Thank you so much Trasael Adnepos!
http://www.timebomb2000.com/vb/showthread.php?t=208638
Search is your friend! ... You just have to ask the correct question! :scratch:
A friend asked for help and I racked my brains and hdd looking for it.
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I tweaked it a bit the first part up to the "Pursuant to the Fair Debt Collection" and fixed the two #31's from the original.
=================================
DEMAND FOR FULL DISCLOSURE
This document contains 4 pages all must be completed & Notarized.
Re: Account #
name
address
city state zip
Deadline: 20 calendar days from receipt.
At no time are you permitted to contact us by email or telephone or fax, all contact must be via registered mail.
Failure to comply with the above will result in a complaint to both the xx & yy State Attorney's.
Pursuant to the Fair Debt Collection Practices Act at 15 USC § I 692g, Debt Collector shall attach, to this completed DISCLOSURE STATEMENT, a verification, (which means: confirmation of authenticity, by affidavit, or oath, by authorized legal signatory for Debt Collector), of the record relating to each of the following:
1. Name of Debt collector: __________________________________________________ _____
2. Address of Debt collector: __________________________________________________ ___
3. Name of Debtor: __________________________________________________ ___________
4. Address of Debtor: __________________________________________________ _________
5. Account Number(s):________________________________________ ___________________
6. Amount of debt owed: $ __________________________________________________ ______
7. Date this debt became payable: ________________________________________________
8. Did Debt Collector purchase this account from the original creditor? YES_____ NO_______
9. Date and Purchase amount: Date: ____________ Amount: $________________
10. Did Debt Collector purchase this account from a previous debt collector? YES____ NO___
11. Date and Purchase amount: Date: _____________ Amount: $ ______________________
12. The transfer of rights to this account was done by which of the following methods:
a) assignment ____ b) negotiation_____ c) novation____ d) other _____ - explain ____________________________________________________________________________
13. What are the terms of the transfer of rights to this account? __________________________
__________________________________________________________________________
__________________________________________________________________________
14. In regard to this account, Debt Collector is currently the:
a)____owner b)____ assignee c)____ holder d)____ holder in due course e)____other -
explain: ___________________________________________________________________
__________________________________________________________________________.
15. If the transfer of rights to this account was by assignment, was there consideration? YES____
NO_____
16. What is the nature and cause of this consideration? _________________________________
__________________________________________________ ________________________
17. If the transfer of rights to this account was by negotiation, was the account taken for value?
YES _____ NO _____
18. What is the nature and cause of this value? ___________________________________
19. If the transfer of rights to this account was by novation, was consent given by Defendant?
YES______ NO______
20. What is the nature and cause of this consent? (Please attach certified copies of any documents responsive to this request) _________________________________________
__________________________________________________ ______________________
__________________________________________________ ______________________.
21. Does Debt Collector have knowledge of any claim(s) or defense(s) to this account?
YES_____NO______
22. Please state with specificity the nature and cause of the claim(s) or defense(s) to this account known to Debt Collector/Plaintiff? _______________________________________________
__________________________________________________ ________________________
__________________________________________________ ________________________
__________________________________________________ ________________________
23. Were any products or services sold by the Debt Collector to the Debtor? YES___ NO____
23. Please state the nature and cause of products or services disclosed at No. 23 above. __________________________________________________ ________________________
24. Does there exist a verifiable commercial instrument(s) between Debt Collector and Debtor that contains Debtor’s signature? YES______ NO_______
25. If your answer to No. 24 above is YES, what is the nature and cause of this verifiable commercial instrument?(Please attach certified copies of any document(s) responsive to this request.) __________________________________________________ ________________
__________________________________________________ ________________________
26. Does there exist verifiable evidence of an exchange of a benefit or detriment between
Debt Collector and Debtor? YES_____ NO______
28. If your answer to No. 26 above is YES, what is the nature and cause of this evidence of an exchange of a benefit or detriment?
__________________________________________________ __________________________________________________ ________________________________________________
29. Does there exist any verifiable external act(s) giving the objective semblance of agreement between Debt Collector and Debtor? YES_____ NO______
30. If your answer to No. 29 above is YES, what is the nature and cause of this external act(s) giving the objective semblance of agreement?______________________________________
__________________________________________________ __________________________________________________ ________________________________________________
31. Have any charge-offs whatever been made by any creditor or debt collector regarding this account? YES______ NO_______ (If YES attach certified document copies.)
32. Have any insurance claims whatever been made by any creditor or debt collector regarding
this account? YES____ NO_____ (If YES attach certified document copies.)
33. Have any tax write-offs whatever been made by any creditor or debt collector regarding this
account? YES_______ NO______ (If YES attach certified document copies.)
