UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In re: Case No. BKY _____________ Debtor(s) Chapter __ Case AMENDMENT TO PETITION To: Clerk of Bankruptcy Court The original petition filed on ____________________________ is amended as follows: -----------------------------------------------------------Social Security Number The correct Social Security numSSN ber(s) and/or Employer's Federal __________________________ and State Tax Identification numSSN ber(s) of the Debtor(s) is (are): __________________________ FTN __________________________ STN __________________________ -----------------------------------------------------------Name The correct name(s) of the Debtor(s), including AKA, DBA, or ASF if any, is (are): -----------------------------------------------------------Address The correct address(es) of the Debtor(s), in __________________ County, is (are): -----------------------------------------------------------Verification I (We), debtor(s) named in the foregoing amended schedule, declare under penalty of perjury that the foregoing is true and correct. Executed on: _________________________ Signed: ___________________________ Debtor Signed: ___________________________ Debtor (spouse if joint case) Signed: ______________________________ Attorney for Debtor(s) Print Attorney Name: ___________________ Attorney Address: __________________________________________________________ Phone: _______________________________ License Number: _______________________ Clerk’s Form 16;Rev10/03 Local Rule 1009-1. American LegalNet, Inc. www.USCourtForms.com