Fill and Sign the Agreement with Creditor Form

11/29/20001 of 2 Agreement with Creditor (Real Estate Related) The parties to this agreement include:Petitioner, andRespondent, , who are parties to a dissolution of marriage action filed in County Superior Court, Arizona, case number and , who is a duly authorized representative of (Creditor).The undersigned parties agree that the debt owed by the parties to (Creditor), Account/Loan # , i s s e cu re d b y r e al p ro perty l o cate d i n t h e S ta te o f A riz o n a, l e g al d esc rip tio n a s f o llo w s: I n se rt full legal description)Copies of the note and recorded security agreement for the above described debt are attached hereto and incorporated herein for all purposes as though fully restated as Exhibits A (Note) and B (Security Agreement). (Attach these documents) 11/29/20002 of 2The undersigned parties also agree that the debt owed by the parties to (Creditor) is to be disposed as follows (check one): The t e rm s f o r t h e r e p ay m en t o f t h e d eb t r e m ain u nch an ged .T he t e rm s f o r t h e r e p ay m en t o f t h e d eb t h av e b ee n m odif ie d , a n d, b eg in nin g o n t h e d ate o f t h e e x ecu tio n o f t h e a ck n ow le d gm en t b elo w , t h e c re d ito r h as a g re ed t h at o ne o f t h e d eb to rs , , a ssu m es t h e s o le r e sp onsib ility f o r th e d eb t a n d t h at t h e o th er d eb to r i s r e le ase d f ro m a n y f u rth er l ia b ility o n t h e d eb t.T he d eb t i s p aid i n f u ll a n d a ll p artie s t o t h e d eb t a re r e le ase d f ro m a n y f u rth er l ia b ility . We, the undersigned, acknowledge the above agreement. Date Petitioner’s Signature Date Respondent’s Signature Date Creditor’s Representative’s Signature Company State of Arizona ) )ss.Acknowledged before me on: County of )My Commission Expires: Notary Public or Clerk