Century Support Services, LLC

2000 Commerce Loop, Suite 2111

North Huntingdon, PA 15642
Office: (888) 913-8784 Fax: (877) 895-8538

Debt Resolution Agreement

This Debt Resolution Agreement, along with each of the documents referenced in the subsection entitled "Documents Incorporated by
Reference" in Section 7, (collectively the "Agreement"), is made by and between Century Support Services, LLC, (“CSS”) a Delaware
limited liability company ("we," "us" or "our") and Derek Counts("you" or "your") residing at 16001 40th Ave, , Clearlake CA 95422. This
Agreement will not be effective until we receive from you a signed (or initialed) copy of each required document ("Effective Date"). You
may sign or initial manually or electronically.

1. Our Guarantee: We will not charge any fee for our services until a debt is resolved and you have made a payment toward the
settlement of that debt. When one of your debts is resolved, we will charge you only the fee associated with that debt at that time. Our
fees are described in more detail in Section 5, below.

2. Our Responsibilities: We will work with you in good faith toward the resolution of each of the debts listed on Exhibit A (individually
a "Debt" and collectively the "Debts") through the negotiation of settlements with your creditors (individually a "Creditor" and collectively
the "Creditors"; as used herein, the terms "Creditor" or "Creditors" shall include any assignee or successor in interest to any Creditor).
We believe that each Creditor listed on Exhibit A will work to negotiate a settlement of your Debts. Your personal involvement in the
negotiation and settlement process may be required for certain Creditors identified as “Difficult Creditors”, and we will provide you with
the information identifying those Difficult Creditors as well as the information that you will need to participate in the negotiations and
settlement process.

A. Program Progress: We will keep you reasonably informed of the progress of our efforts on your behalf and advise you if we
become aware of any significant changes in Creditor policies or other factors that may materially affect any good faith estimates made
by us with respect to the timing or amount of any settlement. We will respond promptly to your inquiries and communications.

B. Program Length: While we have estimated a program length of 60 months that we believe is appropriate for the full resolution of
your Debts, the actual length of your program will depend upon your ongoing ability to make your program deposits, as described in more
detail in Section 3, below, your Creditors' willingness to settle your Debts and the length of any structured settlement of a Debt that is
negotiated..

3. Your Responsibilities: You will (i) respond promptly, truthfully and cooperatively to any inquiry or request we may make of you, (ii)
assist us in verifying the information associated with any Debt, including but not limited to account numbers, creditor identity and amount
owed on the Effective Date, (iii) notify us promptly of any change of your telephone number, e-mail or physical address or other contact
information, (iv) fill out and return within five (5) business days any and all documents we may reasonably request, (v) notify us
promptly if you receive a settlement offer directly from a Creditor and (vi) consider promptly and in good faith our recommendations
regarding any proposed settlement offer.

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A. Program Deposits: You agree to establish a dedicated, FDIC-insured Settlement Savings Account ("Settlement Account") with an
FDIC-insured Settlement Account provider of your choosing, for the exclusive purpose of accumulating funds for settlements and for the
payment of our fees. Beginning on Aug 16, 2019, you will deposit $200.92 per month (or every 28 days for clients electing the bi-weekly
deposit option) into your Settlement Account. You will, at all times, retain full ownership and control over your Settlement Account, the
terms and conditions of which are set forth in the Account Agreement between you and your Settlement Account Provider. Fees and
other charges associated with your Settlement Account and Settlement Account Provider are set forth in your Account Agreement with
your Settlement Account Provider, and are not part of the fee charged by us for the settlement of your debts.

By your execution of this Agreement, you are acknowledging that it is your responsibility to set aside sufficient funds
in your Settlement Account, on a regular basis, to enable the negotiation of settlement offers. Unless we can
demonstrate to a Creditor that you have sufficient funds available in your Settlement Account to make a settlement
payment, settlement offers may not be able to be negotiated

B. Your Representations, Agreements & Acknowledgements: By your execution of this Agreement, you are representing to us,
and acknowledging your understanding of, the following matters.

(i) Unsecured Debt Only: Each of the Debts is an unsecured debt owed by you to the Creditor, and (subject to Section 5(A),
below) in the amount, listed on Exhibit A and is your sole obligation and responsibility. You further acknowledge that we will not
assume or pay any Debt, attempt to extend the time you may have to pay any Creditor or otherwise attempt to modify the terms of
any existing obligation.

(ii) No Additional Charges; Additional Debt Not Covered By This Agreement: Any additional charges you may make after
the Effective Date on any Debt may impair the ability to secure settlement offers; accordingly, you agree not to incur any further
charges on any Debt after the Effective Date. This Agreement covers only the obligations listed in Exhibit A; the enrollment or
resolution of additional debts or debts arising after the Effective Date will be addressed as the situation arises and will be added by
oral agreement between you and Century.

(iii) Certification of Financial Hardship: Debt resolution is only suitable for persons who are in a verifiable state of financial
hardship and are unable to pay or continue to pay their minimum monthly payments to Creditors without severe financial hardship.
By your execution of this Agreement you are confirming the truth and accuracy of all financial information you have furnished to us,
and confirming that you have considered other ways of dealing with your debt, including, for example, credit counseling or
bankruptcy.

(iv) Effects of Participation in a Debt Resolution Program: Failing to make your minimum monthly payments to your Creditors
(a) will negatively affect your creditworthiness, (b) may result in "unpaid," "late," "uncollected" or "charged-off" entries on your
credit report(s), (c) may cause the amount of a Debt to increase due to the assessment and accrual of additional interest and late
and other fees and (d) could result in ongoing collection efforts and, possibly, legal action including being sued by Creditors or debt
collectors. A Creditor may notify the Internal Revenue Service of any forgiveness of some or all of a Debt, and the amount of such
forgiveness may be taxable income to you.

C. Exclusions & Limitations: YOU UNDERSTAND AND ACKNOWLEDGE THAT WE DO NOT PROVIDE LEGAL, TAX, BANKRUPTCY,
ACCOUNTING OR INVESTMENT ADVICE. You further understand and acknowledge that we (i) will provide professional debt negotiation
services on your behalf in an attempt to settle your debts with your Creditors, and we do not make your regularly scheduled monthly
payments as shown on your monthly statements you receive from your Creditors, (ii) make no claim that our debt resolution program will
improve your credit rating or that we will attempt to modify, correct or remove any reference or entry on your credit report(s), (iii) cannot
advise or assist you in the modification, improvement or correction of any reference or other entry contained in any credit report and (iv)
have not represented that we can stop collection phone calls or other creditor communications.

