UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY Caption in Compliance with D.N.J. LBR 9004-1(b) In Re: Case No.: Judge: Chapter: APPLICATION FOR REFUND OF FILING FEE On , the undersigned filed a on behalf of . A fee concerning the filing was paid in the amount of . I request that the court issue a refund of the filing fee for the reason set forth below. Applicant must describe in detail the circumstances surrounding the error: I certify under penalty of perjury that the above is true. Dated: Applicant222s signature new.2/1/16 American LegalNet, Inc. www.FormsWorkFlow.com