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Proof of Claim United States Bankruptcy Court

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UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF NORTH CAROLINA

Division

REAFFIRMATION AGREEMENT

Debtor's Name

Bankruptcy Case No.

Chapter

Creditor's Name and Address

Instructions:

1) Attach a copy of all court judgments, security agreements, and evidence of their perfection

2) File all the documents by mailing them or delivering them to the Clerk of the Bankruptcy Court

NOTICE TO DEBTOR

This agreement gives up the protection of your bankruptcy discharge for this debt.

As a result of this agreement, the creditor may be able to take your property or wages if you do not pay the agreed amounts. The creditor may also act to collect the debt in other ways.

You may rescind (cancel) this agreement at any time before the bankruptcy court enters a discharge order or within 60 days after this agreement is filed with the court, whichever is later, by notifying the creditor that the agreement is canceled.

You are not required to enter into this agreement by any law. It is not required by the Bankruptcy Code, by any other law, or by any contract (except another reaffirmation agreement made in accordance with Bankruptcy Code § 524(c)).

You are allowed to pay this debt without signing this agreement. However, if you do not sign this agreement and are later unwilling or unable to pay the full amount, the creditor will not be able to collect it from you. The creditor also will not be allowed to take your property to pay the debt unless the creditor has a lien on that property.

If the creditor has a lien on your personal property, you may have a right to redeem the property and eliminate the lien by making a single payment to the creditor equal to the current value of the property, as agreed by the parties or determined by the court.

This agreement is not valid or binding unless it is filed with the Clerk, U. S. Bankruptcy Court. If you were not represented by an attorney during the negotiation of this reaffirmation agreement, the agreement cannot be enforced by the creditor unless: (1) you have attended a reaffirmation hearing in the bankruptcy court, and (2) the agreement has been approved by the bankruptcy court. (Court approval is not required if this is a consumer debt secured by a mortgage or other lien on your real estate.)

REAFFIRMATION AGREEMENT

The debtor and creditor named above agree to reaffirm the debt described in this agreement as follows:

THE DEBT

Total amount of debt when case was filed

$

Total amount of debt reaffirmed

$

Above total includes the following:

Interest accrued to date of agreement

$

Attorney fees

$

Late fees

$

Other expenses or costs relating to the collection of this debt (Describe)

$

Annual percentage rate (APR)

%

Amount of monthly payment

$

Date payments start

Total number of payments to be made

Total of Payments if paid according to schedule

Date any lien is to be released if paid according to schedule

The debtor agrees that any and all remedies available to the creditor under the security agreement remain available.

All additional terms agreed by the parties (if any):

Payments of this debt (were)(were not) in default on the date on which this bankruptcy case was filed.

This agreement differs from the original agreement with the creditor as follows:

CREDITOR'S STATEMENT CONCERNING AGREEMENT
AND SECURITY/COLLATERAL

(IF ANY)

Description of Collateral. (If applicable, list manufacturer, year and model):

Value

$

Basis or source for valuation

Current location and use of collateral

Expected future use of collateral

Check applicable boxes:

Any lien described herein is valid and perfected.

This agreement is part of a settlement of a dispute regarding the dischargeability of this debt under section 523 of the Bankruptcy Code (11 U.S.C. § 523) or any other dispute. The nature of dispute is:

DEBTOR'S STATEMENT OF
EFFECT OF AGREEMENT ON DEBTOR'S FINANCES

My monthly income (take home pay plus any other income received) is

$

My current monthly expenses total

$

not including any payment due under this agreement or any debt to be discharged in this bankruptcy case.

I believe this agreement impose an undue hardship on me or my dependents.

DEBTOR'S STATEMENT CONCERNING
DECISION TO REAFFIRM

I agree to reaffirm this debt because

I believe this agreement is in my best interest because

I redeeming the collateral under section 722 of the Bankruptcy Code (11 U.S.C. § 722). I chose not to redeem because

I represented by an attorney during negotiations on this agreement.

