FORM Debt Conversion AgreementDebt Conversion Agreement • August 22nd, 2011 • 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 ____.
