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Disclosure Of Compensation Of Bankruptcy Petition Preparer Form. This is a Louisiana form and can be use in Bankruptcy Court Federal.
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Tags: Disclosure Of Compensation Of Bankruptcy Petition Preparer, Louisiana Federal, Bankruptcy Court
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
UNITED STATES BANKRUPTCY COURT
:
JUDICIAL SUBPOENA
Plaintiff(s)
EASTERN DISTRICT OF LOUISIANA
-against:
IN THE MATTER OF
BANKRUPTCY NO.
:
DEBTOR(S)
:
CHAPTER
Defendant(s)
Address: ___________________________________________________
:
......................................................
Social Security No(s).: ________________________________________
Employer’s Tax ID No.: _______________________________________
THE PEOPLE OF THE STATE OF NEW YORK
TO
DISCLOSURE OF COMPENSATION OF BANKRUPTCY PETITION PREPARER
1. Under 11 U.S.C. §110 (h), I declare under penalty of perjury that I am not an attorney or
GREETINGS:
employee of an attorney, that I prepared or caused to be prepared one or more documents for
filing by the above-named debtor(s) in connection with this bankruptcy case, and that
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
compensation paid to me within one year before the filing of the bankruptcy case, and that
,
the Honorable
at the
Court
compensation paid to me within one year before the filing of the petition in bankruptcy, or
located at
County of agreed to be paid to me, for services rendered or to be rendered on behalf of the debtor(s) in
in room
, on the
day of
, 20
, at
noon, and at any recessed
contemplation of or in connection with the bankruptcy case o'clock in the
is as follows:
or adjourned date, to testify and give evidence as a witness in this action on the part of the
For document preparation services, I have agreed to accept…$___________________
Prior to the filing of this statement I have received…$__________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
Balance Due…………………………………………..$_________________________
result of your failure to comply.
2. I have prepared or caused to be prepared the following documents (itemize):
Witness, Honorable
, one of the Justices of the
Court in
County,
day of
, 20
and provided the following services (itemize):
3. The source of the compensation paid to me was:
[ ]
Debtor
[ ]
[ ]
Debtor
[ ]
(Attorney must sign above and type name below)
Other (specify)
Attorney(s) for
4. The source of the compensation to be paid to me is:
Other (specify)
Office and P.O. Address
5. To my knowledge no other person has prepared for compensation a document for filing in
connection with this bankruptcy case except as listed below:
Telephone No.:
Facsimile No.:
_____________________________________
___________________________
NAME
SOCIAL SECURITY NUMBER
E-Mail Address:
Mobile Tel. No.:
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