Official Form 427 Cover Sheet For Reaffirmation Agreement Page 3
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310. Debtor’s certification
I certify that each explanation on lines 7-9 is true and correct.
about lines 7-9
If any answer on lines 7-9 is
Yes, the debtor must sign
here.
_______________________________________
_______________________________________
If all the answers on lines 7-9
Signature of Debtor 1
Signature of Debtor 2 (Spouse Only in a Joint Case)
are No, go to line 11.
No
11. Did an attorney represent
the debtor in negotiating
Yes. Has the attorney executed a declaration or an affidavit to support the reaffirmation agreement?
the reaffirmation
No
agreement?
Yes
Part 2:
Sign Here
Whoever fills out this form I certify that the attached agreement is a true and correct copy of the reaffirmation agreement between the
must sign here.
parties identified on this Cover Sheet for Reaffirmation Agreement.
Date
Signature
MM / DD / YYYY
Printed Name
Check one:
Debtor or Debtor’s Attorney
Creditor or Creditor’s Attorney
Official Form 427
Cover Sheet for Reaffirmation Agreement
page 3
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