302 (12/1/2018) Page 1 of 2 UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) Case No. ) ) Notice of Amended Claim to Debtor(s) ) Not Represented by an Attorney ) [For Use Only in Chapter 12 and 13 Cases] Debtor(s) ) I, the undersigned, certify that I was authorized on behalf of (creditor) to file the attached amended proof of claim, which amends claim number previously filed for $ . The amended claim differs from the original in the following ways (e.g., amount, status, etc.): PLEASE BE ADVISED that: (1) 11 U.S.C. 247 502(a) provides that a proof of claim filed under 247 501 is deemed allowed unless objected to, and (2) FRBP 3001(f) provides that a proof of claim executed and filed in accordance with the Federal Rules of Bankruptcy Procedure shall constitute prima facie evidence of the validity and amount of the claim. NOTICE IS NOW GIVEN that any further disbursements made by the trustee will be based on the amended claim unless, within 14 days of the service date of this notice, the debtor: (1) files an objection setting forth the specific grounds for the objection with the clerk at 1050 SW 6th Ave. #700, Portland OR 97204 or 405 E 8th Ave. #2600, Eugene OR 97401; and (2) serves the objection on the trustee, whose name and service address are: . Signature (OSB# if attorney) Signer's Name (Type or Print) Signer's Relation to Creditor Signer's Address American LegalNet, Inc. www.FormsWorkFlow.com 302 (12/1/2018) Page 2 of 2 I certify that on the above notice and amended proof of claim were served on the debtor(s) and trustee. Signature of Creditor or Attorney American LegalNet, Inc. www.FormsWorkFlow.com