FINANCIAL RESPONSIBILITY AGREEMENTFinancial Responsibility Agreement • January 25th, 2021
Contract Type FiledJanuary 25th, 2021This certifies that the above named individual agrees to pay in full for all professional services rendered at the time they are performed, unless other arrangements are made in advance of the set appointment. The below named guarantor understands a $ 10.00 returned check fee will be charged along with any appropriate collection or attorney’s fee which may accrue upon collection of any outstanding balance.