FORM NO. 15 (LF015) UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF TENNESSEE ________________________________________________________________________________________________________ In re Case No. Chapter 11 Debtor(s). ________________________________________________________________________________________________________ FINAL REPORT OF DEBTOR IN CHAPTER 11 CASE ________________________________________________________________________________________________________ The above-named debtor represents as follows: (The amounts shown in this Final Report should include all the accounts shown on previous Follow-Up Reports and any additional amounts paid at the time of the filing of this FINAL REPORT.) ADMINISTRATIVE EXPENSES PAID: (DO NOT include operating expenses) (Attach separate list if not enough space) 1. Accountant's Fees (Show names) _____________________________________________________ _____________________________________________________ 2. Auctioneer's Fees (Show names) _____________________________________________________ _____________________________________________________ 3. Appraiser's Fees (Show names) _____________________________________________________ _____________________________________________________ 4. Attorney Fees for Creditors' Committee(s) (Show names) _____________________________________________________ _____________________________________________________ 5(a). Attorney Fees for Trustee (Show names) _____________________________________________________ _____________________________________________________ (b). Trustee's Commission (Show names) _____________________________________________________ _____________________________________________________ 6. Attorney Fees for Debtor (Show names) _____________________________________________________ _____________________________________________________ $___________________________ ____________________________ $___________________________ ____________________________ $___________________________ ____________________________ $___________________________ ____________________________ $___________________________ ____________________________ $___________________________ ____________________________ Amounts $___________________________ ____________________________ 7. Other Attorney Fees (Show names) _____________________________________________________ _____________________________________________________ $___________________________ ____________________________ American LegalNet, Inc. www.FormsWorkFlow.com FORM NO. 15 (LF015) 8. Taxes, Fines, Penalties, etc. (Show names) _____________________________________________________ _____________________________________________________ Amounts $___________________________ ____________________________ 9. Other Expenses of Administration (non-operating) (itemize) ____________________________________________________ _____________________________________________________ $___________________________ ____________________________ TOTAL OF ALL ADMINISTRATIVE EXPENSES PAID AT THE TIME OF CLOSING THIS CHAPTER 11 CASE (non-operating) PAYMENTS TO CREDITORS (According to the plan) 1. Total amount paid and TO BE paid to general unsecured creditors according to the confirmed plan 2. Total PERCENTAGE of allowed claims paid and TO BE paid to general unsecured creditors according to the confirmed plan TOTAL AMOUNT OF CLAIMS ALLOWED: (Under the plan) 1. 2. 3. Secured Claims Priority Claims Unsecured Claims $___________________________ $___________________________ $___________________________ $___________________________ $___________________________ $___________________________ (Please be sure to show an amount on EACH of the lines above. If there is no payment show "none" on the line.) Describe briefly any transfers proposed by the plan that have taken place and/or to take place in the future. Show cause of same . (Estimate if necessary.) Are there any matters still requiring judicial administration in this case but that do not prevent this FINAL REPORT from being filed for statistical purposes? (Describe briefly) ____________________________________________________ Debtor or Attorney for Debtor ____________________________________________________ Address ____________________________________________________ Date:________________________________________________ I, ____________________________________________, the person whose signature appears above, declare under penalty of perjury that the foregoing is true and correct. (Signature)___________________________________________________ CERTIFICATE OF SERVICE I hereby certify that a copy of the foregoing "Final Report of Debtor in Chapter 11 Case" has been served on the United States Trustee. ____________________________________________________ Debtor or Attorney for Debtor American LegalNet, Inc. www.FormsWorkFlow.com