FORM NO. 2 (LF002) UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF TENNESSEE WESTERN DIVISION _______________________________________________________________________________________________ In re Case No. Chapter 13 Debtor(s). _____________________________________________________________________________________________ CHAPTER 13 PLAN (INDIVIDUAL ADJUSTMENT OF DEBTS) _______________________________________________________________________________________________ S.S.#____________________________ (H) (W)_________________________________ S.S.#____________________________ ADDRESS: _____________________________________ _____________________________________ PLAN PAYMENT: Debtor(s) to pay $____________ (weekly, every two weeks, semi-monthly, monthly) PAYROLL DEDUCTION: __________________________ OR ( ) DIRECT PAY ________________________________ BECAUSE:____________________________ ________________________ FIRST PAYMENT DATE:_______________________ PLACE OF EMPLOYMENT: _____________________________________ Pay filing fee, Trustee's fee, and debtor's attorney fee, pursuant to Court Order. ADMINISTRATIVE: MONTHLY PLAN PMT. AUTO INSURANCE: ( )Not included in Plan ( ) Included in Plan $____________ CHILD SUPPORT: Future support through Plan to ________________________ $__________ Child support arrearage amount _______________________ $__________ PRIORITY CREDITORS: ______________________________________ $__________ ______________________________________ If no arrearage, ongoing payments are to be paid directly by the debtor(s). HOME MORTGAGE: DEBTOR(S): _______________________________________ongoing pmt. begin ____________________________, ______ Approx. arrearage ______________________Interest_________% _______________________________________ongoing pmt. begin ____________________________, ______ Approx. arrearage _______________________Interest_________% $____________ $_______________ $_____________ $_______________ SECURED CREDITORS: (retain lien 11 U.S.C. § 1325{a}{5}) VALUE COLLATERAL RATE OF INTEREST MONTHLY PLAN PMT. ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% ___________________________________________ $____________ _________% UNSECURED CREDITORS: Pay _____________% of these claims after above claims are paid or pay all disposable income for term of plan; $__________ $___________ $_____________ $_____________ $____________ $__________ $____________ ESTIMATED TOTAL UNSECURED, NON-PRIORITY DEBT:______________________ TERMINATION: Plan shall terminate upon payment of the above, approximately _____ months. *ADEQUATE PROTECTION PAYMENT WILL BE 1/4 (25%) OF PROPOSED CREDITOR MONTHLY PAYMENT. FAILURE TO FILE TIMELY WRITTEN OBJECTION TO CONFIRMATION WILL BE DEEMED ACCEPTANCE OF PLAN. Absent a specific court order otherwise, all claims, other than those specifically provided for above, shall be paid as general unsecured debts. General unsecured creditors will receive ___________ % American LegalNet, Inc. www.FormsWorkFlow.com