IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF MARYLAND at _____________________ IN RE: * * * Debtor(s) * PRE-CONFIRMATION CERTIFICATION Debtor(s) hereby certify under penalty of perjury that the following statements are true and correct: 1. Debtor(s) has/have paid any fee, charge, amount required under Section 1930 of title 28, U.S.C, or by the plan (i.e. adequate protection payments) to be paid before confirmation. 2. Debtor(s) has/have paid all amounts that are required under a domestic support obligation and that first became payable after the date of the filing of the petition, if applicable. 3. Debtor(s) has/have filed all applicable Federal, State, and Local tax returns with the appropriate taxing authorities for all taxable periods ending during the 4-year period ending on the date of the filing of the petition. Debtor(s) affirm that the plan is proposed in accordance with 11 U.S.C § 1325 and request said plan be confirmed. Date:___________________________ ____________________________________ Debtor's Signature ____________________________________ Joint Debtor's Signature Case No. _______ Chapter 13 Date:___________________________ Local Bankruptcy Form O Ver. 08.16 American LegalNet, Inc. www.FormsWorkFlow.com