UNITED240STATES240BANKRUPTCY240COURT NORTHERN240DISTRICT240OF240FLORIDA APPLICATION240FOR240LOGIN240AND240PASSWORD FOR240CHILD240SUPPORT240CREDITOR240OR240REPRESENTATIVE Applicant Name: Address: City: State: Zip: Bar ID, if applicable: State of: Case(s) in the Northern District of Florida in which you will be filing (debtor name(s) and case number(s):Are you requesting reactivation of a login and password previously issued to you by the U.S. Bankruptcy Court for the Northern District of Florida? Yes No If yes, provide the login to be reactivated: 1.I affirm that I am authorized to prepare and file documents and pleadings on behalf of the childsupport creditor,. 2.I understand that my use of the login and password to file a document or pleading in the record ofthe bankruptcy case(s) or proceeding(s) noted above constitutes my signature and my signing ofthose documents and/or pleadings for all purposes authorized and required by law, including,without limitation, the United States Code, Federal Rules of Civil Procedure, Federal Rules ofBankruptcy Procedure, Federal Rules of Criminal Procedure and any applicable non-bankruptcy law.3.I understand that I must retain all documents bearing my original signature and which are filedusing my login and password, and all documents and pleadings bearing the original signature of anysigner on whose behalf I file the documents and pleadings using my login and password, for aperiod of four years after the closing of the case or proceeding in which the documents orpleadings were filed.4.I understand that it is my responsibility to protect and secure the confidentiality of my password. IfI believe my password has been compromised, I understand that I am to notify the Court in writingimmediately.5.I understand that it is my responsibility to notify the Court immediate or any change in my address,telephone number, fax number, or email address.6.I understand that the issuance of a password to me constitutes waiver of conventional servicepursuant to the Federal Rules of Bankruptcy Procedure 9036 and the Court's Electronic CaseFiling general order. I agree to accept a Notice of Electronic Filing by hand, facsimile, first classmail, or authorized email in lieu of conventional service. In doing so, I also agree to maintain acurrent and active email address by which to receive such notification. FLNB Local Form A-7 (09/17) Electronic240Case240Filing240access240is240provided240pursuant240to240247240304(g)240of240the240Bankruptcy240Reform240Act240of2401994240(Pub.L.240No.240 103394)240and will be240terminated240by240the240Court240at240the240conclusion240of240the240case(s)240or240proceeding(s)240noted240above. 240 240 240 7.I understand that in cases wherein service of documents filed electronically is required to be madeon the United States and its agencies, corporations or officers, full compliance with Rules 2002(j)and 7004(b)(4), (5) and (6) of the Federal Rules of Bankruptcy Procedure, and Rule 4(I) and (j) of theFederal Rules of Civil Procedure is also required.8.I understand that all documents and/or pleadings filed in the Electronic Case Filing system whichcontain an individual's social security number, taxpayer identification number, birthdate, the nameof an individual other than the debtor(s) known to be and identified as a minor, or a financialaccount number must be redacted in accordance with Fed. R. Bankr. P. 9037.9.I affirm that I have read and understand, and agree to adhere to the Court's guidelines for theElectronic Case Filing system (the Administrative Procedures Regarding Electronic Case Filing) andthe Local Rules for the U.S. Bankruptcy Court for the Northern District of Florida. Date:Return completed application to Samantha Kiser: Fax: (850) 521-5004 Email: CMECFHelpDesk@flnb.uscourts U.S. Mail: U.S. Bankruptcy Court, 110 E. Park Ave., Ste. 100, Tallahassee, FL 32301 Your login and password will be emailed to you at the email address provided above. If you wish to request online training, please contact the CM/ECF Help Desk (CMECFHelpDesk@flnb.uscourts.gov or 888-765-1752) for access to the training database. Applicant Signature AO Form 281 (08/06) FLNB Local Form A-7 (Attachment)UNITED240STATES240BANKRUPTCY240COURT NORTHERN240DISTRICT240OF240FLORIDAIn re: Case No.:Chapter:Debtor(s)APPEARANCE OF CHILD SUPPORT CREDITOR* OR REPRESENTATIVE I certify under penalty of perjury that I am a child support creditor* of the above-named debtor, or the authorized representative of such child support creditor, with respect to the child support obligation which is set out below. Name: Organization: Address: Telephone Number: Summary of Child Support Obligation Amount in arrears: If Child Support has been assigned: $ Amount of Support which is owed under assignments: Amount currently due per week or per month $ on a continuing basis: Amount owed primary child support creditor (balance $ not assigned): (per week)(per month) $ Attach an itemized statement of account. Do not disclose the name of a minor child. See 11 U.S.C. 247 112. If a social security number or taxpayer identification number is included, set out only the last four digits of the number. Judicial Conference Privacy Policy (09/01). Date: Child Support Creditor* or Authorized Representative*Child support creditor includes both creditor to whom the debtor has a primary obligation to pay child support as well asany entity to whom such support has been assigned, if pursuant to Section 402(a)(26) of the Social Security Act or if such debt has been assigned to the Federal Government or to any State or political subdivision of a State.