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Cover Sheet For Schedules Statements Lists And-Or Amendments - New York
| Cover Sheet For Schedules Statements Lists And-Or Amendments Form. This is a New York form and can be used in Western District Bankruptcy Court Federal . |
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(Rev. 11/11: Previous Versions are Obsolete) UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF NEW YORK COVER SHEET FOR SCHEDULES, STATEMENTS, LISTS AND/OR AMENDMENTS Case Name: _____________________________________________________________ Case No._______________ Chapter ______ A. IDENTIFY TYPE OF DOCUMENT BEING FILED: (Select either #1, #2 or #3) #1--Amendment to previously filed document (Go to Sec. B) #2--Schedule/Statement not previously filed (Go to Sec. B) #3--Schedule of Post-Petition Debts (result of conversionno fee due) (Go to Sec. D) B. SUMMARIZE SPECIFICS OF DOCUMENT BEING FILED BY CHECKING APPLICABLE DATA ELEMENTS: Amendment to Case Caption: Name Social Security/Tax ID # aka/dba/fkba/fka information Petition Page: County Resident/Mailing address Signature: Debtor(s) Attorney Corporation/Partnership Exhibit B Statistical/Administrative Information Creditor Matrix Summary of Schedules Schedules: (Please check schedules attached to this Cover Sheet) Schedule A Schedule B Schedule C Schedule D (Go to Sec. C) Schedule E (Go to Sec. C) Schedule F (Go to Sec. C) Schedule G Schedule H Schedule I Schedule J Statement of Financial Affairs Statement Pursuant to Rule 2016(b) Exhibit A Chapter 13 Plan (Pre-confirmation): Decrease Payments Increase Payments Increases length of plan Other (Please specify): _________________________________________________________________________________________ FOR CHANGES AFFECTING SCHEDULE(S) D, E, or F, THE LIST OF CREDITORS, MATRIX, OR MAILING LIST, PROCEED TO SECTION "C" OF THIS FORM. OTHERWISE, PROCEED TO SECTION "D." C. CREDITOR/SCHEDULE INFORMATION: (Select either #1, #2 or #3) #1 Creditors are being added or deleted by this amendment/schedule, AND The $30.00 amendment fee is attached A matrix in the format prescribed by the Clerk with the complete names and addresses of the parties added is attached. Note: Do not repeat creditor information from a previously filed matrix. The Clerk's Office Will Not Delete Creditors Unless a Motion to Delete Creditors Is Granted. #2 Schedule(s) of creditors (Schedules D, E, F), list of creditors, matrix or mailing list is being amended for purposes other than adding or deleting creditors. The $30.00 fee is attached for this amendment [e.g. changing amount of a debt or classification of a debt]. The $30.00 fee does not apply for this amendment [e.g. change of address of a creditor or change of attorney]. #3 No Creditors are being added or deleted. D. CERTIFICATION OF SERVICE, ATTORNEY'S DECLARATION AND DEBTOR'S UNSWORN DECLARATION CERTIFICATION OF SERVICE: Attach an "Affidavit of Service" listing each party served with a copy of the referenced document(s), this cover sheet and a copy of the §341 Meeting Notice (if applicable). Be sure to include the U.S. Trustee and the Case Trustee. DECLARATION OF ATTORNEY [Attorney or debtor(s), if pro se, must sign]: I declare that the above information contained on this cover sheet may be relied upon by the Clerk of Court as a complete and accurate summary of the information contained in the documents attached. Dated _____________________________ Signature: _____________________________________________________ DECLARATION of Debtor(s) [ Required if declaration is not completed on the document(s) itself or by separate instrument ]: I declare under penalty of perjury that I have read this cover sheet and the attached schedules, lists, statements, etc., consisting of _____ sheets, numbered 1 through ______, and that they are true and correct to the best of my knowledge, information and belief. Dated: ________________________ Signature:____________________________________________________ (debtor) Dated: ________________________ Signature:____________________________________________________ (joint debtor, if any) Please contact our Financial Department with any questions regarding whether or not a fee is due at (716) 362-3200. American LegalNet, Inc. www.FormsWorkFlow.com
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