FLNB Local Form 26 Rev. 09/10 UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF FLORIDA DIVISION In re: Case No.: Chapter 11 Debtor(s) Last 4 Digits of SSN: XXX-XX- Individual Debtor(s) Motion for Entry of Discharge, Certificate of Compliance and Notice of Time to Object Notice of Time to Object Any interested party who fails to file and serve a written objection to this motion within twenty one (21) days after the date of service of this motion shall be deemed to have consented to the entry of an order of discharge. If no objection is filed, a discharge pursuant to 11 U.S.C. § 1141(d)(5)(A) may be entered without further notice or hearing. I/We, the undersigned debtor(s), move the court for entry of a discharge in this case pursuant to 11 U.S.C. § 1141(d)(5)(A) by certifying under penalty of perjury that: 1. All plan payments have been completed. 2. Compliance with 11 U.S.C. § 1141(d)(5)(C): I/We did not have, either at the time of filing this bankruptcy case or at the present time, equity in excess of the dollar amount specified in § 522(q), in the type of property described in 11 U.S.C. § 522(p)(1). OR A. There has been no conviction in any proceeding and there is not currently pending a proceeding in which the debtor(s) may be found guilty of a felony or liable for a debt of a kind described in 11 U.S.C. §522(q)(1)(A) [circumstances showing that the filing of this case was an abuse of the Bankruptcy Code], and American LegalNet, Inc. www.FormsWorkFlow.com B. Neither I (individual case) nor either of us (joint case) is liable for a debt of the kind described in 11 U.S.C. § 522(q)(1)(B) [securities law violations; civil remedies under 18 U.S.C. § 1964; or criminal, intentional, or reckless misconduct that caused death or serious physical injury to an individual in the past five (5) years]. I declare under penalty of perjury that the information contained in this Certificate is true and correct. /s/ Debtor Signature /s/ Joint Debtor Signature CERTIFICATE OF SERVICE The undersigned hereby certifies that on the day of , 20 , a true and correct copy of the Motion for Entry of Discharge, Certificate of Compliance and Notice of Time to Object was served upon all creditors and parties in interested listed on the attached service list by either first class, U.S. Mail or via the CM/ECF system of the United States Bankruptcy Court. If the debtor is appearing pro se, the Clerk's Office will serve the Motion and Certificate on all creditors and parties in interest. /s/ Attorney Signature OR Debtor, if Pro se Print Form Reset Form Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com