Debtor(s) Declaration Regarding Electronic Filing (Form A) {ELR07a}

, Southern District of Georgia Debtor(s) Declaration Regarding Electronic Filing Debtor______________________Joint Debtor_______________________ Case No.________________ Electronic Docket No. Date of Electronic Filing Declaration for Filing of a Petition, (Schedules, Statement of Affairs, Chapter 13 Plan, if filed with the petition) and Verification of Social Security Number. I (We) SSN or No SSN and SSN or No SSN the undersigned Debtor(s), hereby declare under penalty of perjury, that I/we have read the petition, statements, schedules, lists, and Chapter 13 plan (if filed with the petition) as prepared by the undersigned attorney for electronic filing, as well as the information appearing above, and that the information contained therein is true and correct. (Check the appropriate boxes): Petition, Statement of Affairs, Schedules or Lists Chapter 13 Plan (if filed with the petition) If petitioner is an individual whose debts are primarily consumer debts and who has chosen to file under Chapter 7: I am aware that I may proceed under Chapter 7, 11, 12 or 13 of Title 11, United States Code, and understand the relief available under each chapter and choose to proceed under Chapter 7. I request relief in accordance with the chapter specified in the petition. If petitioner is a corporation or partnership: I declare under penalty of perjury that the information provided in the petition is true and correct, and that I have been authorized to file this petition on behalf of the Debtor. The Debtor requests relief in accordance with the chapter specified herein. If petitioner files an application to pay the filing fee in installments: I certify that I completed an application to pay the filing fee in installments. I am aware that the bankruptcy case will be dismissed and that I may not receive a discharge of my debts if the fee is not timely paid. I understand that this DECLARATION REGARDING ELECTRONIC FILING is to be filed with the Clerk of the Court no later than fifteen (15) days following the date the petition or other document was electronically filed. I understand that failure to file the signed original of this DECLARATION may cause my case to be dismissed. I have reviewed a true copy of the document(s) filed under this declaration and find them to be true and correct. I consent to my attorney sending such petition, statements, schedules, lists, and chapter 13 plan (if filed with the petition) thereto to the United States Bankruptcy Court by electronic means. Date Debtor Joint Debtor Declaration of Attorney I ___________________________________,attorney for the Debtor(s), declare under penalty of perjury that the Debtor(s) signed this form before I electronically transmitted the petition, statements, schedules, and Chapter 13 plan (if filed with the petition) to the United States Bankruptcy Court; I have followed all other requirements in General Order 2005-7(as amended); and I have provided the Debtor with a true copy of the aforementioned petition, statements, schedules, lists, and Chapter 13 plan (if filed with the petition), that reflect the exact documents filed with the court. If the Debtor is an individual, I further declare that I have informed the petitioner that he or she may proceed under Chapter 7, 11, 12 or 13 of Title 11, United States Code, and have explained the relief available under each chapter. This declaration is based on information of which I have knowledge. Date____________ Attorney___________________________________Georgia Bar ID No._________________________ E-Mail Address__________________________________________________Telephone Number_____________________ Instructions: Use this form when filing the petition. The form is designed to cover the schedules, statements and chapter 13 plan when accompanying the petition itself. Pursuant to Rule 1007 Federal Rules of Bankruptcy Procedure [Interim], and Local Bankruptcy ECF Rule 7, this form must be executed by the debtor(s) and the attorney for the debtor(s) and submitted to the Clerk within fifteen (15) days after electronic filing of the petition. Petition Form No. ELR07a(Rev.02/07) American LegalNet, Inc. www.FormsWorkflow.com