IN THE UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF TEXAS, ________ DIVISION

)

In re: ) Chapter 13

) Case No.

) Debtor(s) )

DEBTOR’S CERTIFICATION OF COMPLETION OF INSTRUCTIONAL

COURSE CONCERNING PERSONAL FINANCIAL MANAGEMENT

[Complete one of the following statements.]

 I/We, the debtor(s) in the above-

(Print Name(s) of Debtor and Joint Debtor, if any)

styled case hereby certify that on I/We completed an

(Date)

instructional course in personal financial management provided by ______ an

(Name of Provider)

approved personal financial management instruction provider. If the provider furnished a document attesting to the completion of the personal financial management instructional course, a copy of that document is attached.

 I/We, the debtor(s) in the above-

(Print Name(s) of Debtor and Joint Debtor, if any)

styled case hereby certify that no personal financial management course is required, because:

Check the appropriate box

[ ] I am/We are incapacitated or disabled, as defined in 11 U.S.C. § 109(h);

[ ] I am/We are on active military duty in a military combat zone; or

[ ] I/We reside in a district in which the United States trustee (or the bankruptcy administrator, if any) has determined that the approved instructional course are not adequate at this tie to serve the additional individuals who would otherwise be required to complete such courses.

Signature of Debtor:

Date:

Signature of Joint Debtor:

Date: