Reaffirmation Agreement Template (Official Forms 2400A/B ALT and 427)

REAFFIRMATION AGREEMENT — COMPREHENSIVE TEMPLATE

Worksheet for Official Forms 2400A/B ALT and Official Form 427 (Cover Sheet)

This is a comprehensive worksheet covering all components of a reaffirmation agreement filing under 11 U.S.C. § 524. A reaffirmation agreement is an agreement between a debtor and a creditor that the debtor will remain personally liable for a particular debt, notwithstanding the discharge. This worksheet incorporates the Cover Sheet (Form 427), Part A (Disclosures), Part B (Agreement), Part C (Attorney Certification), Part D (Debtor's Statement in Support), and Part E (Motion for Court Approval). Transfer finalized content to the Official Forms before filing.

PART 0: COVER SHEET FOR REAFFIRMATION AGREEMENT (Official Form 427)

UNITED STATES BANKRUPTCY COURT
FOR THE [________________________________] DISTRICT OF [________________________________]

In re:

Debtor 1: [________________________________]
Debtor 2 (if joint case): [________________________________]

Case No.: [________________________________]

Chapter: 7

Cover Sheet Information

1. Name of Creditor: [________________________________]

2. Amount of debt reaffirmed: $[________________________________]

3. Annual percentage rate of interest: [____]%
   ☐ Fixed rate
   ☐ Variable rate

4. Does a presumption of undue hardship arise? (See Part D)
   ☐ Yes
   ☐ No

5. Is the debtor represented by an attorney in connection with the reaffirmation agreement?
   ☐ Yes — Attorney certification required (Part C)
   ☐ No — Court approval required (Part E); hearing will be scheduled unless the debt is secured by real property

6. Type of debt:
   ☐ Consumer debt secured by real property (e.g., mortgage)
   ☐ Consumer debt not secured by real property
   ☐ Non-consumer debt

7. Is the debt secured?
   ☐ Yes — Describe collateral: [________________________________]
   ☐ No

8. Was the agreement filed within 60 days after the first date set for the meeting of creditors under 11 U.S.C. § 341(a)?
   ☐ Yes
   ☐ No — Explain: [________________________________]

PART A: DISCLOSURES — SUMMARY OF REAFFIRMATION AGREEMENT (11 U.S.C. § 524(k))

A.1 Amount Reaffirmed

The amount of debt you are agreeing to reaffirm:

Itemized fees and costs:

• Late charges: $[________________________________]
• Attorney fees: $[________________________________]
• Collection costs: $[________________________________]
• Other (specify): $[________________________________]

A.2 Annual Percentage Rate

The Annual Percentage Rate (APR) applicable to the reaffirmed debt:

APR: [____]%

☐ This is a fixed rate
☐ This is a variable rate

• Index: [________________________________]
• Margin: [____]%
• Current rate: [____]%
• Maximum rate: [____]%

(The APR must be disclosed in accordance with the Truth in Lending Act, 15 U.S.C. § 1601 et seq., and Regulation Z, 12 C.F.R. Part 1026.)

A.3 Repayment Schedule

Monthly payment amount: $[________________________________]

Payment due date: The [____] day of each month

Date of first payment: [__/__/____]

Date of last payment: [__/__/____]

Total number of payments: [____]

Total amount to be paid over life of the agreement (including interest): $[________________________________]

☐ A complete repayment schedule is attached as Exhibit A

A.4 Security Interest (if applicable)

☐ The debt is secured by a lien on the following property:

Description of collateral: [________________________________]

Collateral type:
☐ Motor vehicle — Year: [____] Make: [________________________________] Model: [________________________________] VIN: [________________________________]
☐ Real property — Address: [________________________________]
☐ Household goods/furnishings — Description: [________________________________]
☐ Electronics/appliances — Description: [________________________________]
☐ Other — Description: [________________________________]

Original purchase price of collateral: $[________________________________]
Current estimated value of collateral: $[________________________________]
Amount owed on collateral (including this debt): $[________________________________]

A.5 Required Debtor Disclosures

YOU ARE NOT REQUIRED TO REAFFIRM ANY DEBT. The following important information must be understood before signing this agreement:

Right to Rescind: You have the right to rescind (cancel) this reaffirmation agreement at any time before the bankruptcy court enters your discharge order, or within 60 days after this agreement is filed with the court, whichever occurs later. To rescind, you must notify the creditor that the agreement is rescinded.

