Outstanding Debt Report

Outstanding Debt Report
The following documents must be attached for family debts:
- Copies of product and money receipts
- Communications related to collection attempts (call log, texts, emails, social media posts, etc.)
The following documents must be attached for other debts:
- Police report (theft or damage related debt)
- Insurance claim (theft or damage related debt)
- Counterfeit bill report (only denominations of $50 or less will be accepted)
- Other relevant info
Missing documentation can result in the debt not being approved.
Cookie ProgramFall Product Program
SU*
Troop #
Family DebtOther
Amount Paid to Date*
Amount of Debt*
Guardian Name*

First NameLast Name
Girl Scout Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guardian Phone Number*
Format: (000) 000-0000.
Guardian Email*
example@example.com
Please describe nature of the debt: *
Troop Product Manager Name*

First NameLast Name
Troop Product Manager Phone Number*
Format: (000) 000-0000.
Troop Product Manager Email*
example@example.com
Attach all relevant documentation*

Cancelof
Should be Empty: