UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF FLORIDA www.flsb.uscourts.gov In re: Case No. Chapter Debtor* / SUMMONS TO DEBTOR IN INVOLUNTARY CASE To the above named debtor: A petition under title 11, United States Code was filed against you on (date) in this bankruptcy court, requesting an order for relief under chapter of the Bankruptcy Code (title 11 of the United States Code). YOU ARE SUMMONED and required to submit to the clerk of the bankruptcy court a motion or answer to the petition within 20 days after the service of this summons. A motion to convert by the debtor in an involuntary chapter 7 proceeding shall be deemed a consent to entry of an order for relief under the chapter to which the case is being converted (Local Rule 1013-1(B)). A copy of the petition is attached. Address of Clerk G 51 S.W. First Ave., Room 1517, Miami, FL 33130 G 299 E. Broward Blvd., Room 112, Ft. Lauderdale, FL 33301 G 1515 North Flagler Drive, Room 801, West Palm Beach, FL 33401 At the same time you must also serve a copy of your motion or answer on petitioner's attorney. Name and Address of Petitioner's Attorney If you make a motion, your time to serve an answer is governed by Bankruptcy Rule 1011(c). If you fail to respond to this summons, the order for relief will be entered. CLERK OF COURT By: Date Deputy Clerk *Set forth all names, including trade names, used by the debtor within the last 8 years. (Bankruptcy Rule 1005). LF-55 (rev. 06/02/08) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Case No. CERTIFICATION OF SERVICE I, of** certify: , , That I am, and at all times hereinafter mentioned was, more than 18 years of age; That on the petition filed in this case, on , I served a copy of the within summons, together with the debtor in this case, by [describe here the mode of service] the said debtor at I certify under penalty of perjury that the foregoing is true and correct. Executed on (Date) (Signature) ** State mailing address LF-55 (rev. 06/02/08) Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com