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D. Authorization to Review Consumer Credit Report Information: By your execution, below, you hereby authorize and instruct
us to obtain one or more credit reports about you from any consumer reporting agency (often called a "credit bureau") for the purpose of
performing the debt relief services described herein, including reviewing the way that your creditors have reported your debts and your
settlements to the credit bureaus. This authorization shall remain in effect until you no longer have an ongoing relationship with us.

4. Settlement of Your Debts:

A. Timing and Amount of Settlement Offers: We begin contacting your Creditors as soon as we determine that a good faith offer to
settle a given debt, whether on a lump-sum or installment basis, may be made, with such determinations dependent upon such factors
as the Creditor's settlement policies, the rate of account accretion, the size of each Debt and how close a Debt may be to charge-off.
Some Creditors prefer that they not be contacted until you have accumulated sufficient funds in your Settlement Account to allow a
negotiated resolution within their historic norms. While settlement guidelines differ widely among Creditors, an accumulation of 25% of
the then-current balance of a Debt will normally enable a good-faith offer to settle that Debt.

B. Completing Settlement Offers: The negotiations process is intensive and often requires several offers before a settlement
opportunity may be obtained. Immediately following the negotiation of an appropriate settlement offer, we will contact you and inform you
of the terms of the proposed settlement and ask that you confirm your acceptance. The same procedure will apply to any settlement that
you may have participated in, as referenced above. to us. All settlement offers must be specifically accepted by you before we can
accept any payment of fees from your Settlement Account.

AFTER YOU RECEIVE NOTICE FROM US, YOU MUST PROMPTLY CONFIRM YOUR APPROVAL OF THE SETTLEMENT OFFER.

C. Program Estimates: Based upon both our experience in working with your Creditors as well as your personal financial
circumstances, we have made a good faith estimate that your program length and your monthly program deposit requirements will be
sufficient to enable the negotiation of settlements of each of your Debts; however your actual results may vary. Although reasonable
efforts will be made to negotiate a settlement offer from each of your Creditors, we cannot make promises or warranties as to the
outcome of these efforts or the time that it may take to resolve your Debts.

5. Fees: We do not charge or collect any fee for our settlement services unless and until a Debt is successfully resolved. When a
proposed settlement of a Debt is negotiated and you make a payment toward settlement of that Debt, we charge and are entitled to
collect 25% of the enrollment amount of that Debt, as reflected on Exhibit A. On an annualized basis, if we settle your debts over the
estimated 60 month program life, your fee would work out to be approximately 5.00% of your enrolled debt per year. Century will earn
and receive a settlement fee on all accounts settled during your program, including those accounts where you participated in the
negotiation and settlement process.

Although the negotiated settlement offers may have terms that require a single payment (for example, a $1,000 lump sum payment to
settle a $2,000 account) or that require a number of payments (for example, payments of $1,000 per month for five months to settle a
$10,000 account), our fee for the settlement of any Debt is earned, and is charged in full, at the time you make any payment to a Creditor
toward an agreed upon settlement of that Debt on terms substantially similar to those negotiated..

We reserve the right to present settlement offers only after you have accumulated sufficient funds in your Settlement Account to pay
both the negotiated amount of the settlement and the full amount of the fee associated with that Debt. Similarly, in order to secure a
beneficial settlement of a Debt, we reserve the right, in our sole discretion, to spread our fee over time if sufficient funds are not
available in your Settlement Account. In such cases no interest or other finance charge is assessed. Payment methods other than ACH
methods are available, and may be modified by calling CSS at 1-888-913-8784.

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Otherwise, our fees, once earned, will be paid to us via electronic ACH debit from your Settlement Account, which you agree to
authorize at the same time you authorize the settlement of your debt. As explained above in Section 4(B), we will contact you when a
settlement offer has been received from a Creditor and you must specifically confirm your acceptance of that settlement offer. You
agree, simultaneous to confirming acceptance of a particular settlement offer, to execute and ACH authorization for us to collect our fee
via automatic ACH debit from your Settlement account. Once paid, you understand CSS’s fees are non-refundable.

A. Verifying Your Debt Balance: If you have completed Exhibit A based on one or more credit card statements dated prior to the
Effective Date, or based on no credit card statements at all, Exhibit A may not reflect the actual amount owed to each of your Creditors.
We may, from time to time, contact some or all of your Creditors to ascertain the exact amount owed to such Creditor(s) as of the
Effective Date. If we substantiate that the amount actually owed to any Creditor on the Effective Date differs from the amount set forth
on Exhibit A, Exhibit A shall be deemed restated with your consent as of the Effective Date, with any corrected amount(s) controlling for
all purposes.

6. Withdrawal from the Program; Termination of this Agreement: You may terminate this Agreement and withdraw from your
debt resolution program at any time, without any termination fee or other penalty, by providing us with written notice of termination
(which may be electronic). Our right to collect settlement fees that are earned but remain unpaid, in whole or in part, for any reason will
survive any termination of this Agreement and we have the right to pursue collection of our fees prior to and after termination or
completion of your debt settlement program.
Federal regulations provide that you can stop payment of preauthorized transfers from your account by notifying CSS not later than
three (3) business days before the scheduled date of the transfer. All authorizations to communicate with your Creditors and any other
authorizations we may have to act on your behalf will be revoked and ineffective immediately upon termination. In the event that you fail
to make any payment required by this Agreement, fail to approve a settlement that we believe, in good faith, is in your best interests or
otherwise fail to discharge any of your obligations, we have the right to terminate this Agreement with five (5) days' written notice
(which may be electronic) to you, without any further obligation of any sort.

7. Additional Program Provisions

Governing Law: Unless otherwise set forth herein or required by the law of your state, this Agreement shall be governed by and
construed in accordance with the laws of the state of Pennsylvania, excluding any conflicts of law provisions or principles. Unless
otherwise required by the law of your state, any claim or dispute must be resolved by a court located in Allegheny County,
Pennsylvania, and the parties agree to submit to the personal jurisdiction of the courts located within Allegheny County, Pennsylvania for
the purpose of litigating all such claims or disputes.
No Power of Attorney Conferred: We shall at all times act on your behalf as an independent contractor and not as attorney-in-fact.
We shall not have any authority to contract for or bind you other than as expressly set forth herein or in the Authorization to
Communicate with Creditors and Collection Agencies, attached to this Agreement as Exhibit C.

