REQUIRED STATEMENT TO ACCOMPANY MOTIONS FOR RELIEF FROM STAY All Cases: Debtor(s) ________________________________________ Case No. _______________ Chapter _____ All Cases: Moving Creditor ____________________________________________ Date Case Filed ____________ Nature of Relief Sought: ~ Lift Stay ~ Annul Stay ~ Other (describe) ___________________________ Chapter 13: Date of Confirmation Hearing ______________________ or Date Plan Confirmed ________________ Chapter 7: ~ No-Asset Report Filed on ______________________________ ~ No-Asset Report not Filed, Date of Creditors Meeting ___________________________________ 1. Collateral a. ~ Home b. ~ Car Year, Make, and Model ___________________________________________ c. ~ Other (describe)______________________________________________________ 2. Balance Owed as of Petition Date $ _________________________ Total of all other Liens against Collateral $_____________________ 3. In chapter 13 cases, attach a payment history listing the amounts and dates of all payments received from the debtor(s) post-petition. 4. Estimated Value of Collateral (must be supplied in all cases) $ ___________________________ 5. Default a. ~ Pre-Petition Default Number of months _____ b. ~ Post-Petition Default i. ~ On direct payments to the moving creditor Number of months _____ Amount $ _____________________ ii. 6. Amount $ _____________________ ~ On payments to the Standing Chapter 13 Trustee Number of months _____ Amount $ _____________________ Other Allegations a. ~ Lack of Adequate Protection § 362(d)(1) i. ~ No insurance ii. ~ Taxes unpaid Amount $ _____________________ iii. ~ Rapidly depreciating asset iv. ~ Other (describe) _______________________________________________________ b. ~ No Equity and not Necessary for an Effective Reorganization § 362(d)(2) c. ~ Other “Cause” § 362(d)(1) i. ~ Bad Faith (describe)____________________________________________________ ii. ~ Multiple Filings iii. ~ Other (describe) _______________________________________________________ d. Debtor’s Statement of Intention regarding the Collateral i. ~ Reaffirm ii ~ Redeem iii. ~ Surrender iv. ~ No Statement of Intention Filed Date: _____________________________ (Rev. 8 /18/09) _______________________________________________ Counsel for Movant American LegalNet, Inc. www.FormsWorkFlow.com