{\rtf1\mac\ansicpg10000\uc1 \deff0\deflang1033\deflangfe1033{\upr{\fonttbl{\f0\fnil\fcharset256\fprq2{\*\panose 00020206030504050203}Times New Roman;}{\f1\fnil\fcharset256\fprq2{\*\panose 00020b06040202020202}Arial;} }{\*\ud{\fonttbl{\f0\fnil\fcharset256\fprq2{\*\panose 00020206030504050203}Times New Roman;}{\f1\fnil\fcharset256\fprq2{\*\panose 00020b06040202020202}Arial;}}}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255; \red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0; \red128\green128\blue128;\red192\green192\blue192;}{\stylesheet{\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid \snext0 Normal;}{\s1\sl300\slmult0\keepn\nowidctlpar \tldot\tx4680\tldot\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f1\lang1033\cgrid \sbasedon0 \snext0 heading 1;}{\*\cs10 \additive Default Paragraph Font;}}{\info{\title Future Payment Submission Worksheet}{\author Karen Knott} {\operator George Karl}{\creatim\yr1998\mo7\dy6\hr15\min59}{\revtim\yr2003\mo2\dy11\hr15\min21}{\version4}{\edmins15}{\nofpages1}{\nofwords93}{\nofchars532}{\*\company Pino Training Organization}{\nofcharsws653}{\vern16411}}\margl1440\margr1440 \ftnbj\aenddoc\ftnrestart\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\horzdoc\dgmargin\dghspace120\dgvspace120\dghorigin1440\dgvorigin1440\dghshow0\dgvshow3\jcompress\viewkind1\viewscale150\nolnhtadjtbl \fet0\sectd \sbknone\linex0\endnhere\sectdefaultcl {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4 \pnlcltr\pnstart1\pnindent720\pnhang{\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (} {\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}\pard\plain \qc\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\b\f1\fs24 Future Payment Submission Worksheet \par }{\f1\fs24 \par }\pard \nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 CCFC/Referral Representative Information \par \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx6930\tlul\tx9187\tlul\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Name\tab Date\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Company\tab \tab \par Address \tab \tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx5040\tlul\tx9187\tlul\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 City\tab State ____________ ZIP\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx5040\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Phone \tab Fax\tab }{\b\f1\fs24 \par \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 Client Information}{\f1\fs24 \par \par }\pard\plain \s1\sl300\slmult0\keepn\nowidctlpar\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f1\lang1033\cgrid {Name\tab \par }\pard\plain \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 Address\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx5040\tlul\tx9187\tlul\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 City\tab State ____________ ZIP\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Phone \tab Fax\tab }{\b\f1\fs24 \par }\pard\plain \s1\sl300\slmult0\keepn\nowidctlpar\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f1\lang1033\cgrid {Driver\rquote s license number and state\tab \tab \par }\pard\plain \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 Attorney\rquote s name (if applicable)\tab \tab }{\b\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par }{\b\f1\fs24 Future Payment Information}{\f1\fs24 \par \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Source of payment(s)\tab \par Address\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx5040\tlul\tx9187\tlul\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 City\tab State ____________ ZIP\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx4680\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Phone \tab Fax\tab }{\b\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Date payment(s) is/are expected\tab }{\b\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par }{\b\f1\fs24 Client\rquote s Need}{\f1\fs24 \par \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 What is the client\rquote s motivation for selling the payment(s)?\tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 How much cash does the client need now \tab \tab \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 Transaction Details}{\f1\fs24 \par }\pard \sl300\slmult0\nowidctlpar\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \tab \par \tab \par \tab \par }\pard \sl300\slmult0\nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1 /fut_pymt}{ \par }}