This form was created by Carlisle Law Firm based on experience in settling thousands of consumer and small business debts. This form will not be shared with the debt collector. This information will be used to determine the true value of your debt, by assessing your current income and resources, your remaining earning capacity, cause of financial hardship, and the time probability of collection. Select information deemed helpful to settlement will be shared with the debt collector. We will redact any confidential or privileged information or documents, and will not share any information you want to remain private. Please complete and submit the form as soon as possible.