COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : - Index No. : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA UNITED STATES BANKRUPTCY COURT -against: MIDDLE DISTRICT OF LOUISIANA : IN RE : CASE NO. Defendant(s) : DEBTOR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR THE PEOPLE OF THE STATE OF NEW YORK 1. Pursuant to 11 U.S.C. § 329(a) and Bankruptcy Rule 2016(b), I certify that I am the attorney for the above-named debtor(s) and that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case GREETINGS: is as follows: TO WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before For legal services, I have agreed to accept $ . , the Honorable at the Court located at County ofPrior to the filing of this statement I have received $ . in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the . Balance Due $ 2. The source of the compensation paid to me was: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Debtor Other (specify) result of your failure to comply. 3. The source of compensation to be paid to me is: Witness, Honorable Court in County, 4. , one of the Justices of the day Debtorof , 20 Other (specify) I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law(Attorney must sign above and type name below) firm. I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm. A copy offor agreement, together with Attorney(s) the a list of the names of the people sharing in the compensation, is attached (as is set forth below). 5. In return for the above-disclosed fee, I have agreed to render legal service for and in the Office and P.O. Address bankruptcy case, including: [For example: Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : a. b. c. d. e. Index No. Analysis of the debtor's financial situation, and rendering advice to the debtor in : Calendar No. determining whether to file a petition in bankruptcy; Preparation and filing of any petition, schedules, statement of affairs and plan which : JUDICIAL SUBPOENA Plaintiff(s) may be required; Representation of the debtor at the meeting(s) of creditors and confirmation -against: hearing(s), and any continued meetings or hearings, and, generally, in the bankruptcy case; : Representation of the debtor in adversary proceedings and other contested bankruptcy : matters and proceedings; Other provisions as needed.] Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK 6. TO By agreement with the debtor(s), a copy of which is either set forth herein or attached hereto, the above-disclosed fee does not include the following services, for which, if I am to be retained, the debtor will be charged and will have to agree to pay fees and reimbursement of expenses as follows: GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of CERTIFICATION OF ATTORNEY in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for representation of the debtor(s) in this bankruptcy proceeding. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Date Witness, Honorable Court in County, Signature of Attorney , one of the Justices of the day of , 20 Name of Law Firm (Attorney must sign above and type name below) SEE NEXT PAGE FOR CERTIFICATION OF DEBTOR(S) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. CERTIFICATION OF DEBTOR(S) : Calendar No. [if applicable, i.e. services limited and agreement is contained in disclosure as opposed to being : JUDICIAL SUBPOENA Plaintiff(s) separately attached]. -against- : I certify that the above agreement with my attorney has been explained to me by my attorney and accurately reflects the services that my attorney:has agreed to provide for the fees paid or promised as stated in this disclosure. Further, I agree that the description of those services that : will not be provided by my attorney for the fees paid or promised in the disclosure is accurate and that I understand that if any of these excluded services become necessary, my attorney is under no Defendant(s) : . .duty. to. represent .me .unless .I. make. further . . . . . . . . . . . . . as set forth by my attorney above, for the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . arrangements, . . . attorney to act on my behalf. THE PEOPLE OF THE STATE OF NEW YORK __________________________ Date TO __________________________ GREETINGS: Signature of Debtor WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court __________________________ located at County of Signature of Joint Debtor in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com