Payment Plan Request

Payment Plan Request

Payment plan request. The client requires an alternate payment schedule than the one designated by ADC. This form needs to be submitted, and the the Director will either approve, reject or offer alternate suggestions to adhere to financial requirements and business needs.

Name(Required)
Payment Dates List(Required)
Date
Amount
 
Please enter payment dates and if you require to distribute payment. You can add extra lines to show multiple payment requests. Or make full payment on one specified date.
Add if required.
Please add any further information you believe is required to facilitate the requested payment plan. If you need to add further details that do not fit in the above-formulated boxes, please add them here.
Please note that this will be submitted for approval, and if the requested plan is approved, a confirmation email will be sent. If additional alterations are required then another payment plan form and written approval will be required for each alteration.