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EBTOR xxx-xx-xxxx Debtor s Address Debtor Case No. xx-xxxxx Chapter 11 NOTICE OF PLAN COMPLETION AND 522(q) STATEMENT BY INDIVIDUAL DEBTOR IN A CHAPTER 11 CASE I, declare under penalty of perjury that: , as a debtor in the above-referenced Chapter 11 case,1 (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 11 plan in this case; (2) I G have G have not: been convicted of a felon.

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