Free Declaration for electronic filing - Florida

THE UNITED STATES BANKRUPTCY COURT MIDDLE DISTRICT OF FLORIDA ___________________ Division In Re: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ Debtor(s). ___________________/ DECLARATION UNDER PENALTY OF PERJURY FOR ELECTRONIC FILING The undersigned, _________________________________, declares under penalty of perjury that: 1. I have signed the original(s) of the document(s) identified below under penalty of perjury ("Verified Document(s)"). The information contained in the Verified Document(s) is true and correct to the best of my knowledge and belief. I understand that the Verified Document(s) are to be filed in electronic form with the United States Bankruptcy Court in connection with the above captioned case. Chapter: ________ Case No: ____________

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______________________________ Signature of Debtor or other claimant

______________________________ Signature of Joint Debtor

Verified Document(s): Full Descriptive Title ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Date Executed ______________________ ______________________ ______________________ ______________________ ______________________