Newport News - Attn: DQA Team P.O. Box 1938 Norfolk VA 23501-1938 (600 Granby St., 4th Floor) UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF VIRGINIA CASE MANAGEMENT/ELECTRONIC CASE FILING (CM/ECF) SYSTEM LIMITED PARTICIPANT REGISTRATION FORM Live System This form is to be used to register for LIMITED FILING PRIVILEGES for filing documents via the Internet component of the Case Management/Electronic Case Filing system (hereafter CM/ECF), in the United States Bankruptcy Court for the Eastern District of Virginia. Limited filing privileges shall include the authorization to file a proof of claim, request for notice/service, notice of appearance, reaffirmation agreement and notice of transfer of claim via the Internet with the Clerk’s Office. The Clerk may authorize the registration of an entity for other, limited purposes. The following information is required for CM/ECF registration and MUST BE TYPEWRITTEN: Name (First, Middle, Last): __________________________________________ Agency/Company __________________________________________ Mailing Address: __________________________________________ __________________________________________ If Attorney, State of Admission and Bar ID #: State: ___________; Bar ID #: _________________ Voice Phone Number: _( E-Mail Address: __________________________________________ )____________________________________ By signing and submitting this registration form, I agree to abide by the following requirements: 1. Signatures on a proof of claim, request for notice/service, notice of appearance, reaffirmation agreement, and notice of transfer of claim shall be indicated by “/s/” and the typed name of the person signing in the following format: “/s/ Jane Smith” on the signature line. My password constitutes my signature. American LegalNet, Inc. www.FormsWorkflow.com 2. The login and password for filing via the Internet shall be used exclusively by me and by any of my employees to whom I give authorization. I will not knowingly permit my login and password to be used by anyone who is not so authorized. 3. I will select and activate a new password in CM/ECF if an employee of mine who has been authorized to use my login and password no longer serves in such a capacity. 4. I will report any suspected compromise of my password to the DQA Team/Training Contact at the appropriate Divisional Office of the Eastern District of Virginia Bankruptcy Court. 5. Except as specifically waived by me at paragraph 6 below, I will abide by all of the requirements set forth in the “Administrative Procedures for Filing, Signing, Retaining and Verification of Pleadings and Papers in the Case Management/Electronic Case Filing (CM/ECF) System” currently in effect, and any changes or additions that later may be made. 6. Waiver from Receiving E-Mail Notifications I waive service of documents and docket activity electronically. _____________________________ Applicant Name (please print) __________________________ Applicant Signature _____________________________ Last 4 Digits of SS # (for security purposes) __________________________ Deputy Clerk Of USBC (to be signed upon receipt of application) _____________________________ Clerk of Court (or Designee) Mail or deliver this completed form to our Richmond divisional office: U.S. Bankruptcy Court Attn: ACC Team 1100 East Main Street, Suite 301 Richmond VA 23219 American LegalNet, Inc. www.FormsWorkflow.com