Severability; Waiver: If any provision of this Agreement is found to be invalid or unenforceable, the remainder of this Agreement shall
not be affected and the remaining terms will continue in effect and be binding on the parties, provided that such holding of invalidity or
unenforceability does not materially affect the essence of this Agreement. The failure of either of us at any time to enforce any provision
of or any right under this Agreement will in no way be construed to be a waiver of such provisions or rights, nor shall the failure of
either of us to exercise any rights or options under this Agreement preclude or prejudice the exercising of the same or any other right
under this Agreement or in any way affect the validity of this Agreement.

Notice: Any notice or demand that is required or provided to be given under this Agreement shall be deemed to have been sufficiently
given and received for all purposes when delivered by hand or nationally recognized overnight courier, or five days after being sent by
certified or registered mail, postage and charges prepaid, return receipt requested, to the person and at the address given in the first
paragraph of this Agreement.

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Assignment: You may not assign or transfer any of your rights or obligations under this Agreement, and any attempt to assign or
transfer such rights or obligations will be null and void. We may assign this Agreement without your consent to (i) any parent, subsidiary
or affiliate of ours, (ii) an acquirer of all or substantially all of our assets or (iii) a successor to us by merger.

Documents Incorporated by Reference: The following documents are hereby incorporated herein by reference as part of this
Agreement: (i) Exhibit A (listing of Debts covered by this Agreement and Creditors to which the Debts are owed); (ii) Exhibit B
(Settlement Fee Payment Acknowledgment and Agreement to Execute ACH Authorization); (iii) Exhibit C (Authorization to Communicate
with Creditors and Collection Agencies); (iv) Exhibit D (Dispute Resolution Procedures); (v) Exhibit E (Client Financial Analysis); and (vi)
the AFCC Disclosure Statement. Any usage herein of the term "Agreement" shall be deemed to include each of the aforementioned
documents, as if each of them had been set forth herein in their entirety. Please print and save a copy of this Agreement and all exhibits
and attachments for your records.

Communication Consent: In order to keep you updated on your program, payments, or to provide other important information to you,
you expressly consent and agree that we may contact you at any address or telephone number that you provide to us, including any
cellular or wireless number, landline, or ported landline number, even if on any do-not-call list. You further consent and agree that we
may contact you through any other available technology, including U.S. mail, electronic mail, telephone, or telephone technology such as
the use of an autodialing device, text or SMS message, and prerecorded messages to your telephone (including cellular, wireless,
landline, or ported landline), or any other form of communication. This consent does not require a purchase. You are not required to
consent to the use of any of these communication methods, and if you wish to opt out of their use you may simply call our toll-free
number at any time and inform us of such, and we will immediately update your preferences in our system. This consent, unless you opt
out, shall survive any termination of this Agreement.

_____Check this box if you wish us to inform you of additional programs and services that we feel align with the goals of your program,
or we believe may benefit you (checking this box or leaving it unchecked does not affect how we communicate with you about your
program as indicated in the above paragraph). Your privacy is important to us, and we have committed to helping you achieve resolution
of your debts as expeditiously as possible. To that end, we occasionally become aware of supplemental programs or services that may
be of interest to you. Please select below ALL methods by which you prefer to receive these related communications.

________ Cellular/mobile telephone

________ Residential telephone/landline
________ Text message/SMS
________ E-mail
________ US Mail
________ Other

Mobile phone carriers may still impose normal text message rates/fees, especially if text messaging is not already included in your mobile
phone plan.

Mobile Phone Number Mobile Phone Carrier

Mobile Phone Number (Co-Client) Mobile Phone Carrier (Co-Client)

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Complete Agreement; Modification & Amendment: This Agreement represents our complete and exclusive statement of our
mutual understandings and supersedes all previous written and oral agreements and communications relating to the provision of any
service(s). Other than as set forth herein, including but not limited to any amendment provided for by Section 5(A), this Agreement may
only be modified or amended by a writing signed by both of us, provided, however, that we may change any term of this Agreement, or
add any additional term to this Agreement, by providing you with fifteen (15) days' advance written notice of such change. If you decline
to accept such change, your sole and exclusive remedy will be to terminate this Agreement and withdraw from our debt resolution
program.

I represent that I have read, understand and agree to be bound by the terms of this Debt Resolution Agreement, as set
forth above and in the exhibits, schedules and attachments hereto. I further acknowledge that (a) the terms and
conditions of this Agreement have been explained to my full satisfaction, (b) this Agreement and all program
disclosures have been presented to me in my primary language and (c) I have no unanswered questions about the
program or this Agreement

Client Signature:
Full Name: Derek Counts Date: 08/08/2019

Michael Leuthold
Vice President of Operations
Aug 08, 2019

You may cancel this Agreement at any time prior to midnight of the third business day after the last date set forth
above, as described in the attached Notice of Cancellation form.

PRIVACY POLICY DISCLOSURE

We recognize that your financial information is personal. We use and share information about you to perform our obligations under this
Debt Resolution Agreement and as permitted or required by law. We are careful to use only accurate, current, and complete
information. We will correct any erroneous information quickly if you so request. We are also careful to protect the security of your
information from third parties and unauthorized employees. Please refer to our Privacy Policy, a copy of which will be provided to you
in our Welcome Pack and is available at Our Client Web Portal at: https://www.centurysupportservices.com/clientportal/cp/login.aspx.
You may call us at (888) 913-8784 or fax us at (877) 895-8538, or email us at: info@centuryss.com, if you have any questions or
concerns.

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 CENTURY SUPPORT SERVICES, LLC.
E-SIGN DISCLOSURE AND CONSENT
This E-Sign Disclosure and Consent applies to all communications between the client and Century Support Services, LLC, (“CSS”) that
are not otherwise governed by the terms and conditions of our Agreement. The words "we," "us," and "our" refer to Century Support
Services, LLC, and the words "you" and "your" mean you, the individual client. "Communication" means any agreements or amendments
thereto, disclosures, notices, responses to claims, transaction history, privacy policies and all other information related to the product or
service, including but not limited to information that we are required by law to provide to you in writing.

