FORM 1. AFFIDAVIT OF PROFESSIONAL PERSON [Caption] 1. I hereby represent that neither I nor any member of my firm, or represents any interest adverse to the estate of the above-named debtor. , holds 2. My, and my firm's connections with the debtor, creditors or other parties-in-interest, their respective attorneys and accountants, are as follows: I hereby represent that I have not agreed to share with any person the compensation to be 3. paid for services rendered in this case, except as follows: 4. In witness thereof, has/have set hand(s) and seal(s) this SIGNED: , the said day of , 20 . Printed name of affiant and firm STATE OF MAINE COUNTY OF Dated: , being duly Then appeared before me the above-named sworn upon oath, and acknowledged the foregoing instrument to be true. Before me, Name Notary Public/Attorney-at-Law [Effective April 15, 1997] American LegalNet, Inc. www.FormsWorkFlow.com