Verification Of Creditor Matrix Template

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Revised 7/2001
LBR Appendix 1007-b-6
UNITED STATES BANKRUPTCY COURT
EASTERN DISTRICT OF TEXAS
IN RE:
______________________________
_____________________
Debtor(s)
Bankruptcy Case Number
VERIFICATION OF CREDITOR MATRIX
The above named Debtor(s) hereby verifies that the attached list of creditors is
true and correct to the best of my/our knowledge.
Creditor Matrix Format (check one):
Diskette:
________________
Paper:
________________
Date: __________________
_________________________________
Debtor Signature
Date: __________________
_________________________________
Joint Debtor Signature

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