Effect of Reaffirmation: If you reaffirm a debt, you give up the protection of your bankruptcy discharge for that debt. You will remain personally liable for the full amount of the reaffirmed debt. If you default, the creditor may be able to collect the debt from you personally, including through wage garnishment, bank levy, or lawsuit.

Liens Survive Discharge: Even if you do not reaffirm a debt, a creditor's lien on your property generally survives the bankruptcy discharge. However, the creditor cannot pursue you personally for any deficiency unless you reaffirm.

Alternatives to Reaffirmation:

• Redemption (11 U.S.C. § 722): You may redeem certain tangible personal property intended primarily for personal, family, or household use by paying the creditor the full amount of the allowed secured claim in a single lump-sum payment.
• Surrender: You may surrender the collateral to the creditor and discharge the debt.
• Retain and pay: In some circuits, you may retain the property and continue making payments without reaffirming (often called the "ride-through" option), though this is not available in all jurisdictions.

PART B: REAFFIRMATION AGREEMENT

B.1 The Agreement

This Reaffirmation Agreement is entered into between:

Creditor:
Name: [________________________________]
Address: [________________________________]
City: [________________________________] State: [____] Zip: [__________]
Telephone: [________________________________]
Account Number: [________________________________]

Debtor 1:
Name: [________________________________]
Address: [________________________________]
City: [________________________________] State: [____] Zip: [__________]

Debtor 2 (if applicable):
Name: [________________________________]
Address: [________________________________]
City: [________________________________] State: [____] Zip: [__________]

B.2 Terms

1. The Debtor agrees to reaffirm and pay to the Creditor the amount of $[________________________________], which represents the amount described in Part A above.

2. The Debtor agrees to pay this amount according to the following terms:
   ☐ Under the same terms as the original agreement (a copy of which is attached as Exhibit B)
   ☐ Under modified terms as follows:

• Monthly payment: $[________________________________]
• Interest rate: [____]%
• Duration: [____] months
• Other modified terms: [________________________________]

3. No additional fees or charges: The creditor shall not impose any additional fees, charges, or costs beyond those disclosed in Part A of this agreement, except as permitted by applicable non-bankruptcy law.

4. Default provisions: In the event of default, the creditor may exercise all rights and remedies available under applicable non-bankruptcy law, including but not limited to:
   ☐ Acceleration of the remaining balance
   ☐ Repossession of collateral (if secured)
   ☐ Collection of the full amount owed
   ☐ Reporting default to credit bureaus
   ☐ Other: [________________________________]

5. Voluntary agreement: The Debtor acknowledges that this agreement is voluntary and is not required by any provision of the Bankruptcy Code, title 11 of the United States Code, or by any other law.

B.3 Signatures to the Agreement

Creditor:

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

Title: [________________________________]

Debtor 1:

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

Debtor 2 (if joint):

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

PART C: CERTIFICATION BY DEBTOR'S ATTORNEY (11 U.S.C. § 524(c)(3))

(This part is required ONLY if the debtor is represented by an attorney in connection with this reaffirmation agreement. If the debtor is not represented, skip to Part E.)

I, [________________________________], attorney for the Debtor(s), hereby certify as follows:

1. ☐ I have fully advised the debtor(s) of the legal effect and consequences of this Reaffirmation Agreement.

2. ☐ I have fully advised the debtor(s) of the legal effect and consequences of any default under this Reaffirmation Agreement.

3. ☐ This Reaffirmation Agreement represents a fully informed judgment of the debtor(s).

4. ☐ This Reaffirmation Agreement does not impose an undue hardship on the debtor(s) or any dependent of the debtor(s).

5. ☐ The debtor(s) entered into this Reaffirmation Agreement voluntarily and without coercion.

If there is a presumption of undue hardship (Part D, Section D.4):

☐ I have explained to the debtor(s) that there is a presumption of undue hardship arising from the debtor's income and expense information.

☐ In my opinion, the debtor(s) is/are able to make the required payments because: [________________________________]

[________________________________]

[________________________________]

Attorney Signature:

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

Bar Number: [________________________________]

State(s) of Admission: [________________________________]

Firm: [________________________________]

Address: [________________________________]

City: [________________________________] State: [____] Zip: [__________]

Telephone: [________________________________]

Email: [________________________________]

PART D: DEBTOR'S STATEMENT IN SUPPORT OF REAFFIRMATION AGREEMENT

D.1 Monthly Income

(Complete this section using information from Schedule I or updated figures.)

