Fill and Sign the Bankruptcy Fundamentals and Advanced Bankruptcy Institute Form

UNITED STATES BANKRUPTCY COURT DISTRICT OF SOUTH DAKOTA Division In re: ) Bankr. No. ) Chapter ) Soc. Sec. No. ) REAFFIRMATION AGR EEMENT AND ) DECLARATION OF ATTORNEY Debtor. ) (SECURED DEBT) 1 1. Debtor and Creditor agree that Debtor reaffirms the debt (s)he owes t o Creditor. 2 2. This debt is secured by a lien against Debtor’s . Debtor and Creditor agree that this property is worth $ . 3. Debtor agrees to pay Creditor p rincipal of $ 3 and interest at the rate of % per year. Interest will begin to accrue on . Debtor will make monthly payments of $ , for a total of $ . Debtor’s first payment will be due on .................... 4 The principal amount does not include any attorney fees or other costs incurred by the Creditor. 5 4. The parti es’ original note and security agreement dated are: unchanged changed as follows: The amount owed has been reduced to the value of the collateral. The monthly payment has be en reduced by $ . The term has been extended months. 5. This agreement may be rescinded at any time prior to discharge or within 60 days after it is filed with the Court, whichever occurs later, by giving written notice of rescission to Creditor at the address set forth below. 6. Reaffirmation of this debt is not required under the Bankruptcy Code, under nonbankruptcy law, or under any agreement not in accordance with the provisions of 11 U.S.C. § 524(c). Date: ________________________ _______________________________ Debtor Date:________________________ _______________________________ Creditor's Representative DECLARATION OF ATTORNEY 6 I declare under penal ty of perjury that I have represented Debtor in connection with this agreement, that this agreement represents a fully informed and voluntary agreement by Debtor, that this agreement does not impos e an undue hardship on Debtor or any dependent of Debtor, and that I have fully advised Debtor of the legal effect and consequences of this agreement and any default under it. Dated: _______________________ ________________________________ Attorney for Debtor Counsel for Debtor COMMITTEE NOTES 1. If the d ebt being reaffirmed is unsecured, see Appendix 23. This form is intended to comply with 11 U.S.C. § 524(c). No representation is made that it complies with nonbankruptcy law regarding the extension of credit, including specifically the Truth in Lending Ac t, 15 U.S.C. § 1601 et seq. 2. If the debt being reaffirmed was not listed on the debtor’s Statement of Intention, the debtor should file an amended Statement of Intention with the reaffirmation agreement. Refer to Local Bankruptcy Rule 1009 -3 for guidanc e on amending a Statement of Intention. 3. If the principal amount being reaffirmed is greater than the value of the property (per ¶ 2), include an explanation of why the debtor wishes to reaffirm the unsecured balance in a separately numbered paragraph ( and renumber ¶¶ 4, 5, and 6), e.g., “Debtor wishes to reaffirm the undersecured debt because her mother has personally guaranteed it (or the debt may be nondischargeable, the credit will extend the debtor new credit, the debtor wishes to protect a co - debto r, etc.).” 4. Include the principal amount being reaffirmed, the interest rate, the number, frequency, and amount of payments, the total sum to be paid, and the date of the first payment. 5. If the principal amount being reaffirmed includes attorney fees or other costs, the last sentence of ¶ 3 should be changed to: “The principal amount includes attorney fees of $ and costs of $ incurred by Creditor.” 6. Omit the Declaration of Attorney if the debtor is not represented by an attorney.