UNITED STATES BANKRUPTCY COURT

WESTERN DISTRICT OF MISSOURI

IN RE: Enter debtor(s) name	)

)

)	Case No. Enter Case No.

Debtor(s) Full Social Security Number	)

NOTICE AND VERIFICATION OF CORRECTED

DEBTOR SOCIAL SECURITY NUMBER

You are hereby notified that the debtor has corrected the social security number previously provided. The correct number is shown above.

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Debtor's attorney

Type name, address

Debtor(s) Verification:

I declare under penalty of perjury that the foregoing social security number is true and correct.

Enter a date	Enter signature	Enter signature

Date	Debtor’s Signature	Co-debtor’s Signature (if applicable)

Certificate of Service:

I, Enter text, certify the above notice was served on all creditors by first class, postage prepaid mail, on Enter a date.

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Typed Name or Signature

Instructions:

ECF Event: