AK LBF 40

(12/18)

UNITED STATES BANKRUPTCY COURT

DISTRICT OF ALASKA

In re:

(Debtor) and

(Joint Debtor),

Debtor(s).	Case No. (Case Number)

Chapter (Chapter Number)

VERIFICATION OF CREDITOR MAILING MATRIX

I [We], _________________________ and _________________________, the undersigned

(Debtor)	(Joint Debtor)

debtors, do hereby certify under penalty of perjury that the attached master mailing list of creditors ("Matrix"), or amended master mailing list ("Amended Matrix"), is true and correct to the best of my [our] knowledge, and I [we] assume all responsibility for errors and omissions.

___________	__________________________________________

(date)	(signature of debtor)

___________	__________________________________________

(date)	(signature of joint debtor)