UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF
PENNSYLVANIA
LOCAL BANKRUPTCY FORMS
Effective December 1, 2017
BANKRUPTCY FORMS
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
TABLE OF CONTENTS
L.B.F. 1002-2A Statement of Qualification as Complex Chapter 11 Case 1
L.B.F. 1002-2B Notice of Date of Expedited Hearing, Matters to Be Heard 2
L.B.F. 2016-2 Application for Compensation and Reimbursement of Expenses 4
L.B.F. 2016-3A “Short Form” - Chapter 13 Application for Compensation 8
L.B.F. 2016-3B “Long Form” - Chapter 13 Application for Compensation 10
L.B.F. 2016-3C Chapter 13 Application for Supplemental Compensation 13
L.B.F. 2016-4 Statement of Pro Se Debtor 16
L.B.F. 3007-1 Notice of Objection to Claim and Hearing Date 18
L.B.F 3015-6A Pre-Confirmation Certification (by Counsel) 19
L.B.F 3015-6B Pre-Confirmation Certification (Pro Se) 20
L.B.F. 3015.1-1 Chapter 13 Plan 21
L.B.F. 4003-1 Notice of Objection to Claim of Exemption and Hearing Date 29
L.B.F. 5011-1 Caption of Motion for Withdrawal of the Reference 30
L.B.F. 8012-1 L.B.R. 8012-1 Disclosure Form 31
L.B.F. 9014-3 Notice of Motion, Response Deadline and Hearing Date 33
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L.B.F. 1002-2A
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter 11
:
Debtor : Bky. No.
STATEMENT OF QUALIFICATION AS COMPLEX CHAPTER 11 CASE
This chapter 11 case was filed on ______, 20____.
The undersigned attorney for the debtor believes that this case qualifies under Local Bankruptcy
Rule 1002-2 as a complex chapter 11 case because
_____ the total debt in the case is more than 3 times the dollar amount stated in
§101(51D),
_____ the debtor’s debt securities are publicly traded,
_____ the debtor’s equity securities are publicly traded, and/or
_____ there are 100 or more parties in interest in the case.
Date: ________ Signed: __________________________
Attorney for the Debtor
[Attorney’s name] ………………………
[Firm Name] ……………………………
[Address] ……………………………….
[Phone No.] …………………………….
[Fax No.] ……………………………….
[E-mail address] ………………………..
The Statement may also be signed by a chapter 11 individual debtor, or by an authorized
person if the chapter 11 debtor is a corporation, limited liability company, partnership, or other
business entity. The form should be adapted to properly reflect the status of the person signing
the Statement.
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L.B.F. 1002-2B
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter 11
:
Debtor : Bky. No.
*******
NOTICE OF DATE OF EXPEDITED HEARING, MATTERS THAT WILL BE
HEARD AT THE EXPEDITED HEARING, AND HOW TO RESPOND
(Name of debtor) has filed a chapter 11 case, a Statement of Qualification for Complex
Chapter 11 Case Status, and a motion for Scheduling an Expedited Hearing. Presently, this case is
being administered under L.B.R. 1001-2 as a Complex Chapter 11 case.
1. Your rights may be affected. You should read these papers carefully and discuss
them with your attorney, if you have one in this bankruptcy case. (If you do not
have an attorney, you may wish to consult an attorney).
2. An Expedited Hearing is scheduled to be held on (date and time), in Courtroom ,
United States Bankruptcy Court, (address of Bankruptcy Court). Unless the court orders
otherwise, the hearing on this contested matter will be an evidentiary hearing.
3. At the Expedited Hearing, the court will consider the Debtor’s motions and applications that
are listed below:
4. If you do not want the court to grant the relief sought in these matters or if you want
the court to consider your views, then you must either file a response (see Instructions on next
page) or appear at the hearing.
5. Copies of motions and applications that will be heard at the Expedited Hearing are enclosed
[or will be delivered separately].
6. If you do not file a response (see Instructions on next page) or appear at the hearing, the
court may grant the relief that has been requested.
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Filing Instructions
A. If you are required to file documents electronically by Local Bankruptcy Rule
5005-1, you must file your response electronically.
B. If you are not required to file electronically, you must file your response at
( address of bankruptcy clerk's office )
C. If you mail your response to the bankruptcy clerk’s office for filing, you must mail it
early enough so that it will be received on or before the date and time stated in Paragraph
2 on the previous page of this Notice.
D. On the same day that you file or mail your Response to the Motion, you must mail or
deliver a copy of the Response to the movant’s attorney.
[Attorney’s name] .....................
[Firm name] ..............................
[Address] ..................................
[Phone No.]...............................
[Fax No.]...................................
[E-mail address] .......................
[If applicable, name and address of others to be served.]
Date: _____________
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L.B.F. 2016-2
Application for Compensation and Reimbursement of Expenses
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: ) Chapter
)
)
)
Debtor ) Bky. No.
................... APPLICATION FOR
first, second, etc. as applicable
COMPENSATION AND REIMBURSEMENT OF EXPENSES
Of.....................................................
name of applicant, professional capacity
For.....................................................
entity represented or engaged by
For THE PERIOD ................ THROUGH ................
