American LegalNet, Inc.www.FormsWorkflow.com UNITED STATES BANKRUPTCY COURTFOR THE NORTHERN DISTRICT OF ALABAMA DIVISIONIn re:)Case No.)Chapter 7DEBTOR222S CERTIFICATE OF COMPLIANCE, MOTION FOR ISSUANCE OF DISCHARGE AND NOTICE OF DEADLINE TO OBJECT The Debtor(s)*, in the above captioned matter certifies as follows:1.The Debtor is requesting the Court issue a discharge in this case.2.The Debtor has completed an instructional course concerning personal financial managementdescribed in 11 U.S.C. 247 111 and has filed Official Form 23 with this Court.3.The following creditors hold a claim that is not discharged under 11 U.S.C. 247 523(a)(2) or (a)(4)or a claim that was reaffirmed under 11 U.S.C. 247 524(c): 4.Compliance with 11 U.S.C. 247 727(a)(12):A.The Debtor has not claimed an exemption under 247 522(b)(3) in excess of theallowable amount in effect at time case filed in property of the kind described in247 522(p)(1) [generally the Debtor222s homestead];orB.The Debtor has claimed an exemption under 247 522(b)(3) in excess of theallowable amount in effect at time case filed in property of the kind described in247 522(p)(1) but there is no pending proceeding in which the Debtor may be foundguilty of a felony of a kind described in 247 522(q)(1)(A) or found liable for a debtof the kind described in 247 522(q)(1)(B). *All further references to 223Debtor224 shall include and refer to both of the Debtors in a case filed jointly bytwo individuals, unless any information is noted as specifically applying to only one Debtor.Page 1 of 2American LegalNet, Inc.www.FormsWorkflow.com 5.The Debtor has not received a discharge in a chapter 7 or 11 case commenced within 8 yearsbefore the date of filing of the instant case, or in a chapter 12 or 13 case commenced within 6years before the date of filing of the instant case, unless payments under the plan in such casetotaled at least 100 percent of the allowed unsecured claims in such case, or 70 percent of suchclaims, and the plan was proposed by the debtor in good faith, and was the debtor222s best effort.I declare under penalty of perjury that the information provided in this Certificate is true and correct./s/ Debtor/s/ DebtorCERTIFICATE OF SERVICEThe undersigned hereby certifies that on , 200, a true and correct copy ofthe Certificate of Compliance and Request for Discharge was served upon all creditors and parties ininterest listed on the attached service list by either first-class, U.S. mail or via the CM/ECF system of theUnited States Bankruptcy Court. If the Debtor is appearing pro-se, the clerk222s office will serve thisCertificate and Motion on all creditors and parties in interest./s/ Attorney for DebtorNOTICE OF TIME TO OBJECTAny interested party who fails to file and serve a written response to this motion within 20 daysafter the date of service of this motion shall be deemed to have consented to the entry of an order ofdischarge. If no objection is filed, the Court may enter a discharge pursuant to 11 U.S.C. 247 727(a)without further notice or hearing.Page 2 of 2