OFFICIAL LOCAL FORM 4 UNITED STATES BANKRUPTCY COURT DISTRICT OF MASSACHUSETTS In re Case No. Chapter Debtor ORDER CONFIRMING CHAPTER 13 PLAN The debtor(s) filed a First Amended Chapter 13 Plan (the "Plan") on _________________. The debtor(s) filed a Certificate of Service on __________________, reflecting that the Plan was served on all creditors and parties in interest. No objections to the confirmation of the Plan were filed, or all objections were overruled by the Court or resolved by the parties. Upon consideration of the foregoing, the Court hereby orders the following: 1. The Plan is confirmed. The term of the Plan _____ months. 2. The debtor(s) shall pay to the chapter 13 trustee the sum of $_________________ per month commencing _______________ which payments shall continue through completion of the Plan and shall be made on the first day of each month unless otherwise ordered by the Court. Payments shall be made by Money Order or Bank Treasurer's check (personal checks will not be accepted) and shall be made payable to and forwarded to; Chapter 13 Trustee, P.O. Box 8250, Boston, MA 02114 or, if applicable, Chapter 13 Trustee, P.O. Box 16607, Worcester, MA 01601. 3. The effective date of confirmation of the Plan is ___________________. The disbursements to be made by the chapter 13 trustee pursuant to the confirmed plan are set forth on the attached summary which is incorporated by reference. Interested parties should consult the detailed provisions of the Plan for treatment of their particular claims and other significant provisions of the Plan. Unless otherwise ordered by the court, all property of the estate as defined in 11 U.S.C. '' 541 and 1306, including, but not limited to, any appreciation in the value of real property owned by the debtor as of the commencement of the case, shall remain property of the estate during the term of the plan and shall vest in the debtor(s) only upon discharge. All 174 American LegalNet, Inc. www.FormsWorkFlow.com property of the estate shall remain within the exclusive jurisdiction of the bankruptcy court. The debtor(s) shall not transfer, sell or otherwise alienate property of the estate other than in accordance with the confirmed plan or other order of the bankruptcy court. The debtor shall be responsible for, preserving and protecting property of the estate. Dated: ___________, 20__ ___________________________________ United States Bankruptcy Judge 175 American LegalNet, Inc. www.FormsWorkFlow.com SUMMARY OF DISBURSEMENTS TO BE MADE UNDER THE PLAN A. SECURED CLAIMS 1. Modified Secured Claims The secured claim of (Creditor) is being modified as follows: (describe modified treatment). The secured creditor is retaining its lien on (describe property) to the following extent: ___________________. The balance of the claim will be treated as an unsecured claim in the sum of $_________ as set forth below. 2. Unmodified Secured Claims (Creditor) is retaining its lien on (describe property). The debtor(s) shall continue to make regular monthly payments in accordance with the contract with (creditor). (Creditor) will be paid its prepetition arrearage in the sum of $______ over ____ months in the sum of $_____ per month. 3. Administrative Claims (Creditor) will be paid $______ over ______ months. 4. Priority Claims a) Tax Claims b) Other 5. Unsecured Claims 6. Other Pertinent Provisions 176 American LegalNet, Inc. www.FormsWorkFlow.com