COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. United States Bankruptcy CourtNo. : Calendar Northern District of Iowa : Plaintiff(s) JUDICIAL SUBPOENA Chapter 11 : Bankruptcy Case No. -against- In re : : Defendant(s) : Debtor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CHAPTER 11 SUPPLEMENTAL BANKRUPTCY CLOSING REPORT A. B. THE PEOPLE OF THE STATE OF NEW YORK [ ] [ TO] Plan confirmed Plan not confirmed q ______% Dividend to be Paid. Check Box if future payments are contemplated under Plan but percentage dividend is not determinable GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court FEES located at AND EXPENSES County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give Compensation (If Chapter 11 trustee appointed)the evidence as a witness in this action on the part of $_______________________ 1. Trustee $_______________________ 2. Fee for Attorney for Trustee (if any) $_______________________ 3. Fee for Attorney(s) for Debtor Paid After case filed $_______________________comply with this subpoena is punishable as a contempt of court and will make you liable to Your failure to 4. Fees - All Other Professionals the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a $_______________________ 5. All out-of-pocket EXPENSES of administration, result of your failure to comply. including trustee’s (excluding fees) Witness, Honorable Court in County, Item A. Confirmation of Plan: Place an “X” in appropriate box. day of , one of the Justices of the , 20 Item B. Percentage Dividend to be Paid: This item should only be completed when a plan has been confirmed and the petition is not dismissed. The percentage dividend to be reported is that which is to (Attorney must sign above and type name below) be paid to the unsecured creditors under the plan. It will usually be set forth in the plan reflected as, for example, a “30% payment” or “30% dividend” to unsecured creditors. Attorney(s) for NOTE: If the plan contemplates no payment to unsecured creditors, enter a “0" in the percent dividend box. Percentage Dividend Not Determinable: Complete only when a percentage dividend cannot be determined. This space Office and P.O. Address is provided for cases where neither the percentage dividend nor dollar amount was disclosed and thus cannot be calculated. Prepared by: _______________________ Attorney’s Name and Address: Telephone No.: Date: ________________________ Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com