COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. UNITED STATES BANKRUPTCY COURT : Calendar No. Western District of Washington Attorney Name, Address, Telephone No. & Bar ID No. Plaintiff(s) -against- : JUDICIAL SUBPOENA : : : BANKRUPTCY NO. In re Defendant(s) : ...................................................... (Debtor) DECLARATION RE: ELECTRONIC FILING OF PETITION, SCHEDULES & STATEMENTS THE PEOPLE OF THE STATE OF NEW YORK PART I - DECLARATION OF PETITIONER TO I (WE) and , the undersigned debtor(s), hereby declare under penalty of perjury that the information provided in the electronically filed petition, statements, and schedules is true and correct. I consent to my attorney sending my petition, this declaration, statements and GREETINGS: schedules to the United States Bankruptcy Court. I understand that this DECLARATION RE: ELECTRONIC FILING is to be filed with the Clerk of the Court no later than 5 business days following the date the petition was electronically filed. I understand that failure to file the signed original of this DECLARATION will cause my case to be dismissed pursuant to 11 U.S.C. §attend before WE COMMAND YOU, that all business and excuses being laid aside, you and each of you 707(a)(3) without further notice. , the Honorable at the Court located at County of in room If petitioner is an individual whose debts are primarily consumer debts and who has chosen to andunder chapter , on the day of , 20 , at o'clock in the noon, file at any recessed I am aware that I give evidence as a witness in this action of the 11, United or adjourned :date, to testify andmay proceed under chapter 7, 11, 12 or 13 on Titlepart of the States Code, understand the 9 relief available under each chapter, and choose to proceed under chapter the chapter specified in this petition. . I request relief in accordance with 9 If petitioner is to corporation or this subpoenaI is punishable as a contempt of court the information provided in to Your failure a comply with partnership: declare under penalty of perjury that and will make you liable this the partypetition is true and this subpoena was issued for a maximumfile this petition on behalfdamages sustained as a on whose behalf correct, and that I have been authorized to penalty of $50 and all of the debtor. The debtor result of requests relief incomply. your failure to accordance with the chapter specified in this petition. 9 Court If petitioner files an application to pay filing fee in installments: I certify that I completed an application to pay the Witness, Honorable , one of the Justices of the filing fee in installments. I am aware that the bankruptcy case will be dismissed and I may not receive a discharge in of my debts if the fee is not paid within 120 days of the date of filing the petition. County, day of , 20 Dated: (Attorney must sign above and type name below) Signed: (Applicant) PART II - DECLARATION OF ATTORNEY (Joint Applicant) Attorney(s) for I declare under penalty of perjury that the debtor(s) signed this form before I electronically transmitted the petition, schedules, and statements to the United States Bankruptcy Court, and have followed all other requirements in General Order No. 3. If an individual, I further declare that I have informed the petitioner that [he or she] may proceed under chapter 7, 11, 12 or 13 of Office and P.O. Address Title 11, United States Code, and have explained the relief available under each chapter. This declaration is based on the information of which I have knowledge. Dated: [Local Rules W.D. Wash. Bankr. form 6] Rev. 01/02 Telephone No.: Facsimile No.: Attorney for Debtor(s) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com