Disclosure Regarding Information Disclosed for Bankruptcy Assistance

You will be requested to provide information to counsel in order to advise you whether to file bankruptcy and what type of bankruptcy to file if bankruptcy is recommended. You will be requested to provide information for the filing of the bankruptcy itself. With respect to this information and documents filed with the bankruptcy we are required to notify you of the following:

(A) All information that the you are required to provide with a petition and thereafter during a case under this title is required to be complete, accurate, and truthful;

(B) all assets and all liabilities are required to be completely and accurately disclosed in the documents filed to commence the case, and the replacement value of each asset as defined in section 506 must be stated in those documents where requested after reasonable inquiry to establish such value;

(C) current monthly income, the amounts specified in section 707(b)(2) of the bankruptcy laws, and, in a case under chapter 13 of this title, disposable income (determined in accordance with section 707(b)(2) of the bankruptcy laws), are required to be stated after reasonable inquiry; and

(D) information that an assisted person provides during their case may be audited pursuant to this title, and that failure to provide such information may result in dismissal of the case under this title or other sanction, including criminal sanction.

Receipt Acknowledged _________________ Date __________________