Agreement for Judgment, with Debtor

I, ___________________, (“Debtor”) hereby agree for judgment against me for $_________ as of today, ____________, to ______________ (“Creditor”). I, Debtor, do further agree not to protest any collections efforts, in any Court of law or otherwise, against me for this amount of money, plus accrued interest, and any legal fees, by Creditor, its successors or assigns.

I further agree, not to protest any attachments to any property I own directly or indirectly, in any Court of law or otherwise, for $___________ (“Judgment Amount”) plus accrued interest and any legal fees incurred by Debtor, its successors or assigns.

This Agreement for Judgment arises out of my default on a Note or Notes for $________, plus accrued interest and legal fees, due on _____________.

I, Debtor, do agree to this Agreement for Judgment without any reservations and in consideration of immediate forbearance, for 10 days, on collection for my Note in Default to Creditor. Creditor does hereby agree to accept this Agreement for Judgment in return for Debtor’s Agreement to permit entry of a Judgment for the above amount in a Court of competent jurisdiction immediately.

A copy of the original Note or Notes is (are) attached.

______________________
Debtor

______________________
Creditor

______________________
Date

Enc. Copy or copies of the Note or Notes outstanding.