Statement Of Social Security Numbers
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Statement Of Social Security Numbers Form. This is a Illinois form and can be use in USBC Southern Federal.
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Tags: Statement Of Social Security Numbers, Illinois Federal, USBC Southern
IN THE UNITED STATES BANKRUPTCY COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
IN RE:
________________________________________________
________________________________________________
In Proceedings
Under Chapter ___
BK ___-_______
Debtor(s)
STATEMENT OF SOCIAL SECURITY NUMBERS
1. Name of Debtor (enter Last, First, Middle): ________________________________________________
(Check the appropriate box and, if applicable, provide the required information.)
Debtor has a Social Security Number and it is: ______________
(If more than one, state all.)
Debtor does not have a Social Security Number.
2. Name of Joint Debtor(enter Last, First, Middle):_____________________________________________
(Check the appropriate box and, if applicable, provide the required information.)
Joint Debtor has a Social Security Number and it is: ______________
(If more than one, state all.)
Joint Debtor does not have a Social Security Number
I declare under penalty of perjury that the foregoing is true and correct.
X _______________________________________________
Signature of Debtor
Date
X ________________________________________________
Signature of Joint Debtor
Date
______________________________________________________________________________
*Joint Debtors must provide information for both spouses.
Penalty for making a false statement: Fine of up to $250,000 or up to 5 years imprisonment or both. 18 U.S.C. ยงยง 152 and 3571.
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