1. Scope of Communications to Be Provided in Electronic Form. When you use a product or service to which this disclosure
applies, you agree that we may provide you with any communications in electronic format, and that we may discontinue sending
paper communications to you, unless and until you withdraw your consent as described below. Your consent to receive electronic
communications and transactions includes, but is not limited to:

a. All legal and regulatory disclosures and communications associated with our service.

2. Method of Providing Communications to You in Electronic Form. All Communications that we provide to you in electronic form will
be provided either (1) via e-mail, (2) by access to the CSS web site, or (3) to the extent permissible by law, by access to a web site
that we will generally designate in advance for such purpose.

3. How to Withdraw Consent. You may withdraw your consent to receive Communications in electronic form by contacting us at
info@centuryss.com. At our option, we may treat your provision of an invalid email address, or the subsequent malfunction of a
previously valid email address, as a withdrawal of your consent to receive electronic Communications. We will not impose any fee
to process the withdrawal of your consent to receive electronic Communications. Any withdrawal of your consent to receive
electronic Communications will be effective only after we have a reasonable period of time to process your withdrawal.

4. How to Update Your Records. It is your responsibility to provide us with true, accurate and complete e- mail address, contact,
and other information related to this Disclosure and your Account(s), and to maintain and update promptly any changes in this
information. You can update information (such as your e-mail address) by contacting us at info@centuryss.com or by writing to us
at 2000 Commerce Loop, Suite 2111, North Huntingdon, PA 15642.

5. Hardware and Software Requirements. In order to access, view, and retain electronic Communications that we make available
to you, you must have:

a. An Internet browser that supports 128 bit encryption;

b. Sufficient electronic storage capacity on your computer's hard drive or other data storage unit; and

c. An e-mail account with an Internet service provider and e-mail software in order to participate in our electronic
communications programs; or a personal computer (for PC's: Pentium 120 MHz or higher; for Macintosh, Power Mac 9500,
Power PC 604 processor 120-MHz Base or higher), operating system and telecommunications connections to the Internet
capable of receiving, accessing, displaying, and either printing or storing communications received from us in electronic form
via a plain text-formatted e-mail or by access to our web site using one of the browsers specified above.

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 6. Requesting Paper Copies. You can obtain a paper copy of an electronic communication by printing it yourself or by requesting
that we mail you a paper copy, provided that such request is made within a reasonable time after we first provided the electronic
communication to you. To request a paper copy, contact us by logging in to the CSS website client login, or request a paper copy via
email, or send a postal letter. We may charge you a reasonable service charge for the delivery of paper copies of any
communication provided to you electronically pursuant to this authorization. We reserve the right, but assume no obligation, to
provide a paper (instead of electronic) copy of any communication that you have authorized us to provide electronically.

7. Communications in Writing. All communications in either electronic or paper format from us to you will be considered "in writing."
You should retain or download for your records a copy of this disclosure and any other communication that is important to you.

8. Federal Law. You acknowledge and agree that your consent to electronic communications is being provided in connection with
a transaction affecting interstate commerce that is subject to the federal Electronic Signatures in Global and National Commerce Act,
and that you and we both intend that the Act apply to the fullest extent possible to validate our ability to conduct business with you
by electronic means.

9. Termination/Changes. We reserve the right, in our sole discretion, to discontinue the provision of your electronic
communications, or to terminate or change the terms and conditions on which we provide electronic communications. We will
provide you with notice of any such termination or change as required by law.

10. Consent. By agreeing to the terms of this Agreement, you hereby give your affirmative consent to provide electronic
communications to you as described herein. You further agree that your computer satisfies the hardware and software
requirements specified above and that you have provided us with a current e-mail address at which we may send electronic
Communications to you.

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 Exhibit A
Schedule of Creditors That Are Part of Your Program and Debt Owed
** PLEASE FILL IN MISSING ACCOUNT NUMBERS FOR EACH ACCOUNT LISTED BELOW **
**INCORRECT OR INCOMPLETE ACCOUNT NUMBERS MAY IMPACT YOUR PROGRAM**

Current Amount of
Current Creditor Original Creditor Account Number Business Debt? Fee
Debt
Loan Me Loan Me 2785731 $7,784.00 $ 1,946.00
TARGET/TD TARGET/TD 5859752083040110 $2,035.00 $ 508.75
MERRICK BK MERRICK BK 4493110013129617 $2,150.00 $ 537.50
FST PREMIER FST PREMIER 5178006518032596 $1,049.00 $ 262.25
FST PREMIER FST PREMIER 5178006652997281 $832.00 $ 208.00
CHECKNGO/AXF CHECKNGO/AXF 46213431 $1,806.00 $ 451.50
Estimated Total: $15,656.00 $3,914.00

*** PLEASE DO NOT ADD CREDITORS TO THE ABOVE LIST. IF YOU HAVE ADDITIONAL CREDITORS
TO INCLUDE, PLEASE CALL - WE WILL NEED TO RECALCULATE DRAFT AND FEE AMOUNTS FOR
YOU

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 Additional CSS Contract Provisions
(Continued from Exhibit A)

1. The total projected program deposit including fees is $12,055.12. Based on historic average settlements for your listed portfolio of
Creditors, we estimate that you will need to save approximately 52.00% of each debt to fully fund a settlement. The total projected
settlement payments to your Creditors is $ 8,141.12. These projections are only estimates based on averages for a large pool of
individuals and your actual settlements and total program cost will vary based upon factors including, but not limited to, your individual
circumstances and creditor settlement policies. You are encouraged to set aside more money into your Settlement Account as you are
able - additional savings will help your success in the program and potentially speed up results.

2. The timing of when a settlement may be achieved also varies greatly - for lump sum settlements, the above referenced percentage
of each debt (and in many cases the fee associated with that settlement) must be saved before a settlement will be reached. If a
payment plan for a settlement is negotiated so that the entire settlement amount is not needed at one time, then the settlement may be
obtained sooner than projected.

3. Upon termination under Section 6 of the Agreement, your third-party processor will return any monies deposited except for any
settlement fees earned by Century, to which Century will be entitled to be paid, directly by your third-party processor out of your
Settlement Account.

