Debtor(s) Election To Use A Portion Of Tax Refund Pursuant To Confirmed Plan Terms {13-30}

FLNB Local Form 13-30 UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF FLORIDA In re: Case No.: Chapter 13 Debtor(s) DEBTOR(S)' ELECTION TO USE A PORTION OF TAX REFUND PURSUANT TO CONFIRMED PLAN TERMS COMES NOW the Debtor by and through the undersigned attorney, and hereby files the Election to Use a Portion of Tax Refund Pursuant to Confirmed Plan Terms, and states as follows: 1. The confirmed plan allows the Debtor to use thirty percent (30%) of a tax refund each year for the first three (3) years in a 36 month term case, plus an additional forty percent (40%) of each year's tax refund for each year thereafter in a 60-month term case. 2. The plan term in this case is 3. This is the Debtor's 4. The Debtor is electing to use $ tax year 13 Trustee. 5. The Debtor agrees that the plan base shall be adjusted by the total amount of the United States Income Tax Refund ($ Trustee as set forth below: ) and shall be paid to the months. election in this case for the year . of the total tax refund for . The remainder shall be transmitted forthwith to the Chapter American LegalNet, Inc. www.FormsWorkFlow.com a. Portion used ($ ) to be submitted (explain terms of repayment): b. Remainder ($ ) to be submitted within ten (10) days from the date of receipt of the refund. 6. This election is being made due to the need for payment of necessary expenses and/or due to the loss of income. RESPECTFULLY SUBMITTED this day of , . Debtor(s) or Debtor(s)' Attorney CERTIFICATE OF SERVICE I HEREBY certify that a true and accurate copy of the foregoing has been furnished by electronic filing or first class mail to: on the same date as the document was filed electronically as reflected on the Court's docket. Debtor(s) or Debtor(s)' Attorney American LegalNet, Inc. www.FormsWorkFlow.com