UNITED STATES BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA In re (12/2010) Case No. , Chapter 11 , Reorganization Debtor(s). AFFIDAVIT REQUESTING ENTRY OF DISCHARGE ORDER AFTER COMPLETION OF PLAN PAYMENTS *** IN A JOINT CASE, EACH DEBTOR MUST COMPLETE A SEPARATE AFFIDAVIT TO BE ELIGIBLE FOR A DISCHARGE*** The undersigned Debtor testifies under penalty of perjury to the following (complete all sections and provide all required information) and requests that the Court enter a discharge order pursuant to 11 U.S.C. § 1141(d). 1. All payments under the plan have been completed. 2. ____ 11 U.S.C. § 1141(d)(3) does not apply, and the Financial Management Course (Debtor Education) is not required to be completed for a discharge. Or The provisions of 11 U.S.C. § 1141(d)(3)(A) and (B) do apply; however, I would not be denied a discharge under 11 U.S.C. § 727(a) if this case were a case under Chapter 7, and I have completed a Financial Management Course (Debtor Education) and have previously filed a certificate of completion (Form 23). or I have completed a Financial Management Course (Debtor Education) and a certificate of completion (Form 23) is attached hereto. 3. I did not have, either at the time of filing this bankruptcy case or at the present time, equity in the type of property described in 11 U.S.C. § 522(p)(1) {generally the debtor’s homestead} in excess of the aggregate value specified therein. American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 Or There is not currently pending any proceeding in which I may be found guilty of a felony of the kind described in 11 U.S.C. § 522(q)(1)(A) or liable for a debt of the kind described in 11 U.S.C.§ 522(q)(1)(B). I declare under penalty of perjury that all of the above statements are true and correct to the best of my knowledge, information, and belief, and that the Court may rely on the truth of each statement in determining whether to grant a discharge in this Chapter 11 case. The Court may revoke my discharge if the statements relied upon are not accurate. Date: ____________________________ Signature of Debtor American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2