☐ Schedule I has not changed since filing — amounts are as stated in Schedule I
☐ Schedule I has changed — updated figures are reflected above

D.2 Monthly Expenses

(Complete this section using information from Schedule J or updated figures.)

☐ Schedule J has not changed since filing — amounts are as stated in Schedule J
☐ Schedule J has changed — updated figures are reflected above

D.3 Net Monthly Income Available for Reaffirmation Payments

D.4 Presumption of Undue Hardship Analysis (11 U.S.C. § 524(m))

A presumption of undue hardship arises if the debtor's monthly income less monthly expenses (D.3) is less than the scheduled payment on the reaffirmed debt.

Monthly net income (from D.3): $[________________________________]
Monthly reaffirmation payment: $[________________________________]

☐ No presumption of undue hardship — Net income exceeds or equals the reaffirmation payment
☐ Presumption of undue hardship arises — Net income is less than the reaffirmation payment

If presumption arises, the debtor must explain how payments will be made:

I can make the payments on this reaffirmed debt because: [________________________________]

[________________________________]

[________________________________]

(Examples: additional sources of income not listed above, anticipated increase in income, ability to reduce expenses, contribution from non-debtor spouse or family member, creditor has agreed to reduced payment.)

D.5 Debtor's Certification

I/We declare under penalty of perjury:

☐ I/We have read and understand all of the disclosures in this Reaffirmation Agreement.
☐ This agreement does not require me/us to pay more than the amount described in Part A.
☐ I/We can afford to make the payments on the reaffirmed debt.
☐ I/We understand that I/we may rescind this agreement at any time before my/our discharge is entered, or within 60 days after this agreement is filed with the court, whichever is later.
☐ I/We were not required to reaffirm this debt.
☐ I/We believe this agreement is in my/our best interest because: [________________________________]

[________________________________]

Debtor 1 Signature:

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

Debtor 2 Signature (if applicable):

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

PART E: MOTION FOR COURT APPROVAL OF REAFFIRMATION AGREEMENT

(This part is required ONLY if the debtor is NOT represented by an attorney and the debt is a consumer debt NOT secured by real property. See 11 U.S.C. § 524(c)(6).)

E.1 Motion

The Debtor respectfully moves the Court for approval of the Reaffirmation Agreement attached hereto and states as follows:

1. On [__/__/____], the Debtor filed a voluntary petition for relief under Chapter 7 of the Bankruptcy Code. The case number is [________________________________].

2. The Debtor seeks to reaffirm a debt owed to [________________________________] ("Creditor") in the amount of $[________________________________].

3. The debt is:
   ☐ Secured by: [________________________________]
   ☐ Unsecured

4. The Debtor is not represented by an attorney in connection with this Reaffirmation Agreement.

5. The Debtor believes this Reaffirmation Agreement:
   ☐ Does not impose an undue hardship on the Debtor or any dependent of the Debtor
   ☐ Is in the best interest of the Debtor because: [________________________________]

[________________________________]

6. The Debtor requests the Court schedule a hearing on this Motion pursuant to 11 U.S.C. § 524(d).

E.2 Grounds for Approval

The Debtor respectfully requests the Court approve this agreement based on the following:

☐ The agreement does not impose an undue hardship on the debtor or any dependent of the debtor
☐ The agreement is in the best interest of the debtor
☐ The debtor was fully informed of the legal effect and consequences of the agreement
☐ The debtor voluntarily entered into the agreement

E.3 Signature

Signature: _________________________________ Date: [__/__/____]

Printed Name: [________________________________]

Address: [________________________________]

City: [________________________________] State: [____] Zip: [__________]

Telephone: [________________________________]

COURT APPROVAL ORDER

(For court use where debtor is unrepresented or where a presumption of undue hardship arises and is not rebutted.)

ORDER ON REAFFIRMATION AGREEMENT

The Court, having reviewed the Reaffirmation Agreement between the Debtor(s) and [________________________________] ("Creditor"), and having conducted a hearing on [__/__/____] pursuant to 11 U.S.C. § 524(d), finds:

☐ The Reaffirmation Agreement is in the best interest of the debtor(s).
☐ The Reaffirmation Agreement does not impose an undue hardship on the debtor(s) or any dependent of the debtor(s).
☐ The debtor(s) voluntarily entered into the agreement.
☐ The debtor(s) was/were fully informed of the consequences of the agreement.

