0001019687-10-004332 Sample Contracts

FORM Debt Conversion Agreement
Agreement • December 7th, 2010 • Universal Detection Technology • Industrial instruments for measurement, display, and control • California

This Agreement (the “Agreement”) is entered into by and between Universal Detection Technology (the “Issuer”) and [NAME](the “Noteholder”) on the date first shown above. The Noteholder confirms that pursuant to the note dated _________ (the “Note”) in the principal amount of $_______ with an interest rate of __% per annum and a maturity date of _______, the Issuer owes the Noteholder a balance of $____ including principal and accrued interest as of ____.

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