IN THE UNITED STATES BANKRUPTCY COURT



IN THE UNITED STATES BANKRUPTCY COURT

MIDDLE DISTRICT OF ALABAMA

IN RE: CHAPTER 13 CASE NUMBER:

Debtor.

AFFIDAVIT REGARDING TAX RETURNS

My name is ___. I am the Chapter 13 debtor in the above styled Chapter 13 case. After being duly sworn, I do hereby declare under penalty of perjury the following:

The last Federal and State Income tax return I was required to file by applicable tax law was for the tax year ending ___.

I have not filed a tax return for tax years ________. I was not required to file tax returns for tax years ____ for the following reason: (state reason for non-filing).

Submitted this ____ day of _____________, 20___.

______________________________

Debtor/Affiant

STATE OF ALABAMA

COUNTY OF _____

Sworn to and subscribed before me this ____ day of _____________, 20____.

______________________________

Notary Public

My Commission Expires: _________

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