................................................................................ in accordance
Name of applicant, professional capacity, and entity represented or engaged by
with F.R.B.P. 2016 applies under § 330 of the Code for an award of compensation and
reimbursement of actual, necessary expenses and represents:
Part A Preliminary Statement
1. Applicant is [professional capacity] for [entity represented or engaged by].
2. All services rendered and expenses incurred for which compensation or reimbursement is
requested were performed or incurred for or on behalf of [entity represented or engaged
by].
3. The services described in this Application are actual, necessary services and the
compensation requested for those services is reasonable.
4. The expenses described in this Application are actual, necessary expenses.
-4-
[Additional numbered paragraphs may be used by the Applicant to set forth other
statements or information.]
Part B General Information
1. Period xx/xx/xx to xx/xx/xx
Final Application ________
Interim Application ________
Requested
Fees $________
Expenses $________
Total $________
2. General Information
a. Date case filed: xx/xx/xx
b. Date application to approve employment filed: xx/xx/xx
c. Date employment approved: xx/xx/xx
d. First date services rendered in the case: xx/xx/xx
e. Compensation request is under § 330: _____ Yes _____ No
If other statutory basis, specify: § ________
f. Any fees awarded will be paid from the estate:
______ Yes ______ No
If no, state the source of payment of any fee that is awarded.
________________________________________
g. This application is for a period less than 120 days after the filing of the case
or less than 120 days after the end of the period of the last application.
_____ Yes _____ No
If yes, state date and terms of court order allowing filing at shortened intervals.
Order date: xx/xx/xx
Terms, if any,_______________________________________________
___________________________________________________________
-5-
3. Prior Applications
First Application Period
xx/xx/xx to xx/xx/xx Date of Order xx/xx/xx
Requested Allowed Paid Due
Fees $________ $________ $________ $________
Expenses $________ $________ $________ $________
Second Application Period
xx/xx/xx to xx/xx/ Date of Order xx/xx/
Requested Allowed Paid Due
Fees $________ $________ $________ $________
Expenses $________ $________ $________ $________
Grand Totals $________ $________ $________ $________
4. Attorneys' Billing for Current Period
Name Admitted Hours Billing Rate Total
_________ ________ _____ ________ $________
etc. etc. etc. etc. etc.
Grand Total $________
5. Paralegals' Billing for Current Period
Name Hours Billing Rate Total
________ _____ ________ ________
Grand Totals $_______
6. Billing Rates
a. Are any of the billing rates different than the billing rates set forth in your last
application? _____ Yes _____ No
-6-
b. If yes, indicate whose billings rates are different and explain why?
_______________________________________________________________________________
_______________________________________________________________________________
Part C Billing Summary
1. Description of Services. Provide adequate detail appropriate for the amount of time
billed and the nature and variety of the services rendered.
2. Detail of Hours Expended. Set forth in list form or attach a list that shows the name of
the professional or paraprofessional, date, activity, and time expended. The list may be
organized in either of two ways.
a. By each professional or paraprofessional in chronological order for the application
period; or
b. By day in chronological order showing all professionals or paraprofessionals that
billed time on a particular day during the application period.
* * * * * * *
Category Reporting. If category reporting of time expended is required under L.B.R. 2016-3(c),
only categories for which services were rendered during the period covered by the application
should be included. A separate Description of Services and Detail of Hours Expended shall be
provided for each category.
Part D Expense Summary
Set forth in list form or attach a list that shows the type of expenses for which reimbursement is
sought. For each type of expense either
a. State the amount of the expense that is calculated using the applicant’s in-house
actual cost or the actual amount billed by a third party provider, or
b. Explain how the amount of the expense is calculated.
WHEREFORE, Applicant requests an award of $ ___________ in compensation and of $
____________ in reimbursement of actual, necessary expenses.
Date: Signed:_____________________________
[Applicant’s name] ………………………
[Firm Name] ……………………………..
[Address] ………………………………...
[Phone No.] ……………………………...
[Fax No.] ………………………………...
[E-mail address] …………………………
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L.B.F. 2016-3A
“Short Form” Application of Counsel for Debtor for Compensation and Reimbursement
of Expenses in Chapter 13 Case
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: ) Chapter 13
)
Debtor(s) )
) Bky. No.
)
APPLICATION FOR COMPENSATION AND REIMBURSEMENT OF EXPENSES
Name of applicant applies under § 330 of the Bankruptcy Code for an award of compensation and
reimbursement of actual, necessary expenses and represents:
1. Applicant is counsel for the debtor.
2. The debtor filed a petition under chapter 13 of the Bankruptcy Code on (date).
3. The debtor’s annualized current monthly income as set forth on Form B22C is:
above median (the amount on line 15 is not less than the amount on line 16).
below median (the amount on line 15 is less than the amount on line 16).
4. All services rendered and expenses incurred for which compensation or reimbursement is
requested were performed or incurred for or on behalf of the debtor, the services and expenses
were actual and necessary, and the compensation requested for those services is reasonable.
