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Declaration Regarding Electronic Filing For Petitions Schedules And Amendments (Petitioner) Form. This is a New Hampshire form and can be use in Bankruptcy Court Federal.
Tags: Declaration Regarding Electronic Filing For Petitions Schedules And Amendments (Petitioner), LBF 5005-4A, New Hampshire Federal, Bankruptcy Court
UNITED STATES BANKRUPTCY COURT
DISTRICT OF NEW HAMPSHIRE
In re:
__________________________________________,
Debtor
Full Social Security No. of Debtor:
Full Social Security No. of Joint Debtor:
Bk. No. ____-_________-____
Chapter ____
_______-_____-_______
_______-_____-_______
DECLARATION REGARDING ELECTRONIC FILING FOR PETITIONS,
SCHEDULES AND AMENDMENTS TO SCHEDULES
PART 1 - Declaration of Petitioner:
I, ________________________________________, the undersigned debtor, corporate officer,
partner or managing member, hereby declares under penalty of perjury that the information I
have given my attorney and the information contained in the petition, statements and schedules,
or amendments thereof that are to be electronically filed (the “petition and schedules”),
consisting of ___ pages, is true and correct, to the best of my knowledge and belief. I understand
that this DECLARATION REGARDING ELECTRONIC FILING is to be submitted to the clerk
after the petition and schedules have been filed electronically but, in no event, no later than seven
(7) days after the petition and schedules have been filed. I acknowledge receipt of a copy of the
petition and schedules that are to be electronically filed.
9 [If petitioner is an individual] I am aware that I may proceed under Chapter 7, 11, 12, or 13 of
Title 11 of the United States Code, and I understand the relief available under each such chapter.
I request relief in accordance with the chapter specified in the petition. I declare under penalty of
perjury that the foregoing Social Security number is true and correct.
9 [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.
I understand that failure to file the signed original of this DECLARATION is grounds for
dismissal of my case pursuant to 11U.S.C. § 707(a)(3).
Date: _____________________
Signed: _________________________
Debtor
__________________________________________
Authorized Corporate Officer/Partnership Member
__________________________________________
Joint Debtor (if joint case, both spouses must sign)
LBF 5005-4A (Eff. 12/1/09)
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Part 2 - Declaration of Attorney:
I declare that, to the best of my knowledge, information and belief, formed after an inquiry
reasonable under the circumstances, that the petition and schedules are not being presented for
any improper purpose; that the claims, defenses, and other legal contentions therein are
warranted and are not frivolous; that the allegations and other factual contentions have, or will
have, evidentiary support; and that the denials of factual contentions are warranted. I further
certify that the debtor signed this Declaration and authorized me to electronically file the petition
and schedules, that I gave the debtor a copy of the petition and schedules that are to be
electronically filed, and that the petition and schedules identified in the attached Notice of
Electronic Filing from the CM/ECF system fully and accurately reflect the information given to
me by the debtor. I have complied with all other electronic filing requirements. I have informed
the individual petitioner that [he and/or she] may proceed under Chapter 7, 11, 12 or 13 of Title
11of the 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.
Date: ___________________
____________________________________
Attorney Signature
____________________________________
Print Name
Address_____________________________
____________________________________
Tel. No._____________________________
NOTE: You must attach the Notice of Electronic Filing as an exhibit.
(FILE ORIGINAL WITH COURT. DO NOT FILE ELECTRONICALLY.)
LBF 5005-4A (Eff. 12/1/09)
American LegalNet, Inc.
www.FormsWorkFlow.com