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Reaffirmation Agreement Coversheet (For Cases Filed On Or After 10-17-05) 718.05 - Oregon
| Reaffirmation Agreement Coversheet (For Cases Filed On Or After 10-17-05) Form. This is a Oregon form and can be used in Bankruptcy Court Federal . |
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UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) ) ) ) ) ) ) ) ) e e Case No. _________________ REAFFIRMATION AGREEMENT COVER SHEET [NOTE: YOU MUST FULLY COMPLETE ALL BLANKS ON THIS FORM AND ATTACH COPIES OF ALL DOCUMENTS REQUIRED BELOW. Debtor(s) IF DOCUMENTS ARE DEFICIENT IN ANY WAY, THEY WILL BE RETURNED AND WILL NOT BE CONSIDERED BY THE COURT!] 1.e CREDITOR NAME: _____________________________________________________________________________________ 2.e CREDITOR ADDRESS: __________________________________________________________________________________ e 3.e PROPOSED: PRINCIPAL: $____________ INTEREST RATE: ______% per annum MONTHLY PAYMENT: $____________ 4. 5. DESCRIPTION OF SECURITY: _____________________________________________________________________________ (If none, so indicate) PRESENT MARKET VALUE OF SECURITY: $_________________________________________________________________ e 6.e MAXIMUM MONTHLY PAYMENT REQUIRED UNDER THIS REAFFIRMATION AGREEMENT: $___________ 7. TOTAL MONTHLY INCOME FROM SCHEDULE I: TOTAL MONTHLY INCOME LISTED ON $___________ REAFFIRMATION AGREEMENT: TOTAL MONTHLY EXPENSES LISTED ON $___________ REAFFIRMATION AGREEMENT: TOTAL MONTHLY PAYMENTS ON DEBTS NOT INCLUDED IN EXPENSES LISTED ON $___________ REAFFIRMATION AGREEMENT: NET MONTHLY INCOME (Total monthly income listed on Reaffirmation Agreement and in pt. 7 MINUS the total of BOTH the Monthly Expenses listed in pt. 8 AND in pt. 9. NOTE: If this total is $___________ less than zero, put the number in brackets): $___________ $___________ 8.e TOTAL MONTHLY EXPENSES FROM SCHEDULE J: 9. TOTAL MONTHLY PAYMENTS ON REAFFIRMED DEBTS NOT LISTED ON SCHEDULE J: NET MONTHLY INCOME (Schedule I Total Monthly Income in pt. 7 MINUS the total of BOTH the Monthly Expenses in pt. 8 AND in pt. 9. NOTE: If this total is less than zero, put the number in brackets): $___________ 10. $___________ ____NO 11. IS UNDUE HARDSHIP PRESUMED? (NOTE: Mark "YES" if EITHER amount in pt. 10 is less than zero): ____YES I, THE UNDERSIGNED, CERTIFY UNDER PENALTY OF PERJURY THAT: (1) The original reaffirmation agreement using Local Form #718.5 IS ATTACHED; (2) the reaffirmation agreement controls if there are any discrepancies between it and this LBF #718.05; AND (3) all of the above information is true and correct. ______________________________________________________ Signature ____________________________________________________ Print/Type Name & Signer's Relation to Case OSB# (if atty.) 718.05 (3/1/06) American LegalNet, Inc. www.USCourtForms.com
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