UNITED STATES BANKRUPTCY COURT
NORTHERN DISTRICT OF CALIFORNIA

In re _______________________________________ ___________________________________________ Debtor(s)

) )Bankruptcy Case No. ____________ ) )Chapter ___ ) )

Please be aware that special rules apply to bankruptcy petition preparers in this court.

Bankruptcy petition preparers are non-attorneys who are not authorized to practice law or give legal advice. The U.S. Bankruptcy Court has issued the Bankruptcy Petition Preparer Guidelines (the "Guidelines") to govern the work performed by bankruptcy petition preparers and the fees they may charge.

Under the Guidelines, a bankruptcy petition preparer must give you a copy of this notice before taking any money or property from you for payment and before preparing any papers for filing in the bankruptcy court. You and the bankruptcy petition preparer must sign a copy of this Notice in the space below, a copy must be given to you, and the original must be filed with the Bankruptcy Court.

According to the Court's Guidelines, a bankruptcy petition preparer may not:

• Advise you whether to file bankruptcy or whether chapter 7, 11, 12 or 13 is more appropriate for you;
• Advise you whether your debts will be eliminated, or "discharged," in a bankruptcy case;
• Advise you whether you will be able to keep your home after filing a bankruptcy case;
• Advise you as to the tax consequences of filing a bankruptcy case;
• Advise you whether you should promise to repay, or "reaffirm," debts to creditors; or
• Charge you more than $150 for preparing, photocopying and forwarding your bankruptcy papers to the bankruptcy court.

The Guidelines contain additional restrictions. A complete copy of the Guidelines is attached to this form. You should read the Guidelines to understand what the U. S. Bankruptcy court requires of bankruptcy petition preparers.

If you have any questions about bankruptcy petition preparers or believe that the Guidelines have been violated, please call the United States Trustee at the following numbers:

San Francisco/Santa Rosa Office	415.705.3333
Oakland Office	510.637.3200
San Jose/Salinas Office	408.535.5525

I, ________________________, and ______________________, the debtor(s) in the above-captioned case, have read and understand the foregoing, and have received a copy of the Guidelines.

Dated: ____________________	__________________________________ (signature)
	__________________________________ (signature)

I, _________________________, hereby certify under penalty of perjury that I am the bankruptcy petition preparer who has assisted the debtor(s) in filing the above-captioned case. I have not charged fees in excess of the amount allowed in Guideline 1 of the Guidelines, attached hereto. I have not advised the debtor(s) concerning any of the matters referred to in Guideline 3.

Dated: ____________________

__________________________________ (signature)