Affidavit Of Payment Of Fees
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Affidavit Of Payment Of Fees Form. This is a New Hampshire form and can be use in Bankruptcy Court Federal.
Tags: Affidavit Of Payment Of Fees, LBF 1017-2, New Hampshire Federal, Bankruptcy Court
UNITED STATES BANKRUPTCY COURT
DISTRICT OF NEW HAMPSHIRE
In re:
______________________________________,
Debtor
Bk. No. ____-_________-____
Chapter ____
AFFIDAVIT OF PAYMENT OF FEES
The undersigned depose and say as follows:
All fees owing by the above-captioned Debtor to the United States Bankruptcy Court for the
District of New Hampshire and the United States Trustee including, without limitation, unpaid
installment filing fees and quarterly fees payable to the United States Trustee, have been paid in
full by said Debtor.
[Form for Individual Debtors]
Date:____________________
_________________________________
_______________________[Print Name]
[Form for Partnership/Corporate Debtors]
Date:____________________
_________________________________
_______________________[Print Name]
Duly Authorized
[Form for Attorneys]
Date:____________________
_________________________________
_______________________[Print Name]
STATE/COMMONWEALTH OF _____________________
COUNTY OF_____________________________________
Subscribed and sworn to before me this ____ day of _________________, 20___, by
________________________________ [Name of Deponent].
_________________________________
Notary Public
My commission expires:
LBF 1017-2 (Eff. 12/1/09)
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