34. Have any tax deductions been made by any creditor or debt collector regarding this account?
YES______ NO _______. (If YES please attach certified document copies.)
35. Have any judgments been obtained by any creditor or debt collector regarding this account?
YES_____ NO____. (If YES please attach certified document copies.)
36. If your answer to No. 35 above was YES, are any such judgments presently in force or effect?
YES ____ NO ____. (If NO, please explain provide a written explanation.) _______________________________________________________________ __________________________________________________ ________________________________________________.
Any failure or refusal whatever of Plaintiff/ Debt Collector to complete and return this Discovery and Disclosure Statement and to provide all verification of this debt requested herein, shall constitute tacit agreement with actual notice to the Court and Defendant/ alleged Debtor, that Plaintiff has no bona fide verifiable claim to this account, and shall further constitute tacit agreement of Plaintiff to waive any and all claims against Defendant named herein, and to pay Defendant for all costs and attorney fees, expended to date or future, in defending against the above entitled action and subject account in this and any future collection action, excepting acceptance in writing of Defendants above Good Faith Offer In Compromise by Order stipulating to immediate dismissal of the instant action and all claims of plaintiff, with prejudice.
Plaintiff is directed to return this completed Disclosure Statement along with all required documents requested and to file one original copy of record in this cause. Plaintiff’s claim cannot be considered if any portion of this form is not completed and returned with the required documents.
In addition to a Discovery Request requiring your timely complete response under procedural law, this is a Request for Verification and Full Disclosure made pursuant to Federal Law, which is codified as the Fair Debt Collection Practices Act at 15 USC § 1692 et seq., which states in relevant part that, “A debt collector may not use any false, deceptive, or misleading representation or means in connection with the collection of any debt” which includes “the false representation of the character, or legal status of any debt” and “the threat to take any action that cannot legally be taken” all of which are violations of applicable state and federal law.
The undersigned hereby certifies under penalty of perjury under the laws of the United States and of the State of ____________ that the answers above given are true and complete, and that documents provided in response are properly authenticated and certified for entry in the court records and Exhibit pursuant to FRE and ER.
__________________ _______________________________ Date completed _____________
Signatory
Printed name of Signatory __________________________________________________ ____
Official Title or Capacity of Signatory _____________________________________________
Notary Information here:
http://www.timebomb2000.com/vb/showthread.php?t=208638
Search is your friend! ... You just have to ask the correct question! :scratch:
A friend asked for help and I racked my brains and hdd looking for it.
-------------------
I tweaked it a bit the first part up to the "Pursuant to the Fair Debt Collection" and fixed the two #31's from the original.
=================================
DEMAND FOR FULL DISCLOSURE
This document contains 4 pages all must be completed & Notarized.
Re: Account #
name
address
city state zip
Deadline: 20 calendar days from receipt.
At no time are you permitted to contact us by email or telephone or fax, all contact must be via registered mail.
Failure to comply with the above will result in a complaint to both the xx & yy State Attorney's.
Pursuant to the Fair Debt Collection Practices Act at 15 USC § I 692g, Debt Collector shall attach, to this completed DISCLOSURE STATEMENT, a verification, (which means: confirmation of authenticity, by affidavit, or oath, by authorized legal signatory for Debt Collector), of the record relating to each of the following:
1. Name of Debt collector: __________________________________________________ _____
2. Address of Debt collector: __________________________________________________ ___
3. Name of Debtor: __________________________________________________ ___________
4. Address of Debtor: __________________________________________________ _________
5. Account Number(s):________________________________________ ___________________
6. Amount of debt owed: $ __________________________________________________ ______
7. Date this debt became payable: ________________________________________________
8. Did Debt Collector purchase this account from the original creditor? YES_____ NO_______
9. Date and Purchase amount: Date: ____________ Amount: $________________
10. Did Debt Collector purchase this account from a previous debt collector? YES____ NO___
11. Date and Purchase amount: Date: _____________ Amount: $ ______________________
12. The transfer of rights to this account was done by which of the following methods:
a) assignment ____ b) negotiation_____ c) novation____ d) other _____ - explain ____________________________________________________________________________
13. What are the terms of the transfer of rights to this account? __________________________
__________________________________________________________________________
__________________________________________________________________________
14. In regard to this account, Debt Collector is currently the:
a)____owner b)____ assignee c)____ holder d)____ holder in due course e)____other -
