B-1009-1 (rev 5/22/12) UNITED STATES BANKRUPTCY COURT Southern District of Indiana In re: [Name of Debtor(s)], Debtor(s). ) ) ) ) Case No. (xx-xxxxx) CERTIFICATE OF SERVICE: NOTICE TO ADDED CREDITORS I hereby certify that on (date) the attached Notice to Added Creditors and the documents listed on that notice were mailed by first class U.S. mail, postage prepaid and properly addressed, to the following added creditors: (List creditors with mailing addresses.) /s/ Counsel for Debtor(s) Counsel for Debtor(s) (required signature block) 1 American LegalNet, Inc. www.FormsWorkFlow.com B-1009-1 (rev 5/22/12) UNITED STATES BANKRUPTCY COURT Southern District of Indiana In re: [Name of Debtor(s)], Debtor(s). ) ) ) ) Case No. (xx-xxxxx) NOTICE TO ADDED CREDITORS NOTICE IS GIVEN that you have been added as a creditor in this bankruptcy case. The following documents are provided with this notice: notice of meeting of creditors [send copy of notice with full social security number(s) or describe method by which creditor(s) (was/were) given notice of social security number(s)]; (plan or amended plan) dated (date); notice of bar date (if any and if not shown on meeting notice); notice of confirmation hearing (if any); other (list any other pleading or notice served on all creditors prior to the addition of a new creditor to the list). /s/ Counsel for Debtor(s) Counsel for Debtor(s) (required signature block) 2 American LegalNet, Inc. www.FormsWorkFlow.com