COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : DEBTOR: ____________________________ Plaintiff(s) Index No. Calendar No. MONTHLY FINANCIAL REPORT : JUDICIAL CHAPTER 11 SUBPOENA : -againstCASE NO: ____________________ : For Period ____________ to ____________, ________ : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COVER .SHEET . . . ....... ...... Accounting Method Used: [ ] Accrual Basis [ ] Cash Basis ______________________________________________________________________ THE PEOPLE OF THETHIS REPORTNEW YORK AFTER THE END OF THE MONTH STATE OF IS DUE 15 DAYS Mark One Box For Each TO Required Document Debtor must attach each of the following reports/documents unless the U.S. Trustee has waived the requirement in writing. File the original with the Clerk of Court. Transmit a duplicate, with original signature, to the U.S. Trustee. ______________________________________________________________________ GREETINGS: REQUIRED REPORTS/DOCUMENTS Report/Document Previously Attached Waived WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ] [ ] Cash Receipts & Disbursements Statement (Form 2-B) , the [Honorable at the Court located at County of [ ] [ ] Balance Sheet (Form 2-C) in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give ] witness Loss Statement (Form 2-D) [ ] [ evidence as aProfit and in this action on the part of the [ ] [ ] [ ] [ ] Supporting Schedules (Form 2-E) [ Quarterly Fee Summary (Form 2-F) Your failure to comply with] this subpoena is punishable as a contempt of court and will make you liable to the [party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a ] [ ] Narrative (Form 2-G) result of your failure to comply. [ ] Bank Statement(s) for Debtor in Possession Account(s) ______________________________________________________________________ Witness, Honorable , one of the Justices of the Court in under penalty of perjury that the of County, day following Monthly 20 , Financial Report, and any attachments thereto, is true I declare and correct to the best of my knowledge and belief. (Attorney must sign above and type name below) Executed on: _______________________ Debtor(s): ________________________________ By ________________________________ Position: DEBTOR: _______________________________ Attorney(s) for ________________________________ Office and P.O. Address CASE NO: ______________ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Form 2-B Page 1 of 2 Revised 10/96 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. CASH RECEIPTS AND DISBURSEMENTS STATEMENT : JUDICIAL SUBPOENA Plaintiff(s) For Period __________ to ____________,______ -against: : CASH RECONCILIATION : 1. Beginning Cash Balance (Ending Cash Balance Defendant(s) : . . . . . . . . .from. last .month's. report) . . . . . . . . . . . . . . . . . . . . . . . . ... ... ...... ...... $ ___________ 2. Cash Receipts (from Cash Receipts Journal on next page) $ ___________ THE PEOPLE OF THE STATE OF NEW YORK 3. Cash Disbursements (from Cash Disbursements Journal on next page) (___________) TO 4. Net Cash Flow (line 2 minus line 3) ___________ 5. Ending Cash Balance (to Form 2-C) GREETINGS: $ ___________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court CASH SUMMARY - ENDING BALANCE located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Financial the or adjourned date, to testify and give evidence as aAmount this action on the part of Institution witness in Petty Cash $ ___________ _________________________ Regular Checking to comply with this subpoena is punishable as a contempt of court and will make you liable to ___________ _________________________ Your failure the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Tax Account ___________ _________________________ result of your failure to comply. Other CheckingHonorable Witness, Accounts Court in County, Interest-Bearing Deposits ___________ , 20 ___________ day of Short-Term Investments _________________________ , one of the Justices of the _________________________ ___________ _________________________ (Attorney must sign above and type name below) TOTAL (must agree with line 5 above) $ Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Form 2-B Page 2 of 2 Revised 10/96 American LegalNet, Inc. www.USCourtForms.com