Last updated: 2/17/2015
Pay Advice Cover Sheet
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Description
IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF OKLAHOMA IN RE: ) ) ) ) ) Case No. _____ - __________ - _____ Chapter ______ Debtor. PAY ADVICE COVER SHEET The following pay advice/income record information is filed on behalf of the debtors: Pay advices are attached as follows: Beginning Date __________________ __________________ __________________ Ending Date __________________ __________________ __________________ Employer _______________________________ ________________________________ _______________________________ The debtor certifies by his/her signature below that he/she has no pay records because: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Dated on the __________ day of ____________, 20______. ________________________________________ (Debtor Signature) Pro se Debtor Represented by Counsel s/____________________________________________ Telephone Number Fax Number Counsel for American LegalNet, Inc. www.FormsWorkFlow.com
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