Disclosure Form {LBF 8012-1}

L.B.F. 8012-1 UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA In re: : Chapter ::C.A. No. Debtor : : : Bky. No. L.B.R. 8012-1 DISCLOSURE FORM Instructions This L.B.R. 8012-1 Disclosure Form is for parties to an appeal to make the disclosures required under Fed. R. Bankr. P. 8012 and LB.R. 8012-1.The purpose of these disclosure rules is to provide the judge assigned the appeal with information about any conflicts of interest which might prevent that judge from hearing the case. Paragraphs (a) and (b) of the form are for a non-governmental corporate party to an appeal to fulfill its obligation under Fed. R. Bankr. P. 8012 to file a statement identifying any parent corporation and any publicly held corporation that owns 10% or more of the party222s stock. Paragraph (c) is for each party to an appeal to comply with LB.R. 8012-1(c) by identifying any publicly owned corporation not a party to the appeal that has a financial interest in the outcome of the appeal and the nature of that interest. Paragraph (d) is for the appellant to comply with LB.R. 8012-1(d) by identifying (1) the debtor if not named in the caption; (2) the members of the creditors222 committee or the top 20 unsecured creditors; and (3) any entity not named in the caption which is an active participant in the bankruptcy proceedings giving rise to the appeal. The completed L.B.R. 8012-1 Disclosure Form must be filed no later than 30 days after the docketing of the appeal. L.B.R. 8012-1(d), and a copy of the form of the information on the form must be included before the table of contents in the party222s principal brief. The L.B.R. 8012-1 Disclosure Form must be supplemented if the information changes. Fed. R. Bankr. P. 8012. If additional space is needed, please attach a new page. American LegalNet, Inc. www.FormsWorkFlow.com As required by Fed. R. Bankr. P. 8012 and LB.R. 8012-1, (Name of Party) makes the following disclosure: (1) For non-governmental corporate parties, please list all parent corporations: (2) For non-governmental corporate parties, please list all publicly held companies that hold 10% or more of the party222s stock: (3) If there is a publicly held corporation which is not a party to the appeal but which has a financial interest in the outcome of the proceeding, each party to the appeal please shall identify all such parties and specify the nature of the financial interest or interests: (4) The appellant must identify (a) the debtor, if not identified in the case caption; (b) the members of the creditors222 committee or the top 20 unsecured creditors; and, (3) any entity not named in the caption which is active participant in the bankruptcy proceeding giving rise to the appeal. Dated: (Signature of Counsel or Party) American LegalNet, Inc. www.FormsWorkFlow.com