UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF CALIFORNIA In re: Chapter 13 Case No. APPLICATION FOR COMPENSATION; DECLARATION Debtor(s)_________________________________/ 1. Debtor(s') attorney, ______________________________________, requests the approval of attorney's fees in the sum of $______________ pursuant to the attorney's fee disclosure statement filed with the Court and the Guidelines for Payment of Attorney's Fees in Chapter 13 Cases (San Jose Division). Of the sum requested, the amount of $______________ has been previously paid to Debtor(s') attorney. 2. In addition to the basic case, the Debtor(s') case involves: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Real property claims Compromise plan use Certain additional real property: ____ piece(s) State or federal tax claims Vehicle loans or leases An operating business Support arrears Student loans 25 or more creditors Motion to commence or extend the automatic stay 3. A copy of the RIGHTS AND RESPONSIBILITIES OF CHAPTER 13 DEBTORS AND THEIR ATTORNEYS, executed by the Debtor(s) and Debtor(s') attorney, has been filed with the Court. 4. All fees are subject to Court approval, whether paid in advance or through the plan. I, the undersigned, declare, under penalty of perjury, that the foregoing is true and correct to the best of my knowledge. Dated: ________________________ _______________________________________ Attorney for Debtor(s) Rev. 6/06 American LegalNet, Inc. www.USCourtForms.com