Free Application for Entry of Chapter 13 Discharge - Connecticut

UNITED STATES BANKRUPTCY COURT DISTRICT OF CONNECTICUT ---------------------------------------------In re: : : Chapter 13 [Debtor(s) name], : : Case No. Debtor(s) : ---------------------------------------------APPLICATION FOR ENTRY OF CHAPTER 13 DISCHARGE The above named Debtor(s) requests the entry of a Chapter 13 discharge. In support of this request, I state as follows [in joint chapter 13 cases, this Application must be signed by both debtors]: 1. I have made all of the payments required under my confirmed Chapter 13 plan, and I have fully complied with the terms of that plan. 2. If, on or before the date of this Application, I was ordered by a court or required by law to pay a domestic support obligation (for example, alimony or child support obligations), I certify that I have paid all such obligations that were due before the date of this Application. 3. I have not been convicted of, and I have no reason to believe that there is pending any proceeding in which I may be found guilty of, a felony (a crime punishable by a maximum term of imprisonment of more than one year) involving the abuse of bankruptcy law. 4. I am not liable for a debt, and I have no reason to believe there is pending any proceeding which I may be held liable for a debt, for: (i) any violation of federal or state securities law; (ii) fraud, deceit, or manipulation in a fiduciary capacity (where I am responsible for managing someone else's money, property, or affairs) or in connection with the purchase or sale of any securities; (iii) any civil remedy under § 1964 of Title 18 U.S. Code (arising from a claim under the Racketeer Influenced and Corrupt Practices Act (RICO)); or (iv) any criminal act, any intentional harm to another, or willful or reckless misconduct that caused serious physical injury or death to another individual in the preceding five (5) years.

_______________________ Debtor Date

_________________________ Joint Debtor ( if applicable) Date