Declaration Regarding Electronic Filing For Petitions Schedules And Amendments (Declarant)
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Declaration Regarding Electronic Filing For Petitions Schedules And Amendments (Declarant) 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 (Declarant), LBF 5005-4B, New Hampshire Federal, Bankruptcy Court
UNITED STATES BANKRUPTCY COURT
DISTRICT OF NEW HAMPSHIRE
In re:
__________________________________________,
Debtor
Bk. No. ____-_________-____
Chapter ____
DECLARATION REGARDING ELECTRONIC FILING FOR DOCUMENTS OTHER
THAN PETITIONS, SCHEDULES AND AMENDMENTS TO SCHEDULES
PART 1 - Declaration of Declarant:
I,_____________________________________________________, the undersigned declarant,
hereby declares under penalty of perjury that I have signed the document identified below and
that the information contained in the document identified below that is to be electronically filed
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
document identified below has been filed electronically but, in no event, no later than seven (7)
days after the document has been filed. I acknowledge receipt of a copy of the document that is
to be electronically filed.
PART 2 - Identification of Document:
_____________________________________[Name of document] dated ________________,
consisting of _______ pages.
I understand and agree that failure to file the signed original of this DECLARATION is
grounds for the Court to strike the document identified above from the record in this
proceeding.
Date: ___________________
_______________________________________
Name
_______________________________________
Title
(Insert acknowledgment if required)
LBF 5005-4B (Eff. 12/1/09)
American LegalNet, Inc.
www.FormsWorkFlow.com
Part 3 - 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 document identified above is not being presented for
any improper purpose; 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 declarant signed this Declaration and authorized me to electronically file the document
identified above, that I gave the declarant a copy of the document identified above that is to be
electronically filed, and that the document identified in the attached Notice of Electronic Filing
from the CM/ECF system is the document identified above.
Date: ___________________
_______________________________________
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 5005-4B (Eff. 12/1/09)
American LegalNet, Inc.
www.FormsWorkFlow.com