UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re: Case No. Debtor. CERTIFICATION/STATEMENT REGARDING MARITAL STATUS Pursuant to NM LBR 1002-1, I certify that: EITHER (CHOOSE ONLY ONE) [] OR [] I have a non-filing spouse, whose name is . To the best of my knowledge, information and belief, the last four digits of my spouse's social security number are , and my spouse's mailing address is: ________________ . I declare under penalty of perjury that this information is true and correct. I have no spouse; ________________________________________ Debtor's signature Name: __________________________________ Address: _________________________________ _________________________________ Telephone: _______________________________ Email: __________________________________ NM LF 1002-1 American LegalNet, Inc. www.FormsWorkFlow.com