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Official form 2400C, Order on Reaffirmation Agreement

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UNITED STATES BANKRUPTCY COURT __________ District of __________ In re ____________________________, Case No.__________________ Debtor Chapter________________




I (we), the debtor(s), affirm the following to be true and correct:


I am not represented by an attorney in connection with this reaffirmation agreement.

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 Reaffirmation Agreement, and because (provide any additional relevant reasons the court should consider):


Therefore, I ask the court for an order approving this reaffirmation agreement under the following provisions (check all applicable boxes):


11 U.S.C. § 524(c)(6) (debtor is not represented by an attorney during the course of the negotiation of the reaffirmation agreement)


11 U.S.C. § 524(m) (presumption of undue hardship has arisen because monthly expenses exceed monthly income, as explained in Part II of Form 2400A, Reaffirmation Documents)


Signed:_______________________________ (Debtor) _______________________________ (Joint Debtor, if any)

Date: __________________

Automatically apply your county expense standards and state income standards to your means test calculation.

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