__________________________ __________________________ __________________________ _______For Chapter 13 Trustee
|In re: ||Case No. __________________ Chapter 13|
|1. Date of Petition:||_____________________|
|2. Date Plan Confirmed:||_____________________|
|3. Amount of Fees Approved at Confirmation||$ _____________________|
|4. Subsequent Fee Application Filed:||Yes _____||No _____|
|If yes:||Date Approved||Amount Approved|
|5. Amount of Fees Received to Date:||$ _____________________|
|6. Time Period of this Application:||From: _______________||To: _____________________|
|7. Hourly Rate of Professional:||$ _____________________|
|8. Total Hours in this Application:||_____________________|
|9. Total Fees Requested:||$ _______ x Hours =||$ _____________________|
|10. Amount Included for Appearance at Hearing on this Application||$ _____________________|
|11. Total Costs Requested this Application:||$ _____________________|
|12. Total Fees and Costs Requested:||$ _____________________|
|Dated: _________________||___________________________________________ ___________________________________________ ___________________________________________ ________________________For Debtor|
That I am familiar with and have read the above application and the facts therein are true to my knowledge and belief. The copies of the billing statements are true and correct copies of ________________________________________’s billing statements for this case.
That the firm of ___________________________________________________ has not been paid or promised any compensation from any other source for services rendered in connection with this case.
That ____________________________________________________________ has not entered into any agreement or understanding with any other entity for the sharing of compensation received or to be received for services rendered and/or to be rendered in connection with this case.
That to the best of my knowledge, information and belief, the compensation and expense reimbursement sought herein is in conformity with the Guidelines for Compensation and Expense Reimbursement of Professionals and Trustees for the United States Bankruptcy Court for the Northern District of California, except to the extent set forth in the application.
That this application is submitted in accordance with Guideline No. 9 of the Guidelines for Compensation and Expense Reimbursement of Professionals and Trustees for the United States Bankruptcy Court for the Northern District of California.
That the compensation and expenses sought herein were billed at rates no less favorable than those customarily billed by applicant and generally accepted by the applicant’s clients.
I declare under penalty of perjury that the foregoing is true and correct and that this certification was executed this ______ day of _________________at ________________________, California.