Acknowledgement of Merchandise Returned For Repair



FOR VALUE RECEIVED, the undersigned being a creditor of _ (Organization) hereby enters into an agreement to compromise and reduce the indebtedness due the undersigned on the following terms and conditions:

1. The Organization and the undersigned acknowledge that the present debt due is $_.

2. The parties agree that the undersigned shall receive the sum of $_ as full and total payment on said debt and in complete discharge of all monies presently due, provided the sum herein shall be paid timely in the following manner:


3. In case of the event the Organization fails to pay on time the reduced amount, the undersigned creditor shall have full rights to prosecute it claim for the total debt due under paragraph 1 (less payments made).

4. This agreement shall be binding upon and inure to the benefit of the parties, their successors, assigns and personal executives.

Signed under seal this _ day of _, 20_.





 Acknowledgement of Merchandise Returned For Repair

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