Form B "Credit Counseling Organizations Supplemental Form - Office Location" - South Carolina

What Is Form B?

This is a legal form that was released by the South Carolina Department of Consumer Affairs - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the South Carolina Department of Consumer Affairs;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form B by clicking the link below or browse more documents and templates provided by the South Carolina Department of Consumer Affairs.

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Download Form B "Credit Counseling Organizations Supplemental Form - Office Location" - South Carolina

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STATE OF SOUTH CAROLINA
DEPARTMENT OF CONSUMER AFFAIRS
CREDIT COUNSELING ORGANIZATION
SUPPLEMENTAL FORM B
OFFICE LOCATION
Mailing Address
Street Address
S.C. Code Ann. §§ 37-7-101 through - 122
P.O. Box 5757
293 Greystone Boulevard, Ste. 400
Columbia, SC 29250-5757
(803) 734-4251 |
www.consumer.sc.gov
| (803) 734-4200
Columbia, SC 29210-8004
IMPORTANT: Print legibly or type information requested on this form in its entirety. Illegible or faxed applications will not be
accepted. Incomplete information could result in delay or denial of your application. When completing the application, attach
additional pages as necessary. The following form must be provided on a separate form for EACH location listed in the “Locations”
section of the Credit Counseling Organization Initial Application.
*Application is not complete without the filing fees. Make checks payable to S.C. Department of Consumer Affairs.*
GENERAL INFORMATION
Business Name
(Headquarters/Main)
DBA
Contact Person*
Title
Location Manager/Supervisor
Physical Address
City
State
Zip
Mailing Address
(If different from above)
City
State
Zip
E-mail Address
Phone No.
(
)
-
Website Address
Fax No.
(
)
-
*The contact person is the person the Department will call with any questions about the application.
EMPLOYEE INFORMATION. List all employees engaged in credit counseling services (credit counselors) by name, for this
location. Attach additional pages as necessary. Each employee listed must complete a Credit Counselor Application.
EMPLOYEE NAME
TITLE/POSITION
DATE OF EMPLOYMENT
(List Alphabetically)
The undersigned warrants that his or her signature is duly authorized and delivered by and for the business for which s/he signs. The undersigned
swears or affirms and certifies that all information contained in this form and any attachments to this form is true, accurate, and complete.
Signature
Title
Print Name
Date
The South Carolina Freedom of Information Act may require the Department to release a copy of your filing as a
public record. Personal identifying information will be released only if required by law.
Credit Counseling Supplemental B Form
MUST BE RENEWED BY DECEMBER 1
EACH YEAR
ST
Revised 11/2019
Page 1 of 1
STATE OF SOUTH CAROLINA
DEPARTMENT OF CONSUMER AFFAIRS
CREDIT COUNSELING ORGANIZATION
SUPPLEMENTAL FORM B
OFFICE LOCATION
Mailing Address
Street Address
S.C. Code Ann. §§ 37-7-101 through - 122
P.O. Box 5757
293 Greystone Boulevard, Ste. 400
Columbia, SC 29250-5757
(803) 734-4251 |
www.consumer.sc.gov
| (803) 734-4200
Columbia, SC 29210-8004
IMPORTANT: Print legibly or type information requested on this form in its entirety. Illegible or faxed applications will not be
accepted. Incomplete information could result in delay or denial of your application. When completing the application, attach
additional pages as necessary. The following form must be provided on a separate form for EACH location listed in the “Locations”
section of the Credit Counseling Organization Initial Application.
*Application is not complete without the filing fees. Make checks payable to S.C. Department of Consumer Affairs.*
GENERAL INFORMATION
Business Name
(Headquarters/Main)
DBA
Contact Person*
Title
Location Manager/Supervisor
Physical Address
City
State
Zip
Mailing Address
(If different from above)
City
State
Zip
E-mail Address
Phone No.
(
)
-
Website Address
Fax No.
(
)
-
*The contact person is the person the Department will call with any questions about the application.
EMPLOYEE INFORMATION. List all employees engaged in credit counseling services (credit counselors) by name, for this
location. Attach additional pages as necessary. Each employee listed must complete a Credit Counselor Application.
EMPLOYEE NAME
TITLE/POSITION
DATE OF EMPLOYMENT
(List Alphabetically)
The undersigned warrants that his or her signature is duly authorized and delivered by and for the business for which s/he signs. The undersigned
swears or affirms and certifies that all information contained in this form and any attachments to this form is true, accurate, and complete.
Signature
Title
Print Name
Date
The South Carolina Freedom of Information Act may require the Department to release a copy of your filing as a
public record. Personal identifying information will be released only if required by law.
Credit Counseling Supplemental B Form
MUST BE RENEWED BY DECEMBER 1
EACH YEAR
ST
Revised 11/2019
Page 1 of 1