LBR Form 2016­1(a)(1)(C) UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF OHIO _____________ DIVISION In re: Case No: Chapter Debtor(s) Judge NOTICE OF [INTERIM] APPLICATION OF _______________________ FOR ALLOWANCE OF COMPENSATION AND REIMBURSEMENT OF EXPENSES FOR THE PERIOD __________________ THROUGH __________________ 1. Name of Applicant (specify): 2. Type of Services Rendered: a. b. c. Attorney for (specify): Accountant for (specify): Other Professional (specify): 3. Date of Filing of Petition under Chapter _____ of the Bankruptcy Code: 4. Date of Entry of Order Approving Applicant's Employment: 5. Date of Filing of last Fee and/or Expense Application: 6. TOTAL FEES REQUESTED THIS APPLICATION: $____________ 7. TOTAL EXPENSE REIMBURSEMENT REQUESTED THIS APPLICATION: $_____________ American LegalNet, Inc. www.FormsWorkFlow.com A copy of the [Interim] Application of ____________________________ For Allowance of Compensation and Reimbursement of Expenses for the Period ______________________ Through ______________________ may be obtained by contacting: [Name of Contact] [Address of Contact] [Telephone Number of Contact] A Response must be filed and served within twenty-one (21) days after the date set forth on the Certificate of Service. Unless an objection to the Application is timely filed, the Court may grant the relief requested without further notice in accordance with Local Bankruptcy Rule 9013­1. Dated: _______________ ___________________________________ American LegalNet, Inc. www.FormsWorkFlow.com