Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address FOR COURT USE ONLY Individual appearing without attorney Attorney for: UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA -- **SELECT DIVISION** In re: CASE NO.: CHAPTER: 13 DIVISION DECLARATION RE FILING OF TAX RETURNS AND PAYMENT OF DOMESTIC SUPPORT OBLIGATIONS 1 (PRECONFIRMATION) Next Meeting of Creditors Date: Time: Debtor(s). Next Confirmation Hearing Date: Time: Instructions: In a joint case, both debtors must answer and sign. This declaration must be filed with the court and served upon the chapter 13 trustee not later than 7 days before the first scheduled §341(a) meeting of creditors. If necessary, further declarations must be filed on or before the date of each hearing on confirmation of the Debtor's plan. Check the appropriate boxes. I, _______________________________________________________________________________ (Debtor's name(s)), hereby declare: Tax Returns: Debtor Joint Debtor I have filed all tax returns required to be filed with federal, state, or local taxing authorities for all taxable periods ending during the 4-year period ending on the date of the filing of the petition, as required by 11 U.S.C. § 1308. 1 The term "domestic support obligation" is defined in 11 U.S.C. § 101(14A). This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2012 Page 1 F 3015-1.08.DEC.TAX.DSO Debtor Joint Debtor I have NOT filed all tax returns required to be filed with federal, state, or local taxing authorities for all taxable periods ending during the 4-year period ending on the date of the filing of the petition, as required by 11 U.S.C. § 1308. I have not filed the following return(s) for the following years: 2 Year _______ _______ Taxing Authority (federal, state, or local) ___________________________________ ___________________________________ Proposed Date for Filing Return ________________________________ ________________________________ I am not required to file federal, state, or local tax returns because: ______________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Domestic Support Obligations: Debtor Joint Debtor I do not owe any domestic support obligations. As of the date of this declaration, I have paid all amounts that are required to be paid under a domestic support obligation that have come due after the date of the filing of the petition. No domestic support obligations will come due between the date of this declaration and the date set for hearing on confirmation of my plan set forth above. As of the date of this declaration, I have NOT paid all amounts that are required to be paid under a domestic support obligation that have come due after the date of the filing of the petition. I am delinquent on the following post-filing payments: ____________________________________________________________________________________ ____________________________________________________________________________________ I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Debtor's name Debtor's signature I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Joint Debtor's name Joint Debtor's signature 2 Attach additional pages as necessary. This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2012 Page 2 F 3015-1.08.DEC.TAX.DSO PROOF OF SERVICE OF DOCUMENT I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is: A true and correct copy of the foregoing document entitled: DECLARATION RE FILING OF TAX RETURNS AND PAYMENT OF DOMESTIC SUPPORT OBLIGATIONS (PRECONFIRMATION) will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d); and (b) in the manner stated below: 1. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date) , I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below: Service information continued on attached page 2. SERVED BY UNITED STATES MAIL: , I served the following persons and/or entities at the last known addresses in this bankruptcy On (date) case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and addressed as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page 3. SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL (state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing to such service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Printed Name Signature This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2012 Page 3 F 3015-1.08.DEC.TAX.DSO