5. Applicant requests an award of compensation of $__________ for providing the following
services: (Description of Services)
6. Applicant requests reimbursement of expenses in the amount of $_______ for the following
expenses: (Description of Expenses)
7. The debtor paid Applicant $__________ prior to the filing of the petition.
8. A copy of the Applicant’s disclosure of compensation pursuant to Fed. R. Bankr. P. 2016(b) is
attached hereto as Exhibit “A.”
9. None of the compensation paid to applicant will be shared with any person other than a
member or regular associate of applicant’s law firm unless 11 U.S.C. §504(c) applies.
-8-
WHEREFORE, Applicant requests an award of $_________ in compensation and of
$___________ in reimbursement of actual, necessary expenses.
Date:____________________ Signed:_____________________________
[Applicant’s name] ………………………
[Firm Name] ……………………………..
[Address] ………………………………...
[Phone No.] ……………………………...
[Fax No.] ………………………………...
[E-mail address] …………………………
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L.B.F. 2016-3B
“Long Form” Application of Counsel for Debtor for Compensation and Reimbursement of
Expenses in Chapter 13 Case
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: ) Chapter 13
)
Debtor(s) )
) Bky. No.
)
APPLICATION FOR COMPENSATION AND REIMBURSEMENT OF EXPENSES
Name of applicant applies under § 330 of the Bankruptcy Code for an award of compensation
and reimbursement of actual, necessary expenses and represents:
1. Applicant is counsel for the debtor.
2. The debtor filed a petition under chapter 13 of the Bankruptcy Code on (date).
3. The debtor’s annualized current monthly income as set forth on Form B22C is:
above median (the amount on line 15 is not less than the amount on line 16).
below median (the amount on line 15 is less than the amount on line 16).
4. All services rendered and expenses incurred for which compensation or reimbursement is
requested were performed or incurred for or on behalf of the debtor, the services and
expenses were actual and necessary, and the compensation requested for those services is
reasonable.
5. Applicant requests an award of compensation of $__________ for _____ hours expended
on the initial consultation with client(s) and in providing before confirmation
(a) the customary services of counseling and representing the chapter 13
debtor(s) including: analysis of the financial situation; preparation, review and filing with
the court of all required documents; correspondence, telephone conversations and
miscellaneous contact with creditors, the trustee, attorneys and other parties in interest;
preparation for and attendance at 341(a) meeting; and
(b) in representing the debtor(s) in connection with [check applicable item(s)]:
cure of a residential mortgage default or other treatment of residential real
property claims
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ownership and claims relating to other real property (specify the number of
properties and describe the issues)
motor vehicle loans or leases
state or federal tax claims
domestic support obligations
student loans
an operating business
20 or more creditors listed in Schedule F
automatic stay litigation
other litigation (describe)
6. [Optional. Applicant may supplement paragraph 5 with a description of those matters,
whether or not they are listed in paragraph 5, that took an unusual amount of time to
complete or involved complex legal or factual issues.]
7. Applicant requests that compensation be awarded at the following hourly rate(s): (Specify
the hourly rate for each person who provided services)
8. Applicant requests reimbursement of expenses in the amount of $_______ for the
following expenses: (Description of expenses)
9. The debtor paid Applicant $__________ prior to the filing of the petition.
10. A copy of the Applicant’s disclosure of compensation pursuant to Fed. R. Bankr. P.
2016(b) is attached hereto as Exhibit “A.”
11. None of the compensation paid to applicant will be shared with any person other than a
member or regular associate of applicant’s law firm unless 11 U.S.C. §504(c) applies.
12. Attached as Exhibit “B” is a copy of Applicant’s time records setting forth the dates and
amount of time expended for the services performed on behalf of the debtor.
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WHEREFORE, Applicant requests an award of $_________ in compensation and of
$___________ in reimbursement of actual, necessary expenses.
Date:_______ Signed:_____________________________
[Applicant’s name] ………………………
[Firm Name] ……………………………..
[Address] ………………………………...
[Phone No.] ……………………………...
[Fax No.] ………………………………...
[E-mail address] …………………………
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L.B.F. 2016-3C
“Supplemental” Application of Counsel for Debtor
for Compensation and Reimbursement of Expenses for Post Confirmation
Services Payable by the Chapter 13 Trustee
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: ) Chapter
)
)
)
Debtor ) Bky. No.
SUPPLEMENTAL APPLICATION FOR COMPENSATION AND REIMBURSEMENT OF
EXPENSES FOR SERVICES PERFORMED AFTER CONFIRMATION OF CHAPTER 13
PLAN
.............................................................................................
Name of applicant
applies under § 330 of the Code for an order directing the chapter 13 trustee to pay an award of
compensation and reimbursement of actual, necessary expenses for services performed after
confirmation of the debtor’s chapter 13 plan and represents:
Applicant is counsel for the debtor.
