THIS AGREEMENT ON DISPUTED ACCOUNT (hereinafter “Agreement”), is
made and effective as of [insert date of agreement] [the “Effective Date”] by
and between Acme Collections, a California corporation with its principal
offices located at 123 Collections Lane, Los Angeles, CA 12345 (hereinafter
“Creditor”), and [insert your name] (hereinafter “Debtor”), residing at [insert
WHEREAS Creditor asserts to hold certain claims against Debtor for [enter
account information] in the amount of [enter amount allegedly owed];
AND WHEREAS Debtor disputes said claim and denies said debt is due; AND
WHEREAS the parties desire to resolve and forever settle said claim.
NOW, THEREFORE, Debtor agrees to pay to Creditor and Creditor agrees to
accept from Debtor simultaneously herewith, the sum of [settlement amount] in
full payment, settlement, satisfaction, discharge, and release of said claim and in
release of any further claims thereto.
Creditor acknowledges that if any adverse report(s) has been filed by Creditor
with any credit bureau regarding this disputed account, it/they will be removed
immediately [or updated to “paid as agreed” if applicable] upon receipt of the
settlement funds. Creditor further agrees to never reinsert any information
relative to this account on Debtor’s credit reports.
This agreement shall be binding upon and inure to the benefit of all the parties,
their successors, assigns and personal representatives.
IN WITNESS WHEREOF the parties hereto have executed this Agreement as of
the date first written above.
Authorized Signature Authorized Signature
Printed Name Printed Name
SETTLEMENT AGREEMENT PDF
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