Revised 7/2001
LBR Appendix 1007-b-6
UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF TEXAS IN RE:
______________________________
Debtor(s)
_____________________
Bankruptcy Case Number
VERIFICATION OF CREDITOR MATRIX The above named Debtor(s) hereby verifies that the attached list of creditors is true and correct to the best of my/our knowledge.
Creditor Matrix Format (check one): Diskette: Paper: ________________ ________________
Date: __________________
_________________________________ Debtor Signature
Date: __________________
_________________________________ Joint Debtor Signature