1. The debtor filed a petition under chapter 13 of the Bankruptcy Code on (date) .
2. The debtor’s chapter 13 plan was confirmed by the court on (date).
3. The debtor paid the applicant $ ______ prior to the filing of the chapter 13 petition.
4. Applicant’s prior applications:
First Application Period
xx/xx/xx to xx/xx/xx Date of Order xx/xx/xx
Requested Allowed Paid Due
Fees $________ $________ $________ $________
Expenses $________ $________ $________ $________
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Second Application Period
xx/xx/xx to xx/xx/xx Date of Order xx/xx/xx
Requested Allowed Paid Due
Fees $________ $________ $________ $________
Expenses $________ $________ $________ $________
Grand Totals $________ $________ $________ $________
5. Applicant requests an award of supplemental compensation of $_____ for _____ hours
expended in providing the following services:(Description of Services)
6. Applicant requests that compensation be awarded at the following hourly rate(s): (Specify
the hourly rate for each person who provided services)
7. Applicant requests reimbursement of expenses in the amount of $ _____ for the
following expenses (Description of expenses)
8. A copy of the applicant’s disclosure of compensation pursuant to Fed. R. Bankr. P.
2016(b) is attached as Exhibit “A.”
9. Attached as Exhibit B is a copy of the applicant’s time records setting forth the
the dates and amount of time expended for the services performed on behalf of the debtor
after confirmation of debtor’s chapter 13 plan.
10. All services rendered and expenses incurred for which compensation or reimbursement is
requested
a. were performed or incurred for or on behalf of the debtor, the services and
expenses were actual and necessary, and the compensation requested for those
services is reasonable; and
b. are not duplicative of services and expenses for which compensation or
reimbursement was previously requested.
11. If this supplemental application is granted, the debtor’s confirmed chapter 13 plan
(check whichever is applicable)
is adequately funded.
is not adequately funded.
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12. None of the compensation paid to applicant will be shared with any person other than a
member or regular associate of applicant's law firm unless 11 U.S.C. §504(c) applies.
WHEREFORE, Applicant requests an award of $ __________ in compensation and of $
__________ in reimbursement of actual, necessary expenses.
Date:____________________ Signed:_____________________________
[Applicant’s name] ………………………
[Firm Name] ……………………………..
[Address] ………………………………...
[Phone No.] ……………………………...
[Fax No.]…………………………………
[E-mail address] …………………………
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L.B.F. 2016-4
STATEMENT OF PRO SE DEBTOR
Debtor’s Name ________________________ Case No. _____________________________
Address______________________________ Chapter of Case ______________________
Telephone Number (home) _______________ Date Case Filed _____________________
Telephone Number (work) _______________
1. List the name, address, and telephone number of any person or business assisting you in
filing or preparing papers for this case:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
2. State how you were referred to the person or business named above or the source of
advertisement you responded to.
_____________________________________________________________
3. a. Total fee charged by person or business named above $ __________
b. Amount of fee paid as of the date you filed bankruptcy $ _________
c. Did the preparer tell you the amount of court costs that must be paid to file your
case?
YES NO (circle one)
4. Were various chapters or types of bankruptcy explained to you?
YES NO (circle one)
Other Comments _____________________________________________________
5. Did the preparer explain to you that you have the right to claim certain property as
exempt?
YES NO (circle one)
-16
6. Did the preparer give you a copy of the papers he prepared for you?
YES NO (circle one)
Date: __________ _______________________________
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L.B.F. 3007-1
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter
:
:
Debtor : Bky. No.
NOTICE OF OBJECTION TO CLAIM AND HEARING DATE
___[name]_______ has filed an objection to the proof of claim you filed in this bankruptcy
case.
1. Your claim may be reduced, modified, or eliminated. You should read these papers
carefully and discuss them with your attorney, if you have one. (If you do not have an
attorney, you may wish to consult an attorney).
2. If you do not want the court to change or eliminate your claim, you or your lawyer
must attend the hearing on the objection, scheduled to be held on xx/xx/xx,
at .m., in Courtroom , United States Bankruptcy Court ( address of
Bankruptcy Court ). If you or your attorney do not attend the hearing on the objection,
the court may decide that you do not oppose the objection to your claim.
3. If you intend to appear at the hearing to contest the objection to your claim, you must
notify the person listed below at least 7 days before the hearing date. If you do not
notify the person listed below that you intend to appear, the Objector will be entitled to a
postponement of the hearing.
Date: _______________________________________
[Attorney’s Name] ……………………………...
[Firm Name] ……………………………………
[Address] ……………………………………….
[Phone No.] …………………………………….
[Fax No.] ……………………………………….
[E-mail address] ………………………………..
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L.B.F. 3015-6A
UNITED STATES BANKRUPTCY COURT
EASTERN DISTRICT OF PENNSYLVANIA
IN RE: : Chapter
:
Debtor(s) : Bky. No.
PRE-CONFIRMATION CERTIFICATION
OF COMPLIANCE WITH POST-PETITION OBLIGATIONS IN ACCORDANCE
WITH 11 U.S.C. §§ 1325(a)(8) and 1325(a)(9)
I hereby certify as follows in connection with the confirmation hearing in the
above case:
1. The above named debtor(s) has/have paid all post-petition amounts that are required to be
paid under any and all Domestic Support Obligations.
2. The above named debtor(s) has/have filed all applicable federal, state and local tax returns as
required by 11 U.S.C. § 1308.
