CSD 1231 [01/27/06] Name, Address, & Telephone No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West "F" Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. NOTICE OF HEARING AND MOTION ON AGREEMENT TO REAFFIRM A DEBT TO CREDITOR: (Name and Address of Creditor) ATTORNEY FOR DEBTOR, IF ANY: (Name and Address of Debtor’s Attorney) TRUSTEE: (Name and Address of Chapter 7 Trustee) UNITED STATES TRUSTEE: 402 West Broadway, Suite 600, San Diego, California 92101 The undersigned debtor(s) affirm the following to be true and correct: I believe this reaffirmation agreement is in my best interest based on the income and expenses I have disclosed in my Statement in Support of the reaffirmation agreement, and because (provide any additional relevant reasons the court should consider): I ask the court for an order approving this reaffirmation agreement. PLEASE TAKE NOTICE that a hearing for approval of the accompanying Reaffirmation Agreement pertaining to the debt of the creditor named above has been calendared for: HEARING DATE: HEARING TIME: The hearing will be held in Department No. , Room , of the Jacob Weinberger United States Courthouse, located at 325 West "F" Street, San Diego, California 92101-6991. I hereby declare under penalty of perjury that on this date a copy of this Notice and the accompanying Reaffirmation Agreement were mailed to the above named person(s). DATED: Signature of Debtor CSD 1231 Signature of Joint Debtor, if any American LegalNet, Inc. www.USCourtForms.com