Local Form 14 (04/06) UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF FLORIDA IN RE: CASE NUMBER: Debtor(s) Chapter 13 CERTIFICATION REGARDING FILING OF FEDERAL, STATE, AND LOCAL TAX RETURNS BY CHAPTER 13 DEBTOR PURSUANT TO LOCAL RULE 3015-1 NOTICE IS HEREBY given that, pursuant to Local Rule 3015-1, the debtor(s) hereby states as follows: 1. Name of Debtor:___________________________ G That individual debtor has filed all applicable Federal, State and local tax returns as required by Sections 1308 and 1325(a)(9) of the U.S. Bankruptcy Code and Local Rule 3015-1. 2. Name of Joint Debtor: ______________________ (if applicable) G That individual debtor has filed all applicable Federal, State and local tax returns as required by Sections 1308 and 1325(a)(9) of the U.S. Bankruptcy Code and Local Rule 3015-1. I declare under penalty of perjury that the foregoing is true and correct. _______________________________________ Signature of Debtor ________________ Date _______________________________________ Signature of Joint Debtor (if applicable) ________________ Date American LegalNet, Inc. www.FormsWorkflow.com