CERTIFICATION OF ATTACHMENTS

Any documents which created and perfected the security interest or lien attached. (If documents are not attached: The documents which created and perfected the security interest or lien are not attached because

SIGNATURES

Signature of Debtor

Name of Creditor

Date

Signature of Creditor Representative

Signature of Joint Debtor

Date

Date

CERTIFICATION BY DEBTOR'S ATTORNEY (IF ANY)

I hereby certify that (1) this agreement represents a fully informed and voluntary agreement by the debtor(s); (2) this agreement does not impose a hardship on the debtor or any dependent of the debtor; and (3) I have fully advised the debtor of the legal effect and consequences of this agreement and any default under this agreement.

Signature of Debtor's Attorney, (if any)

Date

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What the Proof of Claim is and when it matters

A Proof of Claim is a formal written statement filed in a bankruptcy case that asserts a creditor’s right to payment from the debtor’s estate. The form identifies the creditor, states the amount owed, indicates whether the claim is secured or unsecured, and describes supporting facts and documents. Courts and appointed claims agents use proofs of claim to determine distributions, resolve priorities, and reconcile creditor schedules. Filing rules and deadlines are set by the bankruptcy court’s notice and the Federal Rules of Bankruptcy Procedure.

Why filing a clear Proof of Claim matters

A properly completed Proof of Claim preserves the creditor’s right to share in distributions, provides the court with necessary claim details, and reduces the risk of disallowance or late claims objections. It also creates a docketed record for later enforcement or settlement.

Why filing a clear Proof of Claim matters

Who typically completes or reviews proofs of claim

Creditors, trustees, and counsel rely on proofs of claim to document and quantify claims against a bankruptcy estate.

  • Individual creditors — File to establish a claim and receive distributions under the confirmed plan.
  • Institutional creditors — Banks and bondholders submit detailed claims with supporting schedules and liens.
  • Attorneys and claims agents — Prepare, file, and reconcile claims on behalf of clients and the estate.

If you represent a creditor, confirm whether the court requires filings via the claims agent, CM/ECF, or another method before preparing the form.

Signing authority and typical filers

Claims Agent

Claims agents handle high-volume claim intake for large cases; they accept electronic filings, maintain claim registers, and coordinate distribution calculations for creditors and the court.

Creditor Representative

An authorized officer, attorney, or designated agent signs or files the Proof of Claim on behalf of a creditor; documentation of authority is often required for corporate filers.

Essential fields to include on the form

Creditor Name: Full legal name
Creditor Address: Street, city, state, ZIP
Case Information: Debtor name and case number
Claim Amount: Principal and total amount
Secured Status: Secured, priority, or unsecured
Supporting Docs: Invoices, contracts, liens

Consequences of errors or missing information

Late Filing: Claim may be disallowed
Incorrect Debtor: Claim deemed inapplicable
Missing Evidence: Trustee may object
Wrong Amount: Subject to reconciliation
Unsigned Form: Rejected or returned
Improper Authority: Proof of authority required

Common preparation pitfalls to avoid

  • Using the debtor’s trade name rather than exact legal name leads to misallocation and potential disallowance by the claims agent or court.
  • Failing to attach supporting invoices, mortgages, or security agreements slows review and often prompts trustee objections or requests for more information.
  • Classifying a secured claim as unsecured (or vice versa) can trigger adversary motions or lien litigation and delay distributions.
  • Relying on a handwritten signature without clear authority documentation risks rejection; electronic submission rules may differ by case and court.

Step-by-step: completing a Proof of Claim

Follow these sequential steps to prepare a complete and accurate Proof of Claim for filing with the bankruptcy court or claims agent.

  • 01
    1. Identify case: Enter debtor name and bankruptcy case number exactly.
  • 02
    2. Provide creditor details: List full legal name, contact, and service address.
  • 03
    3. State claim amount: Break out principal, interest, and fees where required.
  • 04
    4. Attach evidence: Upload contracts, invoices, lien docs as separate attachments.

