Form 240a Sample - Reaffirmation Agreement Page 7
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10Form 240A - Reaffirmation Agreement (Cont.)
6
PART B: REAFFIRMATION AGREEMENT.
I (we) agree to reaffirm the debts arising under the credit agreement described below.
1. Brief description of credit agreement:
Description of credit agreement must be included here.
2. Description of any changes to the credit agreement made as part of this reaffirmation
agreement:
SIGNATURE(S):
Creditor's name
(not just the name
of the person who
Borrower:
Accepted by creditor:
signed for the
creditor) must
appear here
Debtor must
______________________________
______________________________
sign here
(Print Name)
(Printed Name of Creditor)
______________________________
______________________________
(Signature)
(Address of Creditor)
Creditor must
Date: ________________
______________________________
sign here
(Signature)
Joint debtor
Co-borrower, if also reaffirming these debts:
______________________________
must sign
here IF it's a
____________________________
(Printed Name and Title of Individual
joint reaf
(Print Name)
Signing for Creditor)
____________________________
(Signature)
Date of creditor acceptance:
Date: ________________
_______________________
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