NFCC Membership Online Application Step 1 of 5 20% Thank you for your interest in taking the first step toward becoming an NFCC Member!Before starting this initial application, please complete the following steps: Review the Application Qualification Requirements and check each box when completed:Please review the following application qualification requirements: • Operate as a tax-exempt organization under section 501(c)(3) of the Internal Revenue Code.• Must be an accredited nonprofit financial counseling organization in compliance with federal and state laws and regulations• Maintain accreditation through the Council on Accreditation (COA) or ISO 9001 certification through Bureau Veritas• Agree to comply with the NFCC Mission Statement & Code of Ethics and Member Quality Standards• Agree to the NFCC BylawsDownload, complete and return these items:• Application fee processing form ($2,500)• NFCC Member Dues Worksheet• Most current audited financial statements.• Most current Form 990.• Save completed forms and upload them when prompted at the start of the application.The membership application fee is $5,000, split into two payments. You’ll pay $2,500 when you apply online and the remaining $2,500 after your initial application review, before the agency site visit. The entire process may take six to eight weeks. Payment is by ACH or check only.Please begin the application:Today's date(Required) MM slash DD slash YYYY Applicant must review and accept the application qualification requirements (listed above).(Required) I have reviewed and accept the application qualification requirements. Please use the space below to upload the following documents before proceeding to the next section of the application.(Required)• Completed annual dues worksheet • Completed application fee processing form, $2,500 • Articles of Incorporation and Bylaws • IRS determination letter and all IRS audit determinations Drop files here or Select files Max. file size: 8 MB. Contact PersonThe contact person can be either a volunteer board member or a paid staff member and will serve as NFCC’s contact for questions, correspondence, and discussion during the application process.Name(Required) Street address(Required) City(Required) State(Required) Zip code(Required) Phone number(Required) Email(Required) Enter Email Confirm Email AgencyProvide the name you intend to use as your operating name when approved for membership. In the event you wish to use a “Consumer Credit Counseling Service” or the “CCCS” name and mark, the use is limited by license with the NFCC and may not be available in requested areas.Agency name(Required) Agency website(Required) Agency street address(Required) City(Required) State(Required) Zip code(Required) Agency phone number(Required) Enter number of agency staffed workers(Required)A staffed worker is an individual working ≥ 40 hours per weekPlease enter a number greater than or equal to 0.Agency will have more than one physical service location?(Required) Yes No Services to provided by agency:(Required) In-person counseling Phone counseling Internet counseling DMP processing Select AllDMP service provider(s)(Required) ComplianceThe agency is a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code.(Required) Yes No In the past ten years, has the agency been audited by the Internal Revenue Service?(Required) Yes No When did the audit begin?(Required) MM slash DD slash YYYY What is the audit status?(Required)Select...ongoingclosedresults being challengedWhen was the audit closed?(Required) MM slash DD slash YYYY Did the IRS direct the agency to take any action as part of the closing?(Required) Yes No Please specify actions required by the IRS.(Required)Has the agency been notified by the IRS that the IRS is considering revoking or otherwise challenging the Agency’s status under Section 501(c)(3) of the Internal Revenue Code?(Required) Yes No When was that notification received?(Required) MM slash DD slash YYYY What is the status of the notification?(Required) Compliance with NFCC Member Quality StandardsPlease review the NFCC Member Quality Standards prior to proceeding. NFCC Member Quality StandardsThe agency is in compliance with NFCC Member Quality Standard # 01.00: Accreditation(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 02.00: Access and Availability(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 03.00: Group Financial Literacy(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 04.00: Counseling Sessions(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 04.01: Counselors(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 05.00: Debt Management Plans(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 05.01: Model Member Agency Funding Disclosure(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 05.02: Model Member Agency Dual Role Disclosure(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 05.03: Model Member Agency DMP Duration Disclosure(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 06.00: Fiscal Integrity(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 06.01: Client Trust Accounts(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 06.02: Annual Financial Audit(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 06.03: IRS Forms 990 and 990-T(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 07.00: Governance / Board of Trustees(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 08.00: D&O, E&O and Fidelity Insurance(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 09.00: Fair Fees Guideline(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 10.00: Ethical Practices and Conduct(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 11.00: Advertising(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 12.00: Compliance with Federal, State, and Local Laws(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 13.00: Grievances(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 14.00: Private Inurement and Private Benefit(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 15.00: Reporting(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 16.00: Nepotism(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 17.00: Technology Requirements for Delivering Quality Programs(Required) Yes No If no, please comment(Required) The agency is in compliance with NFCC Member Quality Standard # 18.00: Data Security(Required) Yes No If no, please comment(Required) Certification and digital signatureDigital Signature(Required) Digital signature certification(Required)I certify, under penalty of perjury and the laws of the United States of America, that the foregoing is true and correct. 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