Statement Under Penalty Of Perjury Concerning Payment Advices Due Pursuant To 11 USC 521(a)(1)(B)(iv)
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Statement Under Penalty Of Perjury Concerning Payment Advices Due Pursuant To 11 USC 521(a)(1)(B)(iv) Form. This is a Maryland form and can be use in Bankruptcy Court Federal.
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Tags: Statement Under Penalty Of Perjury Concerning Payment Advices Due Pursuant To 11 USC 521(a)(1)(B)(iv), LBF Q, Maryland Federal, Bankruptcy Court
UNITED STATES BANKRUPTCY COURT
FOR THE DISTRICT OF MARYLAND
IN RE:
§
§
§ Case No. __________
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§
§
Debtor(s).
STATEMENT UNDER PENALTY OF PERJURY CONCERNING
PAYMENT ADVICES DUE PURSUANT TO 11 U.S.C. §521(a)(1)(B)(iv)
I, _____________________________(Debtor’s name1), state that I did not provide
copies of all payment advices or other evidence of payment received within 60 days before the
date of the filing of the petition, by me from any employer because:
_____ (1) I was not employed during the period immediately preceding the filing of the
above-referenced case _______________________ (state the dates that you were not employed);
_____ (2) I was employed during the period immediately preceding the filing of the
above referenced case but did not receive any payment advices or other evidence of payment
from my
employer within 60 days before the filing of the petition;
_____ (3) I am self employed and do not receive any evidence of payment;
_____ (4) Other (please explain) _______________________________________.
I declare under penalty of perjury that I have read the foregoing statements and that they
are true and accurate to the best of my knowledge, information and belief.
Dated this _____ day of __________, 20___.
__________________________________________ (Signature of Debtor)
Debtor
1
A separate form must be filed for each Debtor
Local Bankruptcy Form Q
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