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Certificate Of Chapter 13 Debtor Regarding 11 USC 522(q) Exemptions EDC 3-191 - California
| Certificate Of Chapter 13 Debtor Regarding 11 USC 522(q) Exemptions Form. This is a California form and can be used in EDC Forms USBC Eastern Federal . |
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United States Bankruptcy Court Eastern District of California IN RE Debtor(s). ) ) ) ) ) CASE NO. CHAPTER 13 CERTIFICATE OF CHAPTER 13 DEBTOR REGARDING 11 U.S.C. § 522(q) EXEMPTIONS [Instructions: In accordance with 11 U.S.C. § 522(q), Fed. R. Bankr. P. 1007(b)(8), and Local Bankruptcy Rule 5009-1, a chapter 13 debtor who claims exemptions in real property, personal property, and/or a cooperative used as a residence or claimed as a homestead, or in a burial plot, which exceed in the aggregate $146,450, must file this Certificate with the Court after making the last plan payment or, if applicable, prior to the deadline set by the Court when it authorizes a hardship discharge under 11 U.S.C. § 1328(b). See 11 U.S.C. § 522(p)(1)(A), (B), (C), and (D) and (q). Debtors who have NOT claimed exemptions in real property, personal property, and/or a cooperative used as a residence or claimed as a homestead, or in a burial plot, which exceed in the aggregate $146,450, should NOT file this Certificate. Failure to timely file this Certificate may bar or delay entry of a discharge.] 1. I have claimed exemptions in the aggregate amount of $ _____________. PLEASE CHECK ALL BOXES THAT APPLY: Yes G No G 2. I have been convicted (or there is a proceeding currently pending against me in which I may be convicted) of a felony offense punishable by a maximum term of imprisonment of more than one year. No G 3. I owe a debt (or there is pending against me a proceeding in which I may be found liable for a debt) due to a violation of a Federal Securities law (as defined in section 3(a)(47) of the Securities Exchange Act of 1934), including, but not limited to, the Securities Act of 1933 (15 U.S.C. § 77a et seq.); the Securities Exchange Act of 1934 (15 U.S.C. § 78a et seq.); the Sarbanes-Oxley Act of 2002 (Pub. L. No. 107-204, 116 Stat.); the Trust Indenture Act of 1939 (15 U.S.C. § 77aaa et seq.); the Investment Company Act of 1940 (15 U.S.C. § 80a-1 et seq.); the Investment Advisers Act of 1940 (15 U.S.C.A. § 80b-1 et seq.); and the Securities Investor Protection Act of 1970 (15 U.S.C. § 78aaa et seq.); any State securities laws; or any regulation or order issued under Federal securities laws or State securities laws. No G 4. I owe a debt (or there is pending against me a proceeding in which I may be found liable for a debt) due to fraud, deceit, or manipulation in a fiduciary capacity or in connection with the purchase or sale of a security registered under section 12 or 15(d) of the Securities Exchange Act of 1934 or under section 6 of the Securities Act of 1933. EDC 3-191 (Rev. 9/13/12) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Yes G Yes G Yes G Yes G No G 5. I owe a debt (or there is pending against me a proceeding in which I may be found liable for a debt) due to a civil remedy under section 1964 of Title 18. No G 6. I owe a debt (or there is pending against me a proceeding in which I may be found liable for a debt) due to a criminal act, intentional tort, or willful or reckless misconduct that caused serious physical injury or death to another individual in the preceding 5 years. No G 7. Although I answered YES to one or more of questions 2 through 6, I am entitled to the exemptions I have claimed and I should receive a discharge because the exemptions are reasonably necessary to support me (and my dependent(s), if any). I declare under penalty of perjury that the foregoing is true and correct. Yes G Date:___________________ Signed: ___________________________ Debtor Printed Name: ___________________________ EDC 3-191 (Rev. 9/13/12) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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