Form B19 - Declaration And Signature Of Non-Attorney Bankruptcy Petition Preparer Page 2

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B19 (Official Form 19) (12/07) - Cont.
2
NOTICE TO DEBTOR BY NON-ATTORNEY BANKRUPTCY PETITION PREPARER
[Must be filed with any document(s) prepared by a bankruptcy petition preparer.]
I am a bankruptcy petition preparer. I am not an attorney and may not practice law or give
legal advice. Before preparing any document for filing as defined in § 110(a)(2) of the Bankruptcy
Code or accepting any fees, I am required by law to provide you with this notice concerning
bankruptcy petition preparers. Under the law, § 110 of the Bankruptcy Code (11 U.S.C. § 110), I am
forbidden to offer you any legal advice, including advice about any of the following:
whether to file a petition under the Bankruptcy Code (11 U.S.C. § 101 et seq.);
whether commencing a case under chapter 7, 11, 12, or 13 is appropriate;
whether your debts will be eliminated or discharged in a case under the Bankruptcy Code;
whether you will be able to retain your home, car, or other property after commencing a case
under the Bankruptcy Code;
the tax consequences of a case brought under the Bankruptcy Code;
the dischargeability of tax claims;
whether you may or should promise to repay debts to a creditor or enter into a reaffirmation
agreement with a creditor to reaffirm a debt;
how to characterize the nature of your interests in property or your debts; or
bankruptcy procedures and rights.
[The notice may provide additional examples of legal advice that a bankruptcy petition preparer is
not authorized to give.]
In addition, under 11 U.S.C. § 110(h), the Supreme Court or the Judicial Conference of the
United States may promulgate rules or guidelines setting a maximum allowable fee chargeable by a
bankruptcy petition preparer. As required by law, I have notified you of this maximum allowable
fee, if any, before preparing any document for filing or accepting any fee from you.
____________________________________
_______________________________
Signature of Debtor
Date
Joint Debtor (if any)
Date
[In a joint case, both spouses must sign.]
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