UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF IOWA
In re
Debtor(s)
) ) ) ) ) )
Case No.
VERIFICATION OF MASTER ADDRESS LIST ON PAPER (CREDITOR MATRIX)
I (we) declare under penalty of perjury that I (we) have read the attached Master Address List (creditor matrix), consisting of _____ pages, and that it is true and correct to the best of my (our) knowledge, information, and belief.
DATED: Debtor's Signature
Joint Debtor's Signature
PRINT
VER_MTRX (Rev. 04/00)