Free FORM 3015-5 – Debtor’s Certification In Support of Discharge - Pennsylvania

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LOCAL BANKRUPTCY FORM 3015-5

IN THE UNITED STATES BANKRUPTCY COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA IN RE: : : : : : CHAPTER 13 CASE NO. -bk-

Debtor(s)

DEBTOR'S CERTIFICATION IN SUPPORT OF DISCHARGE I, 1. , upon my oath according to law, hereby certify as follows: My current address is: ___________________________ ___________________________ ___________________________ The name and address of my current employer is: _______________________________________ _______________________________________ _______________________________________ _______________________________________ _____ I am not required to pay any Domestic Support Obligations, or _____ I am required to pay Domestic Support Obligations and I have paid any amounts payable under a Court Order or Statute that were due on or before the date of this Certification. If this Certification is being signed by counsel for Debtor(s), that the Debtor(s) was/were duly questioned about the statements in this Certification and supplied answers consistent with this Certification.

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I hereby swear or affirm under penalty of perjury under United States laws that the foregoing statements made by me are true and correct (28 U.S.C. Section 1746; 18 U.S.C. Section 1621.) DATED:__________________ BY:_______________________________ Counsel for Debtor(s) BY:_______________________________ Debtor BY:_______________________________ Debtor

DATED:__________________

DATED:__________________