REAFFIRMATION AGREEMENT

UNITED STATES BANKRUPTCY COURT

_____________ DISTRICT OF _____________

PART 1: AGREEMENT IDENTIFICATION

Section A: Parties to Agreement

DEBTOR INFORMATION:

CREDITOR INFORMATION:

PART 2: DESCRIPTION OF DEBT AND COLLATERAL

Section A: Original Debt Information

Section B: Current Debt Status

Section C: Collateral Description (for Secured Debts)

Type of Collateral:
☐ Motor Vehicle
☐ Real Property (Residence)
☐ Real Property (Other)
☐ Household Goods
☐ Other: _________________________

Detailed Collateral Description:

Section D: Lien Information

PART 3: REAFFIRMATION TERMS

Section A: Payment Terms

Payment Structure:

Payment Method:
☐ Automatic bank draft
☐ Check/money order by mail
☐ Online payment
☐ Other: _________________________

Section B: Comparison of Terms

Terms Modified:
☐ No modification - Same terms as original agreement
☐ Interest rate reduced
☐ Payment amount reduced
☐ Term extended
☐ Principal reduced
☐ Other modifications: _________________________

PART 4: DEBTOR'S STATEMENT OF INCOME AND EXPENSES

Section A: Monthly Income

Section B: Monthly Expenses

Section C: Income and Expense Summary

PART 5: PRESUMPTION OF UNDUE HARDSHIP

Section A: Hardship Determination

Calculate whether presumption of undue hardship applies:

DETERMINATION:

☐ Line C is POSITIVE - No presumption of undue hardship
Court approval may not be required if attorney represented

☐ Line C is NEGATIVE or ZERO - Presumption of undue hardship arises
Court hearing required under 11 U.S.C. § 524(m)

Section B: Explanation of Ability to Pay (If Hardship Presumption Applies)

If the reaffirmation payment exceeds available income, explain how the debtor will make payments:

☐ Expected increase in income (explain): _________________________________
☐ Expected decrease in expenses (explain): _________________________________
☐ Financial assistance from family/friends: _________________________________
☐ Other sources (explain): _________________________________

Detailed Explanation:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

PART 6: REQUIRED DISCLOSURES AND WARNINGS

Section A: Right to Rescind

IMPORTANT: YOU MAY RESCIND (CANCEL) THIS AGREEMENT

☐ I understand that I may rescind this agreement at any time before the bankruptcy court enters my discharge, OR within 60 days after this agreement is filed with the court, whichever is later.

☐ I understand that to rescind, I must give written notice to the creditor.

☐ I understand that rescission will restore the original discharge treatment of this debt.

Section B: Consequences of Reaffirmation

BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND UNDERSTAND:

☐ This debt will NOT be discharged in my bankruptcy case

☐ I will remain personally liable for the full amount of the debt

☐ If I default on payments, the creditor may:
- Pursue collection actions against me
- Repossess the collateral (if secured)
- Sue me for any deficiency balance
- Report the default to credit bureaus

☐ I cannot obtain another Chapter 7 discharge for 8 years

☐ I am voluntarily agreeing to be bound by this debt

☐ I have not been pressured or coerced into signing this agreement

Section C: Alternative Options Disclosure

I UNDERSTAND THAT I HAVE ALTERNATIVES TO REAFFIRMATION:

☐ Surrender the collateral - Return the property and discharge the debt
☐ Redemption - Pay current fair market value in lump sum (11 U.S.C. § 722)
☐ Retain and pay (where permitted) - Continue payments without reaffirming
☐ Negotiate with creditor - Seek better terms before reaffirming

PART 7: ATTORNEY CERTIFICATION (If Represented)

Section A: Attorney Declaration

I, the undersigned attorney, declare under penalty of perjury:

☐ I am the attorney for the debtor(s) in this bankruptcy case

☐ I have fully informed the debtor(s) of the legal consequences of:
- Reaffirming this debt
- Defaulting on this reaffirmation agreement
- The alternatives to reaffirmation

☐ I have explained to the debtor(s) that reaffirmation is voluntary

☐ Based on my analysis of the debtor's income and expenses:

☐ This agreement does not impose an undue hardship on the debtor(s) or their dependents

☐ This agreement may impose hardship, but the debtor(s) can explain their ability to pay

☐ In my opinion, the debtor(s) is/are able to make the required payments under this agreement

☐ I believe this reaffirmation agreement is in the best interest of the debtor(s)

Attorney Certification Regarding Undue Hardship:

☐ The presumption of undue hardship DOES NOT apply (income exceeds expenses plus payment)

☐ The presumption of undue hardship DOES apply, but in my opinion, the debtor can make payments because: _______________________________________________

Attorney Signature: _________________________ Date: _____________

PART 8: DEBTOR(S) SIGNATURE AND CERTIFICATION

Section A: Debtor Statement

I/We, the undersigned debtor(s), declare under penalty of perjury:

☐ I have read and understand this entire reaffirmation agreement

☐ I understand that I am not required to reaffirm this debt

☐ I am reaffirming this debt voluntarily and of my own free will

☐ I understand the consequences of reaffirmation, including:
- Continued personal liability for the debt
- The creditor's right to pursue collection if I default
- That I cannot obtain another Chapter 7 discharge for 8 years

☐ I believe I will be able to make the payments under this agreement

☐ The income and expense information I have provided is true and accurate

☐ I understand my right to rescind this agreement

Represented Debtor Additional Certification:
☐ My attorney has explained this agreement to me and answered my questions

Pro Se Debtor Additional Certification:
☐ I understand that I am entitled to court review and approval of this agreement
☐ I request a hearing before the court to approve this reaffirmation

Section B: Signatures

DEBTOR:

Signature: _________________________ Date: _____________

Printed Name: _________________________

CO-DEBTOR (if applicable):

Signature: _________________________ Date: _____________

Printed Name: _________________________

PART 9: CREDITOR CERTIFICATION

Section A: Creditor Declaration

The creditor named in this agreement certifies:

☐ The debt amount stated in this agreement is accurate as of the date signed

☐ All required disclosures have been provided to the debtor(s)

☐ This agreement complies with 11 U.S.C. § 524(c) and (k)

☐ The terms of reaffirmation are as stated in this agreement

☐ The creditor agrees to be bound by the terms of this agreement

CREDITOR:

Signature: _________________________ Date: _____________

Printed Name: _________________________

Title: _________________________

PART 10: COURT APPROVAL (If Required)

Section A: Circumstances Requiring Court Approval

Court approval is required when:
☐ Debtor is not represented by an attorney
☐ Presumption of undue hardship applies
☐ Agreement involves consumer debt secured by real property (pro se)

Section B: Motion for Court Approval

MOTION FOR APPROVAL OF REAFFIRMATION AGREEMENT

The debtor(s) respectfully move(s) the Court to approve this reaffirmation agreement and state(s):

1. The debtor(s) entered into this agreement knowingly and voluntarily
2. The agreement does not impose undue hardship, OR the debtor(s) can explain ability to pay
3. The agreement is in the debtor's best interest because: _______________________

WHEREFORE, the debtor(s) request(s) that the Court approve this reaffirmation agreement.

STATE-SPECIFIC VARIATIONS

Motor Vehicle Reaffirmations

States with "Retain and Pay" Options:
- Some courts permit debtors to keep vehicles while making payments without formal reaffirmation
- Check local rules and creditor policies

Certificate of Title States:
- May require additional documentation regarding lien release procedures

Real Property Reaffirmations

Recording Requirements:
- Some states require recording of reaffirmation agreements affecting real property liens
- Check local recording requirements

Homestead Exemptions:
- Consider interaction between reaffirmation and homestead exemption laws

State Consumer Protection Laws

Additional Disclosures:
- Some states require additional consumer protection disclosures
- California, New York, and Texas have enhanced disclosure requirements

FILING INSTRUCTIONS

Filing Deadline

☐ File within 60 days after the first date set for the § 341(a) meeting of creditors

Required Documents

☐ Completed Reaffirmation Agreement (this form or Official Form B240A)
☐ Cover Sheet (Official Form B427)
☐ Motion for Court Approval (if pro se or hardship presumption applies)
☐ Proposed Order Approving Reaffirmation (if court approval required)

Service Requirements

☐ Serve copy on creditor
☐ Serve copy on Chapter 7 trustee
☐ Serve copy on U.S. Trustee (if court hearing required)

PRACTICE NOTES FOR ATTORNEYS

Best Interest Analysis

Before recommending reaffirmation, consider:

1. Equity Position - Is there equity in the collateral?
2. Replacement Cost - Would replacing the asset cost more than reaffirmation?
3. Necessity - Is the asset necessary for employment or daily life?
4. Alternative Financing - Can the debtor obtain replacement financing post-discharge?
5. Payment History - Has the debtor been current on payments?

Red Flags for Reaffirmation

☐ Negative equity (debt exceeds value)
☐ High interest rate with no reduction offered
☐ Debtor cannot afford payments
☐ Multiple reaffirmations depleting disposable income
☐ Asset is not essential

Common Issues

1. Creditor fails to file agreement timely
2. Missing signatures or certifications
3. Incomplete income/expense disclosure
4. Court denies agreement for undue hardship
5. Debtor's circumstances change before discharge

This template is designed to assist in preparing reaffirmation agreements pursuant to 11 U.S.C. § 524. Local rules may impose additional requirements. Always verify current filing deadlines and procedures with the local bankruptcy court.