IT IS THEREFORE ORDERED that the Reaffirmation Agreement is:

☐ APPROVED
☐ DISAPPROVED for the following reason(s): [________________________________]

Date: [__/__/____]

_________________________________
[________________________________], United States Bankruptcy Judge

PRACTITIONER NOTES AND PRACTICE TIPS

Key Timing Requirements

1. Filing Deadline: Under Fed. R. Bankr. P. 4008(a), the reaffirmation agreement must be filed no later than 60 days after the first date set for the meeting of creditors under 11 U.S.C. § 341(a). The court may extend this deadline on motion for cause.

2. Rescission Period: The debtor may rescind the agreement at any time before discharge is entered or within 60 days after the agreement is filed with the court, whichever occurs later. 11 U.S.C. § 524(c)(2).

3. Discharge Timing: The agreement must be made before the granting of the discharge. 11 U.S.C. § 524(c)(1). If the agreement is filed after discharge, it is unenforceable.

4. Statement of Intention: Individual Chapter 7 debtors must file a Statement of Intention (Official Form 108) within 30 days of filing or by the date of the 341 meeting, whichever is earlier, indicating whether they intend to reaffirm, redeem, or surrender for each secured debt. 11 U.S.C. § 521(a)(2).

When Court Approval Is Required

• Unrepresented debtor with consumer debt not secured by real property: Court approval is required under 11 U.S.C. § 524(c)(6). The court must find the agreement does not impose undue hardship and is in the debtor's best interest.
• Presumption of undue hardship not rebutted: If a presumption of undue hardship arises under 11 U.S.C. § 524(m) and the debtor does not adequately rebut it, the court must hold a hearing before the discharge order is entered.
• Credit union exception: Under 11 U.S.C. § 524(m)(2), the presumption of undue hardship does not apply to agreements with credit unions as defined in 12 U.S.C. § 1752(1).

Critical Practice Considerations

1. APR disclosure requirements: The annual percentage rate must be disclosed using the same method required by the Truth in Lending Act (15 U.S.C. § 1606). Failure to properly disclose the APR may render the agreement unenforceable.

2. Updated Schedules I and J: If the debtor's income or expenses have changed since the petition was filed, updated financial information must be provided. Courts closely scrutinize the debtor's ability to make payments.

3. Creditor's obligation: The creditor must provide Part A disclosures to the debtor before the agreement is signed. The creditor typically prepares the reaffirmation agreement and provides it to the debtor or debtor's counsel.

4. Multiple reaffirmation agreements: A debtor may enter into multiple reaffirmation agreements in a single case. Each must be separately analyzed for undue hardship.

5. Motor vehicle reaffirmations: These are the most common reaffirmation agreements. Consider whether the vehicle's value supports the reaffirmed amount and whether the debtor truly needs the vehicle.

COMMON PITFALLS

1. Filing after discharge. A reaffirmation agreement filed after the discharge order is entered is unenforceable. Monitor the discharge deadline closely and ensure the agreement is filed before discharge.

2. Incomplete attorney certification. If the debtor is represented, the attorney must certify all four elements under § 524(c)(3). An incomplete certification renders the agreement defective and may require a hearing.

3. Failing to address the presumption of undue hardship. If the presumption arises (net income is less than the reaffirmation payment), the debtor must provide an adequate explanation or the court may disapprove the agreement.

4. Omitting the cover sheet. Official Form 427 (Cover Sheet for Reaffirmation Agreement) must be filed with the reaffirmation documents. Many clerks will reject filings without it.

5. Not advising the debtor of alternatives. Debtors should be informed of their alternatives — surrender, redemption, and (where available) ride-through — before signing the agreement.

6. Reaffirming unsecured debt without justification. Reaffirming unsecured debt is rarely in the debtor's interest and courts may disapprove such agreements for unrepresented debtors.

7. Missing the 60-day filing deadline. Under Fed. R. Bankr. P. 4008(a), failure to file within 60 days of the meeting of creditors may result in the agreement being rejected. File a motion for extension before the deadline passes.

8. Creditor adding undisclosed fees. The reaffirmation agreement must disclose all amounts to be reaffirmed. Post-agreement fees or charges not disclosed in Part A may be unenforceable.

