(Attorney Name)

(Firm Name)

(Address)

(City, State, Zip)

Telephone: ( )

Fax: ( )

Email: ( )

Attorney for: ( )	AK LBF 37A

[12/15]

UNITED STATES BANKRUPTCY COURT

FOR THE DISTRICT OF ALASKA

In re:

(Debtor's Name) and

(Joint Debtor's Name),

Debtor(s).

Case No. ( )

Chapter ( )

Declaration Re: Electronic Filing of

Petition, Schedules, Statements, OF 423,

and Plan if Chapter 11, 12 or 13 Case

[Individuals]

Part I - Declaration of Petitioner(s)

I [We] ___________________________ and__________________________________,the undersigned debtor(s), hereby declare under penalty of perjury that the information given or to be given my [our] attorney and the information provided in the electronically filed petition, statements, schedules, matrix, OF 423 and in my [our] chapter 11, 12 or 13 plan (if this is a case under such chapter) and any amendments thereto, is or will be true and correct. I [We] consent to my [our] attorney sending my [our] petition, statements and schedules (and plan, if applicable) and any amendments thereto, and OF 423, to the United States Bankruptcy Court electronically. I [We] understand that this Declaration re: Electronic Filing is to be filed with the Clerk not later than 14 days following the date the petition is electronically filed. I [We] understand that failure to file the signed original of this Declaration will result in the dismissal of my [our] case after a hearing on shortened time of no less than five days notice.

If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter 7: I am [We are] aware that I [we] may proceed under chapter 7, 11, 12 or 13 of 11 United States Code, understand the relief available under each such chapter, and choose to proceed under chapter 7. I [We] request relief in accordance with the chapter specified in this petition.

Dated:_____________________________

Signed: _______________________________ _______________________________

(Applicant)	(Joint Applicant)

Part II - Declaration of Attorney

I declare under penalty of perjury that the debtor(s) signed this form before I electronically submitted the petition, schedules, and statements (and chapter 11, 12 or 13 plan, if applicable). Before filing, I will give the debtor(s) a copy of all documents to be filed with the United States Bankruptcy Court, and have followed all other requirements in the most recent ECF System Procedures. I further declare that I have examined or will examine the debtor's petition, schedules, and statements and any amendments thereto, as well as the debtor's OF 423, and, to the best of my knowledge and belief, they are or will be true, correct, and complete. I further declare that I have informed the petitioner(s) that [he or she or they] may proceed under chapter 7, 11, 12 or 13 of Title 11, United States Code, and have explained the relief available under each such chapter. This declaration is based on all information of which I have knowledge.

Dated:_____________________________

_______________________________

Attorney for Debtor(s)