UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY Caption in Compliance with D.N.J. LBR 9004-1(b) In Re: Case No.: Chapter: Judge: ___________________ ___________________ ___________________ CERTIFICATION OF DEBTOR'S COUNSEL SUPPORTING SUPPLEMENTAL CHAPTER 13 FEE Under D.N.J. LBR 2016-5 this supplemental fee application may contain requests for compensation of $2,000 or less. Requests for compensation over $2,000 must be filed under D.N.J. LBR 2016-1. __________________________________, Esquire, certifies as follows: 1. I represent the debtor in connection with the following proceeding(s) in debtor's chapter 13 case: American LegalNet, Inc. www.FormsWorkFlow.com STANDARD FEES Prosecution of motion on behalf of debtor. Nature of motion: _________________________________ _________________________________ Hearing date(s): _________________________________ _________________________________ Defense of motion on behalf of debtor (Including filing Objection to Creditor's or Trustee's Certification of Default). Nature of motion: _________________________________ _________________________________ Hearing date(s): _________________________________ _________________________________ Additional court appearance(s). (Not to exceed three). Purpose: _________________________________ _________________________________ Hearing date(s): _________________________________ _________________________________ Filing and appearance on a modified Chapter 13 Plan. Preparation of Wage Order Preparation and filing of Amendments to Schedules D, E, F, G, H or List of Creditors Preparation and filing of other amended schedules Preparation and filing of Application for Retention of Professional $300.00 $100.00 $100.00 $100.00 $400.00 $500.00 $100.00 $200.00 Preparation and filing of Notice of Sale or Settlement of Controversy $100.00 2 American LegalNet, Inc. www.FormsWorkFlow.com NON-STANDARD FEES Do not combine standard and non-standard fees for the same motion or service. If you believe the standard fee is inappropriate for services in a particular instance, you must request only nonstandard fees for that particular service. Describe non-standard services in detail, and attach a time detail (including applicable hourly rates) as Exhibit A:____________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Describe non-standard expenses in detail: ____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 2. To date, in this case: I have applied for fees (including original retainer) in the amount of: To date, I have received: ______________ ______________ 3. I seek compensation for services rendered in the amount of $ ____________________ payable: through the chapter 13 plan as an administrative priority. outside the plan. 4. This allowance will not impact on plan payments. This allowance will impact on plan payments. Present plan: Proposed Plan: $ _______________ per month for _______________ months. $ _______________ per month for _______________ months. 3 American LegalNet, Inc. www.FormsWorkFlow.com 5. Pursuant to D.N.J. LBR 2016-5(b)(3), I have not filed a supplemental fee application within the preceding 120 days. I certify under penalty of perjury that the above is true. Date: _____________________ ______________________________________ Signature rev. 8/1/15 4 American LegalNet, Inc. www.FormsWorkFlow.com