United States Bankruptcy Court Debtor'S 11 U.s.c. 1328 Certificate printable pdf download

United States Bankruptcy Court Debtor'S 11 U.s.c. 1328 Certificate

IN THE UNITED STATES BANKRUPTCY COURT

FOR THE NORTHERN DISTRICT OF GEORGIA

__________________ DIVISION

IN RE

)

CASE NO.

)

CHAPTER 13

)

Debtor.

DEBTOR’S 11 U.S.C. § 1328 CERTIFICATE

This form must be completed and filed with the court in order for each debtor to

receive a discharge. In joint cases, this Certificate must be completed and signed by

each debtor.

I declare under penalty of perjury that the information provided

in this Notice is true and correct.

A. Appropriate Box Must Be Checked:

1. During the time this bankruptcy case has been pending, I have not been

required to pay a domestic support obligation (such as child support, maintenance

or alimony) by any order of a court or administrative agency or by any statute.

2. During the time this bankruptcy case has been pending, I have paid all

domestic support obligations (such as child support, maintenance or alimony) as

required under any order of a court or administrative agency or under any statute.

3. During the time this bankruptcy case has been pending, I have not paid all

domestic support obligations, such as child support, maintenance or alimony, as

required by an order of a court or administrative agency or by statute.

If you were obligated to pay a domestic support obligation, please complete the

information below. If not, skip to paragraph B.

The name and address of each holder of a domestic support obligation are:

Name:__________________________

My Current Address:

Address:________________________

______________________________

_______________________________

______________________________

_______________________________

______________________________

_______________________________

United States Bankruptcy Court Debtor'S 11 U.s.c. 1328 Certificate