CSD 1025 [12/01/15] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. STATEMENT OF EXIGENT CIRCUMSTANCES AND REQUEST FOR EXTENSION OF TIME TO FILE CERTIFICATE OF CREDIT COUNSELING PURSUANT TO 11 U.S.C. § 109(h)(3) The debtor(s) declare under penalty of perjury that the following exigent circumstances exist which have prevented me from obtaining budget and credit counseling within the 180-day period prior to the filing of my bankruptcy petition. Those circumstances include (provide a detailed explanation in the space provided below) I further declare that I requested credit counseling services from: an approved nonprofit budget and credit counseling agency, on (date) I understand that this initial counseling does not replace or waive the necessity to complete a course concerning personal financial management. I understand that I must file a Certification About a Financial Management Course (Official Form 423) no later than 45 days from (1) the first date set for the first meeting of creditors under § 341 in order to receive a chapter 7 discharge or (2) if a chapter 13 debtor, no later than the last payment made as required by my chapter 13 plan or the filing of a motion for entry of a discharge under § 1328(b) in my chapter 13 case. I request that I be granted an extension of 30 days from the date of the filing of my petition within which to complete the credit counseling, obtain and file a Certificate of Credit Counseling issued by a United States Trustee approved nonprofit budget and credit counseling agency. DATED: , but was unable to obtain the services during the 7-day period following my request. Debtor CSD 1025 Joint Debtor American LegalNet, Inc. www.FormsWorkFlow.com