New York Codes, Rules and Regulations
Title 3 - BANKING
Appendices
Appendix 11

Current through Register Vol. 44, No. 38, September 21, 2022

REAFFIRMATION AGREEMENT WITH CANCELLATION NOTICE AND

STATEMENT OF RIGHTS OF BORROWER

Important-Read

Statement of Rights

1. In order to obtain this new loan you will be required to reaffirm and/or to apply all or part of the proceeds of the new loan to your outstanding debt to [insert name of licensee] that was discharged in bankruptcy. However, you are under no legal obligation to do so.

2. Your discharge in bankruptcy has fully released you from any legal obligation to reaffirm or to repay any part of your outstanding debt to [insert name of licensee].

3. You have the right to bargain with [insert name of licensee] as to the amount of the new loan to be applied to your old loan.

4. You have the right to cancel within 10 days your agreement to reaffirm and/or to apply an agreed amount to your old loan.

5. If you decide within 10 days that you want to cancel your agreement with [insert name of licensee] to reaffirm your old loan and/or to apply an agreed amount to your old loan, tear off, date, sign and mail the bottom of this notice, below the dotted line to [insert name of licensee] at this branch office address.

6. If you do cancel, the amount applied to your old loan will be credited in full to your new loan, but you are required to meet your payments as scheduled until the new loan less the amount credited is paid.

7. If you do not cancel within 10 days your agreement with [insert name of licensee] to reaffirm your old loan and/or to apply an agreed amount to your old loan, then the note representing your obligation under the old loan will be marked paid and cancelled and promptly returned to you by [insert name of licensee].

Agreement

The following is a statement of what [insert name of licensee] and I have agreed upon:

[Insert name of licensee] has agreed to make me a new loan in the amount financed of $ ________

I have agreed to reaffirm my old loan from [insert name of licensee] and or that [insert name of licensee] will apply to my old loan that was discharged in bankruptcy $________

There will be disbursed to me or on my behalf from the new loan the sum of $________

Amount financed on new loan ________

Amount applied to old loan ________

Amount actually disbursed to borrower ________

By signing this agreement, I acknowledge that I have read and understood its terms and that I have received a copy. I understand I am under no legal obligation to enter into such an agreement.

Date:________ Signature: ____________

Witness, representative of [insert name of licensee]____________

............

Cancellation Notice

To: [Insert name of license]:

Address: ____________

City: ____________ State: ____________ Zip: ____________

I hereby cancel my agreement with [insert name of licensee] to reaffirm my old loan and/or to apply an agreed amount to my old loan.

Date: ________ Signature: ____________

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