This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2016 Page 1 F 7067-1.1.ORDER.REGISTRY.FUND Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address FOR COURT USE ONLY Debtor appearing without attorney Attorney for: UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA -Name of DIVISION In re: CASE NO.: CHAPTER: ORDER ON MOTION: (A)TO DEPOSIT FUNDS INTO THE COURT222SREGISTRY, OR(B)TO DISBURSE FUNDS OUT OF THECOURT222S REGISTRY[LBR 7067-1] No hearing held Hearing held DATE: TIME: COURTROOM: ADDRESS: Debtor(s). MOVANT: Based on the motion for authority to (a) deposit funds into or (b) disburse funds out of the Bankruptcy Court222s registry, filed on (date) as docket entry number , it is ordered that the motion is: Granted as follows: 1.Deposits (for a motion for authority to deposit funds into the Bankruptcy Court222s registry): A.The party specified in the motion is authorized and directed to deposit (exact dollar amount): $ , by check or money order, made payable to "U.S. Bankruptcy Court," personally delivered, together with a copy of this Order, to the Clerk of the Bankruptcy Court or Chief Deputy Clerk, (i) assoon as practicable after funds are available, or (ii) no later than (date, if applicable) . B.The Clerk is directed to deposit the funds into an interest bearing account with an authorizeddepository as specified in General Order 13-01 (as it may be amended from time to time), subject toThis form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2016 Page 2 F 7067-1.1.ORDER.REGISTRY.FUND deduction of an investment fee from the income earned as provided in that general order and LBR 7067-1(e), and to retain such funds on deposit until further order of the court. C.Nature of deposit (choose one):i. Not "disputed ownership funds" (CRIS system). Based on the record presented, this court does not find or conclude that the funds at issue must be treated as "disputed ownership funds" as that term is defined by the Internal Revenue Service (26 C.F.R. 247 1.468B-9(b)(1)). Accordingly, pursuant to General Order 13-01 (as it may be amended from time to time) and LBR 7067-1(e), the Administrative Office of the United States Courts is hereby authorized and directed to administer the funds, and charge fees, under the Court Registry Investment System (CRIS). ii. Ordinary "disputed ownership funds" (CRIS DOF). This court finds and concludes that the funds to be deposited are interpleader funds, or other funds which qualify as 223disputed ownership funds224 as that term is defined by the Internal Revenue Service (26 C.F.R. 247 1.468B-9(b)(1)). Accordingly, pursuant to General Order 13-01 (as it may be amended from time to time) and LBR 7067-1(e), the Administrative Office of the United States Courts is hereby authorized and directed to administer the funds, charge fees, and withhold and pay taxes, under its Disputed Ownership Funds system (CRIS DOF). iii. Disputed ownership funds requiring special administration. The funds to be deposited qualify as 223disputed ownership funds224 as that term is defined by the Internal Revenue Service (26 C.F.R. 247 1.468B-9(b)(1)) but require special administration, such as periodic withdrawals for payment of expenses related to this bankruptcy case or a related proceeding. A special administrator is required, and it cannot be the Clerk nor can it be the Administrative Office of the United States Courts, because neither is set up to administer such complex accounting. Accordingly, pursuant to General Order 13-01 (as it may be amended from time to time) and LBR 7067-1, this court appoints the following person as the special administrator to administer the funds, charge fees, and withhold and pay taxes. The special administrator's compensation and other terms are as set forth either in the motion, or elsewhere in this order, or in a separate order. Special administrator: . 2.Disbursements (for a motion for disbursement of funds on deposit with the Bankruptcy Court222s registry): A.This court being satisfied that the time for appeal of any related judgment or order having expired, orupon written stipulation of the parties (docket no. ) approved by this court, the Clerk of the Bankruptcy Court is hereby requested and directed to disburse $ , plus accrued interest, if any, as follows, conditioned on the following persons presenting a W-9 form or other formof taxpayer identification acceptable to the Clerk for tax reporting purposes:i. To (name): $ OR % of the principal balance of the fund, and $ OR % of the accrued interest on the fund, at the following address: ii. To (name): $ OR % of the principal balance of the fund, and $ OR % of the accrued interest on the fund, at the following address: This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. December 2016 Page 3 F 7067-1.1.ORDER.REGISTRY.FUND iii. To (name): $ OR % of the principal balance of the fund, and $ OR % of the accrued interest on the fund, at the following address: See attached continuation page for additional recipients. B.The Clerk of the Bankruptcy Court is relieved from liability for loss of interest, if any, for earlywithdrawal of the above-referenced funds. Denied Set for hearing on (date) at (time) . Other provisions: ###