Statement Of No Employment Income {LF-16}

American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF FLORIDACase No:Chapter: Debtor, , is not required to submit payment advices or other evidence of payment under 11 U.S.C. 521(a)(1)(B)(iv) and certifies as follows: Debtor was not employed and had no income from an employer within 60 days prior to the filing of the petition.Debtor was self-employed and had no income from an employer within 60 days prior to the filing of the petition.Joint-debtor,, is not required to submit payment advices or other evidence of payment under 11 U.S.C. 521(a)(1)(B)(iv) and certifies as follows:Debtor was not employed and had no income from an employer within 60 days prior to the filing of the petition.Debtor was self-employed and had no income from an employer within 60 days prior to the filing of the petition. Date:Date: Check box if statement applies to debtorCheck box if statement applies to joint-debtor FLNB Local Form 16 (Rev. 07/11)DIVISIONIn Re:Debtor(s)