CACB — Declaration of Contribution to (F3015-1.09DECCONTRIBUTION)

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/F3015-1.09DECCONTRIBUTION.pdf

Attorney or Party Name, Address, Telephone & FAX FOR COURT USE ONLY Nos., State Bar No. & Email Address

Individual appearing without attorney
Attorney for:
UNITED STATES BANKRUPTCY COURT
CENTRAL DISTRICT OF CALIFORNIA - SELECT DIVISION DIVISION

In re: CASE NO.: CHAPTER: 13

DECLARATION OF CONTRIBUTION TO CHAPTER 13 PLAN [LBR 3015-1(c)(3)]

Debtor(s)

1. I,___________________________________________________, (Contributor) will contribute $ _______________ (Contribution) every month to the Debtor and I will continue to make this Contribution each month that the Debtor remains in bankruptcy, which may be up to 5 years.
2. My relationship to the Debtor is:____________________________________________________________________.
3. My reason for making this Contribution is:_____________________________________________________________ _____________________________________________________________________________________________.
4. The source of my Contribution is:__________________________________________________________________ _____________________________________________________________________________________________.
5. Proof of my income for the past 60 days is attached.
6. I have the financial ability to make this contribution in addition to paying my own separate monthly expenses and

obligations.

7. I do not foresee any change in my financial circumstances that will inhibit my ability to make this Contribution for the

duration of the Debtor’s Chapter 13 Plan, which may last for 5 years.

I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Executed at __________________________________________, ______ on (date)

Printed name of Contributor Signature of Contributor
This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California.

December 2015 Page 1 F 3015-1.09.DEC.CONTRIBUTION

PROOF OF SERVICE OF DOCUMENT

I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is:

A true and correct copy of the foregoing document entitled: DECLARATION OF CONTRIBUTION TO CHAPTER 13 PLAN [LBR 3015-1(c)(3)] will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d); and (b) in the manner stated below:

1. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date) , I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the

following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below:

Service information continued on attached page

2. SERVED BY UNITED STATES MAIL: On (date) , I served the following persons and/or entities at the last known addresses in this bankruptcy case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and addressed as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed.

   Service information continued on attached page

3. SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL (state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing to such service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed.

   Service information continued on attached page

I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct.

Date Printed Name Signature

This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California.

December 2015 Page 2 F 3015-1.09.DEC.CONTRIBUTION