50 Mon t . LBF 17. A PP L I CA T I ON F OR P RO F ESSION A L F E ES AND COSTS. [M o n t . L BR 2016 - 1 ( a)] Na m e o f A tto r n ey O ff i ce M a ili n g A ddress T e l ep h o n e Nu m b er F ac s imil e Nu m b er E - Ma i l A ddress S t a t e Bar I . D. Nu m b er ( A tto r n ey f o r ) IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF MONTANA IN RE: , , Debtors. Case No. * APPLICATION FOR PROFESSIONAL FEES AND COSTS [* Indicate Whether Interim or Final Application] T h e u n ders i g n ed p r o f e s s i o n al h ere b y m akes app l i ca t i o n f o r appr o v al o f an aw a rd o f f ees i n t h e a m o u n t o f $ a n d c o s t s i n t h e a m o u n t o f $ , a n d i n s upp o rt o f t h i s app l i ca t i o n resp e c t f u ll y rep r e s e n t s : 1. T h i s ca s e was c o mm e n ced o n . 2. A pp li ca n t f il ed an app l i ca t i o n f o r app o i n t m e n t as [des c r i b e pr o f e s s i o n ] f o r [des c r i b e i de n t i t y o f par t y rep r e s e n t ed; e.g . , e s t a t e/de b to r i n p o ss e s s i o n /c o mm i t t ee o f u n s ecured cred i to rs] o n: . 3. A n o rder app o i n t i n g app li ca n t was e n t ered b y t h e C o urt o n . 4. P r o f e s s i o n al s er v i ces were c o mm e n ced o n . 5. T h i s app l i ca t i o n i s t h e [1s t , 2 n d, e t c.] app l i ca t i o n f il ed b y app l i ca n t in t h i s pr o ce e d i n g, a n d t h e f o ll o w i n g i s a c o m p l e t e sc h edu l e o f a l l pr i o r app l i ca t i o n s s u b mi tt ed t o t h e C o urt f o r American LegalNet, Inc. www.FormsWorkFlow.com 51 appr o v a l : Da t e F i l ed A m o u n t R e que s t ed Da t e A ppr o v ed A m o u n t A ppr o v ed T o t al A m o u n t P r e v i o u s l y A ppr o v ed: $ 6. To date, applicant has received as compensation the following amounts from the following sources: Da t e Re c e i v ed A m o u n t R e ce i v ed S o urce o f Pa y m e n t T o t al A m o u n t R e ce i v ed: $ 7. T h i s app l i ca t i o n i s b a s ed o n t h e pe r f o r m a n ce o f pr o f e s s i o n al s er v i ces b y t h e f o ll o w i n g i n d i v i dua l s at t h e r a t es a n d f o r t h e n u m b er o f h o urs des c r i b ed b e l o w: I n d i v i dual T ot al H o urs H o ur l y R a t e C o m pe n s a t i o n T o t al C o m pe n s a t i o n R e que s t ed: $ 8. The compensation requested is based on the customary compensation charged by comparably skilled practitioners in cases other than cases under the Bankruptcy Code. [If not, state the reason for any deviation from such standard.] 9. Applicant certifies that none of the compensation or reimbursement for costs applied for in this application will be shared with any entity in violation of 11 U.S.C. 247 504. 10. A ttached are complete time records detailing each service performed by date, description, and the number of hours expended, under the appropriate project categories (if applicable under Mont. LBR 2016 - 1), for which compensation is requested. American LegalNet, Inc. www.FormsWorkFlow.com 52 11. Attached is a c omplete accounting for all costs incurred for which reimbursement is requested. 12. The amount of costs were computed utilizing the following methods of allocation: [ E x a m p l e] (C o p i es are c h arged at t h e r a t e o f $ . 10 ea c h . ) (L o n g d i s t a n ce ca l l s are c h arged at ac t ual c o s t . ) (M i l eage i s c h arged at f ederal a l l o wed per m il e r a t e.) 13. In addition to the payments already received, applicant has been promised the following payment for se r v i ces i n c o n n ec t i o n w i t h t h i s ca s e: A m o u n t P r o mi s ed Ide n t i t y o f P r o mi s o r C o n d i t i o n s / T er m s 14. Case Status: [Insert relevant information required by Section II.B of the United States Trustee Guidelines, as set forth in the Appendix to the Montana Local Bankruptcy Rules.] 15. [Name of person on whose behalf applicant is employed] has been given the opportunity to review this application and [approves/does not approve] the requested amount. W HER E F O R E , app li ca n t pra y s t h at t h i s C o urt e n t er an Order aw a rd i n g app l i ca n t rea s o n a b l e p r o f e s s i o n al f ees i n t h e a m o u n t o f $ a n d re i m b urse m e n t o f c o s t s a n d e x pe n s es i n t h e a m o u n t o f $ . DATED this day of, 20. [Name of Applicant] [Na m e o f a t to r n e y ] A t to r n ey f o r Debtor(s)/Trustee American LegalNet, Inc. www.FormsWorkFlow.com 53 CERT I F IC A T E OF SERVICE I, t h e u n ders i g n ed, do h ere b y cer t i f y u n der pe n a l t y o f per j ury t h at o n t h e day o f , 20, a copy of the foregoing was served by electronic means pursuant to LBR 9013 - 1(d)(2) on the by mail on the following parties : See attached mailing matrix [ I n s ert t h e n a m e a n d addre s s o f ea c h i n d i v i dual o r e n t i t y s er v ed.] * The attached list will not be mailed out to creditors but will be on file with the United States Bankruptcy Court. A copy will be provided upon request. [Na m e o f pers o n cer t i f y i n g t h e m a i li n g] [Mu s t c o m p l y w i t h M o n t . L BR 9013 - 1 ( d) ( 2), b y re f l ec t i n g t h e n a m e a n d addre s s o f ea c h par t y s er v ed, a n d b y b e i n g s i g n ed u n der pe n a l t y o f per j ur y n d b y i de n t i f y i n g t h e d o cu m e n t s er v ed. Pu r s ua n t t o Ru l e 2002 ( a) ( 6), Fed. R. Bankr. P. , n ot i ce o f a h ear i n g o n an A pp l i ca t i o n s eek i n g c o m pe n s a t i o n o r re i m b urse m e n t o f e x pe n s es e x ce e d i n g $1 , 000 s h o u l d a l s o b e ser v ed up o n t h e de b t o r, a l l cred i to rs, a n y c o m mi tt ee, a n d ot h er par t i es i n i n t ere s t reque s t i n g s pec i al n ot i ce. M o n t . L BR 2002 - 4 requ i res t h e ser v i ce o f a N o t i ce o f A pp li ca t i o n f o r P r o f e s s i o n al F ees a n d C o s t s (M o n t . L BF 18) up o n a l l cred i t o rs, c o mmi tt ee s , a n d ot h er par t i es i n i n t ere s t reque s t i n g s pec i al n ot i ce, d i s c l o s i n g t h at t h e app li ca n t h as f il ed an A pp l i ca t i o n f o r P r o f e s s i o n al F ees a n d C o s t s , w h en t h e a m o u n t o f s uch f ees a n d c o s t s e x ce e ds $1 , 000 . ] American LegalNet, Inc. www.FormsWorkFlow.com