AGREEMENT TO COMPROMISE DEBT The undersigned a creditor of__________________________ (Company) hereby agrees to compromise the indebtedness due the undersigned creditor on the following terms and conditions: 1. The Company and the undersigned agree that the present debt due is $ ___________. 2. The parties agree that the undersigned shall accept the sum of $_____________ as full payment on said debt and in complete discharge of all monies due, provided the sum herein shall be promptly paid in the following manner: 3. In the event the Company fails to promptly pay the compromised amount, the undersigned creditor shall have the right to prosecute its claim for the total debt due under Paragraph 1 less any payments made. 4. This Agreement shall be binding upon and inure to the benefit of the parties, their successors and assigns. Signed and sealed this____day of _____, 20__. _______________________________ _______________________________ Form 116