United States Bankruptcy Court

Southern District of Florida

In re Dard Defrand Case No.

Debtor(s) Chapter 13

DECLARATION REGARDING PAYMENT ADVICES

Debtor:

 Copies of all payment advices, pay stubs or other evidence of payment received by the debtor from any employer within 60

days prior to the filing of the bankruptcy petition are attached. (Note: If you worked some, but not all of the 60 days prior,

attach copies of any and all received and provide explanation that you didn't work the full 60 days.

)

 Copies of all payment advices are not attached because the debtor had no income from any employer during the 60 days

prior to filing the bankruptcy petition.

 Copies of all payment advices are not attached because the debtor:

 receives disability payments

 is unemployed and does not receive unemployment compensation

 receives Social Security payments

 receives a pension

 does not work outside the home

 is self employed and does not receive payment advices

 None of the statements above apply, however, the debtor is unable to timely provide some or all copies of payment advices or

other evidence of payment received

Explain: 

Joint Debtor (if applicable):

 Copies of payment advices, pay stubs or other evidence of payment received by the joint debtor from any employer within 60

days prior to the filing of the bankruptcy petition are attached. (Note: If you worked some, but not all of the 60 days prior,

attach copies of any and all received and provide explanation that you didn't work the full 60 days.

)

 Copies of payment advices are not attached because the joint debtor had no income from any employer during the 60 days

prior to filing the bankruptcy petition.

 Copies of payment advices are not attached because the joint debtor:

 receives disability payments

 is unemployed and does not receive unemployment compensation

 receives Social Security payments

 receives a pension

 does not work outside the home

 is self employed and does not receive payment advices

 None of the statements above apply, however, the joint debtor is unable to timely provide some or all copies of payment

advices or other evidence of payment received

Explain: 

LF-10 (rev. 12/01/09) Page 1 of 2

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Case 20-22409-PDR Doc 7 Filed 11/12/20 Page 1 of 7
NOTE: When submitting copies of evidence of payment such as pay stubs or payment advices, it is your responsibility to redact

(blackout) any social security numbers, names of minor children, dates of birth or financial account numbers before attaching for

filing with the court. See Local Rule 5005-1(A)(2).

/s/ Dard Defrand Date: November 12, 2020

Dard Defrand

Signature of Attorney or Debtor

LF-10 (rev. 12/01/09) Page 2 of 2

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