PAYMENT AGREEMENT

This PAYMENT AGREEMENT, dated as of [insert date], (this “Agreement”), by and between
COLLEEN FOLLANO, whose address for the purposes of this agreement shall be [insert
your physical address] (the “Debtor”), and XXX, whose address for the
purposes of this agreement shall be [insert physical address]. (the “Creditor”) The Creditor
and Debtor are hereby individually referred to as “Party” and collectively “Parties”
RECITALS
WHEREAS, the Debtor is currently obligated to pay Lender an aggregate of [Amount in
Figures] [Amount in Words] pursuant to the terms and conditions of this agreement;
WHEREAS, the Creditor is willing to accept payment of the $50,000,000.00 from the
borrower in accordance with the terms and conditions stipulated in this agreement;
NOW, THEREFORE, in consideration of the above, and for other good and valuable
consideration, the receipt and sufficiency of which is hereby acknowledged, the parties
hereto agree as follows:
1. The Creditor and Debtor agree that the current outstanding debt is [Amount in
Figures] [Amount in Words].
2. All Parties agree that the Creditor will accept a payment of $50,000,000.00 (Fifty
Thousand United States Dollars) immediately upon execution of this agreement.
3. All Parties agree that towards the settlement of the debt in full, the Debtor shall pay
the remainder of the debt in the following manner:
i. The debtor shall pay $3,000.00 monthly to the Creditor until the debt is fully
settled. This amount shall be paid on or before the [insert date] of every
month until full payment in full.

4. If the Creditor does not receive the agreed upon payment by the above date, or if the
Debtor does not make a payment for more than 10 (ten) days after it is due monthly,
for whatever reason including Bankruptcy, Sickness, or other, then the Debtor shall
be granted the ability to demand the entire balance due and may take any legal
actions that are necessary to collect the above-mentioned loan.
5. This Agreement for a settlement of debt owed shall be binding upon all Parties,
including the Debtor and Creditor, as well as their successors, heirs, and assigns.
6. The Parties agree that upon the Creditor’s receipt of the full payment described
above, the debt is full and forever settled. The Parties agree that there would be no
further claims between them of any nature whatsoever from any and all liability or
damages of any kind, known or unknown, in contract or in tort, related to this debt.
7. All Parties agree that the other Parties are free from any liability or wrongdoing.
8. Any liability or wrongdoing is expressly denied. Furthermore, the Parties each agree
that neither Party shall disparage the other to any third party at any time.
9. The Parties agree that the terms of this Agreement are the result of negotiations
between the Parties and constitute a final accord and satisfaction concerning all
disputes between them related to the outstanding debt described by this Agreement.
10. All settlement terms described herein are dependent upon the Creditor receiving from
the debtor the final payment of [Amount in Figures] [Amount in Words].
11. The Parties agree not to bring any claim of any kind against the other Party to this
Agreement concerning any matter released by this Agreement, except for any suits
necessary to enforce the terms of this Agreement. Each Party further agrees that this
Agreement constitutes a bar to any such future claims.

12. The Parties agree that the terms and conditions of this Agreement shall remain
confidential and that no Party shall release any part of this Agreement unless the
Agreement is subpoenaed or to their own accountants or legal counsel.
13. This Agreement constitutes a single, integrated written contract expressing the entire
agreement of the Parties to this Agreement. Any other agreements, discussions,
promises, and representations have been and are integrated into and superseded by
this Agreement.
14. No modifications to any provisions contained in this Agreement shall be binding upon
any Party unless made in writing and signed by all concerned Parties.
15. If any provision of this Agreement is held to be unenforceable for any reason, the
remaining parts of the Agreement shall remain in full force and effect.
16. Each Party affirms and swears that they have not assigned any portion of the claims
released under this Agreement to any third party.
17. Each Party represents that they have the express authority to enter into this
Agreement on behalf of themselves or their respective organizations.
18. This Agreement shall be construed in accordance with the applicable laws in United
States of America. Any dispute arising out of or in connection with this Agreement
shall be subject to the exclusive jurisdiction of the courts at [Name of State].

IN WITNESS WHEREOF, each of the Creditor and Debtor has caused this Agreement
signed in its name effective as of this [insert date].

DEBTOR
/s/________________________
XXX

CREDITOR
/s/________________________
XXX

WITNESS
/s/________________________
[INSERT NAME]

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