Form VTB O-12 04/2018 See Vt. LBR 4004-2(b) UNITED STATES BANKRUPTCY COURT DISTRICT OF VERMONT In re: , Chapter 12 Debtor(s). Case # MOTION FOR ENTRY OF CHAPTER 12 DISCHARGE I am the debtor in this case and hereby request this Court enter an order of discharge. In support of this motion, I certify and state as follows: 1. I have made all of the payments required under the confirmed chapter 12 plan in this case and I have fully complied with the terms of that plan. 2. I have completed an instructional course concerning personal financial management described in 11 U.S.C. 247 111 and have filed a copy of the Certification of Completion, either prior to the filing of this motion or with this motion. 3. Check the box that applies; one box MUST be checked: I am not required by a judicial or administrative order or law to pay a domestic support obligation (child support or spousal support). I was required to pay a domestic support obligation during this case, and I certify I have paid all domestic support due through today, under the order or law requiring support payments. 4. I have no reason to believe that there is any pending investigation or proceeding in which I may be found guilty of: (i) a felony involving the abuse of bankruptcy law; (ii) any violation of federal or state securities law; (iii) fraud, deceit, or manipulation in a fiduciary capacity (where I am responsible for managing someone else's money, property, or affairs) involving the purchase or sale of any securities; (iv) any civil offense under 247 1964 of Title 18 U.S. Code (federal criminal laws); or (v) any criminal act, any intentional harm to another or willful or reckless misconduct that caused serious physical injury or death to another individual in the preceding five (5) years. I certify under oath that the foregoing is true and correct to the best of my knowledge and belief. Debtor: Joint Debtor: Date: Date: If the debtor is represented by an attorney, the attorney must complete the certification, below. American LegalNet, Inc. www.FormsWorkFlow.com Form VTB O-12 04/2018 See Vt. LBR 4004-2(b) ATTORNEY222S CERTIFICATION IN SUPPORT OF DEBTOR'S MOTION FOR CHAPTER 12 DISCHARGE I represent the above captioned debtor(s) and hereby certify that I have explained to the debtor(s) the averments set forth above and, to the best of my knowledge and belief, each debtor identified above is in compliance with the provisions of 11 U.S.C. 247247 521 and 1228(a), and meets the eligibility requirements for a chapter 12 discharge set out in 11 U.S.C. 247 1228(a). Dated: By: Signature of debtor(s)222s attorney [printed name, mailing address, e-mail address, and phone number] American LegalNet, Inc. www.FormsWorkFlow.com