4. Your personal involvement in the negotiations and settlement process is required. Further, settlement offers presented directly to
you by creditors, and your involvement in the negotiation of certain creditors identified as “Difficult Creditors”, will be considered a result
of the debt resolution program and such involvement or offers do not change the fees owed or terms of this Agreement. CSS is entitled
to settlement fees on all accounts on your program that are settled or resolved. CSS does not charge any fees other than the above
schedule. Any added accounts will be separately charged.

5. You expressly consent to our monitoring & recording of any and all telephone conversations with us.

6. Once a settlement has been reached and agreed upon and you make at least one payment towards the settlement of that debt or
account, the services pursuant to this Agreement for that debt or account are considered rendered in full.

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 Exhibit B
Settlement Fee Payment Acknowledgment & Agreement to Execute ACH
Authorization
Century Support Services, LLC does not charge, collect or accept fees prior to the settlement of a debt.

At such time as you make the first payment toward the settlement of a debt, on terms substantially similar to those negotiated with a
creditor, the settlement fee for that debt (equal to a specific percentage of the enrolled amount of that debt, as reflected on Exhibit A to
your Debt Resolution Agreement, which percentage is set forth in Section 5 of your Debt Resolution Agreement) is earned in full,
immediately due and payable, and will be paid to us from your Settlement Account in accordance with the terms of your ACH
authorization as described in Section 5 of your Debt Resolution Agreement and explained more fully below. Although we may, at our sole
discretion, elect to receive our fee in more than one payment from your Settlement Account, our entire fee for that debt will be fully
earned and immediately due when you make your first payment to the creditor. Payment methods other than ACH methods are available
and may be modified by calling CSS at 1- 888-913-8784. Nevertheless, by signing below, you acknowledge your understanding of how
and when our fees are earned.

By signing below, you are also acknowledging your responsibility to authorize payment of the fees due to CSS. Accordingly, at the time
you authorize each debt to be settled, you shall also authorize us to debit your Settlement Account for the purpose of paying the fees
due to us, for each debt settled, via ACH authorization. Failure to authorize settlement of a debt or the payment of our fees via proper
ACH authorization may result in delaying or preventing our ability to settle a debt for you.

I, the undersigned, therefore, in accordance with the foregoing, acknowledge that the fees due to CSS are fully and immediately earned
due once a debt is successfully settled, the settlement has been accepted, and/or first payment toward the settlement of that debt made
on terms substantially similar to those negotiated by CSS. Once paid, I understand CSS’s fees are non-refundable.

I, the undersigned, also acknowledge that I am required to authorize CSS to collect its fees, in connection with the negotiated settlement
of my debts, via ACH authorization simultaneous with the acceptance of a settlement offer for each particular debt. If I fail to do so, I
understand I may be jeopardizing CSS’s ability to settle the associated debt.

Client Signature:
Full Name: Derek Counts Date: 08/08/2019

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 Exhibit C
Authorization to Communicate with
Creditors and Collection Agencies
I (We) authorize Century Support Services, LLC (CSS), including its agents and representatives, to take the following actions:

1. Communicate with my (our) creditors, including but not limited to any agent, representative or third party collection agency or law
firm, and discuss any and all details of my (our) financial situation, all for the purpose of negotiating settlements of my (our) debt
obligations; and

2. Obtain records, debt validations, credit reports and support for the debts allegedly owed on my (our) behalf

I (we) hereby acknowledge that CSS shall only be entitled to charge and/or collect its fee for a settlement negotiated with a creditor at
such time as I (we) make at least one payment pursuant to a settlement proposed by the creditor.. Notwithstanding any other
documentation evidencing the resolution of a debt that the creditor and/or CSS may prepare or that I (we) may sign, my affirmative
payment instruction shall constitute ratification of, and consent to, any settlement negotiated on my behalf.

I (we) affirm that all of the information that I (we) have or will provide to CSS is accurate, timely and correct. I expressly acknowledge
that (i) CSS is not a law firm and does not and will not provide me with legal advice or representation, (ii) any collection activity, demand
or lawsuit resulting from a default in any obligation owed by me (us) to any creditor is not the result of my participation in the CSS debt
reduction program, (iii) CSS does not and will not provide me with any tax, bankruptcy or accounting advice, and (iv) CSS does not and
will not assume or pay any of my debts for me or make periodic payments to my (our) creditors, and is solely engaged to provide those
services described in my Debt Resolution Agreement.

HIPAA Release: I intend that this Authorization to Communicate, within the scope of its limitations concerning my debts, convey to CSS
the authority to be treated as I would be treated with respect to my rights regarding the use and disclosure of my individually-identifiable
health information or other medical records. This release authority applies to any information governed by the Health Insurance Portability
and Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320 (d) and 45 C.F.R. 160-164. I authorize any physician, health care professional,
dentist, health plan, hospital, clinic, laboratory, pharmacy, or other health care provider or insurance company or entity that has provided
treatment or services to me or that has paid, holds a debt, or is seeking payment of a debt from me for such services, to give, disclose,
release, and discuss as if with me personally, without restriction, all of my individually-identifiable health information and medical records.
This authority is effective immediately and supersedes any previous directive I may have given to any health care provider or entity
described above to restrict such access.

The recipient of this Authorization, whether by original, photo copy, facsimile or electronic copy is specifically authorized and instructed
by the undersigned party (ies) to contact, or receive communications from CSS or employees, regarding any of the purposes listed
herein.

Client Signature:
Full Name: Derek Counts SSN: 572-94-7168 Date: 08/08/2019

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 Exhibit D
DISPUTE RESOLUTION BY BINDING ARBITRATION
1. AGREEMENT TO ARBITRATE. IN THE EVENT OF ANY CONTROVERSY, CLAIM OR DISPUTE BETWEEN YOU AND US ARISING
OUT OF OR IN ANY WAY RELATING TO THE AGREEMENT OR THE BREACH, TERMINATION, ENFORCEMENT, INTERPRETATION OR
VALIDITY OF THE AGREEMENT, INCLUDING ANY DETERMINATION OF THE SCOPE, ENFORCEMENT OR APPLICABILITY OF THIS
EXHIBIT D, WE AGREE TO ARBITRATE SUCH DISPUTE IN THE FEDERAL COURT DISTRICT IN WHICH YOU RESIDE OR AT SUCH
OTHER LOCATION UPON WHICH WE MAY AGREE. BY AGREEING TO ARBITRATION, WE BOTH ACKNOWLEDGE AND AGREE THAT
WE ARE EACH WAIVING THEIR RIGHT TO (I) USE ANY OTHER AVAILABLE RESOLUTION PROCESSES, SUCH AS A COURT ACTION
OR ADMINISTRATIVE PROCEEDING, (II) PARTICIPATE IN A CLASS ACTION AND (III) A TRIAL BY JURY. THE AGREEMENT
EVIDENCES A TRANSACTION IN INTERSTATE COMMERCE; THUS, THE FEDERAL ARBITRATION ACT GOVERNS THE
INTERPRETATION AND ENFORCEMENT OF OUR AGREEMENT TO ARBITRATE. NOTWITHSTANDING THE FOREGOING
ACKNOWLEDGEMENT, EITHER PARTY TO THIS AGREEMENT MAY CHOOSE TO BRING AN ACTION IN A SMALL CLAIMS COURT,
TRIBUNAL, OR SIMILAR FORUM. THIS AGREEMENT TO ARBITRATE SHALL SURVIVE TERMINATION OF THE AGREEMENT.

