Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address FOR COURT USE ONLY Individual appearing without attorney Attorney for: UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA In re: CASE NO.: CHAPTER: DIVISION PLAN BALLOT SUMMARY (NOTE: The Plan Proponent must file a Plan Ballot Summary at least 1 day prior to the Confirmation Hearing.) DATE: TIME: COURTROOM: ADDRESS: Debtor(s). 1. Proponent of Plan (specify name): 2. Are there any competing plans filed with the court? 3. Is a cramdown requested? 4. Unimpaired classes (specify class numbers): 5. Impaired classes (specify class numbers): 6. Has any impaired class approved the Plan? (If YES, specify which class or classes): Yes No Yes Yes No No This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2014 Page 1 F 3018-2.PLAN.BALLOT.SUMMARY 7. Pursuant to 11 U.S.C. § 1126(c), only the actual ballots cast are counted to determine whether a given class has voted to accept or reject the plan. That section further provides that a class will have accepted the plan if voting creditors in such class holding at least two-thirds in amount and more than one-half in number have voted to accept the plan. The following is a summary by creditor class of the ballots that were returned in a timely manner (an example is included on the following page): Number Number of claims Total number of voted in favor of Percentage claims voted by accepting the plan accepting members of (A ÷ N) (A) and rejecting class (N) the plan (R) Aggregate dollar amount of claims voted by members of class (Amt) Amount Dollar amount of claims voted in favor Percentage of accepting the plan accepting (A) and rejecting the (A ÷ Amt) plan (R) Class Impaired? (N) (N) (N) (N) (N) (N) (N) (N) (N) (N) see attached continuation page Comments: (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) % (Amt) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) % % % % % % % % % % Date: Signature of Debtor, or attorney for Debtor Printed name of Debtor, or attorney for Debtor This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2014 Page 2 F 3018-2.PLAN.BALLOT.SUMMARY EXAMPLE OF VOTING SUMMARY TABLE The following is an example of a voting summary for an individual debtor's plan: Number Number of claims Total number of voted in favor of Percentage claims voted by accepting the plan accepting members of (A ÷ N) (A) and rejecting class (N) the plan (R) Aggregate dollar amount of claims voted by members of class (Amt) Amount Dollar amount of claims voted in favor Percentage of accepting the plan accepting (A) and rejecting the (A ÷ Amt) plan (R) Class Impaired? Class 1(a) Class 1(b) Class 2(a) Class 2(b) Class 3 Class 4 Class 5 No Yes Yes Yes No Yes No (N) (N) (N) (N) (N) (N) (N) (N) (N) (N) 11 1 0 1 (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) 7 4 63.6% 0 1 0% 1 0 100% (Amt) (Amt) (Amt) (Amt) $469,756.40 (Amt) (Amt) (Amt) (Amt) (Amt) (Amt) $12,536.84 $52,767.98 (A) (R) (A) (R) (A) (R) (A) $0.00 (R) $469,756.40 (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) (A) (R) $7,511.10 $5,025.74 59.9% 0% $52,767.98 $0.00 100% Comments: XYZ's vote in Class 4 to reject the plan was not counted because it was returned untimely on 1/14/14. This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2014 Page 3 F 3018-2.PLAN.BALLOT.SUMMARY PROOF OF SERVICE OF DOCUMENT I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is: A true and correct copy of the foregoing document entitled: PLAN BALLOT SUMMARY will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d); and (b) in the manner stated below: 1. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date) , I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below: Service information continued on attached page 2. SERVED BY UNITED STATES MAIL: On (date) , I served the following persons and/or entities at the last known addresses in this bankruptcy case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and addressed as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page 3. SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL (state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing to such service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Printed Name Signature This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2014 Page 4 F 3018-2.PLAN.BALLOT.SUMMARY