Outstanding Balance Form

Outstanding Balance Form

Troops are financially responsible for all product received from Girl Scouts - Dakota Horizons. Families are financially responsible for all product received from the troop/Cookie Cupboard. This form is a request to transfer financial responsibility from the troop to a family for unpaid product. The troop will remain responsible for the product until this request has been approved by council.
*****IMPORTANT PLEASE READ*****

For your request to be considered, troop leadership MUST do the following:
- Ensure M2 or eBudde records are up to date.
  - All transfers to girl must be recorded with a meaningful comment
  - All deposits from girl must be recorded with a date received and/or deposit date
- Notify council as soon as a problem becomes apparent, please do not wait until the end of a program
- Attempt to collect the debt on three separate occasions by at least two different methods (Facebook, text, email, phone, etc.)
- Submit all dually signed receipts for review (signed by family and troop leadership)
  - Girl Scout Initial Order Worksheet
  - Receipts showing transfers to girl
  - Receipts showing payments received from girl
  - Receipts showing transfers back to troop
  - Please do NOT submit a copy of the Girl Orders Summary for the troop or a girl. GSDH has access to this information.
- Submit a copy of bank activity from beginning of the Product Program to current.
If these outstanding balances gets submitted to our collections agency, Section 809 of the Fair Debt Collection Practices Act entitled "Validation of Debts" requires the collection agency to notify all debtors that, upon their written request, the collection agency shall obtain verification of the debt and mail a copy of it to them. This law requires our collections agency to cease collection of the debt, or any disputed portion thereof, until the verification is mailed to the debtor. Girl Scouts - Dakota Horizons' policy is to have this information prior to approving the transfer of financial responsibility.

Once request and supporting documentation have been received, council will review your request and notify you of its decision within 5 business days.
Troop number:*
Girl Scout name:*

First NameLast Name
Responsible family member's name:*

First NameLast Name
Responsible family member's e-mail address:*
parent@nowhere.com
Responsible family member's address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Responsible family member's phone number:*

Area CodePhone Number
Dollar amount you are requesting to transfer to the family:*
Please provide details of situation and collection attempt(s).*
Please provide details of second collection attempt.*
Please provide details of third collection attempt.*
Please attach all dually signed receipts for review (Girl Scout Initial Order Worksheet, transfers to girl, payments received from girl, transfers back to troop, etc.)

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Please attach a copy of bank activity from beginning of Product Program to current.

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Please attach any other documentation to support request.

Choose a File

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Person submitting request:*

First NameLast Name
E-mail address of person submitting request:*
troopleader@nowhere.com
Phone number of person submitting request:*

Area CodePhone Number
After clicking "Submit" you will receive a confirmation email at the address provided above. Please keep in mind, this is a request to transfer financial responsibility from the troop to a family for unpaid product. The troop will remain responsible for the product until this request has been approved by council. Once your submission and supporting documentation have been received, GSDH will review your request and notify you of its decision within 5 business days. If subsequent events occur regarding your request please notify council by replying to your confirmation email.
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