Sample IndictmentOmission of an Answer as a False
Statement Under Penalty of Perjury, 18 U.S.C. § 152(3)
On or about the _______day of _______, in the__________ District of
JOHN DOE, defendant herein, knowingly and
fraudulently made a material false statement under the penalty of perjury,
permitted under Section 1746 of Title 28, in and in relation to a case under
Title 11, In re John Doe, No. __________, by submitting a
petition under Chapter 13 of Title 11 in which the defendant fraudulently
the question "pending bankruptcy case filed within last six years (if more
one attach additional sheets)" blank, then well knowing that he had filed
previous bankruptcy cases within the past six years.
All in violation of Title 18, U.S.C. § 152(3).
[cited in USAM 9-41.001]