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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 (If known) ___________________________ Local Form H5005dec (12/15) Declaration re: Electronic Filing Important! This form is required when certain documents are filed electronically by your attorney. Signing this form means that you are declaring, under penalty of perjury, that the information in the documents checked below is true and correct. Do not sign this declaration unless you have read the documents and they are complete and accurate. You or your attorney must mail or deliver this declaration to the court within 7 days after the documents are filed or the court may dismiss your case and/or sanction your attorney. You must also sign the original documents that must be retained by your attorney. This declaration concerns the following: Petition Authorization for Non-Individual Entity to File Petition Verification of Creditor List List of 20 Largest Unsecured Creditors Schedules A-J or ______________ Chapter 13 Plan Statement of Financial Affairs Statement of Current Monthly Income/Means Test Calculation/Disposable Income Calculation (Form 122s) Other: (See reverse side if this is an involuntary or chapter 15 case) Declaration by Individual(s). I declare under penalty of perjury that the information provided in the document(s) identified above is true and correct to the best of my knowledge, information, and belief. If the document is a petition and my debts are primarily consumer debts and I have chosen to file under chapter 7, I am aware that I may proceed under chapter 7, 11, 12 or 13 of title 11, United States Code, understand the relief available under each chapter, and choose to proceed under chapter 7. I request relief in accordance with the chapter of title 11, United States Code, specified in my electronically filed petition. If this filing includes a chapter 13 plan, I certify that the plan has been proposed in good faith, that the information provided in the plan is true and correct, and that I will be able to make all plan payments and otherwise comply with provisions of the plan. I declare under penalty of perjury that the Social Security Number or Individual Taxpayer Identification Number transmitted with my petition is true and correct. Declaration by Non-Individual Debtor (Corporation/LLC). I declare under penalty of perjury that the information provided in the document(s) noted above is true and correct to the best of my knowledge, information, and belief, and that I have been authorized to file the petition on behalf of the debtor. I request relief in accordance with the chapter of title 11, United States Code, specified in the electronically filed petition. [When signing below, indicate position or relationship to Debtor.] Signature(s) of Debtor(s) or Authorized Individual: X _________________________________ Debtor 1 X__________________________________ Debtor 2 Dated: _____________________________ Dated: ______________________________ American LegalNet, Inc. www.FormsWorkFlow.com Debtor 1 _______________________________________________________ First Name Middle Name Last Name Case number (if known)_____________________________________ DECLARATION re: ELECTRONIC FILING of Petition and Related Documents (Sign this side if this concerns an involuntary petition or chapter 15 case) Involuntary Petition - Declaration of Petitioning Creditor(s). I declare under penalty of perjury that the information in the electronically filed involuntary petition is true and correct according to the best of my knowledge, information, and belief. The undersigned requests that an order for relief be entered against the debtor under the chapter of title 11, United States Code, specified in the petition. Declaration of Foreign Representative. I declare under penalty of perjury that the information provided in the electronically filed petition is true and correct to the best of my knowledge, information, and belief, that I am the foreign representative of a debtor in a foreign proceeding, and that I am authorized to file the petition. I request relief in accordance with chapter 15, United States Code, or with the chapter of title 11 specified in the petition. Sign and print name and title: X ________________________ __________________________ Date: ______________________ X ________________________ __________________________ Date: ______________________ X _________________________ ___________________________ Date: ______________________ American LegalNet, Inc. www.FormsWorkFlow.com