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) American LegalNet, Inc. www.FormsWorkFlow.com