ANNEX 2 -- REQUEST FOR INTERIM FEE AND EXPENSE ALLOWANCE FEES: Applicant_____________________________________________________________________________ Representing__________________________________________________________________________ 1. Interim Fee Request Number 2. Interim Period Involved 3. 4. 5. 6. 7. Hours of Services Performed this Period Total Interim Fee Allowances to Date Interim Fee Request this Period Average Hourly Rate this Period Any Uncredited Retainer as of this Date ________________ ____/____/______to____/____/______ ________________ $_______________ $_______________ $_______________ $_______________ EXPENSES: 1. Interim Expense Request Number 2. Total Expense Reimbursements to Date 3. Interim Expense Request this Period 4. Breakdown of Item No. 3 Total: a. Travel Expense b. Postage c. Photocopies (max. 10�/pg.) d. Express Mail/Messenger e. Overtime Charges f. Other Expenses (Itemize): ________________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ LBF 2016-1B (Eff. 2/1/13) American LegalNet, Inc. www.FormsWorkFlow.com