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Statement Of No Employment Income 16 - Florida
| Statement Of No Employment Income Form. This is a Florida form and can be used in USBC Northern Federal . |
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FLNB Local Form 16 Rev. 05/07 UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF FLORIDA In Re: __________________________________, Debtor(s) Case No:________________ Chapter: _________ STATEMENT OF NO EMPLOYMENT INCOME Check box if statement applies to debtor 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. Check box if statement applies to joint-debtor 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. I declare under penalty of perjury that the foregoing is true and correct. Date: ____________ Date: ____________ Signature of Debtor: /s/ Signature of Joint-Debtor: /s/ By: /s/ A TTO R N E Y SIG N A TU R E IF R EPR E SE N TE D B Y C O U N SE L American LegalNet, Inc. www.FormsWorkflow.com
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