UNITED STATES BANKRUPTCY COURT CERTIFICATE OF COMMENCEMENT OF CASE

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B 206 (6/91) United States Bankruptcy Court ________________ District Of_______________ In re Case No. ________ Debtor* Social Security No.: Employer's Tax I.D. No. [if any]: Chapter ________ CERTIFICATE OF COMMENCEMENT OF CASE I certify that on _____________________________________, (date) the above named debtor filed a petition requesting relief under chapter ________ of the Bankruptcy Code (title 11 of the United States Code), or a petition was filed against the above named debtor under chapter ________ of the Bankruptcy Code (title 11 of the United States Code), and that as of the date below the case has not been dismissed. _______________________________________________________ Clerk of the Bankruptcy Court _________________________ Date By: ___________________________________________________________ Deputy Clerk ______________________________________________________________________________________________________ *Set forth all names, including trade names, used by the debtor within the last 6 years. (Fed. R. Bankr. P. 1005). For joint debtors set forth both social security numbers.

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