2. Governance; Opt-Out. As indicated above, this arbitration agreement shall be governed by the provisions of the Federal
Arbitration Act (“FAA”). You will have thirty (30) days from the date you sign this agreement to opt out of the terms of this arbitration
agreement, which you must do by notifying us in writing as follows:

By Email: info@centuryss.com, please put “Arbitration Opt Out” in the subject line; or
By US Mail: Century Support Services, LLC, ATTN: Arbitration Opt-Out, 2000 Commerce Loop, Suite 2111, North Huntingdon, PA
15642.

You understand that if you opt out of this arbitration agreement, you will be responsible for your own legal costs and attorney’s fees,
subject to applicable law.

3. Notice. A Party who intends to seek arbitration must first send to the other Party a written Notice of Dispute in accordance with the
provision entitled “Notice” in paragraph 7 of the Agreement. The Notice must describe both the nature and basis of the dispute; and the
specific relief sought. You may download or copy a form Notice and a form to initiate arbitration from the following website:
http://www.adr.org/fileacase.

4. Commencement and Rules of Arbitration. If we do not resolve a claim within 30 days after receipt of the Notice, the party
sending the Notice may commence an arbitration proceeding with the American Arbitration Association (“AAA”). The AAA shall appoint
the arbitrator and shall administer the arbitration proceeding pursuant to its Commercial Dispute Resolution Procedures and the
Supplementary Procedures for Consumer- Related Disputes (“AAA Rules”), as modified by this Exhibit D to the Agreement. The AAA
Rules are available at www.adr.org or by calling the AAA at 1-800-778-7879. The amount of any settlement offer shall not be disclosed
to the arbitrator until after the arbitrator has determined the amount, if any, to be awarded.

5. The Arbitration Award. Any award rendered by the arbitrator shall be final and binding and shall not be subject to vacation or
modification, except as expressly permitted by the FAA. There is no limit to the amount of damages or fees that can be awarded in
arbitration. Judgment on the Arbitration Award may be entered in the jurisdiction in which the arbitration was commenced or in any court
having jurisdiction over the Party against whom judgment is to be entered. If a party fails to comply with the arbitration award, the other
party may petition in any court of competent jurisdiction for enforcement in the jurisdiction in which the arbitration was commenced or
that has jurisdiction over the party against whom enforcement is sought.

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

6. Limitation of Arbitration to Individual Claims; No Class Actions. A party may bring claims against another party only in its
individual capacity and not as a plaintiff or class member in any purported class or representative proceeding. The parties agree that the
arbitrator may not consolidate proceedings of more than one person’s claims, and may not otherwise preside over any form of
representative or class proceeding. The arbitrator may award injunctive relief only in favor of the individual party seeking relief and only
to the extent necessary to provide relief warranted by that party’s individual claim.

7. Costs of Arbitration. CSS will pay the costs of arbitration, including the AAA’s filing, administration and arbitration fees, but
otherwise each Party shall bear their own costs and expenses. If your claim is for $10,000 or less, you may choose whether the
arbitration will be conducted solely on the basis of documents submitted to the arbitrator, through a telephonic hearing, or by an
in-person hearing as established by the AAA Rules. If your claim exceeds $10,000, the right to a hearing will be determined by the AAA
Rules.

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 Exhibit E
Exhibit Financial Analysis
We do not charge or collect any fee for our settlement services unless and until a Debt is successfully resolved.

Client Details
Applicant Name: Draft Type:
Co-Applicant Name:
Derek Counts Monthly
Applicant Email: Fixed Income:
Co-Applicant Email:
countsd885@gmail.com $4,061.00
Day Phone: Evening Phone:
Cell Phone:
530-755-6897 530-755-6897
Program Start Date: Estimated Program End Date:
Aug 16, 2019 07-16-2024
For creditor information please see Exhibit A
Income Information
Co Client Monthly Net Income or Take Home
Client Monthly Net Income or Take Home Pay (After Taxes)
Pay (after taxes)
$4061.00
$0.00
Other Income (Monthly) Total Monthly Income:
$0.00 $4,061.00

Program Details
Program Debt (From Exhibit A) Estimated Program Length: Monthly Program Deposit:
$15,656.00 60 months $200.92

Estimated Program Settlement Amount: Fee Method: Total Program Fees:

$8,141.12 25% of your enrolled debt $3,914.00

Estimated Program Savings:

$3,600.88 Fees, Based Annually of your enrolled debt per year:
5.00%

The estimates on this form are based on our past experience dealing with creditors - actual results vary on a case by
case basis. In addition, accuracy of estimates is dependent on accuracy of information that we received from the client,
and on client's ability to save a consistent amount each and every month.

Client Signature:
Full Name: Derek Counts Date: 08/08/2019

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 AFCC Uniform Program Disclosure Statement

Century Support Services, LLC (“Century”) is a member of the American Fair Credit Council and has agreed to follow
industry “best practices,” as endorsed by the AFCC, including disclosure of the following matters as an integral part of
our contract with consumers.

Century provides consumers with a debt resolution service more popularly known as debt settlement. Debt settlement is the negotiation
of less than full balance settlements of unsecured debt of consumers who are experiencing financial hardship. Century wants you to
understand both the potential benefits and risks that may arise out of your debt settlement program and to be sure you have reasonable
expectations regarding all potential outcomes.

