UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF ALABAMA In Re: ______________________ ________________ Case No. APPLICATION FOR ALLOWANCE OF ATTORNEY FEE 1. Applicant, as attorney for the debtor, has performed services necessary for the confirmation of the debtor's plan. The services provided include interviews with the debtor regarding the debtor's financial condition; the preparation and filing of the debtor's petition, Chapter 13 statement, schedules of property and creditors; and the formulation and filing of the debtor's plan of reorganization. Additionally, the attorney will appear and represent the debtor at the § 341 meeting and at the confirmation hearing on debtor's plan. 2. Applicant states that a reasonable fee for the services performed and to be performed for the debtor is $_______ and asks that the fee be approved and allowed. 3. The total amount of money paid to the applicant or the value of any property transferred to the applicant on behalf of the debtor within one year immediately preceding the filing of this petition for consultation concerning debt consolidation, relief under the Bankruptcy Code or preparation of a petition in bankruptcy is $________. The applicant represents that the following disbursements have been made on behalf of the debtor: Total Received: $____________________ Disbursements: Filing Fee: $____________________ Trustee: $____________________ Other: $____________________ Total Disbursements: $____________________ Amount Applied to Attorney Fees: $____________________ Balance of Attorney's Fees: $____________________ 4. By agreement with the debtor, the requested fee does not include defense of any adversary proceedings, services related to the defense of any objection to discharge raised by a creditor or any other extraordinary contested matter under Rule 9014 of the Rules of Bankruptcy Procedure. The debtor agrees to pay applicant the sum of $_____ per hour for these services, if requested. The applicant and the debtor acknowledge that any fees in addition to the fee requested in paragraph 2 which the applicant may be awarded will be subject to approval of the Bankruptcy Court upon application by the applicant. 2001 © American LegalNet, Inc. 5. The applicant and the debtor further agree that in the event that the Chapter 13 case is not confirmed, any refunds sent to the debtor's counsel by the Chapter 13 Trustee shall be applied by the debtor's counsel to any earned attorney fees in this proceeding and further that the office of the debtor's counsel is authorized by the debtor to endorse and negotiate any refunds from the Chapter 13 Trustee for this purpose. It is further agreed that this representation by the applicant is limited solely and exclusively to this Chapter 13 case in the United States Bankruptcy Court and does not include any other legal matters of any nature or representation in any other courts. ______________________________________ _____________________________________ Debtor Date Date Applicant (Attorney for Debtor) ______________________________________ Debtor Date 2001 © American LegalNet, Inc.