Motion For Disbursement Of Unclaimed Funds {5}

Local Form 5 UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF NORTH CAROLINA [insert correct division name] DIVISION In re: ) ) ) ) ) ) ) ) ) Case No.: Chapter: March 2013 Debtor(s) MOTION FOR DISBURSEMENT OF UNCLAIMED FUNDS hereby moves the Court for an order (Claimant(s) Name) directing the United States Bankruptcy Court to disburse the sum of $ (Enter amount of claim) from the Court's registry fund, payable to (Claimant(s) Name) unclaimed funds previously deposited with the Court. , representing Date _______________ Supporting documentation attached ____yes ____no I understand that pursuant to 18 U.S.C. §§ 152 & 3571, I may be fined up to $500,000, imprisoned for up to 5 years, or both if I have knowingly and fraudulently made any false statements in this document or provided false and fraudulent documentation as part of this application. _____________________________________ Signature of Claimant _____________________________________ Typed or printed name of Claimant _____________________________________ Address of Claimant _____________________________________ Daytime Telephone Number of Claimant American LegalNet, Inc. www.FormsWorkFlow.com IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF NORTH CAROLINA [insert correct division name] DIVISION In re: ) ) ) ) ) ) ) Case No.: Chapter: Debtor(s). NOTICE OF HEARING AND CERTIFICATE OF SERVICE NOTICE IS HEREBY GIVEN that the Court will conduct a hearing on ______________________ at ___________ (a.m./p.m.) in Courtroom number ________ located at ___________________________ to consider the Motion for Disbursement of Unclaimed Funds filed by _____________________________. (Claimant(s) Name) NOTICE IS FURTHER GIVEN to the Court that on ____________________, the United States (Enter date parties served) Attorney, the case trustee, and the Bankruptcy Administrator were served a copy of the Motion for Disbursement of Unclaimed Funds and this Notice of Hearing by U.S. Mail. Signature of Claimant(s) Typed or printed name of Claimant(s) Date _______________________ American LegalNet, Inc. www.FormsWorkFlow.com