BUSINESS BA - 01 1 United States Bankruptcy Court for the Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: Operating reports are to be filed monthly with the Bankruptcy Clerk222s Office by the 15th of each month BUSINESS DEBTOR222S AFFIRMATIONS 1. YES NO All post petition business taxes have been paid/deposited. If you answered 223No224 to the above, list the types of taxes that are now due and owing. TYPE OF TAX AMOUNT $ $ $ $ 2. YES NO Adequate insurance on all assets/property including fire, theft, liability, collision and casualty and workman222s compensation (if applicable) is currently in full force and effect. If no, enter: TYPE not in force. TYPE not in force. 3. YES NO New books and records were opened and are being maintained daily. 4. YES NO Copies of all banks statements are concurrently filed with the Bankruptcy Clerk222s O ffice . 5. YES NO I have otherwise complied with all requirements of the Chapter 11 Operating Order. I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. Date RESPONSIBLE PARTY Phone No. American LegalNet, Inc. www.FormsWorkFlow.com 2 United States Bankruptcy Court Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: CASH RECEIPTS & DISBURSEMENTS INCOME STATEMENT - Accrual (Circle One) - Cash CASH ON HAND (Beginning)is the same figure as cash on Hand (End) of last month. A. CASH ON HAND(Beginning) B. RECEIPTS: Accounts Receivable from Form BA-02(A)-Line II(C) Cash Sales Loan Proceeds from Sale of Property (Not in ordinary course of business) Other C. TOTAL RECEIPTS (Total of B) D. BUSINESS DISBURSEMENTS FROM FORM BA-02(B) E. SURPLUS OR DEFICIT (C minus D) F. CASH ON HAND (End) (A plus E) 1. REVENUE FROM TOTAL SALES $ 2. LESS COST OF THOSE SALES (Cost of materials, Labor, etc.) 3. EQUALS GROSS PROFIT (1 minus 2) 4. LESS OPERATING EXPENSES 5. EQUALS NET PROFIT OPERATIONS (3 minus 4) 6. NON-OPERATING INCOME/EXPENSES (LIST SPECIFIC INCOME/EXPENSES) 7. EQUALS NET PROFIT OR NET LOSS $ (5 plus or minus 6) * Please itemize Cost of Sales and Expenses on a separate sheet of paper. I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. DATE RESPONSIBLE PARTY American LegalNet, Inc. www.FormsWorkFlow.com 3 United States Bankruptcy Court Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: BUSINESS DEBTOR'S ACCOUNTS RECEIVABLE (if applicable) I. NO ACCOUNTS RECEIVABLE WERE COLLECTED THIS MONTH. (Check if true) II. COLLECTION OF ACCOUNTS RECEIVABLE THIS MONTH. A. Amount collected this month on accounts receivable charged and paid this month. $ B. Amount collected this month on accounts receivable charged in prior months and paid this month. $ C. TOTAL collected this month on accounts receivable. $ III. PENDING ACCOUNTS RECEIVABLE AS OF THE END OF THE MONTH: ENTITY 0 - 30 Days 31 - 60 DAYS 61 - 90 DAYS OVER 91 TOTAL $ $ TOTALS $ $ I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. DATE RESPONSIBLE PARTY American LegalNet, Inc. www.FormsWorkFlow.com 4 United States Bankruptcy Court - Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: BUSINESS DEBTOR'S ACTUAL DISBURSEMENTS Advertising $ ------------------------------------------ Automobiles/Vehicles (repairs & maintenance) $ ------------------------------------------ Commissions/Contract Labor $ ------------------------------------------ Insurance $ ------------------------------------- ---- Inventory Purchased $ ------------------------------------- ---- Rent/Lease Payments on Real Estate $ ------------------------------------------- Repairs & Maintenance $ ------------------------------------------- Salaries & Wages Paid $ ------------------------------------------- Secured Loan Payments (specify) $ ------------------------------------------- ---------------------------------- $ ---------------------- ---------------------------------- $ -------------------- ---------------------------------- $ --------------------- Supplies $ ----------------------------------------- Travel & Entertainment $ ------------------------------------------- Taxes (total of all taxes from page 5) $ ------------------------------------------- Unsecured Loan Payments $ ------------------------------------------- Utilities $ ------------------------------------------- Professional Fees (specify) $ ------------------------------------------- Accounting $ ------------------------ Attorney Fees $ ------------------------ Other --------------------- $ ------------------------ Adequate Protection Payments $ ------------------------------------------ Other Business Disbursements (specify) ---------------------------------------------- $ ---------------------------------------- ---------------------------------------------- $ ---------------------------------------- ---------------------------------------------- $ ---------------------------------------- Total Business Disbursements $ ---------------------------------------- I Certify that the above information is true and correct to the best of my knowledge and belief. Dated: ------------------- ---------------------------------------------------- Responsible Party American LegalNet, Inc. www.FormsWorkFlow.com 5 United States Bankruptcy Court Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: BUSINESS DEBTOR'S TAX PAYMENTS A. WITHHELD TAXES FOR EACH PAYROLL PERIOD PAYROLL DATE PAYROLL AMOUNT FICA 941 STATE INCOME TAXES PAID LOCAL INCOME TAXES PAID AMOUNT DUE AMOUNT DEPOSITED TOTAL B. UNEMPLOYMENT TAXES FOR EACH PAYROLL PERIOD PAYROLL DATE TAXABLE PAYROLL FUTA 940 STATE AMOUNT DUE AMOUNT DEPOSITED TOTAL C. OTHER TAXES (SPECIFY TYPE: EXCISE, SALES, ETC. INCLUDE TAXES DUE AND PAID QUARTERLY) DUE PAID DATE TYPE AMOUNT DATE TYPE AMOUNT TOTAL I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. DATE RESPONSIBLE PARTY American LegalNet, Inc. www.FormsWorkFlow.com 6 United States Bankruptcy Court - Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: BUSINESS DEBTOR'S BANK ACCOUNTS Bank, Credit Union, Etc. Account No. (Checking, Savings, CD, Etc.) Statement Balance Date Indicate Pre or Post Petition Account GROSS PAYROLL (Wages, Salaries, Commissions, Bonuses, Etc.) Officer #1 (Name) $ Officer #2 (Name) Other Officer (Name) Employees (Number) Employees (Relatives) Name Name $ $ $ $ $ $ INVENTORY (IF APPLICABLE) Inventory - Beginning of Month (COST) Inventory - Purchased this Month - CASH Inventory - Purchased this Month - CREDIT Inventory - End of Month (COST) $ $ $ $ PAYMENTS MADE TO PRE - PETITION UNSECURED CREDITORS A. No payments on pre-petition debts have been made this month. B. The following payments have been made this month to unsecured creditors whose debts were incurred prior to the filing of this case: CREDITOR AMOUNT & DATE PURPOSE PAYMENT COURT APPROVED? I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. DATE RESPONSIBLE PARTY American LegalNet, Inc. www.FormsWorkFlow.com 7 United States Bankruptcy Court - Southern District of Alabama CASE NAME: CASE NO. : MONTH ENDING: BUSINESS DEBTOR'S POST-PETITION ACCOUNTS PAYABLE CHECK A or B A. All operating expenses since the beginning of this case have been paid. Therefore there are no post-petition accounts payable. ** OR ** B. Post-petition accounts payable are as follows: ENTITY OWED 0 - 30 DAYS 31 - 60 DAYS 61 - 90 DAYS OVER 91 TOTAL $ $ $ $ TOTALS $ $ $ $ I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. Dated : ------------------------------ Responsible Party American LegalNet, Inc. www.FormsWorkFlow.com