3. If the confirmation hearing is postponed for any reason, and the information herein changes, I
will provide an updated Certification to the chapter 13 trustee prior to any subsequent
confirmation hearing.
[to be executed by counsel for the Debtor(s) or the Debtor(s)]
Date:
[name]
Attorney for Debtor(s)
Date:
[name]
Debtor
Date:
[name]
Debtor
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L.B.F. 3015-6B
UNITED STATES BANKRUPTCY COURT
EASTERN DISTRICT OF PENNSYLVANIA
IN RE: : Chapter
:
Debtor(s) : Bky. No.
PRE-CONFIRMATION CERTIFICATION
OF COMPLIANCE WITH POST-PETITION OBLIGATIONS IN ACCORDANCE
WITH 11 U.S.C. §§ 1325(a)(8) and 1325(a)(9)
I/We, [name of Debtor(s)], hereby state under penalty of perjury in connection with the
confirmation hearing in the above case:
1. I/We has/have paid all post-petition amounts that are required to be paid under any and
all Domestic Support Obligations.
2. I/We has/have filed all applicable federal, state and local tax returns as required by 11
U.S.C. § 1308.
3. If the confirmation hearing is postponed for any reason, and the information herein
changes, I/we will provide an updated Certification to the chapter 13 trustee prior to any
subsequent confirmation hearing.
Date:
[name]
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L.B.F. 3015.1-1
UNITED STATES BANKRUPTCY COURT
EASTERN DISTRICT OF PENNSYLVANIA
In re: Case No.:
Chapter: 13
Debtor(s)
Chapter 13 Plan
Original
Amended
Date:
THE DEBTOR HAS FILED FOR RELIEF UNDER
CHAPTER 13 OF THE BANKRUPTCY CODE
YOUR RIGHTS WILL BE AFFECTED
You should have received from the court a separate Notice of the Hearing on Confirmation of Plan, which
contains the date of the confirmation hearing on the Plan proposed by the Debtor. This document is the
actual Plan proposed by the Debtor to adjust debts. You should read these papers carefully and discuss
them with your attorney. ANYONE WHO WISHES TO OPPOSE ANY PROVISION OF THIS PLAN
MUST FILE A WRITTEN OBJECTION in accordance with Bankruptcy Rule 3015 and Local Rule 3015-5.
This Plan may be confirmed and become binding, unless a written objection is filed.
IN ORDER TO RECEIVE A DISTRIBUTION UNDER THE PLAN, YOU
MUST FILE A PROOF OF CLAIM BY THE DEADLINE STATED IN THE
NOTICE OF MEETING OF CREDITORS.
Part 1: Bankruptcy Rule 3015.1 Disclosures
Plan contains non-standard or additional provisions – see Part 9
Plan limits the amount of secured claim(s) based on value of collateral
Plan avoids a security interest or lien
Part 2: Payment and Length of Plan
§ 2(a)(1) Initial Plan:
Total Base Amount to be paid to the Chapter 13 Trustee (“Trustee”) $ ______________
Debtor shall pay the Trustee $ _________ per month for ____ months; and
Debtor shall pay the Trustee $ _________ per month for ____ months.
Other changes in the scheduled plan payment are set forth in § 2(d)
§ 2(a)(2) Amended Plan:
Total Base Amount to be paid to the Chapter 13 Trustee (“Trustee”) $ ______________
The Plan payments by Debtor shall consists of the total amount previously paid ($_______)
added to the new monthly Plan payments in the amount of $_________ beginning ____________
(date) for _____months.
Other changes in the scheduled plan payments are set forth in § 2(d)
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§ 2(b) Debtor shall make plan payments to the Trustee from the following sources in addition to
future wages (Describe source, amount and date when funds are available, if known):
§ 2(c) Use of real property to satisfy plan obligations:
Sale of real property
See § 7(c) below for detailed description
Loan modification with respect to mortgage encumbering property:
See § 7(d) below for detailed description
§ 2(d) Other information that may be important relating to the payment and length of Plan:
Part 3: Priority Claims (Including Administrative Expenses & Debtor’s Counsel Fees)
§ 3(a) Except as provided in § 3(b) below, all allowed priority claims will be paid in full
unless the creditor agrees otherwise:
Creditor Type of Priority Estimated Amount to be Paid
§ 3(b) Domestic Support obligations assigned or owed to a governmental unit and paid
less than full amount.
None. If “None” is checked, the rest of § 3(b) need not be completed.
The allowed priority claims listed below are based on a domestic support obligation that has been
assigned to or is owed to a governmental unit and will be paid less than the full amount of the claim. This plan
provision requires that payments in § 2(a) be for a term of 60 months; see 11 U.S.C. § 1322(a)(4).
Name of Creditor Amount of claim to be paid
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Part 4: Secured Claims
§ 4(a) Curing Default and Maintaining Payments
None. If “None” is checked, the rest of § 4(a) need not be completed.
The Trustee shall distribute an amount sufficient to pay allowed claims for prepetition arrearages; and, Debtor
shall pay directly to creditor monthly obligations falling due after the bankruptcy filing.
