Certificate Of Interested Persons And Corporate Disclosure Statement
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Certificate Of Interested Persons And Corporate Disclosure Statement Form. This is a Florida form and can be use in USDC Middle Federal.
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CERTIFICATE OF INTERESTED PERSONS
AND CORPORATE D ISCLOSURE STATEMENT
I hereby disclose the following pursuant to this Court’s interested persons
order:
1.)
the name of each person, attorney, association of persons, firm, law firm,
partnership, and corporation that has or may have an interest in the outcome of
this action — including subsidiaries, conglomerates, affiliates, parent
corporations, publicly-traded companies that own 10% or more of a party’s
stock, and all other identifiable legal entities related to any party in the case:
[insert list]
2.)
the name of every other entity whose publicly-traded stock, equity, or
debt may be substantially affected by the outcome of the proceedings:
[insert list]
3.)
the name of every other entity which is likely to be an active participant in
the proceedings, including the debtor and members of the creditors’ committee
(or twenty largest unsecured creditors) in bankruptcy cases:
[insert list]
4.)
the name of each victim (individual or corporate) of civil and criminal
conduct alleged to be wrongful, including every person who may be entitled to
restitution:
[insert list]
I hereby certify that, except as disclosed above, I am unaware of any
actual or potential conflict of interest involving the district judge and magistrate
judge assigned to this case, and will immediately notify the Court in writing on
learning of any such conflict.
[Date]
_____________________________
[Counsel of Record or Pro Se Party]
[Address and Telephone]
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