UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF CALIFORNIA In re ) ) ) ) ) Case No. AMENDMENT COVER SHEET Debtor(s). This form shall not be used to amend or modify plans. I am amending the following documents: Petition G Creditor Matrix G List of 20 Largest Unsecured Creditors G Schedules (check appropriate boxes). G A/B G C GD G E/F G G G H GI G Summary of Schedules of Assets and Liabilities A fee of $31 is required for: · · · An amendment that adds or deletes creditors; An amendment that changes amounts owed to a creditor; or An amendment that changes the classification of a debt. NOTICE OF AMENDMENT TO AFFECTED PARTIES I certify that I have notified the trustee in the case (if any) that I have filed or intend to file the amended or supplemental document(s) listed above, and that I have notified all parties affected by the amendment, as required by Federal Rule of Bankruptcy Procedure 1009.* Dated: Attorney's or Pro Se Debtor's Signature: Printed Name: DECLARATION BY DEBTOR I(We), the undersigned debtor(s), hereby declare under penalty of perjury that the information set forth in the amendment(s) pages, is true and correct. attached hereto, consisting of Dated: Dated: G G G G Statement of Financial Affairs Statement of Intention List of Equity Security Holders GJ Debtor's Signature Joint Debtor's Signature INSTRUCTIONS Attach each amended document to this form. If there is a box on the form to indicate that the form is amended or supplemental, check the box. Otherwise, write the word "Amended" or "Supplemental" at the top of the form. If you are amending Schedules A/B, D, E/F, I, or J, you must also file an Amended Summary of Schedules of Assets and Liabilities in order to ensure that the totals are amended for statistical purposes. This form can be found on our website. · · · To add creditors, write or type an "A" next to the creditors you are adding on any amended schedule you file. Additionally, (or, in the event that you are only amending the creditor matrix) attach a list of all creditors with their addresses in .txt format. To correct the names or addresses of creditors that appear on any schedule, use our Change of Address Form (EDC 2-085) instead of filing this form, any amended schedule or an amended master address list. To delete creditors, write or type a "D" next to the creditors you are deleting on any amended schedule you file . Do not submit a .txt file of creditors to be deleted. Only creditors who have not filed a proof of claim in the case will be deleted . *Federal Rule of Bankruptcy Procedure 1009 requires the debtor to give notice of an amendment. Notice of the amendment will not be given by the Clerk's Office. To comply with this requirement, the debtor's attorney or Pro Se debtor must give notice to the trustee and any party affected by the amendment by serving the amendment and all previous court notices including, but not limited to, the notice of meeting of creditors, discharge of debtor, etc. A proof of service, indicating that service has been made, must be filed with the court. Checks and money orders should be payable to "Clerk, U.S. Bankruptcy Court." (NOTE: No personal checks will be accepted.) Form EDC 2-015, Rev. 5/1/17 American LegalNet, Inc. www.FormsWorkFlow.com