(Attorney Name) (Firm Name) (Address) (City, State, Zip) Telephone: ( ) Fax: ( ) Email: ( ) Attorney for: ( AK LBF 13 [11/15] ) UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF ALASKA In re: (Debtor's Name) and (Joint Debtor's Name), Debtor(s). TO: (Creditor's Name) Case No. ( ) Chapter ( ) NOTICE OF OBJECTION TO CLAIM AND NOTICE OF HEARING THEREON Claim No. (Number) Amount: (Amount of Filed Claim) Filed: (Date Filed) As: Administrative / Wage / Tax / Priority / Secured / Unsecured [Choose one] Your claim may be reduced, modified, or eliminated. You should read these papers carefully and discuss them with your attorney, if you have one. PLEASE TAKE NOTICE that the undersigned objects to the allowance of the abovereferenced claim (copy attached) filed in the above captioned case for the following reasons: (State Reasons) The objection asks for the following treatment of your claim [Check One]: Disallow in Full Allow as (Type of Claim) claim for $ (Amount) and as (Type of Claim) claim for $ (Amount) If you dispute the objection to your claim, you must file a written response with the Clerk of the Bankruptcy Court, 605 West Fourth Avenue, Room 138, Anchorage, Alaska 99501-2296 at least five (5) business days before the hearing date shown below and serve a copy on the undersigned. IF YOU FAIL TO SO DO, THE COURT MAY ALLOW THE OBJECTION TO YOUR CLAIM WITHOUT FURTHER NOTICE TO YOU. FURTHER TAKE NOTICE that a hearing will be held on (Date) at (Time) o'clock (a or p) .m. at the Historic Courtroom, U.S. Bankruptcy Court, 605 West 4th Avenue, Anchorage, Alaska 99501 to hear the objection to your claim. If you can not attend the hearing in person, American LegalNet, Inc. www.FormsWorkFlow.com you may call the U.S. Bankruptcy Court In-Court Deputy Clerk at (907) 271-2640, at least three (3) business days in advance of the hearing to request telephonic attendance. Dated: ( ) (Firm Name) Attorney for ( ) By: _________________________________ (Attorney Name) American LegalNet, Inc. www.FormsWorkFlow.com