(Attorney Name)

(Firm Name)

(Address)

(City, State, Zip)

Telephone: ( )

Fax: ( )

Email: ( )

Attorney for: ( )	AK LBF 37B

[11/15]

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 and Statements

[Corporation/Partnership/LLC]

Part I - Declaration of Petitioner

I ______________________________ the ____________________________of the petitioner herein, hereby declare under penalty of perjury that the information given or to be given its attorney and the information provided in the electronically filed petition, statements, and schedules, and any amendments thereto, is or will be true and correct. Petitioner consents to its attorney sending its petition, matrix, statements and schedules to the United States Bankruptcy Court electronically. I understand that this Declaration re: Electronic Filing is to be filed with the Clerk not later than 14 days following the date the petition was electronically filed. I understand that failure to file the signed original of this Declaration will result in the dismissal of the case after a hearing on shortened time of no less than five days notice.

I declare under penalty of perjury that the information provided in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. The debtor requests relief in accordance with the chapter specified in this petition.

Dated:_____________________________

Signed: _______________________________

(Debtor's Authorized Representative)

Part II - Declaration of Attorney

I declare under penalty of perjury that the debtor's authorized representative signed this form before I electronically submitted the petition, schedules, and statements. Before filing, I will give the debtor a copy of all forms and information 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 above debtor's petition, schedules, and statements and any amendments thereto, and, to the best of my knowledge and belief, they are or will be true, correct, and complete. This declaration is based on all information of which I have knowledge.

Dated:_____________________________

___________________________________

Attorney for Debtor