Attorneys Application For Compensation For Representing Chapter 13 Debtor(s) (Cases Filed On Or After 8-21-12 Through 4-19-15) {23}

UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF ILLINOIS In re: Debtor(s) EASTERN DIVISION ) Case No. ) Hearing Date: ) Judge ATTORNEY'S APPLICATION FOR COMPENSATION FOR REPRESENTING CHAPTER 13 DEBTOR(S) (Use for cases filed on or after 8/21/2012 through 4/19/2015) The undersigned attorney seeks compensation pursuant to 11 U.S.C. § 330(a)(4)(B) for representing the interests of the debtor(s) in this case. Use of Court-Approved Retention Agreement: The attorney and the debtor(s) have have not entered into the Court-Approved Retention Agreement. Attorney Certification: The attorney hereby certifies that: 1. All disclosures required by General Order 11-2 have been made, and 2. If a Flat Fee is requested, the attorney and the debtor have not entered into any other agreements that provide for the attorney to receive (a) any kind of compensation, reimbursement, or other payment or (b) any form of, or Compensation for services previously awarded in this case: None a total of $ dates: Compensation for services now sought in this case: $ flat fee for services through case closing $ for itemized services (itemization attached). , pursuant to orders entered on the following . Reimbursement now sought for expenses advanced by the attorney: $ for filing fee paid by the attorney with the attorney's funds $ for other expenses incurred in connection with the case and paid by the attorney with the attorney's funds (itemization attached) $ Total reimbursement for expenses requested. Additional expenses incurred in the case for which the attorney is not seeking reimbursement (either paid by the debtor(s) directly or paid by the attorney with funds provided by the debtor(s)): $ for filing fee $ for other expenses, itemized as follows: $ Describe expenses: $ Describe expenses: (add more lines if needed) $ Total non-reimbursable expenses pre-paid by the debtor (this amount not to appear on fee order). Funds received from debtor for services and expenses advanced by the attorney: None $ for services $ for expenses advanced by the attorney Itemization of time: Date of Application: Not submitted Attached to this application. Attorney's signature: Form No. 23, revised 04/15 American LegalNet, Inc. www.FormsWorkFlow.com