CLF 17 (Rev. 07-07-94) UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF MISSISSIPPI IN RE: CASE NO. _________________ DEBTOR(S) PLAINTIFF(S) VS. ADVERSARY PROCEEDING NO. ________________ DEFENDANT(S) APPLICATION TO CLERK FOR ENTRY OF DEFAULT AND SUPPORTING AFFIDAVIT TO THE CLERK OF THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF MISSISSIPPI: Pursuant to Rule 7055, Federal Rules of Bankruptcy Procedure, and Rule 55(a), Federal Rules of Civil Procedure, the Clerk of Court is hereby requested to enter default against defendant(s) ________________ ____________________________________________________. ___________________________________ ATTORNEY OF RECORD FOR PLAINTIFF(S) STATE OF MISSISSIPPI COUNTY OF ______________________ Affiant is attorney of record for plaintiff(s) and has personal knowledge of the facts set forth in this affidavit, and deposes: that the defendant(s) against whom entry of default is requested herein was/were duly served with a copy of the summons and a copy of the complaint on the date and in the manner described in the certification of service appended to the summons returned herein; that, unlessotherwise alleged pursuant to 50 App. U.S.C., Sec. 520, the individual defendant(s) is/are not in military service; that, as required by Rule 7012(a), Federal Rules of Bankruptcy Procedure, more than 30 days (35 days if the United States or an officer or agency thereof was required to answer) have elapsed since the date of issuance of the summons herein; and that said defendant(s) has/have failed timely to serve an answer as required by Rule 7012, Federal Rules of Bankruptcy Procedure. ___________________________________ AFFIANT/ATTORNEY FOR PLAINTIFF(S) SWORN TO AMD SUBSCRIBED before me on this the ______ day of ______________,______. ___________________________________ NOTARY PUBLIC My Commission Expires: ______________________