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UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF KENTUCKY IN RE: ) ) ) ) ) Debtor(s) ) _______________________________________)

CASE NO.

CERTIFICATE OF SERVICE AND NOTICE OF AMENDMENT TO SCHEDULES I hereby certify that a copy of the attached Amendment to Schedules was this , 20 09 forwarded to: day of

(List any Creditor who has not been previously listed and the trustee. Provide com plete addresses).

along with a copy of the Orde for Meeting of Creditorsby depositing a copy of sam in the United r e States mail, properly addressed and postage prepaid. NOTE - Also included is a copy of the Debtor's Pl an and a blank Proof of Claim form to eac h creditor listed above. (Only if case is a Chapter 13).

Local Form B

UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF KENTUCKY IN RE: ) ) ) ) ) Debtor(s) ) _______________________________________ )

CASE NO.

AMENDMENT TO SCHEDULES Comes the Debtor and states that through error and inadvertence, he/she has failed to list in his schedule(s) the following: INSTRUCTIONS FOR COMPLETING AMENDMENTS ARE ATTACHED

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If amendment lists you as a creditor, you have 90 days from the date of certification of mailing of amendment within which to file a proof of claim. (ONLY IF CASE IS A CHAPTER 13 OR ASSET CHAPTER 7).

The undersigned certifies under penalties of perjury, that I have read (1) the foregoing amendment, and certify that the statements therein contained are true and complete to the best of my knowledge, information and belief. Executed on Debtor's Signature Debtor's Signature

Local Form B

INSTRUCTIONS FOR COMPLETING AMENDMENT

1.

Before each entry, specify the purpose of the Amendment by inserting: A. B. C. "ADDED" if the information was missing from the previously filed petition. "CORRECTED" if the information modifies previously listed information. "DELETED" if previously listed information is to be deleted.

2. 3.

All amendments must be typewritten. All amendments must be signed by the debtor.

Local Form B