A Garden State Consumer Credit Counseling Organization

November 5, 2012 Seble Woldemariam 3201 Wheaton Way Apt B Ellicott City, MD 21043 Re: 114232

Dear Seble Woldemariam: Thank you for showing interest in our Direct Pay Program. As mentioned, it is a fast and secure alternate option that will replace your check or money order payments. Once you elect the Direct Pay Program, your bank automatically deducts your plan amount from your checking account each month. There are no fees or charges for this service. Your Direct Pay Program payment is treated as a check. Your creditors will be paid within 57 days from the date our office receives the funds. Please note: When the date falls on a nonbusiness day, it will be debited on the following business day. As we discussed, please complete the Direct Pay Authorization form enclosed. Novadebts mission is to provide financial education and counseling to anyone in need of assistance. Keep in mind that as a client, you always have access to support when you need it. If you ever experience any difficulties with making your payments or are in search of financial advice, feel free to contact our Client Guidance Department at 18007724557 or 18002824557 for TDD services. A Certified Counselor will be more than happy to take an indepth look at your situation and answer any questions you may have. Sincerely,

Novadebt Representative LLI

225 Willowbrook Road Freehold, New Jersey 07728

Member AICCCA MGDIRECTDEBIT.ptk Printed by LLI November 5, 2012 11:09AM

80077BILLS fax 7324096284 www.novadebt.org

Direct Pay Authorization Form

By signing this form, you authorize Novadebt to withdraw your monthly plan amount directly from your checking or savings account each month Proof of payment will be reflected on your monthly Novadebt statement The authority you provide to deduct your payment will remain in effect until you speak with a Novadebt representative to terminate the authorization If the amount of your debit changes, Novadebt will notify you, in writing, at least 10 days before your next debit. If we do not hear from you regarding this change in debit, the new amount will be withdrawn for your next scheduled debit. If you need to cancel or change the date of your debit, Novadebt requires 3 business days notice. If we do not receive 3 business days notice, we cannot guarantee the ability to comply with your request. Please be advised that changing your debit date may have a negative impact on your status with your creditors and could lead to a loss of creditor benefits. (i.e. your minimum payment and interest may increase and you may start to incur late and/or overlimit fees).

Please complete the information below and return it to Novadebt:

I authorize Novadebt to initiate electronic debit entries to my checking / savings account for my monthly Debt Management Program payment. By signing below, I am authorizing a debit in the amount of $310.00, which is my current monthly plan amount. If the amount is to be higher than $310.00, I understand that Novadebt will provide me with written notice 10 days prior to the debit date, which would include the increased payment. I also understand that if I do not approve the increase to be debited, I must contact Novadebt at least 3 business days prior to my next scheduled debit date to notify Novadebt that the increased amount should not be withdrawn. I agree to have my account debited a minimum of $310.00 on the (circle one) 1st 5th 10th 15th 20th 25th (circle one) of each month, beginning in ____________________________ (month). I/we authorize Novadebt to initiate entries to my account listed above and, if necessary, to initiate adjustments for any transactions credited in error. If a debit is returned unpaid due to "Uncollected", "Insufficient Funds", "Refer to Maker", "Stop Payment", "Closed Account", etc., Novadebt will not process it again, therefore a payment must be submitted via another approved method. A $10.00 (ten) fee will be assessed for returned drafts *as allowable by your state of residence. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of United States law. This authorization will remain in effect until Novadebt receives verbal or written notification at least 3 business days prior to the next scheduled debit date. I/we agree with all of the provisions of this authorization and hold Novadebt, its directors, employees, officers and its agents harmless from any damages that may occur arising out of my/our authorization. Date: ___________________________________ Client Name: _____________________________ lead_direct_pay.clienttext.bankname lead_direct_pay.clienttext.bankstate Bank Name: _____________________________ lead_direct_pay.clienttext.routingnum Bank Routing #: __________________________ lead_direct_pay.clienttext.verifyroutingnum Client Signature: ____________________________ Account Type (Check One): _____ Checking ______ Savings lead_direct_pay.clientradio.checking.group1 lead_direct_pay.clientradio.savings.group1 Bank State: ______________________________ lead_direct_pay.clienttext.acctnum Bank Account #: ____________________________ lead_direct_pay.clienttext.verifyacctnum

For Office Use Only: Rep Initials: LLI Client ID #: 114232