REAFFIRMATION AGREEMENT

ATTORNEY’S DECLARATION FOR DEBTOR

 

UNITED STATES BANKRUPTCY COURT

FOR THE __________ DISTRICT OF __________

 

 

I, ________________________________, attorney for _________________________ ___________________, debtor in the above-entitled case, declare:

 

1.  I represented the debtor in the course of the attached reaffirmation agreement between the debtor and ____________________________, a creditor in the amount of ____________________ Dollars ($___________) pursuant to the provisions of Section _______________ of the United States Bankruptcy Code.

 

2.  I clearly explained the attached reaffirmation agreement to the above-stated debtor. __________ (He or She) is fully informed about the contents of the agreement and has entered into the agreement voluntarily and of __________ (his or her) own free will.

 

3.  I made inquiries of the debtor’s financial condition and, to the best of my knowledge, information, and belief, the attached reaffirmation agreement will not impose any undue hardship on the debtor or on a dependent of the debtor.

 

 

___________________________________________________

Signature

 

________________________________________________

Title

 

_______________________________________________

Address

 

Attachments

 

Under penalty of perjury, I, as declarant in the above statement, declare that the statement is true and correct.

 

Dated ________________

 

 

_________________________________________________

Signature