UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF VIRGINIA _________________ DIVISION In re: CASE NO. Debtor(s) CHAPTER SUMMARY OF REAFFIRMATION AGREEMENT AND DECLARATION I, the undersigned counsel for the debtor(s) in the above case, declare that an agreement has been entered into with the holder of a claim allowing the debtor(s) to retain possession of the collateral, if applicable, and repay the debt hereafter described: that the agreement was made as provided by11 U.S.C. Sections 524, 727, 1141, or 1328; that the debtor(s) understand(s) that the agreement contains a clear and conspicuous statement which advises the debtor(s) that the agreement may be rescinded at any time prior to discharge of within sixty (60) days after such agreement is filed with the Court, whichever occurs later, by giving notice of rescission to the holder of such claim; that in representing the debtor(s) during the course of negotiating the agreement, further declares that such agreement represents a fully informed and voluntary agreement by the debtor(s) and does not impose an undue hardship on the debtor(s) or a dependent of the debtor(s). Pursuant to Section 524(f), debtor(s) in/are advised that he/they may voluntarily repay any debt without reaffirming same. Pursuant to Section 524(c)(3), a copy of the said reaffirmation agreement is attached hereto. Name & Address of Claimant Amount Property Securing Lien (If Any) If the foregoing reaffirmation is filed with the Clerk following the date of the issuance of the discharge, then pursuant to 11 U.S.C. Section 524, counsel certifies that due notice of a hearing on the within post-discharge reaffirmation has been given to the debtor(s), creditor(s), trustee, and U.S. Trustee for hearing on________________(date), at ____________(time), at _______________________________ (court location), which date and time was obtained from the Clerks Office as required byLocal Rule IX (h). The undersigned counsel for the debtor(s) does certify that a copy of this petition was mailed to parties set forth above if this is a post-discharge reaffirmation. Date: ________________________ _____________________________________ Signature of Attorney Upon hearing, the within post-discharge reaffirmation motion is ORDERED (granted)(denied). Date: ____________________ ___________________________________ , Judge 711.wpd 2000 (C) American LegalNet, Inc