We understand that it can sometimes be difficult to discuss financial matters by telephone. That's why we've created an option to submit a payment plan proposal completely online.

Please note that not all proposals can be approved. If your proposed plan does not meet our client's requirements, we will provide alternative options and/or may request additional information.

⚠ Important: This and any communication with our office is an attempt to collect a debt. Any information obtained will be used for that purpose.

How the Process Works

1
Submit Your Proposal Complete the form below with your contact information and proposed monthly payment amount.
2
Review by Our Office A member of our office will review your proposal against client requirements.
3
Response by Email You will be contacted by email with an approval, alternative options, or a request for more information.

STEP 1 Your Information

First Name *

Last Name *

Email Address *

Mobile Phone Number *

Account Number (from letter) *

Street Address *

State *

ZIP Code *

STEP 2 Employment Information

Employer Name

Gross Monthly Income

STEP 3 Your Payment Proposal

Proposed Payment Amount *

Payment Frequency *

Proposed First Payment Date *

Must be within 30 days of today. Dates beyond that range are not selectable.

Semi-Monthly Processing Days *

1st processing day each month

2nd processing day each month

Days are limited to the 1st–28th to ensure consistent processing across all months.

Additional Comments

📋 Communication & Consent Authorization

By submitting this form, I authorize the Office of Special Counsel Andy Bowers and its agents to contact me via text message and email regarding this matter and any other debt placed with this office for collection. I understand that:

Text messages and emails may be sent to the mobile number and email address provided on this form for purposes related to the collection of my account.
Some communications transmitted via text message or email may contain Federal Tax Information (FTI) as defined under IRC §6103. By consenting below, I acknowledge and accept the transmission of such information through these channels.
Message and data rates may apply. Message frequency will vary based on account activity.
I may withdraw this consent at any time by notifying this office in writing; however, withdrawal of consent may limit our ability to communicate with me regarding my account.

I have read and agree to the above Communication & Consent Authorization, including the transmission of Federal Tax Information (FTI) via text and email.

Payment Plan Proposal

Proposal Submitted

Submission Summary

Payment Plan Proposal