(Attorney Name) (Firm Name) (Address) (City, State, Zip) Telephone: ( ) Fax: ( ) Email: ( ) Attorney for: ( AK LBF 12 [11/15] ) UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF ALASKA In re: (Debtor's Name) and (Joint Debtor's Name), Debtor(s). Comes now (Name) , and states that: Case No. ( ) Chapter ( ) CERTIFICATE OF SERVICE On the (Date) day of (Month) , (Year) , I did deposit in the mail of the United States, First Class Postage pre-paid, an envelope containing a copy of the (Name of Document) , a copy of which is attached hereto, to each of the names and addresses set forth on the attached list. I, (Name) , above named in the foregoing, declare under penalty of perjury that the foregoing is true and correct. Dated: ( ) (Firm Name) Attorney for ( ) By: _________________________________ (Attorney Name) American LegalNet, Inc. www.FormsWorkFlow.com