L.B.F . 9013 - 1.3 (12/1 8 ) Page 1 Fill in this information to identify your case UNITED STATES BANKRUPTCY COURT DISTRICT OF COLORADO Debtor 1 : Case #: First Name Middle Name Last Name Debtor 2: Chapter : First Name Middle Name Last Name Local Bankruptcy Form 9013 - 1.3 - Contested Matter and Request for Entry of Order Complete applicable sections. On [month/day/year] , [name of movant] (the 2002 - 1 or 9013 - 1 entitled, [title of motion or application] no. [#] . Movant hereby certifies that the following is true and correct: 1. Service of the Motion , N otice , and P roposed O rder were timely made on all parties against whom relief is sought and those otherwise entitled to service pursuant to the Lo c al Rules as is shown on the C ertificate of Service, L.B. F . 9013 - 1.2, previously filed with th e Motion on [month/day/year] . a. [ complete if applicable] Mailing or other service of the Notice was timely made on all other creditors and parties in interest pursuant to L.B.R. 2002 - 1 and 9013 - 1 (or in the manner permitted by Cour t order , a copy of which is attached), as is shown on the C ertificate of S ervice, L.B.F . 9013 - 1.2, previously filed with the Notice on [month/day/year] . 2. The docket numbers for each of the following relevant documents are: a. the Motion and all documents attached thereto and served therewith, docket no. , [#] ; b. the N otice, docket no. , [#] ; c. the Certificate of S ervice of the M otion and the N otice, docket no. , [#] ; d. the Proposed O rder, docket no. , [#] ; and 3. No obje ctions to or requests for h earing on the Motion were received by the undersigned, or filed with the Court by the date designated in the Notice , or all objections have been resolved by Court order, docket no. , [#] . Accordingly , Movant requests that t he Court enter an order granting the requested relief. Dated: By: Signature Bar Number (if applicable) : Mailing Address: Telephone number: Facsimile number: E - mail address: Part 1 Certificate Part 2 Signature of Movant or Movant (if unrepresented ) American LegalNet, Inc. www.FormsWorkFlow.com