AUTHORIZATION FOR DEBT NEGOTIATION AND SETTLEMENT

(Limited Power of Attorney for Debt Resolution)

Date: [DATE]

PARTIES

PRINCIPAL (DEBTOR):
[DEBTOR FULL LEGAL NAME] ("Principal")
[ADDRESS]
[CITY, STATE ZIP]
[PHONE]
[EMAIL]
[SSN LAST 4: XXX-XX-[LAST 4]]

AUTHORIZED AGENT:
[ATTORNEY OR AGENT NAME] ("Agent")
[LAW FIRM OR COMPANY NAME]
[ADDRESS]
[CITY, STATE ZIP]
[PHONE]
[EMAIL]
[LICENSE/BAR NUMBER, if applicable]

AUTHORIZATION

I, [DEBTOR FULL LEGAL NAME], hereby authorize and appoint the above-named Agent to act on my behalf with respect to the debts, accounts, and creditors identified herein. This authorization is given pursuant to my right to designate a representative to communicate with creditors and debt collectors on my behalf under the Fair Debt Collection Practices Act, 15 U.S.C. Section 1692c(a)(2) and (b).

1. SCOPE OF AUTHORITY

1.1 Accounts Covered

This authorization applies to the following accounts:

☐ Additional Accounts: This authorization also applies to any other debts that may be discovered or arise during the term of this authorization.

☐ All Debts: This authorization applies to ALL of my consumer debts.

1.2 Powers Granted

I authorize my Agent to take the following actions on my behalf:

Communication Authority:
☐ Receive all communications from the above creditors and collectors
☐ Communicate with creditors and collectors regarding my accounts
☐ Request that creditors and collectors direct all communications to my Agent
☐ Receive and respond to debt validation notices
☐ Receive and respond to settlement offers

Information Access:
☐ Request and receive account information, statements, and documentation
☐ Request debt validation and verification
☐ Obtain account history and payment records
☐ Access my credit reports for purposes of debt resolution
☐ Obtain information regarding the status of collection and legal proceedings

Negotiation Authority:
☐ Negotiate payment plans and settlement terms with creditors
☐ Present settlement offers on my behalf
☐ Negotiate reduction of principal, interest, fees, and charges
☐ Request removal or modification of credit bureau reporting
☐ Negotiate stipulated judgments or payment agreements (subject to my approval)

Dispute Authority:
☐ Dispute debts on my behalf
☐ Send debt validation requests
☐ Send cease and desist letters
☐ File disputes with credit bureaus
☐ Assert the statute of limitations defense

Documentation Authority:
☐ Sign routine correspondence related to debt negotiation
☐ Request and receive documents related to my accounts
☐ Submit written offers and counteroffers
☐ Request account verification and audit trails

1.3 Limitations on Authority

My Agent is NOT authorized to:

☐ Accept any settlement or payment agreement without my prior written approval
☐ Make payments on my behalf (unless specifically authorized in writing)
☐ Sign binding settlement agreements without my signature
☐ Consent to judgment without my prior written approval
☐ Waive any of my legal rights without my prior written approval
☐ File for bankruptcy on my behalf
☐ Appear in court on my behalf (unless separately authorized)
☐ Access my bank accounts or financial assets
☐ Other restrictions: [SPECIFY]

2. SETTLEMENT APPROVAL REQUIREMENTS

2.1 Prior Approval Required

Before accepting ANY settlement or payment arrangement, my Agent must:

☐ Provide me with the complete terms in writing
☐ Explain the advantages and disadvantages of the proposed terms
☐ Obtain my written or verbal approval (documented in writing)
☐ Allow me at least [NUMBER] days to consider the terms (unless time-sensitive)

2.2 Settlement Parameters

I authorize my Agent to negotiate settlements within the following parameters:

☐ General Authorization: I authorize settlements at up to [XX]% of the outstanding balance for any creditor.

☐ Case-by-Case: All settlements require my specific approval regardless of terms.

2.3 Payment Terms

☐ I prefer lump-sum settlements
☐ I can make payments over [NUMBER] months
☐ My maximum monthly payment capacity is $[AMOUNT]
☐ I have $[AMOUNT] available for immediate settlement payments

3. COMMUNICATION DIRECTIVE

3.1 Directive to Creditors

I hereby direct all creditors and debt collectors identified above to:

☐ Communicate directly with my Agent at the address provided above
☐ Cease communications directly with me
☐ Send copies of all correspondence to both me and my Agent
☐ Direct all telephone calls to my Agent

3.2 FDCPA Notice

If you are a debt collector, please be advised that pursuant to 15 U.S.C. Section 1692c(a)(2), once you are aware that a consumer is represented by an attorney (or other authorized representative for communication purposes), you must communicate with that representative rather than the consumer.

