Official Form 23 LF023 UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF TENNESSEE In re Case No. Chapter Debtor(s) DEBTOR'S CERTIFICATION OF COMPLETION OF INSTRUCTIONAL COURSE CONCERNING PERSONAL FINANCIAL MANAGEMENT Every individual debtor in a chapter 7 or chapter 13 case must file this certification. If a joint petition is filed, each spouse must complete and file a separate certification. Complete one of the following statements and file by the deadline stated below: [Complete one of the following statements.] I/We,____________________________________________________________, the debtor(s) in (Printed Name(s) of Debtor and Joint Debtor, if any) the above-styled case hereby certify that on _______________________________________ (Date) I/we completed an instructional course in personal financial management provided by__________ _____________________, an approved personal financial management instruction provider. If the provider furnished a document attesting to the completion of the personal financial management instructional course, a copy of that document is attached. Certificate No:______________________________________ Joint Debtor Certificate No: ___________________________ I/We ___________________________________________________, the debtor(s) in above-styled (Printed Name(s) of Debtor and Joint Debtor, if any) case hereby certify that no personal financial management course is required because: [Check the appropriate box.] I am/We are incapacitated or disabled, as defined in 11 U.S.C. §109(h); I am/We are on active military duty in a military combat zone; or I/We reside in a district in which the United States Trustee (or bankruptcy administrator) has determined that the approved instructional courses are not adequate at this time to serve the additional individuals who would Signature of Debtor:_____________________________________ Date:___________________________ Signature of Joint Debtor:_________________________________ Date:____________________________ Instructions: Use this form only to certify whether you completed a course in personal financial management. (Fed. R. Bankr. P. 1007(b)(7).) Do NOT use this form to file the certificate given to you by your prepetition credit counseling provider and do NOT include with the petition when filing your case. Filing Deadlines: In a chapter 7 case, file within 45 days of the first date set for the meeting of creditors under §341 of the Bankruptcy Code. In a chapter 13 case, file no later than the last payment made by the debtor as required by the plan or the filing of a motion for entry of a discharge under § 1328(b) of the Code. (See Fed. R. Bankr. P. 1007©.) American LegalNet, Inc. www.FormsWorkFlow.com