UNITED STATES BANKRUPTCY COURT
District of Maine
IN RE :
Case No.
Chapter 13
Date:
Certification Regarding Domestic Support Obligations or Lack Thereof
I,
, having made the final payment
Debtor Name (enter full name)
under my Chapter 13 Plan on
, do hereby certify that:
(Date)
I am not required by a judicial or administrative order to pay a domestic support
obligation; or
I am required by a judicial or administrative order to pay a domestic support obligation
and all amounts payable under such order or such statute that were due on or before this
date (including amounts due before the petition was filed, but only to the extent provided
for by the plan) have been paid.
______________________________________________________________________________
I declare under penalty of perjury that the foregoing is true and correct
_______________________________________ _______________________
Signature of Debtor
Date
Penalty for making a false statement:
Fine up to $250,000 or imprisonment for up to 5 year, or both. 18 U.S.C.§152 and §3571