UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF CALIFORNIA In re: Chapter 13 Case No. APPLICATION FOR ORDER WAIVING REQUIREMENT FOR BUSINESS EVALUATION; DECLARATION OF DEBTOR(S) Debtor(s)_________________________________/ BUSINESS NAME: Debtor(s) herein request an order waiving the requirement pursuant to 11 U.S.C. 1302 (c) for an evaluation of the Debtor(s') business for the following reasons [check all applicable]: ___ ___ ___ ___ ___ ___ ___ ___ The proposed chapter 13 plan provides for 100% repayment on unsecured claims. The Debtor(s') business is of a de minimus nature. The income derived from the business is nominal and does not comprise the majority of the Debtor(s') net income. The Debtor is an independent contractor. The Debtor either operates the business out of his/her home or does not lease commercial real property for the business. The Debtor is not incurring post-petition trade debt and is current on post-petition taxes. The Debtor is current on post-petition trade debt payments and post-petition taxes. The Debtor either has no employees or employs only members of his/her immediate family. Other: In addition, the proposed plan provides for payment to the Trustee of all projected disposable income of the Debtor(s). Dated: ______________________ ______________________________________________ Attorney for Debtor(s) DECLARATION OF DEBTOR(S) I/We, the undersigned Debtor(s) herein, declare, under penalty of perjury, that the foregoing description of the nature of my/our business is true and correct to the best of my/our knowledge. Dated: ______________________ ______________________________________________ Debtor ______________________________________________ Debtor Dated: ______________________ I have reviewed and have no objection to the foregoing Application. Dated: ______________________ Rev. 2/05 American LegalNet, Inc. www.USCourtForms.com ______________________________________________ DEVIN DERHAM-BURK, Trustee