Understanding the intricacies of the Adoi form is crucial for those looking to establish repayment agreements based on their actual financial capabilities, rather than standardized calculations. The form, short for Alternative Documentation of Income For Rehabilitation Repayment Agreements, serves as a vital tool for individuals aiming to provide a detailed portrayal of their income for the purpose of calculating feasible repayment amounts for debts. It requires borrowers to furnish comprehensive income details, including both taxable and non-taxable sources such as employment income, worker’s compensation, unemployment benefits, alimony, child support, and social security benefits among others. Importantly, it allows for the inclusion of family size, which can considerably influence the repayment plan by accounting for dependents. Borrowers are also given a chance to indicate if they have no income and are fully supported by another individual, which adds a layer of complexity to the process of income verification. Completing the form necessitates the submission of specific documents for each income source declared, to affirm the accuracy of the information under penalty of perjury. Furthermore, the form includes instructions for its return, offering multiple submission options to cater to the borrower's convenience. This multi-faceted approach ensures that repayment plans are tailored to the individual’s financial situation, making the Adoi form a critical step in the journey towards financial rehabilitation.
| Question | Answer |
|---|---|
| Form Name | Adoi Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | adoi form fill, documentation adoi pdf, income adoi repayment form pdf, adoi repayment form |
Alternative Documentation of Income
For Rehabilitation Repayment Agreements
Borrower ID: ___________________ |
Name: ______________________________________________ |
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Address Line 1: |
__________________________________________________________________________ |
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Address Line 2: |
__________________________________________________________________________ |
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City:____________________________________________ |
State: |__|__| |
Zip Code: |__|__|__|__|__| |
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Home Phone: ( |
)_____________________ |
Cell Phone: ( |
)_______________________ |
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Family Size: __________ |
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Email Address:__________________________ |
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Family size includes you, your spouse, and your children (including unborn children who will be born during the year for which you certify your family size), if the children will receive more than half their support from you. It includes other people only if they live with you now, they receive more than half their support from you now, and they will continue to receive this support from you for the year that you certify your family size. Support includes money, gifts, loans, housing, food, clothes, car, medical and dental care, and payment of college costs.
Income: (Include your spouse’s income if you are married and live together)
Taxable Income
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Monthly Average Amount |
Provide |
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Income Type |
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Borrower |
Spouse |
The Following Proof |
1. |
Employment Income |
$ |
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$ |
Copies of 2 most recent pay stubs |
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(Dated within past 90 days) |
2. |
Worker’s Compensation |
$ |
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$ |
Award letter or pay stub |
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(Dated within past 90 days) |
3. |
Unemployment Benefits |
$ |
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$ |
Award letter or pay stub |
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(Dated within past 90 days) |
4. |
Alimony |
$ |
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$ |
Divorce decree |
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5. |
Other Taxable Income |
$ |
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$ |
Evidence of source and amount |
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6. |
Child Support |
$ |
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$ |
Divorce decree or Support Order |
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7. |
Social Security |
$ |
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$ |
Benefit statement |
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8. |
Other |
$ |
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$ |
Evidence of source and amount |
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Check this box if you have no income and are entirely supported by someone other than a spouse. Explain how you are supported in the space below:
I affirm, under penalty of perjury, that the information provided above and in the attached documentation is complete and accurate.
Signed: __________________________________________________________ Date: _____________________
Return this Form to: |
CBE Group, Inc. |
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PO Box 930 |
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Waterloo, IA |
To expedite processing of the Alternative Documentation of Income, the following return options are available:
∙Scan the completed document and
∙Fax the completed form to