(Rev. 03/16) UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF ALABAMA, WESTERN DIVISION In Re: Case No. Debtor(s) CONSENT TO ACTION AT HEARING ON TRUSTEE222S MOTION TO DISMISS This matter is before the Court on the motion (Doc. ) (the 223Motion224) of the standing chapter 13 trustee (the 223Trustee224) to dismiss the above-styled chapter 13 case (the 223Case224). The Motion is set for hearing on at (the 223Hearing224).** The above-named debtor(s) (the 223Debtor224) and the Trustee are in agreement and request that the Court take the following action(s) (collectively, the 223Actions224) at the Hearing (check all that apply): [ ] Dismiss the Case. [ ] Allow the Debtor until (month) (day), (year) to convert the Case to a case under chapter 7 of the Bankruptcy Code (the 223Conversion Deadline224), and order that failure to convert the Case by the Conversion Deadline will result in dismissal of the Case, without further hearing. [ ] Modify the Debtor222s plan payments to $ (amount) (frequency). [ ] Continue the Hearing to (month) (day), (year), at (time). [ ] Approve the Trustee222s withdrawal of the Motion. [ ] Require the issuance of a payroll deduction order to the employer of the Debtor, (name of Debtor), at: Employer222s name: Employer222s address: Employer222s telephone number: The Debtor understands that the Debtor must make direct payments to the Trustee until the employer begins deducting from the Debtor222s pay. [ ] Other Action(s): If a duly executed* consent form is filed electronically with the Clerk of Court by 10:00 a.m. on the business day preceding the Hearing, then (1) the Clerk222s Office will add the consent form to the Hearing docket, and (2) neither the Debtor nor the attorney for the Debtor shall be required to appear for the Hearing. CONSENTED TO BY: Debtor* Date Chapter 13 Trustee Date Debtor* Date Attorney for Debtor(s) Date *If dismissal of the Case is selected above, the Debtor's handwritten signature on this form is required. In joint bankruptcy cases where dismissal is requested, both debtors must sign the form. The date of the Debtor's signature must be the date that the Debtor signs the form. If dismissal is not one of the Actions selected, counsel for the Debtor may sign the form on the Debtor's behalf. **This form should be filed using the Consent to Action at Hearing on Trustee Motion to Dismiss event in CM/ECF (Bankruptcy > Miscellaneous). American LegalNet, Inc. www.FormsWorkFlow.com