Ttggggg information to identify your case: Fill in this Debtor 1 Debtor 2 __________________________________________________________________ First Name Middle Name Last Name ________________________________________________________________ Middle Name Last Name (Spouse, if filing) First Name United States Bankruptcy Court - District of Hawaii Case number ___________________________ Local Form H1009-1 (12/1 ) Cover Sheet for Amendments Part 1: Amendments (attach amended documents to this cover sheet) Check all of the following that are being amended. Schedules: A/B C G H I J Amendments requiring $3 filing fee Schedules: D E/F Creditor List � no fee required for amended list if: only updating an address or only adding a creditor's attorney Statement of Financial Affairs Chapter 7 Statement of Intention Chapter 7 Statement of Current Monthly Income (122A-1) Chapter 7 Means Test Calculation (122A-2) Chapter 13 Statement of Current Monthly Income (122C-1) and Calculation of Disposable Income (122C-2) Other: Part 2: Declaration Under penalty of perjury, the undersigned declares that I have read the documents filed with this declaration and that they are true and correct. [If filing electronically through ECF, a Declaration re: Electronic Filing with original signatures must be submitted on paper not later than 7 days after filing the amendments.] /s/_________________________________ Debtor 1 /s/__________________________________ Debtor 2 Dated: _____________________________ Dated: ______________________________ Part 3: Certificate of Service (attach a list of names and addresses where notice was sent) The undersigned certifies: Notice of the amendments has been served on all creditors and parties in interest on the attached service list. (If exemptions or exemption amounts have been amended, a copy of Schedule C has been served on all creditors and parties in interest.) A copy of the Notice of Bankruptcy Case, Meeting of Creditors, & Deadlines has been served on the additional creditors and parties in interest identified on the attached service list. Dated: _____________________________ /s/ ______________________________ American LegalNet, Inc. www.FormsWorkFlow.com