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Get MA Official Local Form 12

Debtor may be found guilty of a felony of the kind described in 11 U.S.C. 522(q)(1)(A) or liable for a debt of the kind described in 11 U.S.C. 522(q)(1)(B). 4. I hereby declare under the penalty of perjury that the foregoing is true and correct. Dated: Signed: Printed Name: Address: Telephone Number:.

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