Local Form 4004-4 UNITED STATES BANKRUPTCY COURT FOR THE EASTERN DISTRICT OF KENTUCKY In re: Case No. Debtor Chapter 12 CERTIFICATION OF PLAN COMPLETION AND REQUEST FOR DISCHARGE The above-captioned debtor certifies under penalty of perjury that the following are true and correct: 1.All plan payments have been completed and the debtor is entitled to a discharge. 2.Pursuant to 11 U.S.C. 247 1228(a), all amounts payable for domestic support obligations, if any,due on or before the date set forth below (including any amounts due before the filing of thebankruptcy petition to the extent provided for by the plan) have been paid. 3.The provisions of 11 U.S.C. 247 522(q)(1) are not applicable to this case under11 U.S.C. 247 1228(f) and there are no proceedings pending against the debtor of the kind describedin 11 U.S.C. 247 522(q)(1)(A) or 522(q)(1)(B). The undersigned requests that a discharge be granted in accordance with 11 U.S.C. 247 1228(a). DATE: Debtor Joint Debtor (if any) American LegalNet, Inc. www.FormsWorkFlow.com