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Application For Payment Of Unclaimed Funds - And Order - Texas
| Application For Payment Of Unclaimed Funds - And Order Form. This is a Texas form and can be used in Eastern District Bankruptcy Court Federal . |
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Revised 01/2012 UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF TEXAS INSTRUCTIONS FOR SUBMISSION OF AN APPLICATION FOR PAYMENT OF UNCLAIMED FUNDS For all applicants: 1. Submit a completed Application directly to the Court. Have your signature notarized. See Attachment (1). 2. Attach to the Application a certificate of service evidencing that a copy of the Application has been mailed to the proper office of the United States Attorney for the Eastern District of Texas (as determined by the case number) pursuant to Title 28 U.S.C. §2042. Notice to the United States Attorney is required in ALL instances. See Attachment (2). 3. Attach a proposed Order. See Attachment (3). 4. If the applicant is not the owner of record, additional information must be submitted with the application. Consult the court's website at www.txeb.uscourts.gov for complete requirements. 5. Mail a copy of the entire application packet to the United States Attorney's Office for the division indicated in the case number. For claimants in multiple cases, a separate Application must be prepared for each case with all the above requirements attached to each Application. All indications of fraud will be promptly forwarded to the United States Attorney for review. Privacy Note: Because documents filed with the Court are available through the Internet, the Court is committed to the protection of personal identification information. It is also recommended that all but the last four digits of a Social Security number be blackened, for the same privacy reasons. American LegalNet, Inc. www.FormsWorkFlow.com Revised 01/2012 UNITED STATES BANKUPTCY COURT EASTERN DISTRICT OF TEXAS Application (1) IN RE: ______________________________ Debtor ______________________________ Bankruptcy Case Number APPLICATION FOR PAYMENT OF UNCLAIMED FUNDS Comes now the Claimant identified below to make Application for an Order authorizing payment of unclaimed funds now on deposit in the Treasury of the United States for the benefit of Claimant. Claimant was a creditor/debtor in the above captioned bankruptcy case and has not received payment of these funds which are due and owing to the Claimant. Claimant furtlier states that Claimant is: NAME OF CLAIMANT: _______________________________________________________________ PHONE NUMBER: __________________ LAST FOUR DIGITS OF SOCIAL SECURITY NO: ______ MAILING ADDRESS: _______________________________________________________________ _______________________________________________________________ CITY:___________________________ STATE:______ ZIP:_____________ and that a dividend in the amount of $ held by the Clerk of Court. ____ was awarded in this case which dividend is currently unclaimed and Claimant certifies that all statements made by Claimant on this Application and any attachments required for this Application are, to the best of Claimant's knowledge, true and correct. Accordingly, Claimant requests the Court to enter an Order authorizing payment of the pro rata dividend due upon this claim. Date:_____________________ ___________________________________ Claimant's Signature State of _________ County of __________ Subscribed and sworn to before me this ____ day of ________, 20___. ___________________________ Notary Public My commission expires: _______ Mail to: United States Bankruptcy Court 110 N. College Avenue, 8th Floor Tyler, TX 75702 American LegalNet, Inc. www.FormsWorkFlow.com Certificate of Service (2) CERTIFICATE OF SERVICE In accordance with Title 28 U.S.C. Section 2042, the undersigned hereby certifies that on the date designated below a true copy of this application with all required attachments was mailed to [check one as applicable]: For all cases in Beaumont & Lufkin divisions (five-digit case number beginning with 1 or 9): Office of the United States Attorney Eastern District of Texas Attn: Unclaimed Funds Requests 350 Magnolia Avenue, Suite 150 Beaumont, TX 77701-2248 For all cases in Marshall & Tyler divisions (five-digit case number beginning with 2 or 6): Office of the United States Attorney Eastern District of Texas Attn: Unclaimed Funds Requests 110 North College Avenue, Suite 700 Tyler, TX 75702-0204 For all cases in Paris, Sherman, & Texarkana divisions (five-digit case number beginning with 3, 4 or 5): Office of the United States Attorney Eastern District of Texas Attn: Unclaimed Funds Requests 101 East Park Boulevard, Suite 500 Plano, Texas 75074-8858 Date:_____________________ ___________________________________ Claimant's Signature American LegalNet, Inc. www.FormsWorkFlow.com Revised 01/2012 UNITED STATES BANRUPTCY COURT EASTERN DISTRICT OF TEXAS Proposed Order (3) IN RE: ______________________________ Debtor ______________________________ Bankruptcy Case Number ORDER GRANTING APPLICATION FOR PAYMENT OF UNCLAIMED FUNDS The Court having considered the Application for Payment of Unclaimed Funds filed by: NAME OF CLAIMANT: __________________________________________ MAILING ADDRESS: ____________________________________________ _______________________________________________________________ CITY: _______________________ STATE:________ ZIP: _______________ ("Claimant') for payment of a dividend from unclaimed funds in the amount of $ , and, it appearing to the Court that the Claimant is entitled to receive payment, and, these funds are now on deposit in the Treasury of the United States, and that proper notice of the Application was given to the United States Attorney for the Eastern District of Texas pursuant to Title 28 U.S.C. Section 2Ø42, IT IS THEREFORE ORDERED that the Clerk of the Bankruptcy Court direct the issuance of a draft upon the Treasury of the United States in the amount stated above and payable to the Claimant. American LegalNet, Inc. www.FormsWorkFlow.com American LegalNet, Inc. www.FormsWorkFlow.com
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