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Agreement Of Financial Responsibility
"I need an Agreement of Financial Responsibility for my medical practice in California, requiring patients to commit to paying their portion of treatment costs not covered by insurance, with specific provisions for payment plans extending up to 24 months."
1. Parties: Identification of the responsible party and the creditor/institution
2. Background: Context of the financial responsibility arrangement
3. Definitions: Key terms used throughout the agreement
4. Financial Obligations: Detailed description of financial responsibilities and payment terms
5. Payment Terms: Specific payment schedules, methods, and deadlines
6. Default Provisions: Consequences of failing to meet financial obligations
7. Term and Termination: Duration of the agreement and conditions for termination
1. Collateral: Details of any assets securing the financial obligation
2. Insurance Requirements: Required insurance coverage related to the financial responsibility
3. Co-Signer Provisions: Terms and conditions applying to any co-signers of the agreement
1. Payment Schedule: Detailed breakdown of payment amounts and due dates
2. Interest Rate Calculations: Methods and formulas for calculating applicable interest rates
3. Fee Schedule: Comprehensive list of applicable fees and charges
4. Credit Terms Disclosure: Required disclosures under Truth in Lending Act and other applicable regulations
Authors
Payment Period
Due Date
Default
Late Payment
Interest Rate
Principal Amount
Outstanding Balance
Late Fees
Payment Schedule
Responsible Party
Creditor
Co-Signer
Guarantor
Collection Costs
Default Rate
Grace Period
Business Day
Payment Method
Acceleration
Material Breach
Notice
Governing Law
Term
Early Termination
Force Majeure
Collateral
Security Interest
Event of Default
Remedies
Interest and Fees
Default and Remedies
Representations and Warranties
Payment Terms
Security Interest
Collection Rights
Dispute Resolution
Governing Law
Assignment
Notices
Amendments
Severability
Force Majeure
Entire Agreement
Indemnification
Termination
Acceleration
Co-Signer Obligations
Financial Statements
Insurance Requirements
Reporting Requirements
Waiver
Survival
Authority
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