Transitional Local Bankruptcy Form 1002-1 Cover Sheet Check Applicable Boxes to Show All Documents Attached Name of Debtor(s): Attorneys (Firm Name, Address & Telephone): No Attorney: [ ] Filing fee (check applicable box) (checks and credit cards are not accepted): [] [] $299 for Chapter 7 $2,789 for Chapter 11(this figure may be $1,039 if drafting error is not fixed, confirm before filing) [] $239 for Chapter 12 [] $274 for Chapter 13 []____ Other fee paid (enter amount) AND attach applicable application under Fed.R.Bankr.P. 1006 to pay in installments or pursuant to 28 U.S.C. § 1930(f) (if applicable) Individual and Business Debtor(s) (except as otherwise noted): [] [] [] [] [] [] [] [] [] [] [] [] Exhibit D Statement of Compliance with Credit Counseling Requirement for each individual debtor (A list of all authorized Credit Counselors for Colorado is found at http://www.usdoj.gov/ust or the Court has a list that may be viewed in the Records/Public Information Room 114 of the Court.) Voluntary Petition – Official Form 1 (10/06) Statement of Financial Affairs – Form B7 (10/05) Summary of Schedules A–J – Official Form 6–Summary (10/06) Schedules A, B, C, D, E, F, G, H, I, and J – Official Forms 6A, 6B, 6C, 6G and 6H (10/05); Official Forms 6D, 6E, 6F, 6I and 6J (10/06) Declaration Concerning Debtor’s Schedules – Official Form 6 – Declaration (10/06) Notice to Debtor by Non-Attorney Bankruptcy Petition Preparer – Form B19B (10/05) (submitted only if debtor used the services of a bankruptcy petition preparer) For each individual debtor, copies of all payment advices, paycheck stubs, or other evidence of all salary, commissions or income received within 60 days before the bankruptcy case was filed, copied on 8 ½ by 11 paper with the debtor’s first and last name printed on top of each page (and bankruptcy case number, if a number has been assigned); OR, as applicable, complete T.L.B.F. 1007-1 (“Statement Concerning Payment Advices Due”) for each debtor. A record of any interest in an education IRA or qualified State tuition program (529 plans) Attorney Fee Disclosure Statement – L.B.F. 102.1 Verification of Creditors’ Matrix – L.B. Misc. Form List Creditors’ Matrix (on a computer floppy disk if case is filed in paper form) (see attachment to GPO-2001-7 at www.cob.uscourts.gov for instructions). American LegalNet, Inc. www.FormsWorkflow.com Additional Items Due From ALL Individual Debtors: [] [] Statistical Summary of Certain Liabilities – Official Form 6–Statistical Summary (10/06) Social Security Number Statement – Form 21 (Electronic Filers use the Declaration Form) Chapter 7 Individual Debtors also must file: [] Statement of Current Monthly Income and Means Test Calculation Official Form 22A (10/06)* [] Statement of Intention – Form B8 (10/05) (due thirty days post-petition) (the failure to comply with this statement and file reaffirmation agreements or motions to redeem personal property that the debtor does not intend to surrender has ramifications 45 days after the first scheduled meeting of creditors under Section 362(h) of the Bankruptcy Code) Chapter 11 Individual Debtors also must file: [] Statement of Current Monthly Income – Form B22B (10/05)* Chapter 13 Individual Debtors also must file: [] Statement of Current Monthly Income and Disposable Income Calculation – Official Form 22C (10/06)* [] Plan – T.L.B.F. 3015-1 (must be filed no later than fifteen days post-petition) *The links for the updated Internal Revenue Service and Census Bureau Information that may be needed to complete Statement of Current Monthly Income Forms B 22 can be reached from the web site: http://www.usdoj.gov/ust/. (Not applicable in Chapter 7 cases if debts are primarily business debts.) Additional Items due from Chapter 11 debtors: [] [] [] [] Date: List of Twenty Largest Creditors – Form B4 (10/05) List of Equity Interest Holders – Required by Fed.R.Bankr.P. 1007(a)(3) for corporations If the debtor is a corporation it should file a corporate ownership statement – Required by Fed.R.Bankr.P. 1007(a)(1). Small Business Debtors must file the most recent 1) balance sheet, 2) statements of operations, 3) cash-flow statement and 4) Federal income tax return; OR a verified statement that those documents do not exist and have not been prepared or filed. Printed name of party signing: Signature of Attorney (or debtor without counsel): American LegalNet, Inc. www.FormsWorkflow.com