Official Form 101 Voluntary Petition For Individuals Filing For Bankruptcy Page 7
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8Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility
For your attorney, if you are
to proceed under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief
represented by one
available under each chapter for which the person is eligible. I also certify that I have delivered to the debtor(s)
the notice required by 11 U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, certify that I have no
If you are not represented
knowledge after an inquiry that the information in the schedules filed with the petition is incorrect.
by an attorney, you do not
need to file this page.
_________________________________
_________________
Date
Signature of Attorney for Debtor
MM
/
DD / YYYY
_________________________________________________________________________________________________
Printed name
_________________________________________________________________________________________________
Firm name
_________________________________________________________________________________________________
Number
Street
_________________________________________________________________________________________________
______________________________________________________ ____________ ______________________________
City
State
ZIP Code
Contact phone _____________________________________
Email address ______________________________
______________________________________________________ ____________
Bar number
State
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 7
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