Declaration Regarding Status Of Post-Petition Obligations {3015-c}

TXEB Local Form 3015-c (effective 11-1-12) IN THE UNITED STATES BANKRUPTCY COURT FOR THE EASTERN DISTRICT OF TEXAS IN RE: NAME OF DEBTOR Last 4 Digits of Tax ID No. Debtor's Address Debtor(s) § § § § § § § Case No. xx-xxxxx Chapter 13 DECLARATION OF DEBTORS UNDER PENALTY OF PERJURY REGARDING STATUS OF POST-PETITION OBLIGATIONS AS OF CHAPTER 13 PLAN CONFIRMATION HEARING I/We, as the Debtor(s) in the above-referenced case, declare under penalty of perjury that as of the date of this declaration: (1) I /We G have G have not: proposed a plan under which certain claims shall be paid directly by me/us rather than through the Chapter 13 trustee. I/we acknowledge that this includes any claim secured only by a security interest in real property that is my/our principal residence and any other secured claim that I/we have proposed to pay directly (a "direct payment obligation" or "DPO"). Each DPO arising under my/our proposed plan are as follows: Recipient of DPO Payment: ____________________________ ____________________________ ____________________________ (3) Collateral: _____________________________ _____________________________ _____________________________ Due Date of Monthly Payment _____________ _____________ _____________ (2) I/we have paid every DPO that has become due and payable from the date of the filing of my/our bankruptcy case to the date of this declaration; G I/we have paid every "domestic support obligation" ("DSO"), as defined in 11 U.S.C. §101(14A), that has become due and payable from the date of the filing of my/our bankruptcy case to the date of this declaration -- to [name recipient] :_______________________________________________ OR G I/we owe no domestic support obligation; I/we acknowledge that any false statement made herein may result in the imposition of sanctions including, but not limited to, the dismissal of this case with prejudice to my/our rights to re-file for bankruptcy relief for a stated period of time. (4) (5) Date:________________ Signature:___________________________________ Debtor Signature:___________________________________ Joint Debtor, if any Date:________________ American LegalNet, Inc. www.FormsWorkFlow.com