LF 1007-1 (02/15/15) UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF WASHINGTON In re Debtor(s) ) ) ) ) ) ) Case No. DECLARATION REGARDING PAYMENTS Attached hereto are copies of all payment advices, pay stubs or other evidence of payment received by the debtor from an employer within 60 days before the date of the filing of the petition, with redaction of all but the last four digits of the debtor's social security number or individual tax payer identification number. Debtor has received no payment advices, pay stubs or other evidence of payment from any employer within 60 days prior to the filing of the petition. Debtor declares the foregoing to be true and correct under penalty of perjury. Dated: Signature of Debtor DECLARATION REGARDING PAYMENTS American LegalNet, Inc. www.FormsWorkFlow.com