Fill and Sign the Debt Form

Debt Settlement Agreement Agreement made on _____________ (date) between ________________________ of __________________________________________ (Address) , hereinafter referred to as Creditor, and ______________________________________, of ________________________________________ (Address) , hereinafter referred to as Debtor. In consideration of this agreement and the sum of Dollars ($__________), to be paid to Creditor by Debtor, Creditor agrees to release and forever discharge Debtor from all claims and demands arising out of the debt hereinafter described. 1. Acknowledgment of Existing Obligation The parties acknowledge that Debtor is at present indebted to Creditor in the sum of Dollars ($_______________), in connection with the following described obligation: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ (Here describe nature of indebtedness, including description of specific contract under which indebtedness was incurred). 2. Agreement for Different Method of Payment Debtor and Creditor desire, and they agree, to provide for payment of the above - stated indebtedness in accordance with terms and provisions different from, and in substitution of, the terms and provisions for payment of the same contained in the original contract described above in Paragraph One. 3. Consideration In consideration of the mutual promises contained in this agreement, Debtor and Creditor agree as follows: A. Method of Payment Debtor agrees to pay to Creditor, and Creditor agrees to accept from Debtor, in full satisfaction of the indebtedness described in Paragraph One, above, the sum of _________________________ Dollars ($_______________), as follows: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ (Set forth method of payment, including dates and place for making installment payments and the amounts if appropriate). B. Default by Debtor: Time is declared to be of the essence in this agreement; and if Debtor should fail to make any of the payments as provided in this agreement, then Creditor is released forever from his/her/its obligation to accept from Debtor the lesser sum of __________________________ Dollars ($_______________) and shall have no further obligations under this agreement. C. Satisfaction: On full payment by Debtor to Creditor of the installments provided in Paragraph 3 above, the original indebtedness of Debtor to Creditor, as described in Paragraph One, shall forever be cancelled and discharged. In witness whereof, the parties have executed this agreement at ______________________________________ (city & state) on the date first mentioned above. ______________________________ ______________________________ Creditor Debtor