Application For Certification To Chapter 13 Trustee Page 2
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1
2Instructions for completing Application for Certification to
Chapter 13 Trustee
1. Complete the Application showing taxpayer’s name and social security number.
In a joint bankruptcy, each taxpayer must submit a separate application.
2. In paragraph 1, list the date when the bankruptcy petition was filed and the case
number. (If the petition has not been filed, list the expected filing date and write
“to be filed” in the blank for the case number.)
3. In paragraph 2, list the name and address of taxpayer’s attorney. (If you are
filing bankruptcy without an attorney, list your name and address in paragraph
2.)
4. In paragraph 4, indicate any tax years for which the taxpayer was not required to
file a return.
5. Sign the Application and have it notarized.
6. Attach copies of any tax returns filed within 6 months before the application
date.
7. Attach originals of any Iowa income tax returns not previously filed.
8. Mail the completed Application to following address:
Iowa Department of Revenue
Attn: Bankruptcy Unit
P.O. Box 10471
Des Moines, IA 50306
9. If the taxpayer has filed all required income tax return forms for years that ended
within the four years prior to the bankruptcy, the Department of Revenue will
complete the Certificate to Chapter 13 Trustee. The Department will then mail
the Certificate to the trustee.
Accts Rec tab/Chapter 13 Trustee Certification
Last updated: 01/10/07
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