UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) ) ) Debtor(s) Case No. _________________ APPLICATION FOR INTERIM FINAL (Mark ONE) PROFESSIONAL COMPENSATION The applicant, ____________________________________________, has performed professional services as a(n) _________________________________________ for the period from __________ to __________. Pursuant to 11 USC §§330 or 331, and LBR 2016-1, the applicant, by and through the undersigned, applies for compensation as marked above, and certifies the following is true and correct: 1. The applicant has received the following pre-filing compensation (indicate date, amount, payor, payor's relation to case, and description of all monies and any other consideration received): 2. Applicant requests allowance of compensation for: Professional Services of $_________________; Expenses of $_________________; for a Total of $_________________. 3. [If applicable] Applicant was appointed by court order entered on __________, per an Application for Employment filed on __________. The employment order did not specify a rate of compensation except as follows: 4. Applicant's prior requests for compensation in this case are as follows: Date of Application Amount Requested Fees Expenses Amount Allowed Fees Expenses Amount Received Fees Expenses Payment Source TOTALS: $___________ $___________ $___________ $___________ $___________ $___________ 345 (10/15/08) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com 5. The applicant has not shared or agreed to share any compensation received or to be received for services rendered in connection with this case, except with a regular member, partner, or associate of Applicant's firm. 6. The rate of compensation, number of hours and requested fee for each person included in this application are summarized as follows: Timekeeper (name & initials) Title Hourly Rate Number Of Hours Requested Fee 7. [Schedules A, B & C apply only if compensation is sought under 11 USC §§330 or 331] Attached and incorporated herein by reference are the following schedules (check those that apply): Schedule A - A narrative summary of services provided including total hours and resulting benefits to the estate of each activity category. [Preferred, but only mandatory if application exceeds $3,000.] Schedule B - [If this is the First Application for Compensation] A brief narrative and itemization detailing all case-related PRE-PETITION fees. [Itemization mandatory; narrative mandatory if compensation requested exceeds $3,000.] Schedule C - An itemized billing setting forth a description of each event, including the date, amount of time spent, and name of the person performing each event. [Mandatory] 8. Applicant requests the following expense reimbursement: a. A total of $_________________ for expenses that fall within the limits set forth in LBR 2016-1 (no itemization required); AND b. Other (describe each in detail): 9. ADDITIONAL REQUIREMENTS for INTERIM compensation application: (a) a current Interim Report, on LBF #753 for Chapter 7 cases or LBF #1153 for Chapter 11 cases, must be filed with the court before this Application is filed; AND (b) a completed and served Notice of Intent to Compensate Professional(s) using LBF #753.40 must be filed, and linked to each pertinent Application if filed electronically, before the Application will be considered by the court. DATED: __________ 345 (10/15/08) Page 2 of 2 ___________________________________________________________ Signature ___________________________________________________________ Signer's Name, Relation to Applicant, and Phone # ___________________________________________________________ Address ___________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com