Debtors Evidence Of No Employer Payments {MOW 1007-1.2}

MOW 1007-1.2 (05/07) UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF MISSOURI IN RE: Debtor(s) ) ) ) ) Case No. ) ) DEBTOR'S EVIDENCE OF NO EMPLOYER PAYMENTS I, applies): G G (debtor) , hereby state and declare under penalty of perjury that (check the box that I received no payment from any employer for the 60 days prior to filing the petition. I received no payment from any employer from _____________ to ___________________ prior to the filing of the petition. Payment advices for the remainder of the 60-day period have been provided. I was self-employed. Net income for 60 days prior to filing the petition, itemized to show how the amount is calculated is (shown below or in the attachment). G Name of Debtor Instructions ECF Event: File as a separate document on the date the voluntary petition is filed. Bankruptcy>Other>Debtor Evidence of No Employer Payments American LegalNet, Inc. www.FormsWorkflow.com