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Application To Pay Filing Fees In Installments CSD 1006 - California
| Application To Pay Filing Fees In Installments Form. This is a California form and can be used in General USBC Southern Federal . |
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CSD 1006 [11/21/12] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West "F" Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. APPLICATION TO PAY FILING FEES IN INSTALLMENTS In accordance with Federal Rule of Bankruptcy Procedure 1006, application is made for permission to pay half the filing fee at the time the petition is filed with the balance of the fee in not more than one installment due within 30 days of the date my petition is filed (check one): [] [] Chapter 7 payment of $153.00 Chapter 11 payment of $606.50 [] [] Chapter 13 payment of $140.50 Chapter 12 payment of $123.00 I certify that I am unable to pay the filing fee except in installments. Until the filing fee is paid in full, I will not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. I understand that entry of my discharge [or confirmation of any plan] will be delayed until the filing fee is paid in full or, if not paid, that my case will be dismissed without further notice. Dated: Signed: Signature of Debtor Signed: Signature of Joint Debtor (if any) Dated: Attorney for Debtor(s) If this document is prepared by a NON-ATTORNEY BANKRUPTCY PETITION PREPARER, the certification printed on page 2 must be completed Form of payment: Please do not mail cash. Money orders or certified checks only; personal checks of the debtor will not be accepted. CSD 1006 American LegalNet, Inc. www.FormsWorkFlow.com CSD 1006 (Page 2) [11/21/12] DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required under that section; and (4) I will not accept any additional money or any other property from the debtor before the filing fee is paid in full. Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social Security No. (Required by 11 U.S.C. § 110) If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social security number of the officer, principal, responsible person, or partner who signs the document. Address X Signature of Bankruptcy Petition Preparer Date Names and Social Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not an individual: If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156. CSD 1006 American LegalNet, Inc. www.FormsWorkFlow.com
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