Revised 03/2017 UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF TEXAS INSTRUCTIONS FOR SUBMISSION OF AN APPLICATION FOR PAYMENT OF UNCLAIMED FUNDS Unclaimed funds are monies deposited with the court by a case trustee pursuant to 11 USC 247347. Generally, these monies are unclaimed because the trustee does not have a current address for the creditor. Funds may be claimed pursuant to 28 USC 247 2042. If you need further assistance, please contact the Finance Department at (903) 590-3219. Review the US Bankruptcy Unclaimed Funds Locator to see if you are due to receive any funds from this court. Be sure to select TXEB for the Court if searching for information about a case in the Eastern District of Texas. If you are due unclaimed funds, follow the instructions below in order to properly prepare your application and supporting documents. Applications without all of the required documentation may be denied by the court. There are four categories of claimants. Please determine which category is appropriate and use the appropriate checklist below to prepare your application with supporting documentation and follow the mailing instructions. An Individual without Representation Completed application and proposed order for payment of unclaimed funds. A photocopy of current drivers222 license. If you do not have drivers222 license, other identification containing a photograph with current address, and a copy of your social security card is required. This provides proof of ownership of funds. A certificate of service showing that notice of application has been given to the United States Attorney pursuant to 28 USC 247 2042. 1. Mail the ORIGINAL completed Application for Payment of Unclaimed Funds with supporting documents, the original completed Certificate of Service, and an original completed Order Authorizing Payment of Unclaimed Funds to the US Bankruptcy Court, Attn: Unclaimed Funds, 110 North College Ave, 8th Floor, Tyler, TX 75702. 2. Mail a COPY of the completed Application for Payment of Unclaimed Funds with supporting documents to the U.S. Attorney's Office at the address listed on the Certificate of Service. Represented by Attorney or Funds Locator An original power of attorney with a notarized signature. Completed application and proposed order for payment of unclaimed funds. A photocopy of creditor222s current driver222s license or other positive identification credentials. Disbursements will be made in the name of the creditor only. A certificate of service showing that notice of application has been given to the United States Attorney pursuant to 28 USC 247 2042. 1. Mail the ORIGINAL completed Application for Payment of Unclaimed Funds with supporting documents, the original completed Certificate of Service, and an original completed Order Authorizing Payment of Unclaimed Funds to the US Bankruptcy Court, Attn: Unclaimed Funds, 110 North College Ave, 8th Floor, Tyler, TX 75702. 2. Mail a COPY of the completed Application for Payment of Unclaimed Funds with supporting documents to the U.S. Attorney's Office at the address listed on the Certificate of Service. American LegalNet, Inc. www.FormsWorkFlow.com Revised 03/2017 Business or Corporation Completed application and proposed order for payment of unclaimed funds. Evidence consisting of Articles of Incorporation, Articles of Merger or Successor Corporation, etc. Representative of firm must be identified in evidence articles. Documentation establishing chain of ownership of the original claim or proof of the purchase/sale of assets. (For transferred claims only) A photocopy of representative222s identification credentials. A certificate of service showing that notice of application has been given to the United States Attorney pursuant to 28 USC 247 2042. 1. Mail the ORIGINAL completed Application for Payment of Unclaimed Funds with supporting documents, the original completed Certificate of Service, and an original completed Order Authorizing Payment of Unclaimed Funds to the US Bankruptcy Court, Attn: Unclaimed Funds, 110 North College Ave, 8th Floor, Tyler, TX 75702. 2. Mail a COPY of the completed Application for Payment of Unclaimed Funds with supporting documents to the U.S. Attorney's Office at the address listed on the Certificate of Service. Claiming on Behalf of a Deceased Party Completed application and proposed order for payment of unclaimed funds. Copy of the death certificate. Proof of personal identity of the estate administrator. Certified copies of probate documents establishing the representative222s right to act on behalf of the decedent222s estate. A certificate of service showing that notice of application has been given to the United States Attorney pursuant to 28 USC 247 2042. 1. Mail the ORIGINAL completed Application for Payment of Unclaimed Funds with supporting documents, the original completed Certificate of Service, and an original completed Order Authorizing Payment of Unclaimed Funds to the US Bankruptcy Court, Attn: Unclaimed Funds, 110 North College Ave, 8th Floor, Tyler, TX 75702. 2. Mail a COPY of the completed Application for Payment of Unclaimed Funds with supporting documents to the U.S. Attorney's Office at the address listed on the Certificate of Service. Orders approving payment of funds could take up to 60 days to process from the time the application is received by the court. Payment will not be made by the court until claimant completes and returns AO 213 Vendor Information/TIN Certification as directed in the approved order. Form AO 213 only needs to be submitted once to the court. If you have already submitted AO 213 and the court has your vendor information on file, AO 213 Vendor Information/TIN Certification form is not required. Payment will be made upon entry of the order granting the application as directed in the order. For claimants in multiple cases, a separate Application must be prepared for each case with all the above requirements attached to each Application. All indications of fraud will be promptly forwarded to the United States Attorney for review. American LegalNet, Inc. www.FormsWorkFlow.com Revised 1/2018 UNITED STATES BANKUPTCY COURT EASTERN DISTRICT OF TEXAS Application (1) IN RE: APPLICATION FOR PAYMENT OF UNCLAIMED FUNDS Comes now the Claimant identified below to make Application for an Order authorizing payment of unclaimed funds now on deposit in the Treasury of the United States for the benefit of Claimant. Claimant was a creditor/debtor in the above captioned bankruptcy case and has not received payment of these funds which are due and owing to the Claimant. Claimant furtl365er states that Claimant is: and that a dividend in the amount of $ held by the Clerk of Court. was awarded in this case which dividend is currently unclaimed and Claimant certifies that all statements made by Claimant on this Application and any attachments required for this Application are, to the best of Claimant's knowledge, true and correct. Accordingly, Claimant requests the Court to enter an Order authorizing payment of the pro rata dividend due upon this claim. State of County of Subscribed and sworn to before me this day of , 20 . Notary Public Mail to: United States Bankruptcy Court 110 N. College Avenue, 8th Floor Tyler, TX 75702 My commission expires: Date: Claimant222s Signature Co-claimant222s Signature (if any) EMAIL ADDRESS OF CLAIMANT: N AME OF CLAIMANT: PHONE NUMBER: LAST FOUR DIGITS OF SOCIAL SECURITY NO: MAILING ADDRESS: CITY: STATE:ZIP: Bankruptcy Case Number Debtor American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE In accordance with Title 28 U.S.C. Section 2042, the undersigned hereby certifies that on the date designated below a true copy of this application with all required attachments was mailed to [check one as applicable]: For all cases in Beaumont & Lufkin divisions (five-digit case number beginning with 1 or 9): Office of the United States Attorney Eastern District of Texas Attn: Unclaimed Funds Requests 350 Magnolia Avenue, Suite 150 Beaumont, TX 77701-2248 For all cases in Marshall & Tyler divisions (five-digit case number beginning with 2 or 6): Office of the United States Attorney Eastern