Real Property Questionnaire (Los Angeles Division) {USTLA-5}

Attorney or Party Name, Address, Telephone and FAX Pro Se Debtor OFFICE OF THE UNITED STATES TRUSTEE LOS ANGELES DIVISION In Re: SUBMIT TO UNITED STATES TRUSTEE ­ DO NOT FILE WITH COURT Case Number: REAL PROPERTY QUESTIONNAIRE CHECK ONE BOX: Debtor-In-Possession. G Owned G Being Purchased G Within seven (7) days after the filing of the petition, every chapter 11 Debtor in Possession which holds any interest in any parcel of real property shall provide the United States Trustee with a completed Real Property Questionnaire (form UST-5). Included within the meaning of the phrase Aany interest in any parcel of real property@ are real property leases, land sales contracts, open escrows and other transactions under with the Debtor presently may not be a titleholder of record. The United States Trustee deems the requested information necessary to carry out his statutory responsibilities to monitor and evaluate all pending Chapter 11 cases in this District. Therefore, failure to timely and fully submit this form for each parcel of real property may result in the filing of a motion to dismiss this case, convert this case to one under Chapter 7 or for appointment of a Trustee. Consequently, the Debtor is required to fully answer each question contained in each section of this Questionnaire that applies to the particular parcel of real property involved. A separate Questionnaire is to be filed for each parcel of real property. If additional space is required for any answer, and continuation sheet specifying the Section and Question involved should be attached. SECTION ONE: PROPERTY OWNED OR BEING PURCHASED BY DEBTOR A. Address of property including county and state in which it is located: B. Legal Description of Property (i.e. Lot and Tract Number, including Tax Assessor=s I.D. Number) C. D. Percentage interest in the property owned by the Debtor: Date of Debtor=s Acquisition of the Property: Purchase Price: $ Effective September 1, 2011 USTLA 5 In Re: Debtor. Case No.: E. Type of real property (i.e. single family residence, condominium, apartment bldg., office bldg., commercial, industrial, unimproved.) F. Description of property (i.e. square footage, number of units, number of offices, amenities, condition): G. Development status of property: (1) Permits (type, date issued, expiration date): (2) In construction (date of commencement, estimated date and cost of completion, name of construction lender): (3) Rehabilitation (specify nature, cost and status of rehabilitation effort): H. I. Present Fair Market Value: $ State source and basis of the above fair market value: (attach a copy of latest appraisal) J. Does the property meet all federal, state, and local requirements including, but not limited to; health, building, safety, OSHA, earthquake and fire regulations? G YES G NO (If the answer is ANO,@ briefly explain and attach copies of any complaints, citations and/or recorded documents which specify the substance of the alleged violations) K. L. State the name of the titleholder of records as of the date of the filing of the Petition: State the name of the Grantor of the property to the titleholder set forth in AK@ above: 2 Effective September 1, 2011 USTLA-5 In Re: Debtor. M. Case No.: Is the titleholder, specified in AK@ above, the Debtor in this Chapter 11 proceeding? G YES G NO (If ANO,@ explain why the titleholder and the Debtor are different persons/entities) N. O. State the date of the last transfer of any interest in the property and the name of the transferor and transferee: Was title to the property transferred to the Debtor within ninety (90) days prior to the filing of the Chapter 11 Petition? G YES G NO (If AYES,@ state the reason for the transfer) P. If the Debtor is a partnership, did all of the general partners consent to the filing of the Chapter 11 Petition? G YES G NO (If AYES,@ attach documentation to indicate such consent was given by all partners, if ANO,@ explain why all did not consent and identify each non-consenting partner). Q. R. Is the property currently occupied? G YES G NO Does the Debtor, its principals or any other person or entity related to the Debtor or its principals occupy or use any portion of the property? G YES G NO (If AYES,@ state the name of the tenant, nature of the relationship to the Debtor and terms of the agreement, if any) S. Does any other person/entity other than the Debtor use, lease or occupy any portion of the property? G YES G NO (If >YES@, state name of each person/entity, whether it is relation, affiliated or doing business with the Debtor or any principal of the Debtor, and state the terms of such use, lease or occupancy) T. Has the Bankruptcy Petition been recorded in the Office of the Recorder of the county in which this property is located? G YES G NO (If AYES,@ state the Date of Recordation and Instrument Number or Book and Page Number) 3 Effective September 1, 2011 USTLA-5 In Re: Debtor. Case No.: SECTION TWO: FINANCIAL STATUS OF OWNED PROPERTY A. List Voluntary encumbrances of record against the property (e.g. mortgages, stipulated judgments): Lender Name 1st: 2nd: 3rd: 4th: Maturity Date 1st: 2nd: 3rd: 4th: B. List involuntary encumbrances of record against the property (tax, mechanics=s and other liens, judgments, lis pendens): Amount Claimed Date of recordation Date of Last Payment Number of Delinquent Installments Current Principal Balance Installment Amount Frequency (Mo/Qtr/Yr) Type of lien C. Was a Notice of Default and/or a Notice of Sale recorded prior to the filing of the bankruptcy petition? G YES G NO (If AYES,@ state which document was recorded, the name of the lender, and the date of recordation) D. Property Taxes: (1) Assessed value of property per latest real property Tax Bill $ (2) Annual taxes and installment due dates: (3) Indicate the due dates and amounts of any Tax Bills which have not been paid: 4 Effective September 1, 2011 USTLA-5 In Re: Debtor. Case No.: SECTION THREE: SALE OF PROPERTY A. Has a real estate broker been employed? G YES G NO (If AYES,@ state the name of the broker, name of the salesperson, date employed, company name, address and telephone number and the listing agreement expiration date) B. C. D. Has an application to employ the broker been filed with the court? G YES G NO How long as the property been listed or advertised for sale with the current broker? Has any written offer been received? G YES G NO (If AYES,@ state the terms of each such written offer) E. F. What is the dat