UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF CALIFORNIA No.: Debtor(s)/ STATEMENT PURSUANT TO RULE 2016(B) The undersigned, pursuant to Rule 2016(b), Bankruptcy Rules, states that: 1. 2. The undersigned is the attorney for the debtor(s) in this case. The compensation paid or agreed to be paid by the debtor(s), to the undersigned is: a) For legal services rendered or to be rendered in contemplation of and in connection with this case...............................................................................$ b) Prior to the filing of this statement, debtor(s) have paid..................................$_______________ c) The unpaid balance due and payable is............................................................$ $ of the filing fee in this case has been paid. 3. 4. The Services rendered or to be rendered include the following: a) Analysis of the financial situation, and rendering advice and assistance to the debtor(s) in determining whether to file a petition under title 11 of the United States Code. b) Preparation and filing of the petition, schedules, statement of affairs and other documents required by the court. c) Representation of the debtor(s) at the meeting of creditors. The source of payments made by the debtor(s) to the undersigned was from earnings, wages and compensation for services performed, and The source of payments to be made by the debtor(s) to the undersigned for the unpaid balance remaining, if any, will be from earnings, wages and compensation for services performed, and The undersigned has received no transfer, assignment or pledge of property from debtor(s) except the following for the value stated: The undersigned has not shared or agreed to share with any other entity, other than with members of undersigned' law firm, any compensation paid or to be paid except as follows: s Respectfully submitted, 5. 6. 7. 8. Dated: Attorney for Debtor: 2001 © American LegalNet, Inc.