Attorneys for Debtor(s) UNTIED STATES BANKRUPTCY COURT NOTHERN DISTRICT OF CALIFORNIA In re: Chapter 13 Case No. SUPPLEMENTAL APPLICATION FOR COMPENSATION; DECLARATION; CERTIFICATE OF SERVICE [Cases filed on or after September 1, 2012] Debtor(s) 1. 2. 3. 4. / Debtor(s') petition was filed on _________________________________. The "Rights and Responsibilities of Chapter 13 Debtors and their Attorneys" was filed on __________________________. Debtor(s') Attorney, _________________________________requests the approval of additional attorney's fees in the sum of $_________________ pursuant to the Guidelines for Payment of Attorney's Fees in Chapter 13 Cases (San Jose Division). Debtor(s') Attorney represents that the following event has occurred that, according to the Fee Guidelines, gives rise to a claim for additional fees as follows: A post-confirmation plan modification has been filed _____ not requiring amended Schedules I & J [$400] _____ requiring amended Schedules I & J. [$600] A motion to sell, refinance, modify loan, convey title or purchase real property has been filed _____ not requiring a court hearing. [$600] _____ requiring a court hearing. [$850] A motion for relief from stay has been filed in a case pending more than one year, excluding unopposed motions _____ regarding personal property. [$500] _____ regarding real property. [$650] _____ _____ _____ _____ A motion to dismiss, convert, or reconvert has been filed, excluding Trustee's Notices of Default regarding plan payments, and excluding pre-confirmation motions to dismiss [$450] _____ A motion or adversary proceeding to value and/or avoid real property liens has been filed _____ for one lien on the property. [$1200] _____ for each additional lien on the same property. [$400] _____ One or more motions to avoid judicial liens have been filed. [$1200 per property] _____ Optional preparation of tax returns for _____ tax year(s). [$200 per year prepared] 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) CERTIFICATE OF SERVICE I am not less than 18 years of age and not a party to this case. My business address is: I served this Application and Declaration by first class U.S. Mail, postage pre-paid at ___________________________, California on the date below to the party(ies) listed on the attached page. The Chapter 13 Trustee will receive such notice upon the electronic filing of this document. I declare, under penalty of perjury that the foregoing is true and correct. Dated: _____________________ _____________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com