CSD 1129 [12/01/15] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. ORDER FOR RELIEF NOTICE OF CONVERSION OF CASE UNDER CHAPTER 13 TO A CASE UNDER CHAPTER 7 BY DEBTOR Pursuant to 11 U.S.C. §1307(a) and FRBP 1017(f), the Debtor(s) convert(s) this chapter 13 case to a case under chapter 7 of the Bankruptcy Code (title 11 of the United States Code); and further state(s) that 1. The Debtor(s) has filed concurrently with this notice the schedules and statements listed in FRBP 1007(b)(1), if not yet filed, or a separate set of schedules and statements which are dated and accurate as of the date of the notice of conversion. The Debtor(s) further declare(s) under penalty of perjury that the information provided in the schedules, statements, and electronic media, if any, is true and correct. 2. The Debtor(s) will file within 30 days of the date of filing of this notice if the case is converted after the confirmation of a plan: a. a schedule of all property not listed in the final report and account of the chapter 13 trustee which was acquired after the commencement of the chapter 13 case but before the entry of this conversion order; b. a schedule of executory contracts entered into or assumed after the commencement of the chapter 13 case but before the date of filing of this notice; and c. a statement of intention with respect to retention or surrender of property securing consumer debt, as required by 11 U.S.C.§ 521(a), and FRBP 1019(1)(B), and conforming to Official Form 108. DATED: Attorney for Debtor(s) Debtor Joint Debtor REQUIRED FEES: Conversion fee: Division of case fee*: $ 25.00 $310.00 *Due only in those instances when one Debtor elects to continue under the provisions of a chapter 13 while the other Debtor converts to a chapter 7. CSD 1129 American LegalNet, Inc. www.FormsWorkFlow.com