We, the undersigned, being respectively creditors of A. B., of ---------, in the amounts set opposite our respective names below, do hereby severally agree, in consideration of this composition and of the mutual covenants of said creditors herein contained, to accept in full satisfaction and discharge of our said debts, claims and demands a composition of---------per cent., providing the same be paid on or before---------. 19-, (or, if payable in instalments, omit all following the words "providing the same, etc.," and insert instead, "payable as follows,

--------per cent. in cash on or before ---------, 19-, --------- per cent. in --------months, and--------- per cent. in --------- months, from the date hereof").

On payment of said composition as aforesaid, all our respective claims and demands against said --------- shall thereby be fully satisfied and discharged, and we severally agree to execute a full release of the same to said debtor, at his request and expense, and to satisfy of record all judgments against him and to surrender to him all promissory notes and other evidences of indebtedness held by us.

Provided, however, this agreement shall not be binding on any of the undersigned until the same has been duly executed by all the persons listed in the schedule of creditors hereto annexed, marked "Exhibit A" and made a part hereof.

---------, ---------, 19-.

(Names of creditors) (Amounts)

.......................................... $................

.......................................... $................

For consideration in compositions with creditors, see Sec. 9 530 and 699. For effect of composition, see Sec. 699 and 3166.