Local Form United States Bankruptcy Court District of North Dakota In re: Case No. Debtor(s). SIMPLIFIED APPLICATION FOR COMPENSATION AND REIMBURSEMENT FOR DEBTOR(S) IN CHAPTER 13 CASE The undersigned applicant, pursuant to Local Rule 2016-1(A), states that: ; or No plan has been confirmed and the case is pending. The applicant is the attorney for the Debtor(s).The status of the case is as followsA plan was confirmed onThe trustee has funds on hand in the amount of $ . 4.Applicant seeks allowance of fees and reimbursement of expenses as follows: Fees: Pre-confirmation services Post-confirmation services $ $ Expenses: Filing Fee $ Copies (#) @ $ = $ Postage (#) @ $ = $ Other (itemize) $ Total Expenses $ Total Fees and Expenses $ (Collectively, 223Requested Fees and Expenses.224) If the requested expenses include costs in addition to the expenses listed above, an itemization is attached to this application. American LegalNet, Inc. www.FormsWorkFlow.com Local Form 5.The Requested Fees and Expenses constitute reasonable compensation for actual, necessaryservices rendered by the applicant and actual, necessary expenses incurred on behalf of thedebtor(s). The services provided consist of the following:Pre-confirmation servicesPost-confirmation services consisting of the following:Resolving motion(s) for relief from stayResolving motion(s) for dismissalFiling motion(s) for sale of real estateFiling motion(s) objecting to claim(s)Preparing, serving and filing modified plan(s)Assisting the debtor(s) in complying with 247 521(f)(4)Assisting the debtor(s) in responding to requests for information made inconnection with an audit conducted pursuant to 28 U.S.C. 247 586(f) 6.Regarding the Requested Fees and Expenses, the debtor(s) has/have paid applicant the sum of$ as of [insert date]. The Debtor(s) owe the applicant the sum of$ for the unpaid balance. 7.The applicant has applied for fees and/or expenses in the case as follows: Date of Application Amount of Application Date of Order Amount Allowed Paid to Date 8.The applicant has not shared or agreed to share with any other person, other than with members of theapplicant222s law firm, any compensation paid or to be paid in this case. The applicant requests the Court to enter an order awarding $ for totalcompensation or reimbursement and authorizing the Trustee to pay the unpaid balance toapplicant as provided in the plan. Dated: /s/ Attorney Name:Address: Telephone: Attorney(s) for Debtors American LegalNet, Inc. www.FormsWorkFlow.com