APPLICATION
(for out-of-court settlement under article 2 par. 1 of Law 3869/2010)
Personal details of the applicant
| Full name: |
| Father’s name: |
| Address (street, number, postal code, municipality, city):
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| Tax Identification Number and Tax Office: |
| Profession: |
| Year of birth: |
| Contact phone number: |
| Fax/email address: |
| Assisting body or authorized lawyer:
|
I submit this application to my creditors in order to achieve an out-of-court settlement of my debts towards them, as I am in a permanent inability to repay my overdue debts and I solemnly declare that the information stated below is true.
A. Family status
| single □ married □ divorced □ separated □ widowed □ other □ …… dependents: none □ yes □ number …… |
B. Personal and employment status (clarifications, if deemed useful by the debtor)
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C. Financial situation
| a. Income (from any source) average monthly personal income: ………….. average monthly spouse income: ………….. | b. Estimated monthly family living expenses: ………………………………….. | |||||
| c. Assets | ||||||
| c.1 privately owned main residence or other sole residence | no □ yes □ | |||||
| Description (location, size, type and ownership percentage, estimated commercial value):
| ||||||
| c.2 other real estate (location, size, type and ownership percentage, estimated commercial value) | ||||||
| 1. | ||||||
| 2. | ||||||
| 3. | ||||||
| ….. | ||||||
| c.3 movable and intangible assets | ||||||
| No | Yes | Description | Value | |||
| Deposits | □ | □ | ||||
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Vehicles | □ | □ | ||||
| Shares, dividends, bonds, participations in companies etc | □ | □ | ||||
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Claims against third parties
| □ | □ | ||||
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Other movable assets of value | □ | □ | ||||
D. List of creditors and claims
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No. | creditor (name/company name address, phone) | cause of claim
(mortgage/ consumer loan, credit card other type of transaction) | total claim | principal | interest until (date) ……..
| expenses | type of security (mortgage, prenotation etc.) |
E. Proposed settlement
| 1 Settlement with fixed installments | □ | settlement plan 1 |
| 2. Settlement with flexible installments | □ | settlement plan 2 |
| 3. Settlement with lump sum payment | □ | settlement plan 3 |
| 4. Combination of the above | □ | settlement plan 4 |
| 5. Other type of settlement | □ | settlement plan 5 |
I propose to the above creditors the attached debt settlement plan.
I wish my main/sole residence to be excluded from liquidation and I have taken this into account in the above proposal
Yes □ No □
I invite my creditors to inform me of their response within a reasonable period of time
F. Explanations regarding the debt settlement plan
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(place), (date)
……………..…………..
The applicant