Fill and Sign the Reaffirmation Agreement Form

IN THE UNITED STATE BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF MISSISSIPPI IN RE:       CASE NO:       REAFFIRMATION AGREEMENT Debtor(s) and creditor hereby announce their desire to enter into a reaffirmation agreement on the below stated debt which disdischargeable under Chapter 7 or Title 11 of the United States Code. NAME & ADDRESS OF CREDITOR SECURITY REAFFIRMATION AMOUNT MONTHLY PAYMENT                                                                         In consideration of the Debtor’s(s) new promise to pay the above sum as herein stated and the Debtor’s(s) retention of the subject security, this agreement is hereby made after notice to the Debtor(s) as follows: NOTICE TO DEBTOR(S) THIS AGREEEMENT IS NOT REQUIRED UNDER THE BANKRUPTCY CODE, UNDER NONBANKRUPTCY LAW OR UNDER ANY OTHER AGREEMENT WHICH IS NOT IN ACCORDANCE WITH THE PROVISIONS OF 11U.S.C. § 524 (C). THIS AGREEMENT MAY BE RESCINDED AT ANY TIME PRIOR TO DISCHARGE OR WITHIN 60 DAYS AFTER SUCH AGREEMENT IS FILED WITH THE COURT, WHICHEVER OCCURS LATER, BY GIVING NOTICE OF RESCISSION TO THE ABOVE STATED SECURED CREDITOR. DECLARATION OF ATTORNEY I,       , attorney for Debtor(s) do hereby declare or affirm that I represented the Debtor(s) during the court of negotiating this reaffirmation agreement and that: 1. I fully advised the Debtor(s) of the legal effect and consequences of entering into this reaffirmation agreement and of the legal effect and consequences of any default under this reaffirmation agreement. 2. This reaffirmation agreement represents a fully informed and voluntary agreement by the Debtor(s) and does not impose an undue hardship on the Debtor(s) or a dependent of the Debtor(s). ________________________________ ATTORNEY FOR DEBTOR(S) DATED this the       day of       ,       . _________________________________ ______________________________ DEBTOR CREDITOR _________________________________ DEBTOR TRUSTEE’S ABANDONMENT I, the duly appointed Trustee in the above styled case, hereby certify that there is no equity in the above described property for the benefit of the estate, and I hereby abandon said property. DATED this the       day of       ,       . _________________________________ TRUSTEE