MSSB-CC-E (Rev. 12/15) UNITED STATES BANKRUPTCY COURT Southern District of Mississippi In re: ________________________________ Debtor Case Number: ____________ Chapter: ___ Certification of Exigent Circumstances The undersigned debtor (the "debtor") certifies that he/she sought credit counseling services from an approved agency but was unable to obtain those services during the 7 days after he/she made a request. Exigent circumstances merit a 30-day temporary waiver of the requirement for credit counseling. The following is an explanation of: the debtor's efforts made to obtain the credit counseling; the reason(s) why the debtor was unable to obtain credit counseling before filing for bankruptcy; and why the exigent circumstances that merit a 30-day temporary waiver of the requirement: The debtor understands: · · His/Her case may be dismissed if the court is dissatisfied with the reason for not receiving credit counseling before filing for bankruptcy. If the court is satisfied with the debtor's explanation, the debtor must still receive credit counseling within 30 days after filing the bankruptcy case and file a certificate from the approved agency along with a copy of the payment plan developed, if any. If the debtor does not do so, the debtor's case may be dismissed. Any extension of the 30-day deadline will only be granted for cause and is limited to a maximum of 15 days. · I certify under penalty of perjury that the information provided above is true and correct to the best of my knowledge and belief. Date: _______________________________ Debtor's Signature American LegalNet, Inc. www.FormsWorkFlow.com