UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) ) ) Case No. ________________ FINAL ACCOUNT; PAYMENT OF ALLOWED ATTORNEY FEES; AND APPLICATION FOR ENTRY OF FINAL DECREE AND CLOSING ORDER Debtor(s) The undersigned files this final account and represents that: 1. On __________, the court entered an Order Confirming the Chapter 11 Plan. 2. The total (i.e., of what has and will be paid) percentage dividend to be paid unsecured creditors is _______________%. [NOTE: Enter "N/A" if percentage amount is not determinable at this time.] 3. All administrative claims and expenses have been paid in full, or appropriate arrangements have been made for full payment. 4. All secured claims provided for in the Plan have been paid or will be satisfied as provided in the Order of Confirmation. 5. All objections to claims in this case have been resolved. 6. All matters to be completed upon the effective date of the confirmed plan have been completed, the plan has been substantially consummated, and application is therefore made for entry of a final decree and closing order pursuant to Fed. Rule Bankr. Proc. 3022. 7. On __________ copies of this final account were served on the U.S. Trustee; and the debtor(s), any trustee, the Creditors' Committee, and their respective attorneys. 8. I understand that the appropriate attorney may be paid the amount originally allowed, but withheld, after the filing and service of this final account. Date: _________ ________________________________________________________________________ Signature ________________________________________________________________________ Type or Print Signer's Name & Relation to Case ________________________________________________________________________ Signer's Address ________________________________________________________________________ (If signer is a debtor or debtor's attorney) Debtor's Address & Taxpayer ID#(s) (last 4 digits) CLERK, U.S. BANKRUPTCY COURT 1195 (6/1/14) American LegalNet, Inc. www.FormsWorkFlow.com