UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF KENTUCKY IN RE: CASE NO: CHAPTER 11 Debtor CERTIFICATION AND REQUEST FOR ENTRY OF FINAL DECREE The above-captioned debtor certifies that the estate of the above-named debtor has been fully administered, and requests that a Final Decree be entered closing this case pursuant to Fed. R. Bankr. P. 3022. ESTIMATED DISTRIBUTIONS Total amounts proposed to be paid in the confirmed plan: 1. 2. 3. DIVIDEND What percentage of dividend is to be paid to the unsecured creditors when the case is fully consummated? _________________________ Total Secured Claims Allowed Total Priority Claims Allowed Total Unsecured Claims Allowed _________________________ _________________________ DATE: Local Form U American LegalNet, Inc. www.FormsWorkFlow.com