B2830 (Form 2830) (04/19)
* Amounts are subject to adjustment on 4/01/22, and every 3 years thereafter with respect to cases
commenced on or after the date of adjustment.
UNITED STATES BANKRUPTCY COURT
District
Of
In
re
Case
No.
Debto
r
CHAPTER
13 DEBTOR’S
CERTIFICATIONS
RE
GA
RDING
DOMESTIC
SUPPORT
OBLIGATIONS
AND SECTION
522(q)
Part I. Certification Regarding Domestic Support Obligations (check no more than one)
Pursuant to 11 U.S.C. Section 1328(a), I
certify that:
I owed no domestic support obligation when I filed my bankruptcy petition, and I
have not bee
n required to pay any such obligation since then.
I am or have been required to pay a domestic support obligation. I have paid all
such amounts that my
chapter 13 plan required me to pay. I have also paid all such
amounts that became due between the filing of my bankruptcy petition and today.
Part II. If you checked the second box, you must provide the information below.
My current address:
My current employer and my employer’s address:
_ _
Part III. Certification Regarding Section 522(q) (check no more than one)
Pursuant to 11 U.S.C. Section 1328(h), I certify that:
I have not claimed an exemption pursuant to § 522(b)(3) and state or local law (1)
in property that I or a dependent of mine uses as a residence, claims as a homestead, or
acquired as a burial plot, as specified in § 522(p)(1), and (2) that exceeds $170,350* in
value in the aggregate.
I have claimed an exemption in property pursuant to § 522(b)(3) and state or local
law (1) that I or a dependent of mine uses as a residence, claims as a homestead, or
acquired as a burial plot, as specified in § 522(p)(1), and (2) that exceeds $170,350* in
value in the aggregate.
Northern
Illinois
Form 13-15
