MOW 1009-1.2 (05/07)
UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF MISSOURI
IN RE:
Debtor(s)
) ) ) ) ) )
Case No.
VERIFICATION OF MAILING MATRIX The above-named Debtor(s) hereby verifies that the attached list of creditors is true and correct to the best of my knowledge and includes the name and address of my ex-spouse (if any).
Date: ____________________
_____________________________________________ Signature of Debtor
_____________________________________________ Signature of Joint Debtor
Instructions: Include in voluntary petition package if matrix is filed at case opening. File as a separate document when a matrix or amended matrix is uploaded after the date the petition is filed. ECF Event: When filed separately, Bankruptcy>Other>Verification by Debtor