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 - **SELECT DIVISION** In re: CASE NO.: DIVISION CHAPTER: SELECT CHAPTER DECLARATION OF RE: DEFAULT UNDER ADEQUATE PROTECTION ORDER; REQUEST FOR ENTRY OF ORDER GRANTING RELIEF FROM STAY DATE: TIME: COURTROOM: PLACE: Debtor(s). I, (print name of declarant), declare as follows: 1. I have personal knowledge of the matters set forth in this declaration and, if called upon to testify, I could and would testify competently hereto. I am over 18 years of age. 2. On the court entered an order conditioning continuation of the automatic stay in the above-entitled bankruptcy case on the performance by the Debtor of certain obligations for the benefit of (name of Movant) _____________________________________________________________ (Adequate Protection Order). A true and correct copy of the Adequate Protection Order is attached hereto as Exhibit "A." 3. I have knowledge regarding the Debtor's performance (or lack of performance) under the terms of the Adequate Protection Order because (specify): This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2012 Page 1 F 4001-1.DEC.DEFAULT.ADEQ I am the party for whose benefit the Adequate Protection Order was entered (Movant), and the Adequate Protection Order required the Debtor to make payments directly to me. I am counsel for the Movant and the Adequate Protection Order required the Debtor to make payments directly to me. I am employed as for the Movant and, as such, am one of the custodians of the books, records and files of Movant that relate to payments received from the Debtor. I have personally worked on those books, records and files, and as to the following facts, I know them to be true of my own knowledge or I have gained knowledge of them from the business records of Movant on behalf of Movant, which were made at or about the time of the events recorded, and which are maintained in the ordinary course of Movant's business at or near the time of the acts, conditions or events to which they relate. Any such document was prepared in the ordinary course of business of Movant by a person who had personal knowledge of the event being recorded and had or has a business duty to record accurately such event. The business records are available for inspection and copies can be submitted to the court if required. Other (specify): 4. The Debtor defaulted upon his/her/its obligations under the Adequate Protection Order by (specify): Failing to make the payment(s) due (date(s)) _____________________________________________ under the terms of the Adequate Protection Order. Failing to provide evidence of the existence of insurance coverage required under the terms of the Adequate Protection Order in a timely manner. Other (specify): 5. a. Movant caused a notice of default (Notice) identifying the default(s) referenced in paragraph 4 above to be . A true and correct copy of the Notice is attached hereto as served on the Debtor on (date) Exhibit "B." b Movant was not required to serve a notice of the default specified in paragraph 4, because the Adequate notices of default and Movant Protection Order only required Movant to serve a maximum of (number) had already served the required number of notices of default (collectively the "Notices") at the time the default specified in paragraph 4 occurred. Copies of all of the Notices are attached hereto as Exhibit "B." 6. Debtor failed to cure the defaults identified in the Notice within the cure period established by the Adequate Protection Order. 7. In light of the foregoing, under the terms of the Adequate Protection Order, Movant is entitled to relief from the automatic stay. Concurrently herewith, Movant is lodging a proposed form of order granting Movant relief from the automatic stay. I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Printed Name Signature This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2012 Page 2 F 4001-1.DEC.DEFAULT.ADEQ PROOF OF SERVICE OF DOCUMENT I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is: A true and correct copy of the foregoing document entitled: DECLARATION OF RE: DEFAULT UNDER ADEQUATE PROTECTION ORDER; REQUEST FOR ENTRY OF ORDER GRANTING RELIEF FROM STAY will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d); and (b) in the manner stated below: 1. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date) , I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below: Service information continued on attached page 2. SERVED BY UNITED STATES MAIL: , I served the following persons and/or entities at the last known addresses in this bankruptcy On (date) case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and addressed as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page 3. SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL (state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing to such service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page I declare under penalty of perjury under the laws of the United States that