IN THE UNITED STATES BANKRUPTCY COURTFOR THE NORTHERN DISTRICT OF ALABAMA DIVISIONIn re:)Case. No. )) Debtor.)STATEMENT OF DEBTOR State of Alabama*County of Jefferson* (Debtor), who is known to me, and after, by me being first duly sworn, and under oath, diddepose and say as follows:My name is (Debtor). I am the Debtor in the above-styled cause. I ownproperty of the kind described in 11 U.S.C. 247 522(f) which was pledged to (creditor)as collateral on a loan, but th. DebtorSworn to and subscribed before me on this the day of , 20 Notary Public Attorney for DebtorAttorney's AddressCERTIFICATE OF SERVICE I hereby certify that I have served a copy of the above and foregoing on (Trustee,Trustee's address), and on (creditor, creditor's address), by placing a copy of same inthe United States mail, properly addressed, first class po day of , 20 . Attorney for Debtor