United States Bankruptcy Court
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1UNITED STATES BANKRUPTCY COURT
SOUTHERN DISTRICT OF IOWA
In re
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Case No.
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)
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Debtor(s)
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VERIFICATION OF MASTER ADDRESS LIST
ON PAPER (CREDITOR MATRIX)
I (we) declare under penalty of perjury that I (we) have read the attached Master Address List
(creditor matrix), consisting of _____ pages, and that it is true and correct to the best of my (our)
knowledge, information, and belief.
DATED:
Debtor’s Signature
Joint Debtor’s Signature
PRINT
VER_MTRX (Rev. 04/00)
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