IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF KANSAS Case No. Debtor(s)* CERTIFICATION OF EXIGENT OR CRITICAL CIRCUMSTANCES The above-named debtor requests a waiver of the requirement to have credit counseling completed pre-petition pursuant to §109(h). In support of the request, debtor states: 1. I requested credit counseling on (date) from the following approved credit counseling agency (or agencies) . 2. I was unable to obtain the required credit counseling services during the five (5) day period from the date I made the initial request of the agency/agencies. The circumstances which cause me to ask for the waiver of the pre-petition credit counseling requirement are: 3. I declare under penalty of perjury that the foregoing is true and correct. Dated: . Signed: Name: Address: City/State/Zip: Phone: (*Note: If joint debtor case, a separate certificate must be filed by both debtors.) Effective 2/6/06; Revised 5/10/06 American LegalNet, Inc. www.FormsWorkflow.com