UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re Debtor. No. Disclosure of Marital Status Pursuant to New Mexico Local Bankruptcy Rule 1002-1 Pursuant to Local Bankruptcy Rule 1002-1, I certify that I have no spouse Or I have a non-filing spouse, whose name is: , and to the best of my knowledge, information and belief, my spouse's address is: I declare under penalty of perjury that the information provided in this disclosure is true and correct. ________________________________________ Debtor’s signature Address: Telephone: (if not represented by an attorney) Non-joint, individual debtor must file NM Form 400 with petition unless the petition is submitted electronically along with debtor signature forms (NM Form 500 or 501 for the appropriate chapter). F:\FORMS\BY NUMBER\NM Form 400.wpd rev 101705 new number NM Form 400 American LegalNet, Inc. www.USCourtForms.com