IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF DELAWARE In Re: Chapter _______ Debtor. Case No. ____-_______(____) DEBTOR(S) CERTIFICATION OF PLAN COMPLETION AND REQUEST FOR DISCHARGE Debtor(s) hereby certifies under penalty of perjury that the following is true and correct: 1. All plan payments have been completed and the Debtor(s) is entitled to a discharge under 11 U.S.C. § 1328; and 2. That Debtor(s) has paid (or does not have any liability) for domestic support obligations due on or before the date set forth below, including any prepetition amounts to the extent provided for by the plan to: Payee: Address: ___________________________________________ ___________________________________________ 3. The Debtor(s) certifies, if applicable, that all mortgage obligations, fees, charges and all other amounts due under such mortgage have been paid current as of this date. 4. The provisions of 11 U.S.C. § 522(q)(1) are not applicable to my case, pursuant to 11 U.S.C. § 1328(h). 5. There are no proceedings pending against me of the kind described in 11 U.S.C. § 522(q)(1)(A) or 11 U.S.C. § 522(q)(1)(B), pursuant to 11 U.S.C. § 1328(h). 6. I have successfully completed an approved instructional course concerning personal financial management described in 11 U.S.C. § 111. I/We request that a discharge be granted in accordance with 11 U.S.C. § 1328. Dated: _________________ Attorney for Debtor: Address: /s/ Debtor signature /s/ Debtor signature _______________________________________ _______________________________________ _______________________________________ Local Form 104 Del. Bankr. L.R. 3023-1(g) 559091-Wilmington Server 1A - MSW American LegalNet, Inc. www.FormsWorkflow.com