COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Rev. 2/2000 Index No. UNITED STATES BANKRUPTCY COURT : Calendar No. EASTERN DISTRICT OF NORTH CAROLINA Division Plaintiff(s) : JUDICIAL SUBPOENA REAFFIRMATION AGREEMENT -againstDebtor’s Name : Bankruptcy Case No. : Chapter : Defendant(s) : Creditor’s .Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and Address Instructions: PEOPLE OF copy of all court judgments, security agreements, and evidence of their perfection THE 1) Attach a THE STATE OF NEW YORK 2) File all the documents by mailing them or delivering them to the Clerk of the Bankruptcy Court TO NOTICE TO DEBTOR This agreement gives up the protection of your bankruptcy discharge for this debt. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you you do of pay the agreed As a result of this agreement, the creditor may be able to take your property or wages if and eachnot you attend before , theThe creditor may also act to collect the debt in other ways. Honorable at the Court amounts. located at County of in rescind (cancel), thisthe room on agreement at any time before the ,bankruptcy court in the a discharge order orrecessed day of , 20 at o'clock enters noon, and at any You may or days after date,agreement is give evidence as a witness in this is later, by notifying the creditor that the adjourned this to testify and filed with the court, whichever action on the part of the within 60 agreement is canceled. You are not required to enterto complyagreement by any law. It is not as a contempt of Bankruptcy Code, by any Your failure into this with this subpoena is punishable required by the court and will make you liable to other law, or by anywhose behalf this another reaffirmation agreement made in accordance withdamages sustained as a the party on contract (except subpoena was issued for a maximum penalty of $50 and all Bankruptcy Code result § 524(c)). of your failure to comply. You are allowed to pay this debt without signing this agreement. However, if you doof the Justices agreement and Witness, Honorable , one not sign this of the are laterCourt in or unable County,the full amount, the creditor will not be able to collect it from you. The unwilling to pay day of , 20 creditor also will not be allowed to take your property to pay the debt unless the creditor has a lien on that property. (Attorney must sign above and type name below) If the creditor has a lien on your personal property, you may have a right to redeem the property and eliminate the lien by making a single payment to the creditor equal to the current value of the property, as agreed by the parties or determined by the court. Attorney(s) for This agreement is not valid or binding unless it is filed with the Clerk, U. S. Bankruptcy Court. If you were not represented by an attorney during the negotiation of this reaffirmation agreement, the agreement cannot be enforced by the creditor unless: (1) you have attended a reaffirmation hearing in the bankruptcy court, and (2) the Office agreement has been approved by the bankruptcy court. (Court approval isand P.O. Address is a consumer debt not required if this secured by a mortgage or other lien on your real estate.) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT REAFFIRMATION AGREEMENT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. The debtor and creditor named above agree to reaffirm the debt described in this agreement as follows: : Calendar No. : JUDICIAL SUBPOENA THE DEBT Plaintiff(s) Total amount of debt when case was filed $ -against- : Total amount of debt reaffirmed $ Above total includes the following: : : Interest accrued to date of agreement $ Defendant(s) : ....... ... . Attorney. fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . $. . . . . . . . . . . . . . Late fees $ Other expenses or costs relating to the collection THE STATE OF NEW $ THE PEOPLE OFof this debt (Describe) YORK Annual TO percentage rate (APR) % Amount of monthly payment $ GREETINGS: Date payments start WE COMMAND YOU, Total number of payments to be made that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at Total ofCounty of if paid according to schedule Payments in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Date any lien is to be released if paid according to schedule Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued forcreditor under the security agreement remain The debtor agrees that any and all remedies available to the a maximum penalty of $50 and all damages sustained as a result available. of your failure to comply. Witness, Honorable All additional terms agreed to by the parties (if any): Court in County, day of , one of the Justices of the , 20 (Attorney must sign above and type name below) Payments of this debt (were)(were not) in default on the date on which this bankruptcy case was filed. Attorney(s) for This agreement differs from the original agreement with the creditor as follows: Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT CREDITOR’S STATEMENT CONCERNING AGREEMENT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. AND SECURITY/COLLATERAL : Index No. (IF ANY) : Calendar No. Description of Collateral. (If applicable, list manufacturer, year and model): Plaintiff(s) -against- Value : JUDICIAL SUBPOENA : $ : : Basis or source for valuation Defendant(s) : Current .location. and.use. of .collateral. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ... .. .. ....... Expected future use of collateral THE PEOPLE OF Check applicable boxes: THE STATE OF NEW YORK TO 9 Any lien described herein is valid and perfected. 9 This agreement is part of a settlement of a dispute regarding the dischargeability of this debt under section GREETINGS: 523 of the Bankruptcy Code (11 U.S.C. § 523) or any other dispute. The nature of dispute is: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the DEBTOR’S STATEMENT OF EFFECT OF AGREEMENT ON DEBTOR’S FINANCES Your failure to comply with this subpoena is received) as My monthly income (take home pay plus any other income punishableis $a contempt of court and will make you liable to . the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. My current monthly expenses total $ , not including any payment due under this agreement or any debt to be discharged in this bankruptcy case. Witness, Honorable , one of the Justices of the Court agreement (will) (will not) impose an undue hardship on me or my dependents. in County, day of , 20 I believe this DEBTOR’S STATEMENT CONCERNINGsign above and type name below) (Attorney must DECISION TO REAFFIRM I agree to reaffirm this debt because Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : I believe this agreement is in my best interest because Index No. : : Plaintiff(s) Calendar No. JUDICIAL SUBPOENA I (considered)(did not consider) redeeming the collateral under section 722 of the Bankruptcy Code (11 U.S.C. § -against: 722). I chose not to redeem because : : I (was)(was not) represented by an attorney during Defendant(s) on this agreement. negotiations : ...................................................... CERTIFICATION OF ATTACHMENTS THE PEOPLE Any documents whichOF THE STATE OF NEW YORK interest or lien (are)(are not) attached. (If documents created and perfected the security are not attached: The documents which created and perfected the security interest or lien are not attached TO because .) GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before SIGNATURES , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Signature of Debtor Date Name of Creditor Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Signature of Creditor Representative result of your failure to comply. Witness, Signature ofHonorable Joint Debtor Court in County, Date day of , one of the Justices of the , 20 Date (Attorney must sign above and type name below) CERTIFICATION BY DEBTOR’S ATTORNEY (IF ANY) Attorney(s) for I hereby certify that (1) this agreement represents a fully informed and voluntary agreement by the debtor(s); (2) this agreement does not impose a hardship on the debtor or any dependent of the debtor; and (3) I have fully advised the debtor of the legal effect and consequences of this agreement and any default under this agreement. Office and P.O. Address Signature of Debtor’s Attorney, (if any) Date Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com