BTXN 171 IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF TEXAS IN RE: ____________________________ Debtor(s) § § § § § Case No. _________________ Chapter _____ DECLARATION FOR ELECTRONIC FILING OF AMENDED PETITION, ORIGINAL/AMENDED BANKRUPTCY STATEMENTS AND SCHEDULES, AND/OR AMENDED MASTER MAILING LIST (MATRIX) As an individual debtor in this case, or as the individual authorized to act on behalf of the corporation, partnership, or limited liability company named as the debtor in this case, I hereby declare under penalty of perjury that I have read G the original statements and schedules to be filed electronically in this case G the voluntary petition as amended on the date indicated below and to be filed electronically in this case G the statements and schedules as amended on the date indicated below and to be filed electronically in this case G the master mailing list (matrix) as amended on the date indicated below and to be filed electronically in this case and that the information provided therein is true and correct. I understand that this Declaration is to be filed with the Bankruptcy Court within five (5) business days after such statements, schedules, and/or amended petition or matrix have been filed electronically. I understand that a failure to file the signed original of this Declaration as to any original statements and schedules will result in the dismissal of my case and that, as to any amended petition, statement, schedule or matrix, such failure may result in the striking of the amendment(s). G [Only include if petitioner is a corporation, partnership or limited liability company] – I hereby further declare under penalty of perjury that I have been authorized to file the statements, schedules, and/or amended petition or amended matrix on behalf of the debtor in this case. Date: __________________. _________________________ Debtor ________________________ Joint Debtor American LegalNet, Inc. www.USCourtForms.com