Pennsylvania Local Bankruptcy Form 2016-4, Statement of Pro Se Debtor(s) is a legal form used by individuals who are filing a bankruptcy petition without the assistance of an attorney. It is used to provide the court with information about the debtor's personal and financial situation, including the type of bankruptcy being filed, the debtor's assets and liabilities, and the debtor's income and expenses. There are two types of Pennsylvania Local Bankruptcy Form 2016-4, Statement of Pro Se Debtor(s): Chapter 7 and Chapter 13. The form must be filed with the court in order for the debtor to proceed with filing for bankruptcy.