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 REQUEST FOR ISSUANCE OF NOTICE OF TRANSFER OF CLAIM PURSUANT TO FRBP 3001(e) Debtor(s). [No Hearing Required] TO THE CLERK OF THE UNITED STATES BANKRUPTCY COURT: Please issue the required notice to the Original Creditor identified below that all right, title and interest in and to the following claim has been transferred: 1. Person or entity to whom the claim has been transferred (Substitute Creditor): Name: Address: Telephone Number: 2. Date of transfer of claim: This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2012 Page 1 F 3001-1.REQ.TRANSFER.CLAIM 3. Type of claim: 4. Amount of claim: $ secured priority unsecured general unsecured 5. Date of filing of Proof of Claim: 7. Date of transfer of claim: 6. Claims docket number: 8. Person or entity who filed the claim (Original Creditor): Name: Address: Telephone Number: 9. Attorney (if any) for the Original Creditor, as set forth on Proof of Claim: Name: Address: Telephone Number: 10. A true and correct copy of the Proof of Claim originally filed is attached hereto as "Exhibit A." True and correct copies of the documents evidencing the transfer of the claim are attached as "Exhibit B." Date: SUBSTITUTE CREDITOR Signature Printed name of Substitute Creditor This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2012 Page 2 F 3001-1.REQ.TRANSFER.CLAIM 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: REQUEST FOR ISSUANCE OF NOTICE OF TRANSFER OF CLAIM PURSUANT TO FRBP 3001(e) 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 the foregoing is true and correct. Date Printed Name Signature This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California. December 2012 Page 3 F 3001-1.REQ.TRANSFER.CLAIM