Outstanding Debt to Troop Report

Outstanding Debt

Council will only start the collection process if the signed Caregiver Permission & Financial Responsibility Form, receipts, and email/text conversations are attached.
Date

MonthDayYear
Date
Troop Information
For which Product Program are you reporting Outstanding Debt?
Service Unit
Troop Number
Your Information
Your Name

First NameLast Name
Your Position in Troop
If you hold more than one position, please select the one you are submitting this form as.
Email (MUST be the same email associated with your myGS account)
example@example.com
Phone Number
Format: (000) 000-0000.
Service Unit Number
Person Completing form
Position
Troop Leader/Troop Product Program Coordinator
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Responsible Party's Information

This is the person that is responsible for the debt
Responsible Adult's Name

First NameLast Name
Responsible Adult's Email
example@example.com
Responsible Adult's Phone Number
Format: (000) 000-0000.
Girl Scout's Name

First NameLast Name
Beginning Amount Due to Troop
Amount Paid to Troop
Remaining Balance Due
Communication Attempts
Address

Responsible Party’s address

Street Address Line 2

CityState / Province

Zip
Responsible Adult
Girl Scout’s full name
Cell
Core Cookies ($5.00)
# of boxes
Specialty Cookies ($6.00)
# of boxes
Type any collection attempts or notes that we may need:
Upload any receipts of communication and collection attempts through email, text, phone, etc. This can also include bank statements or online transactions.

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Council will contact you with any next steps or additional questions. Keep allcommunication regarding this situation until told otherwise. If the person pays off the debt, email VolunteerResources@gsmidtn.org so we can close the case.
Should be Empty:

Outstanding Debt

Troop Information

Your Information

Responsible Party's Information