Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address FOR COURT USE ONLY Individual appearing without attorney Attorney for: UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA In re: CASE NO.: CHAPTER: DIVISION NOTICE OF DEBTOR NON-PARTICIPATION AND TERMINATION OF LMM ASSISTANCE Debtor(s). TO THE COURT: On (date) _____________, the debtor(s) in the above captioned case submitted to the Program Manager a Pro Se Debtor Request for LMM Assistance. The Program Manager hereby gives notice to the court that the debtor(s) has failed to cooperate or perform its obligations as determined by the Program Manager acting in good faith. Accordingly, the Program Manager will no longer be providing LMM Assistance to the debtor(s) for the following reason(s): Program Manager has been unable to contact the debtor(s). The debtor(s) has advised Program Manager that [he/she/they] do not wish to participate in the LMM. The debtor(s) has failed or refuses to pay the required Pro Se Document Preparation Fee. The debtor(s) has failed or refuses to provide the required information and/or documentation. Other: _______________________________________________________________________ _____________________________________________________________________________ Date: By: __________________________________________ Name December 2016 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com LMM 4001-1.6.NOTICE.NON.PART