OFFICIAL LOCAL FORM 9 UNITED STATES BANKRUPTCY COURT DISTRICT OF MASSACHUSETTS In re Chapter Bankruptcy No. , Debtor(s) CERTIFIED REQUEST PURSUANT TO 11 U.S.C. §109(h)(3) FOR EXTENSION OF TIME TO FILE CREDIT COUNSELING CERTIFICATE Pursuant to 11 U.S.C. §109(h)(3), the Debtor(s) certify (ies) that he/she/they did not obtain the credit counseling briefing pursuant to 11 U.S.C. 109(h)(1) and requests that the Court extend the time to file and/or obtain a credit counseling certificate, based upon the following grounds: 1. The following exigent circumstances exist preventing compliance (for example, foreclosure, eviction, incarceration, medical or other problems): _____________________________ ________________________________________________________________________. 2. I/We (Check whichever applies) _______did request credit counseling services from an approved agency but was/were unable to obtain said services during the 5-day period following the request. _______did not request credit counseling services. 3. I/We request an extension of time to a date no longer than 45 days after the date of the filing of the bankruptcy petition because: __________________________________________. Signed under the pains and penalties of perjury on this _____day of ______________ _________________________, ______. _____________________________ Debtor ___________________________________ Joint Debtor ORDER G The Request is denied. G The Request is approved. The time for filing the certificate is extended to _________________. Dated: ___________________________________ United States Bankruptcy Judge American LegalNet, Inc. www.FormsWorkflow.com