IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF MARYLAND IN RE: * * * Debtor(s) * Case No. _____________ Chapter 11 CHAPTER 11 FINAL REPORT AND MOTION FOR FINAL DECREE The following is the report of payments made pursuant to the Plan, confirmed by this Court on ___________________ . TOTAL DISTRIBUTION PERCENTAGE OF CLAIMS PAID OR PROPOSED TO BE PAID TO THE GENERAL CLASS OF UNSECURED CREDITORS WITHIN THE PLAN A. Gross Cash Receipt Paid B. Priority Payments of Expenses of Administration Other Than Operating Expenses: 1. Trustee's commission (if any) 2. Fee and expenses, Trustee's counsel C. Other Professional Fees and Expenses: 1. Fees and expenses, Accountants 2. Fees and expenses, Auctioneers and Appraisers 3. Fees and expenses, Attorneys for Debtor 4. Other professional fees (specify) 5. Taxes, fines, penalties, etc. _________ _________ _________ _________ _________ _________ _________ _______________ _____________% _______________ Proposed Total _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ Local Bankruptcy Form N­1 Ver. 08.16 American LegalNet, Inc. www.FormsWorkFlow.com Paid 6. Other expenses of administration (must be itemized: includes bond premiums, settlement costs, other expenses 7. Total D. Payments to creditors: (totals under each category sufficient) 1. Payment to secured creditors 2. Payment to priority creditors 3. Payments to unsecured creditors 4. Payments to equity security holders E. F. Other payments: (including surplus payments to debtor) TOTAL DISTRIBUTION _________ _________ _________ _________ Proposed Total _________ __________ _________ _________ _________ _________ _________ _________ _________ _________ _______________ The Plan Proponent, (or Trustee if appointed) hereby avers that all provisions of the Plan have been substantially consummated. Wherefore, the Plan Proponent (or Trustee), having fully administered this estate, prays for entry of a Final Decree. DATE: ____________________________ _________________________________________ Attorney for Plan Proponent (or Trustee) cc: Creditor's Committee (Names and Addresses), or Counsel 20 Largest Unsecured Creditors (Names and Addresses) U.S. Trustee Local Bankruptcy Form N­1 Page Two Ver. 08.16 American LegalNet, Inc. www.FormsWorkFlow.com