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Case No. xx-xxxxx Chapter 12 or 13 STATEMENT OF DEBTOR REGARDING APPLICABILITY OF 11 U.S.C. 522(q) IN A CHAPTER 12 OR 13 CASE I, penalty of perjury that: , as a debtor in the above-referenced case,1 declare under (1) I G have G have not: tendered all payments to creditors required to be tendered by me under the provisions of the confirmed Chapter (12 or 13) plan in this case; (2) I G have G have not: been convicted of a felony (as defined in 18 U.S.C. 3156), the circumstances of which.

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