IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF MARYLAND IN RE: * * * Debtor * Case No. __________ Chapter ______ SUPPLEMENTAL DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR 1. Pursuant to 11 U.S.C. § 329(a) and Federal Bankruptcy Rule 2016(b), I certify that I am the attorney for the above-named debtor(s) and that compensation paid, or agreed to be paid, to me after one year before the filing of the petition in bankruptcy for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case in addition to any amounts already disclosed is as follows: For legal services, I have agreed to accept . . . . . . . . . . . . . . . . . . . . . . . . . $__________ Prior to the filing of this statement I have received . . . . . . . . . . . . . . . . . . . $__________ Balance Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $__________ 2. The source of the compensation paid to me was: G Debtor 3. G Other (specify): The source of compensation to be paid to me is: G Debtor 4. G Other (specify): G I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm. G I have agreed to share the above-disclosed compensation with another person or persons who are not members or associates of my law firm. A copy of the agreement, together with a list of the names of the people sharing in the compensation, is attached. Local Bankruptcy Form E-2 Ver. 0 American LegalNet, Inc. www.FormsWorkFlow.com 5. Since the filing of any prior 2016(b) statement in this case, counsel has agreed to perform the following additional services for the supplemental fees identified above: _____________________________________________________________________ _______________________________________________________________________ 6. By agreement with the debtor(s), the above-disclosed fee does not include the following services: CERTIFICATION 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 proceedings. _________________ Date ________________________________________ Signature of Attorney ________________________________________ Name of law firm Local Bankruptcy Form E-2 Page Two Ver. 0 American LegalNet, Inc. www.FormsWorkFlow.com