Fill and Sign the Debt Settlement Terms of Agreement Please Read Carefully 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 ($__________), to be paid to Creditor by Debtor, Creditor agrees to release and forever discharge Debtor from all claims and demands arising out of the debt hereinafter described. 1. Acknowledgment of Existing ObligationThe parties acknowledge that Debtor is at present indebted to Creditor in the sum of Dollars ($_______________), 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 PaymentDebtor 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. ConsiderationIn consideration of the mutual promises contained in this agreement, Debtor and Creditor agree as follows: A. Method of PaymentDebtor 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 pl
Of receipt, if any). B. Consideration in consideration of debtor's undertaking to provide information concerning the original indebtedness, to be disclosed forthwith upon the execution of the settlement agreement by creditor, in such manner or form as in debtor's discretion debtor may specify in writing and to the satisfaction of creditor, including information by creditor concerning the amount of such original indebtedness and any specific consideration for the provision (if any) of information herein described. 4. Assignment or conveyance of agreement upon written request of both parties this agreement, which includes this provision and additional provisions, may be assigned, conveyed or assigned to any successor in interest or other person authorized to enforce the terms and terms of this agreement. A copy of, and a statement of the terms and provisions of this agreement, shall be filed with each public filing form prescribed by the administrator. The administrator shall not accept for filing, or file, in any office, or other repository maintained by the administrator of the state of New York , any of the documents relating to this agreement or any other agreement or instrument, if the documents contained therein would constitute a contract or other obligation for payment of money with respect to an interest in a debt of the United States or another government or any entity that does not deal at arm's length with the United States or such a government, unless both parties to the document have consented in writing to the public disclosure of the documents. For purposes of enforcement of this agreement, the United States as representative of the united nations or its specialized agencies may serve, or cause to be served, copies of a determination or determination of the United States court of international trade, including each form or other document filed by the administrator, accompanied by duly certified copies of a certificate and an affidavit from the officer (which officer shall have authority to certify as true the contents of the certificate and affidavit) of the representative power or agency verifying that the United States did, within a reasonable time after receipt thereof, serve such order on the person from whom a certified copy of such determination or determination of the United States court of international trade was delivered. 5. Severance and termination no cause of action or controversy arising under this agreement is subject to be severed, and no cause of action or controversy will be terminated at any time by reason only that the agreement may be so severable or terminated by reason only that it may be so completed. 6. Governing law; forum and venue this agreement shall be governed by the laws of the state of New York , without regard to its choice of law rules or.