United States Bankruptcy Court Western District of Wisconsin In re: Debtor(s) Case Number: DECLARATION RE: ELECTRONIC FILING PART I - DECLARATION OF PETITIONER: I[We] _________________________ and _________________________, the undersigned debtor(s), corporate officer, partner, or member, hereby declare under penalty of perjury that the information I have given or will give my attorney and 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 schedules and any future amendments of these documents to the United States Bankruptcy Court, United States Trustee and Panel Trustee. I understand that this DECLARATION RE: ELECTRONIC FILING is to be filed with the Clerk after the petition has been filed electronically but, in any event, no later than 5 business days after the petition has been filed. I understand that failure to file the signed original of this DECLARATION may cause my case to be dismissed. [If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12, or 13 of Title 11, United States Code, understand the relief available under each such chapter, and choose to proceed under chapter 7. I request relief in accordance with the chapter specified in the petition. [If petitioner is a corporation, partnership or limited liability entity] I declare under penalty of perjury that the information provided in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. The debtor requests relief in accordance with the chapter specified in this petition. Signed: Debtor Dated: Joint Debtor (If joint case, both spouses must sign) Authorized Corporate Officer, Partner, or Member PART II - DECLARATION OF ATTORNEY: I declare under penalty of perjury that the debtor(s) signed this Declaration before I submitted the petition, schedules, and statements. I have informed the individual petitioner that he and/or she may proceed under chapter 7, 11, 12, or 13 of Title 11, United States Code, and have explained the relief available under each such chapter. Dated: Signed: Attorney for Debtor(s) print here: Wisconsin Bar Number: Attorney Address, phone, fax and e-mail: (FILE ORIGINAL WITH COURT. DO NOT FILE ELECTRONICALLY) American LegalNet, Inc. www.USCourtForms.com