Creditor Description of Regular Monthly Estimated Interest Rate Amount to be
Secured Payment to be Arrearage on Arrearage, Paid to
Property and paid directly to if applicable Creditor by
Address, if real creditor by the Trustee
property Debtor
§ 4(b) Allowed Secured Claims to be Paid in Full: Based on Proof of Claim or Pre-
Confirmation Determination of the Amount, Extent or Validity of the Claim
None. If “None” is checked, the rest of § 4(b) need not be completed.
(1) Allowed secured claims listed below shall be paid in full and their liens retained until completion of
payments under the plan.
(2) If necessary, a motion, objection and/or adversary proceeding, as appropriate, will be filed to
determine the amount, extent or validity of the allowed secured claim and the court will make its determination
prior to the confirmation hearing.
(3) Any amounts determined to be allowed unsecured claims will be treated either: (A) as a general
unsecured claim under Part 5 of the Plan or (B) as a priority claim under Part 3, as determined by the court.
(4) In addition to payment of the allowed secured claim, “present value” interest pursuant to 11 U.S.C.
§ 1325(a)(5)(B)(ii) will be paid at the rate and in the amount listed below. If the claimant included a different
interest rate or amount for “present value” interest in its proof of claim, the court will determine the present value
interest rate and amount at the confirmation hearing.
(5) Upon completion of the Plan, payments made under this section satisfy the allowed
secured claim and release the corresponding lien.
Description of
Name of Creditor Secured Property Allowed Present Dollar Amount Total
and Address, if real Secured Value of Present Amount to
property Claim Interest Value Interest be paid
Rate
-23-
§ 4(c) Allowed secured claims to be paid in full that are excluded from 11 U.S.C. § 506
None. If “None” is checked, the rest of § 4(c) need not be completed.
The claims below were either (1) incurred within 910 days before the petition date and secured by a
purchase money security interest in a motor vehicle acquired for the personal use of the debtor(s), or (2)
incurred within 1 year of the petition date and secured by a purchase money security interest in any other thing
of value.
(1) The allowed secured claims listed below shall be paid in full and their liens retained until completion
of payments under the plan.
(2) In addition to payment of the allowed secured claim, “present value” interest pursuant to 11 U.S.C.
§ 1325(a)(5)(B)(ii) will be paid at the rate and in the amount listed below. If the claimant included a different
interest rate or amount for “present value” interest in its proof of claim, the court will determine the present value
interest rate and amount at the confirmation hearing.
Name of Creditor Collateral Amount of Present Value Estimated total payments
Claim Interest
% $
% $
§ 4(d) Surrender
None. If “None” is checked, the rest of § 4(d) need not be completed.
(1) Debtor elects to surrender the secured property listed below that secures the creditor’s claim.
(2) The automatic stay under 11 U.S.C. § 362(a) with respect to the secured property terminates upon
confirmation
of the Plan.
(3) The Trustee shall make no payments to the creditors listed below on their secured claims.
Creditor Secured Property
Part 5: Unsecured Claims
§ 5(a) Specifically Classified Allowed Unsecured Non-Priority Claims
None. If “None” is checked, the rest of § 5(a) need not be completed.
Basis for Separate
Creditor Classification Treatment Amount of Amount to
Claim be paid
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§ 5(b) All Other Timely Filed, Allowed General Unsecured Claims
(1) Liquidation Test (check one box)
All Debtor(s) property is claimed as exempt.
Debtor(s) has non-exempt property valued at $ for purposes of § 1325(a)(4)
(2) Funding: § 5(b) claims to be paid as follows (check one box):
Pro rata
100%
Other (Describe)
Part 6: Executory Contracts & Unexpired Leases
None. If “None” is checked, the rest of § 6 need not be completed.
Creditor Nature of Contract or Lease Treatment by Debtor Pursuant to §365(b)
Part 7: Other Provisions
§ 7(a) General Principles Applicable to The Plan
(1) Vesting of Property of the Estate (check one box)
Upon confirmation
Upon discharge
(2) Unless otherwise ordered by the court, the amount of a creditor’s claim listed in its proof of claim
controls over any contrary amounts listed in Parts 3, 4 or 5 of the Plan.
(3) Post-petition contractual payments under § 1322(b)(5) and adequate protection payments under §
1326(a)(1)(B),(C) shall be disbursed to the creditors by the Debtor directly. All other disbursements to
creditors shall be made by the Trustee.
(4) If Debtor is successful in obtaining a recovery in a personal injury or other litigation in which Debtor is
the plaintiff, before the completion of plan payments, any such recovery in excess of any applicable exemption will
be paid to the Trustee as a special Plan payment to the extent necessary to pay priority and general unsecured
creditors, or as agreed by the Debtor and the Trustee and approved by the court.
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§ 7(b) Affirmative Duties on Holders of Claims secured by a Security Interest in Debtor’s
Principal Residence
(1) Apply the payments received from the Trustee on the pre-petition arrearage, if any, only to such
arrearage.
(2) Apply the post-petition monthly mortgage payments made by the Debtor to the post-petition mortgage
obligations as provided for by the terms of the underlying mortgage note.
