is signed, you will be emailed a PDF copy.
Homeowner (B) Signature*

Homeowner (A) Authorization To Release Information
I am aware that Alliance Credit Counseling, Inc. (“Alliance”) is a HUD-approved counseling agency. I am voluntarily seeking Alliance’s assistance in preparing for/maintaining homeownership. In doing so, I will provide all of the requested/ required documents associated with this homeownership counseling experience.

I agree to actively participate in homeownership counseling through required appointments, whether in-person or via telephone, to provide requested documents within the established timeframe, and to supply Alliance with true and accurate information to the best of my knowledge. I authorize Alliance to obtain, review and verify information concerning my income/employment history, bank records, rental history, credit history, and any other items necessary as they relate to homeownership counseling.

In addition, I authorize Alliance to share information I have provided with mortgage lenders, servicers and/or counseling agencies, including any computations and assessments associated. I am aware that these lenders, servicers or counseling agencies may contact me to discuss loans, options, and services.

Alliance may receive funding from government organizations and others, including your creditors. I acknowledge that I have reviewed a copy of the Alliance’s Privacy Policy and will receive a copy. I understand that I may revoke my consent by notifying Alliance in writing.
I/We acknowledge that an electronic document is being electronically signed and is legally binding.
Please enter Homeowner (A) Full Name*
Please sign using a stylus, your mouse, or your finger below to authorize this agreement. By electronically signing this document, you agree to the terms established above. After the document is signed, you will be emailed a PDF copy.
Homeowner (A) Signature*

Homeowner (B) Authorization To Release Information
I am aware that Alliance Credit Counseling, Inc. (“Alliance”) is a HUD-approved counseling agency. I am voluntarily seeking Alliance’s assistance in preparing for/maintaining homeownership. In doing so, I will provide all of the requested/ required documents associated with this homeownership counseling experience.

I agree to actively participate in homeownership counseling through required appointments, whether in-person or via telephone, to provide requested documents within the established timeframe, and to supply Alliance with true and accurate information to the best of my knowledge. I authorize Alliance to obtain, review and verify information concerning my income/employment history, bank records, rental history, credit history, and any other items necessary as they relate to homeownership counseling.

In addition, I authorize Alliance to share information I have provided with mortgage lenders, servicers and/or counseling agencies, including any computations and assessments associated. I am aware that these lenders, servicers or counseling agencies may contact me to discuss loans, options, and services.

In addition, I authorize mortgage lenders, servicers and/or counseling agencies to release any information concerning me to Alliance so that they may assist me in preparing for/maintaining homeownership. Alliance does not influence any decisions made by mortgage lenders, servicers, and/or counseling agencies, nor does it warrant or guarantee any products or services they provide.

Alliance may receive funding from government organizations and others, including your creditors. I acknowledge that I have reviewed a copy of the Alliance’s Privacy Policy and will receive a copy. I understand that I may revoke my consent by notifying Alliance in writing.
I/We acknowledge that an electronic document is being electronically signed and is legally binding.
Please enter Homeowner (B) Full Name*
Please sign using a stylus, your mouse, or your finger below to authorize this agreement. By electronically signing this document, you agree to the terms established above. After the document is signed, you will be emailed a PDF copy.
Homeowner (B) Signature*

Forms for Agreements containing Disclosures and Authorizations

Counseling Agreement

Services and Referral Disclosure

Authorization to Obtain Information

Authorization to Release Information to Legal Services

NFMC Funding Requirements Authorization

Privacy Policy

STATE HOME FORECLOSURE PREVENTION PROJECT- THIRD PARTY AUTHORIZATION AGREEMENT

Homeowner (A) Authorization To Release Information

Homeowner (B) Authorization To Release Information