BY SIGNING BELOW, YOU ARE CONFIRMING THAT CENTURY HAS EXPLAINED TO YOU, AND YOU UNDERSTAND, ALL THE ISSUES
SET FORTH BELOW. If you wish to discuss or comment on any of these disclosures or discuss any aspect of your debt
settlement program, please email us at info@americanfaircreditcouncil.org with your contact information and the AFCC
compliance department will respond to you as quickly as possible.

1. You are enrolling into a debt settlement program. The objective of your debt settlement program is the negotiation of
mutually agreeable resolutions between you and each of your creditor(s) for the resolution of your unsecured debt(s), which are
itemized as part of your enrollment agreement and are referred to as Enrolled Debts. You understand and acknowledge that no
specific results can be predicted or guaranteed.
2. You will be responsible for saving sufficient funds to enable the negotiation of debt resolutions on your
enrolled accounts. In order for Century to negotiate on your behalf, you must adhere to a regular schedule of deposits. These
funds will be deposited into a separate FDIC-insured bank account that you and only you will control. Under no circumstances will
Century have custody or control of the funds you set aside.
3. The savings program necessary to settle your debts is detailed in your enrollment agreement. Summaries of the
minimum monthly savings amount and the estimated period needed to settle all of your debts have been prepared for you. Actual
resolution amounts, and the period required to settle all of your debts are likely to vary, possibly substantially, from these estimates,
based on creditor behavior, your ability and willingness to keep to your deposit schedule and other factors.
4. While most creditors and collectors are eager to negotiate with debt settlement service providers, Century
cannot force creditors to negotiate with them or to accept an offered settlement. Communications with creditors are
handled on a case by case basis. Some creditors may not be contacted for several months after you enroll.
5. Century is not a credit counseling service and does not make regular payments on your behalf to your creditors. Your creditors
may continue to pursue collection efforts on delinquent accounts while you are enrolled in a debt settlement program. Such
collection efforts can include phone calls and letters to you, sending delinquent accounts to collection agencies or even filing a
lawsuit against you.
6. Your debt settlement program assumes an effort that will continue for many months. The time needed to produce
a settlement of a given debt depends on several factors. These include: (a) your financial hardship, (b) the age and balance of the
accounts that you owe, (c) the funds you have available to pay to your creditors for a settlement and (d) the willingness of your
creditors to enter into debt settlement negotiations. While no guarantees can be given, generally the more money you are able to set
aside the sooner we will be able to start negotiating settlements for you.

v.03032019 Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 7. Fees paid to a debt settlement services provider such as Century are not available to pay creditors. The fees
paid to Century are intended to compensate them for their efforts and will only be refundable to the extent they have not been
deemed to have been earned in the manner described in the Client Agreement. Those fees are not being set aside or held in escrow
to fund debt settlements.
8. Century is not a law firm and does not and cannot provide legal advice or counsel, and your signature, below,
acknowledges that you have been advised of this. Should you be sued, you should consult with a lawyer licensed
to practice in your jurisdiction.
9. You have told us that you are in a verifiable state of financial hardship and are unable to meet, on an ongoing
basis, the minimum periodic payments required by your creditors to pay off your debts. If you do not make the minimum
periodic payments on your debts your delinquencies will likely be reported to the consumer reporting agencies as late, delinquent,
charged-off or past due balances. Your creditor may also raise the interest rate on your account and impose other penalties, such
as late fees, over-limit fees and the like. Until your account is charged off, your account balance may continue to grow as your
creditor adds accrued interest and fees and penalties, and, if negotiations are unsuccessful, you could be called upon to pay the
entire balance. Even if we are successful in negotiating a less than full balance resolution for you, your creditor may report to the
credit reporting agencies that the account was “settled for less than the full amount.” CENTURY DOES NOT MAKE YOUR
PAYMENTS TO YOUR CREDITORS ON YOUR DEBTS.
10. When your creditor agrees to settle a debt, a savings of $600 or more (meaning at least $600 less than what you
owe at the time of settlement) may be reported by your creditor to the IRS as Discharge of Indebtedness income.
You should consult your tax advisor to determine whether your individual circumstances require you to include any Discharge of
Indebtedness Income in your reportable income, or whether you qualify for an insolvency exclusion. For more information on tax
ramifications to you personally, refer to the IRS website www.irs.gov IRS Publication 908-“Bankruptcy Tax Guide” and IRS Form
982, Reduction of Tax Attributes Due to Discharge of Indebtedness.

To summarize, each case is unique and results, dependent as they are upon both your ability to set aside sufficient funds and your
creditor’s willingness to negotiate a less than full balance settlement, may be expected to vary widely. For consumers in verifiable
states of financial hardship, a debt settlement program can be a very effective way to resolve unsecured debt but it is not a painless
process and no guarantees as to settlement amounts or timing can be given.

Finally, we encourage you to report any concerns with your debt settlement program directly to the AFCC via email:
info@americanfaircreditcouncil.org.

Please sign below indicating you have read and understand the AFCC Uniform Program Disclosure Statement.

Client Signature:
Full Name: Derek Counts Date: 08/08/2019

v.03032019 Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 Notice of Right of Cancellation
DATE OF TRANSACTION: Aug 08, 2019

Derek Counts

You may cancel your Debt Resolution Agreement with Century Support Services, LLC, without any penalty or
obligation, at any time before midnight of the third business day that begins the day after you agree to it by electronic
communication or by signing it.

If you cancel your agreement within the 3-day period, we will refund any money you may have paid us. You may also
terminate your agreement at any later time.

To cancel your agreement during the three day Cancellation Period or otherwise, send an e-mail to:

info@centuryss.com

Or mail or deliver a signed, dated copy of this notice, or any other written notice to:

Century Support Services, LLC

ATTN: TERMINATIONS
2000 Commerce Loop, Suite 2111
North Huntingdon, PA 15642

Before midnight on the third business day following the Date of Transaction listed above.

You may use this form to cancel your agreement with CSS within three days of the Transaction Date listed by signing
where indicated below, and mailing this page to the address above.

I HEREBY CANCEL MY AGREEMENT WITH Century Support Services, LLC

Client Signature: Date:

Co-Client Signature Date:

By Initialing below you are indicating that you have read and understood the material on this page.

GS.V.06.2018.GFS Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 Client Acknowledgements and Waivers

Century Support Services LLC ("CSS") is committed to fully disclosing any circumstances known to us at the time of
your enrollment in our debt resolution program that may have impact our ability to negotiate a resolution of any
particular debt or any other facts or circumstances that may affect your anticipated program outcome.

