Instructions for Completion of Form, Pro Se Debtor(s)
Provided your bankruptcy petition was accompanied by a list of all your creditors and their addresses, Bankruptcy Rule 1007(c) allows 14 days from the date of filing of the petition to file your schedules. Pursuant to Local Rule 1007-1(b), schedules filed after the filing of a petition must be accompanied by this affidavit. [NOTE: To the extent that the schedules reflect changes from the list of creditors filed with the petition, the list will be deemed to have been amended. Local Rule 1009-1(a) requires that, in order for an amendment to be effective, proof of service in accordance with Local Rule 1009-1(b) must be filed with the Clerk. The amendment must be served upon the United States Trustee, the Case Trustee, and all creditors who were added or deleted, and any other party affected by the amendment. A form of certificate of service is available from the Customer Service Representative at the Clerk’s Office.]
In re: Name(s) of debtor(s) as it/they appear on the petition.
Case No.: The bankruptcy case number assigned at the time of filing of the petition, including the three-digit judge code – EXAMPLE: 03-10345-353
Chapter: The bankruptcy chapter under which relief is being sought (7, 9, 11, 12, 13 or 15)
Debtor: Name(s) of debtor(s) signing affidavit.
Schedule(s): Specify schedule(s) affidavit related to (D and/or E/F)
Check applicable box: Check the first box if there have been no changes to the list of creditors originally filed. If creditors have been added or deleted, or if corrections have been made, check the second box, and attach a listing of all
such creditors. The nature of the change must be indicated for each creditor listed.
Matrix: If creditors have been added, an amended matrix must be submitted, listing added creditors ONLY.
Signature: The form must be signed by the debtor(s). The date of the signing must be indicated at the prompt on the lower left of the form.
Sworn to: You must have the form notarized before presenting it to the Court.
FEE: A $34 fee is due, if creditors have been added to or deleted from the list of creditors originally filed. [Changing of a creditor’s address does NOT require payment of a fee.]
SERVICE OF NOTICE: If creditors have been added, you are responsible for mailing to each such creditor a copy of the notice that the Court issued (and which should have previously been mailed to you) advising of the filing of the case, the meeting of creditors and the fixing of certain deadlines. You should file a certificate of service of the notice along with the schedules. [NOTE: A form of certificate of service is available at the Clerk’s Office.]