(3) Treat the pre-petition arrearage as contractually current upon confirmation for the Plan for the sole
purpose of precluding the imposition of late payment charges or other default-related fees and services based on
the pre-petition default or default(s). Late charges may be assessed on post-petition payments as provided by the
terms of the mortgage and note.
(4) If a secured creditor with a security interest in the Debtor’s property sent regular statements to the
Debtor pre-petition, and the Debtor provides for payments of that claim directly to the creditor in the Plan, the
holder of the claims shall resume sending customary monthly statements.
(5) If a secured creditor with a security interest in the Debtor’s property provided the Debtor with coupon
books for payments prior to the filing of the petition, upon request, the creditor shall forward post-petition coupon
book(s) to the Debtor after this case has been filed.
(6) Debtor waives any violation of stay claim arising from the sending of statements and coupon
books as set forth above.
§ 7(c) Sale of Real Property
None. If “None” is checked, the rest of § 7(c) need not be completed.
(1) Closing for the sale of (the “Real Property”) shall be completed
within months of the commencement of this bankruptcy case (the “Sale Deadline”). Unless otherwise
agreed by the parties or provided by the Court, each allowed claim secured by the Real Property will be paid in full
under §4(b)(1) of the Plan at the closing (“Closing Date”).
(2) The Real Property will be marketed for sale in the following manner and on the following terms:
(3) Confirmation of this Plan shall constitute an order authorizing the Debtor to pay at settlement all
customary closing expenses and all liens and encumbrances, including all § 4(b) claims, as may be necessary to
convey good and marketable title to the purchaser. However, nothing in this Plan shall preclude the Debtor from
seeking court approval of the sale of the property free and clear of liens and encumbrances pursuant to 11 U.S.C.
§363(f), either prior to or after confirmation of the Plan, if, in the Debtor’s judgment, such approval is necessary or
in order to convey insurable title or is otherwise reasonably necessary under the circumstances to implement this
Plan.
(4) Debtor shall provide the Trustee with a copy of the closing settlement sheet within 24 hours of the
Closing Date.
(5) In the event that a sale of the Real Property has not been consummated by the expiration of the Sale
Deadline:
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§ 7(d) Loan Modification
None. If “None” is checked, the rest of § 7(d) need not be completed.
(1) Debtor shall pursue a loan modification directly with or its successor in interest or its
current servicer (“Mortgage Lender”), in an effort to bring the loan current and resolve the secured arrearage claim.
(2) During the modification application process, Debtor shall make adequate protection payments directly to
Mortgage Lender in the amount of $ per month, which represents (describe
basis of adequate protection payment). Debtor shall remit the adequate protection payments directly to the
Mortgage Lender.
(3) If the modification is not approved by (date), Debtor shall either (A) file an amended Plan to
otherwise provide for the allowed claim of the Mortgage Lender; or (B) Mortgage Lender may seek relief from the
automatic stay with regard to the collateral and Debtor will not oppose it.
Part 8: Order of Distribution
The order of distribution of Plan payments will be as follows:
Level 1: Trustee Commissions*
Level 2: Domestic Support Obligations
Level 3: Adequate Protection Payments
Level 4: Debtor’s attorney’s fees
Level 5: Priority claims, pro rata
Level 6: Secured claims, pro rata
Level 7: Specially classified unsecured claims
Level 8: General unsecured claims
Level 9: Untimely filed, allowed general unsecured claims
*Percentage fees payable to the standing trustee will be paid at the rate fixed by the United States Trustee
not to exceed ten (10) percent.
Part 9: Non Standard or Additional Plan Provisions
None. If “None” is checked, the rest of § 9 need not be completed.
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Under Bankruptcy Rule 3015(c), nonstandard or additional plan provisions are required to be set forth in Part 9
of the Plan. Such Plan provisions will be effective only if the applicable box in Part 1 of this Plan is checked.
Any nonstandard or additional provisions set out other than in Part 9 of the Plan are VOID. By signing below,
attorney for Debtor(s) or unrepresented Debtor(s) certifies that this Plan contains no nonstandard or additional
provisions other than those in Part 9 of the Plan.
Date:
Attorney for Debtor(s)
If Debtor(s) are unrepresented, they must sign below.
Date:
Debtor
Date:
Joint Debtor
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L. B. F. 4003-1
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter
:
:
Debtor(s) : Bky. No.
NOTICE OF OBJECTION TO CLAIM OF
EXEMPTION AND HEARING DATE
____________________________ has filed an objection to your claim of exemption in this
bankruptcy case.
1. Your claim of exemption may be eliminated or changed by the court because an
objection has been filed. You should read these papers carefully and discuss them with
your attorney, if you have one in this bankruptcy case. (If you do not have an attorney,
you may wish to consult an attorney).
2. If you do not want the court to eliminate or change your claim of exemption, or if you
want the court to consider your views, you or your lawyer must attend the hearing on the
objection, scheduled to be held on xx/xx/xx, at , in Courtroom , United States
Bankruptcy Court ( address of Bankruptcy Court ).
Date: ______________________________________
[Attorney’s Name] …………………………….