STATE-SPECIFIC VARIATION NOTES

While reaffirmation agreements are governed by federal law (11 U.S.C. § 524), local rules and judicial practices vary by district:

California (C.D. Cal., N.D. Cal., S.D. Cal., E.D. Cal.):

• California does not allow the "ride-through" option (In re Dumont, 581 F.3d 1104 (9th Cir. 2009)), making reaffirmation or redemption more important for debtors who wish to keep secured property.
• The Central District requires a hearing for all reaffirmation agreements where a presumption of undue hardship arises, even if the debtor is represented.
• California local forms may supplement the federal forms; check the local court website for any required local cover sheets or orders.

Texas (N.D. Tex., S.D. Tex., E.D. Tex., W.D. Tex.):

• The Fifth Circuit has held that the "ride-through" or "retain and pay" option is generally not available (In re Johnson, 89 F.4th 467 (5th Cir. 2024)), making reaffirmation the primary mechanism for keeping secured property.
• Texas districts may require the creditor to submit the reaffirmation agreement directly or through the debtor's attorney.
• Local rules may establish specific scheduling procedures for reaffirmation hearings.

Florida (S.D. Fla., M.D. Fla., N.D. Fla.):

• The Eleventh Circuit permits the "ride-through" option in some circumstances, allowing debtors to retain property and continue payments without reaffirming (In re Failla, 838 F.3d 1170 (11th Cir. 2016)).
• Florida districts may have local forms for the order approving or disapproving the reaffirmation agreement.
• The Southern District may impose additional requirements for reaffirmation hearings involving vehicle loans.

New York (S.D.N.Y., E.D.N.Y., N.D.N.Y., W.D.N.Y.):

• The Second Circuit permits the "ride-through" option, making reaffirmation less critical for debtors who wish to retain property and continue payments.
• S.D.N.Y. and E.D.N.Y. have specific scheduling procedures for reaffirmation hearings under their local rules.
• New York districts may require additional documentation or certification from the creditor's attorney.
• Standing orders in some New York districts may set specific requirements for motor vehicle reaffirmation agreements.

FILING INSTRUCTIONS

1. Determine representation status. Identify whether the debtor is represented by an attorney for purposes of the reaffirmation agreement.
2. Obtain creditor disclosures. The creditor should prepare Part A (Disclosures) and Part B (Agreement) and provide them to the debtor or debtor's attorney.
3. Complete the financial statement. Prepare Part D (Debtor's Statement in Support) with current income and expense information.
4. Attorney certification. If the debtor is represented, the attorney must complete Part C (Certification).
5. Unrepresented debtor motion. If the debtor is not represented and the debt is a consumer debt not secured by real property, complete Part E (Motion for Court Approval).
6. Complete the Cover Sheet. Prepare Official Form 427 (Cover Sheet for Reaffirmation Agreement).

7. File the reaffirmation packet with the bankruptcy court via CM/ECF. The packet should include:

   • Official Form 427 (Cover Sheet)
   • Part A (Disclosures)
   • Part B (Reaffirmation Agreement, with signatures)
   • Part C (Attorney Certification) OR Part E (Motion for Court Approval)
   • Part D (Debtor's Statement in Support)

8. Serve copies on the debtor, the creditor, and the Chapter 7 trustee.

9. File a certificate of service documenting service on all required parties.
10. Monitor for hearing. If a hearing is required (unrepresented debtor or presumption of undue hardship), monitor the court docket for the hearing date.
11. Confirm before discharge. Verify that the agreement is properly filed and, if necessary, approved before the discharge order is entered.

SOURCES AND REFERENCES

• Official Form 2400A/B ALT (Reaffirmation Agreement): U.S. Courts
• Official Form 2400A Instructions: U.S. Courts
• Official Form 427 (Cover Sheet): U.S. Courts
• 11 U.S.C. § 524 (Effect of Discharge): Cornell LII
• Fed. R. Bankr. P. 4008: Cornell LII
• District of Rhode Island Reaffirmation Guide: U.S. Bankruptcy Court, D.R.I.
• Northern District of Iowa Reaffirmation Agreements: U.S. Bankruptcy Court, N.D. Iowa
• District of Hawaii Reaffirmation Agreements: U.S. Bankruptcy Court, D. Haw.