UNITED STATES BANKRUPTCY COURT DISTRICT OF SOUTH DAKOTA In re: R. E. FORM, Debtor. ) ) ) ) ) ) Bankr. Case No. 06-43210 Chapter 7 STATEMENT REGARDING PAYMENT ADVICES PURSUANT TO 11 U.S.C. § 521(a)(1)(B)(iv)
Pursuant to 11 U.S.C. § 521(a)(1)(B)(iv), I certify under penalty of perjury I did not receive any payment advices or other evidence of payment from any employer within 60 days before the date of the filing of my petition.
Dated: October 17, 2006
______________________________ R.E. Form