Statement - Motion For Relief Worksheet Not Required {LBF 4001-1B}

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW HAMPSHIRE In re: _________________________________, Debtor Bk. No. ________-_________-_______ Chapter ______ STATEMENT -- MOTION FOR RELIEF WORKSHEET NOT REQUIRED The movant states that LBF 4001-1A, Worksheet Completed by the Mortgagee/Servicer in Support of Motion for Relief from Stay Involving Residential Real Property, is not required to be filed with this motion because: ___ The movant has obtained the debtor's assent to the motion prior to the motion being filed with the court. ___ The debtor has indicated an intent to surrender the real property that is the subject of the motion in the debtor's statement of intention filed with the court pursuant to 11 U.S.C. § 521(a)(2). ___ The debtor has indicated an intent to surrender the real property that is the subject of the motion in the debtor's plan of reorganization. Date: ___________________ ____________________________________ Signature ____________________________________ Print Name Address_____________________________ ____________________________________ Tel. No._____________________________ LBF 4001-1B (Eff. 2/1/13) American LegalNet, Inc. www.FormsWorkFlow.com