UNITED STATES BANKRUPTCY COURT

DISTRICT OF NEW MEXICO

In re

Debtor.	Case No.

STATEMENT DISCLOSING

NON-FILING SPOUSE, PURSUANT TO NM LBR 1002-1(a)(2)

Pursuant to New Mexico Local Bankruptcy Rule 1002-1(a)(2), I state that I have a non-
filing spouse, whose name is .

To the best of my knowledge, information and belief, the last four digits of my spouse's social security number are and my spouse's mailing address is:

.

I declare under penalty of perjury that the information provided herein is true and correct.

________________________________________

Debtor's signature

Address:

Telephone:

Fax:

E-mail: