Free LBF 38 - Alaska

AK LBF 38 Dated 11/12/08

Attorney for Debtor(s)

UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF ALASKA In re Case No. Chapter STATEMENT UNDER PENALTY OF PERJURY CONCERNING PAYMENT ADVICES DUE PURSUANT TO 11 U.S.C. § 521(a)(1)(B)(iv) , state as follows:

Debtor(s)

I,

I have not filed with the court copies of all payment advices or other evidence of payment received within 60 days prior to the filing of my petition from any employer because: I am self employed and did not receive any payments from an employer within the 60 day period before the filing of my petition; My only income during the 60 day period before the filing of my petition was from Social Security, pensions, or disability payments, or from rental or investment income. I was not employed during the 60 day period immediately preceding the filing of my petition. Other. Specify:

I declare, under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Executed on:

(signature of debtor)