explain: ___________________________________________________________________
__________________________________________________________________________.
15. If the transfer of rights to this account was by assignment, was there consideration? YES____
NO_____
16. What is the nature and cause of this consideration? _________________________________
__________________________________________________ ________________________
17. If the transfer of rights to this account was by negotiation, was the account taken for value?
YES _____ NO _____
18. What is the nature and cause of this value? ___________________________________
19. If the transfer of rights to this account was by novation, was consent given by Defendant?
YES______ NO______
20. What is the nature and cause of this consent? (Please attach certified copies of any documents responsive to this request) _________________________________________
__________________________________________________ ______________________
__________________________________________________ ______________________.
21. Does Debt Collector have knowledge of any claim(s) or defense(s) to this account?
YES_____NO______
22. Please state with specificity the nature and cause of the claim(s) or defense(s) to this account known to Debt Collector/Plaintiff? _______________________________________________
__________________________________________________ ________________________
__________________________________________________ ________________________
__________________________________________________ ________________________
23. Were any products or services sold by the Debt Collector to the Debtor? YES___ NO____
23. Please state the nature and cause of products or services disclosed at No. 23 above. __________________________________________________ ________________________
24. Does there exist a verifiable commercial instrument(s) between Debt Collector and Debtor that contains Debtor’s signature? YES______ NO_______
25. If your answer to No. 24 above is YES, what is the nature and cause of this verifiable commercial instrument?(Please attach certified copies of any document(s) responsive to this request.) __________________________________________________ ________________
__________________________________________________ ________________________
26. Does there exist verifiable evidence of an exchange of a benefit or detriment between
Debt Collector and Debtor? YES_____ NO______
28. If your answer to No. 26 above is YES, what is the nature and cause of this evidence of an exchange of a benefit or detriment?
__________________________________________________ __________________________________________________ ________________________________________________
29. Does there exist any verifiable external act(s) giving the objective semblance of agreement between Debt Collector and Debtor? YES_____ NO______
30. If your answer to No. 29 above is YES, what is the nature and cause of this external act(s) giving the objective semblance of agreement?______________________________________
__________________________________________________ __________________________________________________ ________________________________________________
31. Have any charge-offs whatever been made by any creditor or debt collector regarding this account? YES______ NO_______ (If YES attach certified document copies.)
32. Have any insurance claims whatever been made by any creditor or debt collector regarding
this account? YES____ NO_____ (If YES attach certified document copies.)
33. Have any tax write-offs whatever been made by any creditor or debt collector regarding this
account? YES_______ NO______ (If YES attach certified document copies.)
34. Have any tax deductions been made by any creditor or debt collector regarding this account?
YES______ NO _______. (If YES please attach certified document copies.)
35. Have any judgments been obtained by any creditor or debt collector regarding this account?
YES_____ NO____. (If YES please attach certified document copies.)
36. If your answer to No. 35 above was YES, are any such judgments presently in force or effect?
YES ____ NO ____. (If NO, please explain provide a written explanation.) _______________________________________________________________ __________________________________________________ ________________________________________________.
Any failure or refusal whatever of Plaintiff/ Debt Collector to complete and return this Discovery and Disclosure Statement and to provide all verification of this debt requested herein, shall constitute tacit agreement with actual notice to the Court and Defendant/ alleged Debtor, that Plaintiff has no bona fide verifiable claim to this account, and shall further constitute tacit agreement of Plaintiff to waive any and all claims against Defendant named herein, and to pay Defendant for all costs and attorney fees, expended to date or future, in defending against the above entitled action and subject account in this and any future collection action, excepting acceptance in writing of Defendants above Good Faith Offer In Compromise by Order stipulating to immediate dismissal of the instant action and all claims of plaintiff, with prejudice.
Plaintiff is directed to return this completed Disclosure Statement along with all required documents requested and to file one original copy of record in this cause. Plaintiff’s claim cannot be considered if any portion of this form is not completed and returned with the required documents.
In addition to a Discovery Request requiring your timely complete response under procedural law, this is a Request for Verification and Full Disclosure made pursuant to Federal Law, which is codified as the Fair Debt Collection Practices Act at 15 USC § 1692 et seq., which states in relevant part that, “A debt collector may not use any false, deceptive, or misleading representation or means in connection with the collection of any debt” which includes “the false representation of the character, or legal status of any debt” and “the threat to take any action that cannot legally be taken” all of which are violations of applicable state and federal law.
The undersigned hereby certifies under penalty of perjury under the laws of the United States and of the State of ____________ that the answers above given are true and complete, and that documents provided in response are properly authenticated and certified for entry in the court records and Exhibit pursuant to FRE and ER.
__________________ _______________________________ Date completed _____________
Signatory
Printed name of Signatory __________________________________________________ ____
Official Title or Capacity of Signatory _____________________________________________
Notary Information here:
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