Attorney or Party Name, Address, Telephone & FAX Numbers, and California State Bar Number G G FOR COURT USE ONLY Attorney for Pro Se Debtor CHAPTER 13 UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA CASE NUMBER In re DECLARATION SETTING FORTH POSTPETITION, PRECONFIRMATION DEED OF TRUST PAYMENTS Debtor(s). I, LOCAL BANKRUPTCY RULE 3015-1(m) (Debtor’s name), hereby declare: . 1. I am the debtor in this chapter 13 bankruptcy case that was filed on 2. I am the owner of real property1 at the following street address: (the “Property”). 3. The Property is encumbered by the following deeds of trust: . a. First deed of trust in favor of b. Second deed of trust in favor of (if applicable). c. Third deed of trust in favor of (if applicable). (Continued on next page) 1 A separate declaration shall be filed and served for each parcel of real property owned by the Debtor(s). This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. January 2009 F 3015-1.4 Declaration Setting Forth Postpetition, Preconfirmation Deed of Trust Payments Local Bankruptcy Rule 3015-1(m) - Page 2 of 5 In re F 3015-1.4 CHAPTER 13 Debtor(s). CASE NUMBER 4. The following are the postpetition deed of trust payments2 up to the date of plan confirmation (the “Payments”) that I have caused to be mailed/delivered3 to the appropriate deed of trust holder (the “Creditor”)4: Creditor Payment Amount Due Date5 Date Mailed/Delivered Creditor Creditor 5. The Payments were in the form of money order, cashier’s check, wire transfer, or other certified funds payable to the appropriate Creditor and had written on each item my name, the bankruptcy case number and the appropriate loan number. (Continued on next page) 2 Postpetition deed of trust payments are payments that first become due after the bankruptcy filing date. 3 A U. S. Postal Service Certificate of Mailing, stamped by a Postal Service employee, must be obtained for each mailed Payment and copies of the Certificates of Mailing must be attached. If Payments are not mailed, Debtor must state how the Payments were delivered to the deed of trust holder and must provide documents that prove that the Payments have been delivered. For example, a copy of a statement, signed by the deed of trust holder’s representative, acknowledging receipt of the Payment(s), would provide such proof. 4 Attach additional pages if necessary. 5 “Due Date” refers to the last day the Payment can be paid without a late charge penalty. This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. January 2009 F 3015-1.4 Declaration Setting Forth Postpetition, Preconfirmation Deed of Trust Payments Local Bankruptcy Rule 3015-1(m) - Page 3 of 5 In re F 3015-1.4 CHAPTER 13 Debtor(s). CASE NUMBER 6. Attached to this declaration are copies of the: G cashier’s checks, G G other proof of the Payments described in Paragraph 4 above. money orders, G certified funds, or 7. Also attached to this declaration are copies of the: G U. S. Post Office Certificate(s) of Mailing, stamped by a U. S. Postal Service employee, G acknowledgment(s) signed by the Creditor’s representative, or G other documents that prove delivery of the Payments described in Paragraph 4 above. I declare under penalty of perjury that the foregoing is true and correct. Dated: Debtor This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. January 2009 F 3015-1.4 Declaration Setting Forth Postpetition, Preconfirmation Deed of Trust Payments Local Bankruptcy Rule 3015-1(m) - Page 4 of 5 In re F 3015-1.4 CHAPTER 13 Debtor(s). CASE NUMBER NOTE: When using this form to indicate service of a proposed order, DO NOT list any person or entity in Category I. Proposed orders do not generate an NEF because only orders that have been entered are placed on a CM/ECF docket. 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 described as 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 indicated below: I. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (“NEF”) - Pursuant to controlling General Order(s) and Local Bankruptcy Rule(s) (“LBR”), the foregoing document will be served by the court via NEF and hyperlink to the document. On ________________________ I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following person(s) are on the Electronic Mail Notice List to receive NEF transmission at the email addressed indicated below: 9 Service information continued on attached page II. SERVED BY U.S. MAIL OR OVERNIGHT MAIL (indicate method for each person or entity served): On _________________________ I served the following person(s) and/or entity(ies) at the last known address(es) in this bankruptcy 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/or with an overnight mail service addressed as follow. 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. 9 Service information continued on attached page III. SERVED BY PERSONAL DELIVERY, FACSIMILE TRANSMISSION OR EMAIL (indicate method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on _______________________ I served the following person(s) and/or entity(ies) by personal delivery, 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 mailing to the judge will be completed no later than 24 hours after the document is filed. 9 Service information continued on attached page I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. _________________________________________________________ Date Type Name _____________________________________ Signature This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. January 2009 F 3015-1.4 Declaration Setting Forth Postpetition, Preconfirmation Deed of Trust Payments Local Bankruptcy Rule 3015-1(m) - Page 5 of 5 In re F 3015-1.4 CHAPTER 13 Debtor(s). CASE NUMBER ADDITIONAL SERVICE INFORMATION (if needed): This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. January 2009 F 3015-1.4