Chapter 13 - Debtor'S Certificate To Obtain Discharge Pursuant To 11 U.s.c. 1328 Page 2

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DECLARATION UNDER PENALTY OF PERJURY
I declare under penalty of perjury that I have read the foregoing statement and that it is
true and correct to the best of my knowledge, information, and belief.
Dated: ______________________
By: _______________________________
Signature of debtor
__________________________________
Printed name of debtor
Home address
Telephone number
Facsimile number
E-mail address
CERTIFICATE OF SERVICE
The undersigned hereby certifies that a true and correct copy of the Chapter 13 Debtor’s
Certification to Obtain Discharge was served by placing the same in the United States Mail, first
class postage pre-paid, this (month/day/year) to the following:
Commentary
Pursuant to 11 U.S.C. § 1328, this form is to be completed as soon as practicable after
completion by the debtor of all payments under the plan. This form must be completed and filed
with the court in order for the debtor to receive a discharge. In joint cases, the form must be
completed and filed by each debtor.
L. B. Form 3015.11 must be served on the following: chapter 13 trustee, debtor and any parties
in interest, or as otherwise ordered by the court.

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