Fill and Sign the South Dakota Agreement Form

UNITED STATES BANKRUPTCY COURT DISTRICT OF SOUTH DAKOTA       Division In re: ) Bankr. No.       ) Chapter             ) Soc. Sec. No.       ) REAFFIRMATION AGREEMENT AND ) DECLARATION OF ATTORNEY Debtor. ) (UNSECURED DEBT) 1 1. Debtor       and Creditor       agree that Debtor reaffirms the debt (s)he owes to Creditor. 2. This debt is unsecured. 3. Debtor agrees to pay Creditor principal of $       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       . The principal amount does not include any attorney fees or other costs incurred by the Creditor. 5 4. Debtor wishes to reaffirm this unsecured debt because       has personally guaranteed it. 5 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 This agreement may be rescinded at any time prior to discharge or within 60 days after it is filed with the Court, whichever occurs later, by giving written notice of rescission to Creditor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 penalty 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 impose 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 debt 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 Act, 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 guidance on amending a Statement of Intention. 3. 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. 4. If the principal amount being reaffirmed includes attorney fees or other costs, the last sentence of ¶ 2 should be changed to: “The principal amount includes attorney fees of $       and costs of $       incurred by Creditor.” 5. Include an explanation of why the debtor wishes to reaffirm an unsecured debt (e.g., the debt may be non-dischargeable, the creditor will extend the debtor new credit, the debtor wishes to protect a co-debtor, etc.). 6. Omit the Declaration of Attorney if the debtor is not represented by an attorney.