[Firm Name] …………………………………..
[Address] ………………………………………
[Phone No] …………………………………….
[Fax No.] ………………………………………
[E-mail address] ……………………………….
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L.B.F. 5011-1
CAPTION OF MOTION FOR WITHDRAWAL OF THE REFERENCE
UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
Misc. No. ________
In re: : Chapter ____
:
:
Debtor : Bky. No. ____
MOTION OF ...............................
FOR WITHDRAWAL OF REFERENCE
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L.B.F. 8012-1
UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter ____
:
: C.A. No. ____
Debtor :
:
: Bky. No. ____
L.B.R. 8012-1 DISCLOSURE FORM
Instructions
This L.B.R. 8012-1 Disclosure Form is for parties to an appeal to make the disclosures
required under Fed. R. Bankr. P. 8012 and L.B.R. 8012-1.The purpose of these disclosure rules is
to provide the judge assigned the appeal with information about any conflicts of interest which
might prevent that judge from hearing the case.
Paragraphs (a) and (b) of the form are for a non-governmental corporate party to an appeal to
fulfill its obligation under Fed. R. Bankr. P. 8012 to file a statement identifying any parent corporation
and any publicly held corporation that owns 10% or more of the party’s stock.
Paragraph (c) is for each party to an appeal to comply with L.B.R. 8012-1(c) by identifying
any publicly owned corporation not a party to the appeal that has a financial interest in the outcome of
the appeal and the nature of that interest.
Paragraph (d) is for the appellant to comply with L.B.R. 8012-1(d) by identifying (1) the
debtor if not named in the caption; (2) the members of the creditors’ committee or the top 20
unsecured creditors; and (3) any entity not named in the caption which is an active participant in the
bankruptcy proceedings giving rise to the appeal.
The completed L.B.R. 8012-1 Disclosure Form must be filed no later than 30 days after
the docketing of the appeal. L.B.R. 8012-1(d), and a copy of the form of the information on the
form must be included before the table of contents in the party’s principal brief. The L.B.R. 8012-1
Disclosure Form must be supplemented if the information changes. Fed. R. Bankr. P. 8012.
If additional space is needed, please attach a new page.
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As required by Fed. R. Bankr. P. 8012 and L.B.R. 8012-1,
(Name of Party)______________________ makes the following disclosure:
(1) For non-governmental corporate parties, please list all parent corporations:
(2) For non-governmental corporate parties, please list all publicly held companies that hold 10% or
more of the party’s stock:
(3) If there is a publicly held corporation which is not a party to the appeal but which has a financial
interest in the outcome of the proceeding, each party to the appeal please shall identify all such parties
and specify the nature of the financial interest or interests:
(4) The appellant must identify (a) the debtor, if not identified in the case caption; (b) the members of
the creditors’ committee or the top 20 unsecured creditors; and, (3) any entity not named in the caption
which is active participant in the bankruptcy proceeding giving rise to the appeal.
Dated: _________________________
(Signature of Counsel or Party)
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L.B.F. 9014-3
UNITED STATES BANKRUPTCY COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA
In re: : Chapter
:
:
Debtor : Bky. No.
* * * * * * *
NOTICE OF MOTION, RESPONSE DEADLINE
AND HEARING DATE
(Name of movant) has filed (name of motion) with the court for (describe the relief
sought in the motion).
1. Your rights may be affected. You should read these papers carefully and discuss
them with your attorney, if you have one in this bankruptcy case. (If you do not have
an attorney, you may wish to consult an attorney).
2. If you do not want the court to grant the relief sought in the Motion or if you want the
court to consider your views on the Motion, then on or before XX/XX/XX you or your
attorney must file a response to the Motion. (see Instructions on next page).
3. A hearing on the Motion is scheduled to be held on XX/XX/XX, at___________ in
Courtroom _______ , United States Bankruptcy Court, (address of Bankruptcy
Court). Unless the court orders otherwise, the hearing on this contested matter will be an
evidentiary hearing.
4. If you do not file a response to the Motion, the court may cancel the hearing and enter
an order granting the relief requested in the Motion.
5. You may contact the Bankruptcy Clerk's office at 215-408-2800 to find out whether the
hearing has been canceled because no one filed a response.
6. If a copy of the motion is not enclosed, a copy of the Motion will be provided to you if you
request a copy from the attorney whose name and address is listed on the next page of this
Notice.
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Filing Instructions
7. If you are required to file documents electronically by Local Bankruptcy Rule
5005-1, you must file your response electronically.
8. If you are not required to file electronically, you must file your response at
( address of bankruptcy clerk's office )
9. If you mail your response to the bankruptcy clerk’s office for filing, you must mail it
early enough so that it will be received on or before the date stated in Paragraph 2 on the
previous page of this Notice.
10. On the same day that you file or mail your Response to the Motion, you must mail or
deliver a copy of the Response to the movant’s attorney:
[Attorney’s name] ……………….
[Firm name] ……………………..
[Address] ………………………..
[Phone No.] ……………………..
[Fax No.] ………………………..
[E-mail address] ………………...
[If applicable, name and address of others to be served.]
Date: ___________
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