Fill and Sign the Summary of Reaffirmation Agreement Maryland Form

UNITED STATES COURT APPENDIX BANKRUPTCY A DISTRICT OF MARYLAND SUMMARY OF REAFFIRMATION AGREEMENT Name of Debtor(s)       Case No       INSTRUCTIONS 1. Complete debtor’s name and bankruptcy case number above. 2. PART A - Complete each item. Both the debtor(s) and creditors must sign. 3. PART B – Must be signed by attorney who represented debtor during course of negotiating the reaffirmation agreement and should be left blank if the debtor had no attorney for negotiation of the agreement. 4. File the fully completed form by mailing or delivering it to: Clerk, United States Bankruptcy Court. PART A – AGREEMENT Creditor’s Name and Address       Terms of New Agreement a) Amount Principal$       Interest Rate (APR)       Monthly Payments $       b) Security (collateral) Description:             Present Market Value $       Reason for Entry into Agreement       The parties understand that this agreement is purely voluntary and that the debtor(s) may rescind the agreement by giving notice of rescission to the creditor at any time prior to discharge of within sixty (60) days after such agreement is filed with the clerk, whichever occurs later. This agreement was entered into before the date of discharge in the above case. DATE: Creditor’s Signature Debtor’s Signature Joint Debtor’s Signature, if applicable PART B – ATTORNEY’S DECLARATION I declare under penalty of perjury that: (a) this agreement represents a fully informed and voluntary agreement by the debtor; (b) this agreement does not impose an undue hardship upon the debtor or a dependent of the debtor; and (c) I fully advised the debtor of the effect and consequences of this agreement and the consequences of any default under this agreement. Date: Signature of Debtor’s Attorney