Payment Plan Request

    FCCSA Account #:

    Property Address:

    Owner's Name:

    Phone Number:

    Current Balance:

    Email:

     

     

     

     

     

     

     

     

     

     

     


    I, , am the owner of the above referenced property and understand my obligation to pay the amount shown plus administrative, interest, and collection fees as outlined in the FCCSA Collections Policy. Since I am not able to pay the full amount at this time, I submit the following installment plan (consecutive monthly payments only):

    Payment

    Date to Pay

    Amount to Pay

    Remaining Balance

    Check No.
    (Office Use Only)

    #1

    ______

    #2

    ______

    #3

    ______

    #4

    ______

    *Note: Interest Fees will accrue monthly to your account per FCCSA Collections Policy

    Interest at a rate of 10% per year is charged on assessments to all accounts that remain unpaid or delinquent as of the last day of each month. A monthly administrative fee of $15.00 is also applied to all delinquent accounts. (The monthly administrative fee is reduced to $0.00 for those accounts with an approved payment plan – see attached Payment Plan Policy). Formula for calculating monthly interest is as follows:

    Remaining balance multiply by 10% divide by 12 (months) equals interest charge for the month
    Example: 758.00 (remaining balance) x 10% = 72.80 (yearly interest)
    75.80 (yearly interest) ÷ 12 = 6.31 (monthly interest)

    If for any reason I cannot strictly adhere to the above schedule, I understand that First Colony Community Services Association may elect to pursue legal proceedings to collect the amount due under the terms of the FCCSA Collections Policy.

    If I meet the terms of this payment plan, I understand that First Colony Community Services Association, Inc. agrees to suspend any further legal actions against me to collect the amount owed. When I have fully paid off the amount owed and my account balance is zero ($0.00), I understand that First Colony Community Services Association will release any maintenance fee liens and/or judgments that may have been filed against me or the above referenced property.

    Owner's Signature:

    Date:

    THIS PAYMENT PLAN IS NOT CONSIDERED AN APPROVED PAYMENT PLAN UNTIL IT IS SIGNED BY FCCSA. UPON APPROVAL BY FCCSA YOU WILL RECEIVE A FULLY SIGNED COPY. IF YOU DO NOT RECEIVE ONE WITHIN 2 WEEKS AFTER SUBMITTING YOUR PROPOSED PAYMENT PLAN PLEASE CONTACT THE FCCSA OFFICE.