Free LBF - DECLARATION REGARDING ELECTRONIC FILING (Over the Counter Filings Only) - Illinois

UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION EASTERN IN RE: ) Chapter ) Bankruptcy Case No. ) ) ) DECLARATION REGARDING ELECTRONIC FILING Signed by Debtor(s) or Corporate Representative and Attorney To Be Used When Submitting Petition on Diskette PART I - DECLARATION OF PETITIONER A. To be completed in all cases. Date:

Debtor(s)

I(We) and , the undersigned debtor(s), corporate officer, partner, or member, hereby declare under penalty of perjury that the information I(we) have given my (our)attorney, including correct social security number(s) and the information provided in the electronically filed petition, statements, schedules, and if applicable, application to pay filing payin installments,installments, is for Waivercorrect. filed petition, statements, schedules, and if applicable, application to fee filing fee in and Application true and of the I(we) consent to my(our) and correct. If(we) the petition, statements, schedules, and this statements, schedules, and this Chapter 7 Filing Fee, is true attorney sending consent to my(our) attorney sending the petition, DECLARATION to the United States Bankruptcy the United States Bankruptcythat thisI(we) understand that must be filed with the Clerk in addition Clerk in DECLARATION to Court. I(we) understand Court. DECLARATION this DECLARATION must be filed with the to the petition.toI(we) understand that failure to failure to DECLARATION will cause this this case be be dismissed pursuant to 11 addition the petition. I(we) understand that file this file this DECLARATION will cause case to to dismissed pursuant to 11 U.S.C.sections 707(a) and 105. U.S.C. sections 707(a) and 105.

B.

To be checked and applicable only if the petitioner is an individual (or individuals) whose debts are primarily consumer debts and who has (or have) chosen to file under chapter 7.

G

I(we) am(are) aware that I(we) may proceed under chapter 7, 11, 12, or 13 of Title 11 United States Code; I(we) understand the relief available under each such chapter; I(we) choose to proceed under chapter 7; and I(we) request relief in accordance with chapter 7.

C.

To be checked and applicable only if the petition is a corporation, partnership, or limited liability entity.
G
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 the petition. Signature: (Joint Debtor)

Signature: (Debtor or Corporate Officer, Partner or Member)

PART II - DECLARATION OF ATTORNEY
I declare under penalty of perjury that I have reviewed the above debtor's(s') petition and that the information is complete and correct to the best of my knowledge. The debtor(s) will have signed this form before I submit the petition, schedules, and statements. I will give the debtor(s) a copy of all forms and information to be filed with the United States Bankruptcy Court. If an individual, I further declare that I have informed the petitioner(s) that they 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. This declaration is based on all information of which I have knowledge.

Signature of Attorney: Typed or Printed Name of Attorney:

01/08