Attorney or Party Name, Address, Telephone & FAX Numbers, and California State Bar Number FOR COURT USE ONLY UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA In re: CASE NUMBER HEARING DATE: TIME: Debtor. PLACE: MOTION FOR ORDER RELEASING UNCLAIMED FUNDS I, under penalty of perjury under the laws of the United States of America declare (or certify, verify, or state) that the following statements and information are true and correct: 1. I request an order releasing the total amount of $ with the court on the following date(s) on behalf of the creditor number(s) which is the sum of all monies deposited on claim 2. Please check and complete the applicable subparagraph(s) below: G a. I am the creditor named in paragraph 1. G b. I am an employee of the creditor named in paragraph 1 and my title is . The creditor is still legally entitled to the monies and I am authorized by the creditor to this petition. Submit evidence establishing authority to act on behalf of creditor. G c. G d. Subparagraphs a, b, and c above do not apply, but I am entitled to payment of such monies because (submit evidence establishing basis for right to obtain payment). I am the creditor and have appointed as my lawful attorney-in-fact who is duly authorized by the attached original power of attorney to file this motion. (Continued on next page) Revised November 2008 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California. F 3011-1 Motion for Order Releasing Unclaimed Funds - Page 2 In re F 3011-1 CHAPTER Debtor. CASE NUMBER 3. Please complete each of the following subparagraphs: a. The following is the creditor’s address and phone number: b. A brief history of the creditor (from the filing of the claim to the present) which includes, if applicable, identification of any sale of the company and the new and prior owner(s). Submit evidence establishing the sale of the company from the prior to the new owner(s): 4. I understand that, pursuant to 18 U.S.C. § 152, I may be fined or imprisoned, or both, if I have knowingly and fraudulently made any false statements in this document. Revised November 2008 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California. F 3011-1 Motion for Order Releasing Unclaimed Funds - Page 3 In re F 3011-1 CHAPTER Debtor. CASE NUMBER Signature of Creditor/Successor (Corporate Seal Type or Print Creditor’s/Successor’s Name if applicable) Creditor’s/Successor’s Address STATE OF CALIFORNIA, COUNTY OF On before me, personally appeared (insert name and title of the signer) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Notary Public (SEAL) My commission expires on Revised November 2008 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California. F 3011-1 Motion for Order Releasing Unclaimed Funds - Page 4 In re F 3011-1 CHAPTER Debtor. CASE NUMBER Signature of Attorney/Attorney-in-Fact (if appointed) Type or Print Name Address STATE OF CALIFORNIA, COUNTY OF On before me, personally appeared (insert name and title of the signer) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Notary Public (SEAL) My commission expires on Presented by: Revised November 2008 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California. F 3011-1 Motion for Order Releasing Unclaimed Funds - Page 5 In re F 3011-1 CHAPTER Debtor. CASE NUMBER PROOF OF SERVICE I hereby certify under penalty of perjury under the laws of the United States of America that on , I mailed in a sealed envelope, with postage thereon fully prepaid, a fully completed true and correct copy of the document described as “Motion for Order Releasing Unclaimed Funds” to the United States Attorney, United States Trustee, and other persons and entities required to be served by Local Bankruptcy Rule 3011-1(b) and addressed as follows: Please insert the name and address of the trustee appointed in the case and the trustee’s counsel, if any: Please insert the name and address of the Debtor, Debtor in Possession, reorganized Debtor, or other fiduciary appointed to supervise the distribution of funds and assets of the estate (if not the claimant) and their counsel, if any: If Movant is not the original creditor or an employee thereof, please insert the name and address of the original creditor and the creditor’s counsel, if any: Date Signature Type or Print Name Revised November 2008 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California. F 3011-1