This is an agreement whereby a debtor agrees to revive a previously discharged
obligation or debt to a creditor. The original agreement that created the discharged debt
or obligation can be attached to this agreement under “Schedule A.” Additionally, this
agreement provides that the debtor agrees to make regular payments to the creditor for
the specified amount. Payments can be on a weekly, bi-weekly, or monthly basis. This
agreement should be used by individuals or small businesses that want to revive a
previously discharged debt in return for certain considerations.
THE UNDERSIGNED HEREBY AGREES to revive his/her/its liability to
______________ [NAME OF PERSON TO WHOM THE DEBT/OBLIGATION HAD
PREVIOUSLY BEEN OWED] (hereinafter, the “Creditor”), for the indebtedness owing by the
undersigned to _____________ [NAME OF PERSON(S) DEBT IS OWED TO] in the amount
of _______________ ($______) Dollars on the date of the undersigned’s adjudication in
his/her/its bankruptcy proceedings for the consideration of ___________ ($______) Dollar(s).
THE UNDERSIGNED AGREES that the reviver granted herein will apply and cover any
and all obligations, terms and conditions contained in _______________[PROVIDE TITLE
OF AGREMENT, or, OTHER DESCRIPTION OF THAT AGREEMENT], which was
executed by the undersigned on the _____ day of __________, 201_____, a copy of which is
annexed hereto as Schedule “A”.
THIS REVIVOR will apply to any and all claims, judgements and warrants of any
attorney which the Creditor may have against the undersigned in respect to the
____________[PROVIDE SPECIFICS] annexed hereto as Schedule “A” and the undersigned
shall be authorized to commence any proceedings necessary, legal or otherwise, to enforce the
undersigned compliance with the obligations, terms and conditions contained herein.
THE UNDERSIGNED agrees that he/she/it shall pay to the Creditor the monetary sum of
________ ($____) Dollars in weekly/bi-weekly/monthly [SPECIFY WHICH TIME PERIOD]
instalments of ________ ($_____) Dollars which shall be paid to the Creditor by the undersigned
commencing on the ____ day of _________, 201_____.
EXECUTED this _____ day of _______________, 201______.
Print Name of Person reviving the debt.
© Copyright 2011 Docstoc Inc. 2
© Copyright 2011 Docstoc Inc. 3