UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re ___________________________________ Debtor(s). No. APPLICATION TO PAY FILING FEE IN INSTALLMENTS 1. In accordance with Fed. R. Bankr. P. 1006, I apply for permission to pay the filing fee of $ in installments in cash, by money order or by certified check. 2. I am unable to pay the filing fee except in installments. 3. Until the filing fee is paid in full, I will not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. 4. I propose the following terms for the payment of the filing fee* $ $ $ $ Total $ Check one: on or before on or before on or before with filing of petition on or before * The number of installments proposed shall not exceed four (4), and the final payment shall be payable not later than 120 days after filing the petition. For cause shown, the court may extend the time of any installment, provided the last installment is paid not later than 180 days after filing the petition. Fed. R. Bankr. P. 1006(b)(2). 5. I understand that if I fail to pay any installment when due, my bankruptcy case may be dismissed, I may not receive a discharge of my debts, and I will still owe the fee to the Bankruptcy Court. Signature of Debtor Date Signature of Joint Debtor Date (In a joint case, both spouses must sign) Address: ___________________________________ City, state, zip: ______________________________ Telephone: ____________________________ E-mail: _______________________________ _____________________________________________ Signature of Attorney Date Attorney name: __________________________ Address: _______________________________ City, state, zip: __________________________ Telephone: _______________________ Facsimile: ________________________ E-mail: __________________________ F:\FORMS\Fees and money received\installment fee application and order NM OF 3A.wpd NM OF 3A Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re Debtor(s). No. ORDER APPROVING PAYMENT OF FILING FEES IN INSTALLMENTS IT IS ORDERED that the debtor(s) may pay the filing fee in installments, as follows: $ $ $ $ Total $ Check one: on or before on or before on or before with filing of petition on or before IT IS FURTHER ORDERED that until the filing fee is paid in full, the debtor(s) shall not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. _____________________________________ UNITED STATES BANKRUPTCY JUDGE Signature(s) of Debtor(s): __________________________ / ___________________________ If represented by counsel: Attorney name: _____________________________ Address: _____________________________ City, state, zip: _____________________________ Telephone: _____________ Facsimile: _____________ E-mail: _____________________________ Note to debtor: Debtors or the attorney for the debtors must sign this order before submitting it to the Court. The Court will not accept debtor's personal check. Payment must be made in cash or by certified check or money order made payable to Clerk, United States Bankruptcy Court. Mail check or money order to United States Bankruptcy Court, District of New Mexico, PO Box 546, Albuquerque, NM 87103-0546, or deliver to the Customer Service Counter, Dennis Chavez Federal Building and United States Courthouse, 500 Gold Avenue SW, Room 10206, Albuquerque, between 8:30 am and 4:30 pm weekdays. USE OF THIS FORM, in lieu of Official Form 3A, IS REQUIRED BY NM LBR 1006-1 F:\FORMS\Fees and money received\installment fee application and order NM OF 3A.wpd NM OF 3A Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com