OFFICIAL LOCAL FORM 3A UNITED STATES BANKRUPTCY COURT DISTRICT OF MASSACHUSETTS POST-CONFIRMATION AMENDED CHAPTER 13 PLAN DATED: ______________ POST-CONFIRMATION _________________________________ AMENDED CHAPTER 13 PLAN (Insert First, Second etc.) Docket No.:_____________ DEBTOR(S): (H)______________________________________ SS#: _____________________ (W)_____________________________________ SS#: _____________________ I. AMENDED PLAN PAYMENT AND TERM: TERM OF THE PLAN: ___________ Months (Total length of Plan - not no. of months remaining.) If the plan is longer than thirty-six (36) months, a statement of cause under 11 U.S.C. ' 1322(d) must be attached hereto. AMENDED PLAN PAYMENT: Debtor(s) to pay monthly: $________________ EFFECTIVE: ______/______/______ (Insert new payment beginning date.) The claims listed below must include amounts previously disbursed by the Trustee on all claims which have subsequently been withdrawn or disallowed. II. SECURED CLAIMS: A. Claims to be paid through the plan (including arrears): Creditor Description of Claim Amount of Claim 164 American LegalNet, Inc. www.FormsWorkFlow.com (pre-petition arrears, purchase money, etc.) ______________ _______________________________ $________________ ______________ _______________________________ $________________ ______________ _______________________________ $________________ Total of secured claims to be paid through the Plan: $________________ B. Claims to be paid directly by debtor to creditors (Not through Plan): Creditor Description of Claim ______________________ ____________________________________________ _______________________ ____________________________________________ ______________________ ____________________________________________ C. Modification of Secured Claims: Creditor Details of Modification (Additional Details May Be Attached) Amt. of Claim to Be Paid Through Plan ____________________ ______________________________ _________________ ____________________ ______________________________ _________________ ____________________ ______________________________ _________________ D. Leases: i. The Debtor(s) intend(s) to reject the residential/personal property lease claims of ____________________________________________________________; or ii. The Debtor(s) intend(s) to assume the residential/personal property lease claims of _______________________________________________________________. 165 American LegalNet, Inc. www.FormsWorkFlow.com iii. The arrears under the lease to be paid under the plan are __________________ __________________________________________________________________ __________________________________________________________________ . III. PRIORITY CLAIMS: A. Domestic Support Obligations: Creditor Description of Claim Amount of Claim __________________ ____________________________ $______________ Creditor Description of Claim Amount of Claim ____________________ ___________________________ $______________ ____________________ ___________________________ $______________ ____________________ __________________________ $______________ ____________________ _________________________ $______________ B. Other: Total of Priority Claims to Be Paid Through the Plan: $______________ IV. ADMINISTRATIVE CLAIMS: A. Attorneys Fees (to be paid through the plan): B. $_______________ Miscellaneous Fees: 166 American LegalNet, Inc. www.FormsWorkFlow.com Creditor Description of Claim Amount of Claim ____________________ ___________________________ $______________ ____________________ ___________________________ $______________ ____________________ __________________________ $______________ C. The Chapter 13 Trustee's fee is determined by Order of the United States Attorney General. The calculation of the Plan payment set forth utilizes a 10% Trustee's commission. V. UNSECURED CLAIMS: The general unsecured creditors shall receive a dividend of ______% of their claims. A. General unsecured claims: $_______________ B. Undersecured claims arising after lien avoidance/cramdown: Creditor Description of Claim Amount of Claim ____________________ ___________________________ $______________ ____________________ ___________________________ $______________ ____________________ __________________________ $______________ C. Non-Dischargeable Unsecured Claims: Creditor Description of Claim Amount of Claim ____________________ ___________________________ $______________ ____________________ ___________________________ $______________ 167 American LegalNet, Inc. www.FormsWorkFlow.com ____________________ __________________________ $______________ Total of Unsecured Claims(A + B + C): $______________ D. Multiply total by percentage: $______________ (Example: Total of $38,500.00 x .22 dividend = $8,470.00) E. Separately classified unsecured claims (co-borrower, etc.): Creditor Description of Claim Amount of Claim ____________________ ___________________________ $______________ ____________________ ___________________________ $______________ ____________________ __________________________ $______________ Total amount of separately classified claims payable at ____%: $______________ VI. OTHER PROVISIONS: A. Liquidation of assets to be used to fund plan:________________________________________ _______________________________________________________________________________. B. Miscellaneous Provisions: _______________________________________________________________________________ _______________________________________________________________________________. C. Set forth below, all changes from the previously Confirmed Plan: 168 American LegalNet, Inc. www.FormsWorkFlow.com Secured: _______________________________________________________________________. Priority: _______________________________________________________________________. Unsecured: _____________________________________________________________________. Term __________________________________________________________________________. Plan Payment: ___________________________________________________________________. VII. CALCULATION OF AMENDED PLAN PAYMENT: a) Secured claims (Section II-A Total): $_________________ b) Priority claims (Section III-A & B Total): $_________________ c) Administrative claims (Section IV-A&B Total): $_________________ d) Regular unsecured claims (Section V-D Total): + $_________________ e) Separately classified unsecured claims: $_________________ f) Total of a + b + c + d + e above: = $_________________ = $_________________ g) Divide (f) by .90 for total including Trustee's fee: Cost of Plan (This represents the total amount to be paid into the Chapter 13 Plan.) h) Subtract the total amount of payment the Debtor has paid to the Trustee to date: $_________________ i) Total amount left to be paid (g minus h) $_________________ j) Divide (i) by # of months remaining: _________________ 169 American LegalNet, Inc. www.FormsWorkFlow.com k) Round up to nearest dollar: Amended Monthly Plan Payment $________________ Date Amended Payment to begin: _____/_____/______ VIII. LIQUIDATION ANALYSIS G The Debtor avers that there have been no material changes to the total amount set forth in the Summary of the Liquidation Analysis of the Debtor's previously Confirmed Plan. A. Real Estate: List Each Address Fair Market Value Total Amt. of Recorded Liens (Schedule D) ____________________ $_____________________ $_____________________ ____________________ $_____________________ $_____________________ ____________________ $_____________________ $_____________________ Total Net Equity for Real Property: $_____________________ Less Total Exemptions (Schedule C): $_____________________ Available Chapter 7: $_____________________ B. Automobile (Describe year, make, model): ______________ Value $________ Lien $_________ Exemption $_______________________ ______________ Value $________ Lien $_________ Exemption $ _______________________ Total Net Equity: $________________________ Less Total Exemptions (Schedule C) $________________________ Available Chapter 7: $________________________ 170 American LegalNet, Inc. www.FormsWorkFlow.com C. All other Assets: (All remaining items on schedule B) : (Itemize as necessary) _______________________________________________________________________________ _______________________________________________________________________________. Total Net Value: $________________________ Less Exemptions (Schedule C): $ _______________________ Available Chapter 7: $_______________________ D. Liquidation Summary (Total amount available under Chapter 7): Net Equity (A and B) plus Other Assets (C) less all claimed exemptions: $ __________ Additional Comments regarding Liquidation Analysis: _______________________________________________________________________________ _______________________________________________________________________________ 171 American LegalNet, Inc. www.FormsWorkFlow.com IX. Signatures Pursuant to the Chapter 13 rules, the debtor(s) or his or her counsel will serve a copy of the Plan upon the Chapter 13 Trustee, all creditors and interested parties, and file a Certificate of Service accordingly. _____________________________________ Debtor's Counsel _______________________ Date Counsel's Address: _________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tel. # ( ) _______-________ Email Address: _____________________________________________________________________ I/WE DECLARE UNDER THE PENALTIES OF PERJURY THAT THE FOREGOING REPRESENTATIONS OF FACT ARE TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF. ______________________________________ Debtor _______________________ Date ______________________________________ Debtor _______________________ Date 172 American LegalNet, Inc. www.FormsWorkFlow.com