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Declaration Re Electronic Filing Form. This is a Michigan form and can be use in USBC Western Federal.
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Tags: Declaration Re Electronic Filing, Michigan Federal, USBC Western
Revised 04/07
UNITED STATES BANKRUPTCY COURT
WESTERN DISTRICT OF MICHIGAN
In Re:
Bankruptcy Case No.:
Debtor(s)/
DECLARATION RE: ELECTRONIC FILING
PART I - DECLARATION OF PETITIONER:
I _
_____
____ and ___ ___________________, the undersigned debtor(s), corporate officer, partner,
or member, hereby declare under penalty of perjury that the information I have given or will give my attorney and the
information provided in the electronically filed petition, statements and schedules is true and correct. I declare under
penalty of perjury that the Social Security Number(s) indicated below, as electronically transmitted with my
petition, is(are) true and correct. I consent to my attorney sending my petition, this declaration, statements and
schedules and any future amendments of these documents to the United States Bankruptcy Court, United States Trustee
and Panel Trustee. I understand that this DECLARATION RE: ELECTRONIC FILING is to be filed with the Clerk after
the petition has been filed electronically but, in any event, no later than 5 business days after the petition has been filed.
I understand that failure to file the signed original of this DECLARATION will cause my case to be dismissed without
further notice.
[If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter 7] I am
aware that I may proceed under chapter 7, 11, 12, or 13 of 11 United States Code, understand the relief available under
each such chapter,[and choose to proceed under chapter 7]. I request relief in accordance with the chapter specified
in the petition.
[If petitioner is a corporation, partnership or limited liability entity] I declare under penalty of perjury that the information
provided in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor.
The debtor requests relief in accordance with the chapter specified in this petition.
Dated:
Debtor
Soc. Sec. No.:
Dated:
Joint Debtor
Soc. Sec. No.:
______________
Authorized Corporate Officer, Partner, or Member
PART II - DECLARATION OF ATTORNEY:
I declare under penalty of perjury that I have reviewed the above debtor’s[s’] petition, schedules, statements and that
the information is complete and correct to the best of my knowledge. The debtor(s) signed this Declaration before I
submitted the petition, schedules and statements. I will retain all petitions, schedules, statements, amendments, and
pleadings filed with the court which contain the debtor’s original signature. I will give the debtor(s) a copy of all pleadings
and information to be filed with, or received from, the United States Bankruptcy Court, and have complied with all other
requirements of this Court. I have informed the individual petitioner that [he and/or she] may proceed under chapter 7,
11, 12 or 13 of Title 11, United States Code, and have explained the relief available under each such chapter. This
declaration is based upon all information of which I have knowledge.
Dated: ________________
Signed:______
__________________
Attorney for Debtor(s), Michigan Bar No.
Attorney Address/ E-mail Address
Attorney Phone No./ Fax No.
________
(FILE ORIGINAL WITH COURT. DO NOT FILE ELECTRONICALLY)
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