How and where proofs of claim are routed

A Proof of Claim is filed with the bankruptcy court docket and, when appointed, the court’s claims agent; methods vary by case and district.

  • Claims Agent Filing: Many large cases direct creditors to the claims agent portal.
  • Court Clerk Filing: Some claims may be docketed directly with the clerk.
  • CM/ECF: Attorneys typically file via the court’s CM/ECF system.
  • Email or Mail: Follow the claims notice for permitted alternative methods.

Core sections to include for a professional submission

A complete Proof of Claim presents claim facts clearly and attaches supporting evidence so the trustee, court, and other creditors can verify priority and amount.

Creditor Identity

Provide the creditor’s exact legal name, taxpayer identification if required, and current service address; mismatched names cause processing delays and misapplied distributions.

Case Reference

List the debtor’s full legal name and bankruptcy case number as shown on court notices to ensure the claim posts to the correct docket and claim register.

Amount and Basis

State principal, accrued interest, fees, and the legal or factual basis for the claim (contracts, judgment, lease, tax lien) with a concise explanation.

Security and Priority

Indicate whether the claim is secured (describe collateral) or entitled to priority (e.g., administrative, tax), and include lien documentation or statutory citations where relevant.

Supporting Documents

Attach invoices, contracts, mortgage or UCC filings, and court judgments as separate exhibits labeled to match claim line items for quick review by the claims agent and trustee.

Signature and Authority

Include a dated signature block showing who signed, their title, and proof of signing authority if filing on behalf of a corporate or institutional creditor.

Configuring an online submission workflow

When filing electronically, set authentication, attachments, and notifications to match court rules and the claims agent’s requirements.

Field Configuration
Authentication Method Email link, SMS code, or identity proofing
Attachment Handling Require PDF uploads, size limits, and labeling
Signature Capture Allow typed, drawn, or platform eSignature per court acceptability
Notifications Auto-notify filer, trustee, and claims agent on acceptance

Digital formats and integration considerations

Confirm the acceptable file types, authentication level, and integration needs before preparing an electronic Proof of Claim.

  • Document Formats: PDF preferred; DOCX and scanned images accepted
  • Authentication: Email or SMS codes are common for non-attorney filers
  • Integrations: Common integrations: Salesforce, NetSuite, Google Workspace

Tailor the submission workflow to the court’s notice instructions and the claims agent portal; verify file size limits and labeling requirements in advance.

Key timing items to watch in a bankruptcy matter

Deadlines depend on the court’s scheduling order and the case-specific claims bar notice; read the notice carefully and calendar each date.

Claims Bar Date:

The date set in the official notice; file before this date to preserve distribution rights.

Governmental Unit Deadlines:

Governmental units may have a different bar date under the notice; check the supplement.

Amendment Window:

Courts permit amended claims; timetables vary by local rules and objections.

Objection Period:

Trustee or debtor can object after claims are filed; resolution timing varies.

Distribution Timing:

Distributions follow plan confirmation and claim allowance reconciling processes.

Sequential milestone timeline for a typical claim

A general sequence helps creditors anticipate filing, review, objection, and distribution steps in a bankruptcy case.

01

Case Commencement

Debtor files petition and claims bar date is established by the court.

02

File Proof of Claim

Creditor submits claim before the bar date to preserve rights.

03

Claims Reconciliation

Trustee or claims agent reconciles filed claims with schedules and supporting documents.

04

Plan Confirmation & Distribution

Allowed claims receive distributions following plan confirmation and any appeals.

Comparing common eSignature vendor pricing and capabilities

Compare starting price and core capabilities relevant to Proof of Claim workflows; signNow is listed first per vendor comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Verify Verify Verify Verify
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about Proofs of Claim

Answers to common questions about filing, deadlines, electronic signatures, and supporting documentation for Proofs of Claim.


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