Official Form 427 Cover Sheet For Reaffirmation Agreement
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1
2
3Fill in this information to identify your case:
Debtor 1
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
__________
__________
United States Bankruptcy Court for the:
District of
Case number
(If known)
Official Form 427
Cover Sheet for Reaffirmation Agreement
12/15
Anyone who is a party to a reaffirmation agreement may fill out and file this form. Fill it out completely, attach it to the reaffirmation agreement,
and file the documents within the time set under Bankruptcy Rule 4008.
Part 1:
Explain the Repayment Terms of the Reaffirmation Agreement
1. Who is the creditor?
Name of the creditor
2. How much is the debt?
On the date that the bankruptcy case is filed
$
To be paid under the reaffirmation agreement $
$
per month until paid in full
$
per month until paid in full
$
per month until paid in full
$
per month until paid in full
3. What is the Annual
Before the bankruptcy case was filed
%
Percentage Rate (APR)
of interest? (See
Bankruptcy Code
Under the reaffirmation agreement
%
Fixed rate
§ 524(k)(3)(E).)
Adjustable rate
What is the Annual
Before the bankruptcy case was filed
%
Percentage Rate (APR)
of interest? (See
Bankruptcy Code
Under the reaffirmation agreement
%
Fixed rate
§ 524(k)(3)(E).)
Adjustable rate
What is the Annual
Before the bankruptcy case was filed
%
Percentage Rate (APR)
of interest? (See
Bankruptcy Code
Under the reaffirmation agreement
%
Fixed rate
§ 524(k)(3)(E).)
Adjustable rate
What is the Annual
Before the bankruptcy case was filed
%
Percentage Rate (APR)
of interest? (See
Bankruptcy Code
Under the reaffirmation agreement
%
Fixed rate
§ 524(k)(3)(E).)
Adjustable rate
Official Form 427
Cover Sheet for Reaffirmation Agreement
page 1
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