4. CONFIDENTIALITY

4.1 Confidential Information

I authorize my Agent to receive the following confidential information:

☐ Account numbers and balances
☐ Payment history
☐ Personal identifying information as necessary for account verification
☐ Credit report information
☐ Other information necessary for debt resolution

4.2 Agent's Confidentiality Obligation

My Agent agrees to:

☐ Keep all my financial information confidential
☐ Use my information only for purposes of debt resolution
☐ Not share my information with third parties without my consent
☐ Comply with all applicable privacy laws

5. COMPENSATION

☐ Attorney Representation: Agent is my attorney and compensation is governed by our separate Attorney-Client Fee Agreement dated [DATE].

☐ Debt Settlement Company: Agent is a debt settlement company and compensation is governed by our separate Service Agreement dated [DATE].

☐ Pro Bono/No Fee: Agent is providing services at no charge.

☐ Other Arrangement: [DESCRIBE]

6. TERM AND TERMINATION

6.1 Effective Date

This authorization is effective as of [DATE].

6.2 Term

This authorization shall remain in effect:

☐ Until all listed debts are resolved
☐ For a period of [NUMBER] months, unless renewed
☐ Until terminated in writing by either party
☐ Until [SPECIFIC DATE]

6.3 Termination

Either party may terminate this authorization by providing written notice to the other party. Upon termination:

☐ Agent shall notify all creditors that the authorization has been terminated
☐ Agent shall provide Principal with copies of all correspondence and documents
☐ Agent shall provide a status report on all accounts
☐ Agent shall not negotiate or settle any accounts after termination

7. REPRESENTATIONS

7.1 Principal Represents

I represent that:

☐ I am the actual debtor on the accounts listed above
☐ I have the legal capacity to grant this authorization
☐ The information I have provided is true and accurate
☐ I have not filed for bankruptcy (or I have disclosed any bankruptcy filing)
☐ I am not aware of any pending legal actions (or I have disclosed any pending actions)

7.2 Agent Represents

Agent represents that:

☐ Agent is duly authorized/licensed to provide the services described herein
☐ Agent will act in Principal's best interests
☐ Agent will comply with all applicable laws, including the FTC Telemarketing Sales Rule (if applicable)
☐ Agent will keep Principal informed of all material developments

8. IMPORTANT NOTICES

8.1 This Is Not Legal Advice (If Agent Is Not An Attorney)

☐ If Agent is not an attorney: This authorization does not create an attorney-client relationship. Agent is not providing legal advice. If I need legal advice, I should consult with a licensed attorney.

8.2 Tax Consequences

☐ I understand that forgiven debt may be reported to the IRS and may have tax consequences. I have been advised to consult with a tax professional.

8.3 Credit Impact

☐ I understand that debt settlement may have negative effects on my credit score and credit report.

8.4 No Guarantee

☐ I understand that Agent cannot guarantee any particular outcome in negotiations with my creditors.

9. SIGNATURES

9.1 Principal (Debtor)

I have read and understand this Authorization for Debt Negotiation and Settlement. I voluntarily grant the authority described herein to my Agent.

Signature: ___________________________________ Date: _______________

Print Name: [DEBTOR FULL LEGAL NAME]

9.2 Agent Acceptance

I accept this authorization and agree to act in accordance with its terms and all applicable laws.

Signature: ___________________________________ Date: _______________

Print Name: ___________________________________

Title: ___________________________________

Company/Firm: ___________________________________

License/Bar No.: ___________________________________

NOTARIZATION (Optional but Recommended)

STATE OF [STATE]
COUNTY OF [COUNTY]

On this [DAY] day of [MONTH], [YEAR], before me personally appeared [DEBTOR NAME], known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument, and acknowledged to me that he/she executed the same in his/her authorized capacity.

WITNESS my hand and official seal.

Notary Public: ___________________________________

My Commission Expires: _______________

[NOTARY SEAL]

ATTACHMENT A: LETTER TO CREDITORS

Date: [DATE]

To: [CREDITOR/COLLECTOR NAME]
[ADDRESS]

Re: Authorization of Representative
Account Holder: [DEBTOR NAME]
Account Number: [ACCOUNT NUMBER]

Dear Sir or Madam:

Please be advised that I have authorized [AGENT NAME] to act as my representative for all matters related to the above-referenced account.

Effective immediately, please direct all communications regarding this account to:

[AGENT NAME]
[ADDRESS]
[PHONE]
[EMAIL]

Pursuant to the Fair Debt Collection Practices Act, 15 U.S.C. Section 1692c(a)(2), if you are a debt collector, you are required to communicate with my representative rather than directly with me.

Please confirm receipt of this notice and update your records accordingly.

Sincerely,

_______________________________________
[DEBTOR SIGNATURE]

[DEBTOR PRINTED NAME]

Enclosure: Copy of Authorization for Debt Negotiation and Settlement