The enrollment of certain debt account(s) may result in unintended and/or possible adverse consequences. By your
execution of any of the following acknowledgements and waivers, you are agreeing to indemnify and hold harmless
CSS of any liability associated with enrolling these debt accounts into CSS’ debt resolution program.

__ __ Employment Waiver: Military/Federal/State personnel understand that his or her military rank/pay/advancement may be
adversely affected by delinquent debt accounts and/or a poor credit rating.

__X__ Acknowledgement that Requested Payment Amount is Less than Recommended Payment Amount: You have
specifically requested to contribute less than recommended minimum monthly program payment, the projected length of your program has
been extended to a term recommended parameters. You understand that it is essential to your success in the program that you make
each and every payment on time. If it becomes possible during your participation in the program for you to increase your monthly
program payment, we strongly encourage you to contact customer service at (888) 913-8784 to make arrangements to save as much as
possible, in the interest of getting you out of debt as quickly as possible.

__X__ Difficult Creditor Accounts: Your enrollment consists of one or more difficult creditor account(s) may result in an actual
settlement that what is typical for an account that is not with creditors. In addition, during the negotiation process, your involvement may
be required to obtain the best settlement possible. Century is entitled to a settlement fee for all accounts settled on your program,
including accounts with difficult creditors.

Account/s: Target

____ Student Loan Accounts: Private student loans may be eligible for enrollment, although these loans may be difficult to negotiate
and more time-consuming than regular unsecured indebtedness, and could result in a longer program length than we might otherwise
estimate.

Account/s:

____ Legal Disclaimer: By my execution, below, I hereby confirm that I am including debt account(s) to be negotiated which are
either: (i) facing legal collection actions; (ii) likely to face legal collection actions; or (iii) upon which judgment(s) has been granted by a
court of law. Century Support Services LLC. is not able to prevent legal collection actions that may be taken by my creditors. Should my
creditors pursue legal collections actions, I understand that a court may enter judgment against me, if it has not done so already. I confirm
my understanding that Century Support Services LLC cannot prevent this from happening. While Century Support Services LLC. has had
past success in negotiating judgments and will, to the best of its ability, attempt to negotiate a judgment for the lowest reasonable
settlement, there is no guarantee that a settlement can be reached. I hereby confirm my understanding that Century Support Services
LLC. cannot give legal advice. Century Support Services, LLC. encourages customers to research and understand the laws of their
state pertaining to what a creditor can and cannot do to collect a judgment.

v.03032019 Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

____ Same bank / Credit Union: If you enroll an account from a creditor with whom you also have another account, such as a
checking, savings or loan account, you acknowledge that the creditor may close, freeze and/or take possession of any and all monies or
other assets held in such other, non-enrolled accounts.

Account/s:

____ Secured accounts: Enrollment of debt account(s) secured by personal property (such as jewelry store credit cards, furniture
store credit cards, etc.) could result in seizure/repossession of such secured property by the respective creditor(s). In addition, these
types of debts are more difficult to negotiate, potentially resulting in a longer program length and/or higher program settlement cost.

Account/s:

____ Single Account/Card Type: You acknowledge that you are only including a single account on your program. You further
understand, due to the nature of debt settlement, negotiations activity will be very limited until sufficient funds have been saved in your
special purpose account to make a reasonable initial settlement offer and this may not occur until the later portion of your program.

____ Authorization for Third Party Speaker: You hereby authorize to discuss (by telephone, email, chat, SMS text, or by mail)
information concerning your program and make decisions with regard to your program, on your behalf, with CSS, its representatives,
and/or assigns. This includes, but is not limited to the authorization of this Third-Party Speaker to discuss, release, or obtain any
personal and/or financial information relating to your participation in the debt settlement program or that may be needed to update your
account, and also authorization for this person to discuss with CSS and act on your behalf with respect to: settlement authorizations,
settlement fee payments, communication with your creditors who are enrolled on your debt settlement program, communications with
your third-party processor, and pertaining to your program deposits, including modifications to your program deposit amounts and
payment dates. You agree to indemnify and hold CSS harmless from any loss, liability or damage by any reason resulting from
communication with the above named individual or CSS’s reliance on such third party's instructions or directions concerning your debt
settlement program. This authority is not assignable or transferable by the authorized Third-Party Speaker without your written consent.
This Authorization is in effect upon signing, if at enrollment, or upon authorization post enrollment (by telephone, email, or by mail), and
terminates upon completion of your program or upon CSS’s or your written notice revoking this authorization, whichever first occurs.

Derek Counts 08/08/2019

Client Print Name Client Signature Date
{COSIGNATURE} {COSIGNDATE}
Co-Client Print Name Co-Client Signature Date

Third Party Speaker Print Name Third Party Speaker Contact Number

Third Party Speaker Email

v.03032019 Initials: {COINITIAL}

Client Co-Client

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00
ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00
ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00
Derek Counts 572-94-7168 11/05/1954

16001 40th Ave Clearlake CA 95422

16001 40th Ave Clearlake CA 95422

530-755-6897 countsd885@gmail.com

08/08/2019

WELLS FARGO BANK NA 121042882 2728093077

Derek Counts

16001 40th Ave Clearlake CA 95422

200.92 16th

08/08/2019

ID: 79d72ba2-560d-5e19-5008-6a0665bd1b45 Signed: 2019-08-08T15:37:01-05:00

 E-Signature Completion Certificate

Document ID 6283157
Document GUID 79d72ba2-560d-5e19-5008-6a0665bd1b45
Document Title Green State Century Agreement NEW
Sender IP 73.138.181.178
Number of Signers 1
Signer Email countsd885@gmail.com
Signer IP 173.28.41.86
Timestamp 2019-08-08T15:37:01-05:00
Document Hash 62ab65759ec81f2b0f18fa816cb13544

Document Audit

Sent at 2019-08-08T15:28:53-05:00 from IP 73.138.181.178

Delivered to Derek Counts countsd885@gmail.com at 2019-08-08T15:30:18-05:00 from 173.28.41.86
Adopted Signature at 2019-08-08T15:30:41-05:00 from 173.28.41.86
Completed Signing at 2019-08-08T15:37:01-05:00 from 173.28.41.86
PDF Generated at 2019-08-08T15:37:01-05:00

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