Fill and Sign the Agreement Debt Payment Form

© Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States & Canada and by international treaties. IT IS ILLEGAL AND STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER PARTY, THIS PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL BE SUED IN A COURT OF LAW. Agreement to Extend Debt Payment Terms Agreement made on the _________________ (date) , between __________________________ (Name of Creditor) of _________________________ _________________________________________________________ (street address, city, state, zip code) , referred to herein as Creditor , and ________________ (Name of Debtor) , a corporation organized and existing under the laws of the state of __________________, with its principal office located at ________________________ ________________________________________________________ (street address, city, state, zip code) , referred to herein as of _________________________________ _______________________________________________________ (street address, city, state, zip code) , referred to herein as Company . For and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: Whereas, Company presently owes the Creditor the sum of $___________, said sum being presently due and payable under the terms of a Note dated _____________________ (date) ; 1. In further consideration of the Creditor's forbearance, the Creditor agree to allow Company to pay said debt on extended terms in the manner following: (describe extended terms) _______________________________________________________ ______________________________________________________________________ _____________________________________________________________________ . 2. In the event the Company fails to make any payments punctually on the agreed extended terms, the Creditor shall have all of the rights to proceed for collection of the entire amount then outstanding as set out in the Note dated _____________________ (date) . WITNESS our signatures as of the day and date first above stated. __________________________ (Name of Company) ________________________ By:_________________________ (P rinted Name of Creditor) _________________________ ________________________ (P rinted Name & Office in Corporation) (Signature of Creditor) _________________________ (Signature of Officer)