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ADDRESS TELEPHONE NO. CITY, STATE, ZIP PRO SE AFFIDAVIT TO ACCOMPANY PETITION FOR ORDER OF RELIEF I, the undersigned, being under oath and declare under penalty of perjury, that I do not have an attorney to represent me in this case, that I represent myself in this case, that I am the petitioner in the above-stated bankruptcy case under Title 11 of the United States Code, and that the answers given be.

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