Ballot Summary (LBR 3018.1)

[Name of Attorney][Email Address][Idaho State Bar number][Office Mailing Address][Telephone Number][Facsimile Number][Party Represented]UNITED STATES BANKRUPTCY COURTDISTRICT OF IDAHOIn re:)))Case No. ))Chapter 11Debtor,)BALLOT SUMMARY (LBR 3018.1)The following is a summary of the ballots submitted that have either accepted or rejectedthe proposed Chapter 11 Plan filed by [proponent222s name] on [date], which plan is scheduled forconfirmation hearing on [date].Pursuant to 11 U.S.C. 247 1129(a)(8), in order for a plan to be confirmed, each class ofclaims or interests must (A) accept as a class the plan, or (B) be a class that is not impaired underthe plan.1 This form therefore notes each class that is not impaired under the plan.2 This formfurther provides, for each impaired class, a summary of the ballots cast accepting and rejectingthe plan.3 1 If the requirements of 247 1129(a)(8)(A) are not satisfied, [plan proponent] may seek to confirm theplan through compliance with 247 1129(b) as to any impaired, non-accepting class.2 A class that is not impaired under 247 1129(a)(8)(B) is conclusively presumed to have accepted theplan under 247 1126(f). 3 A separate attachment is filed with this form, showing all ballots received, itemized by name ofcreditor/interest holder, the class under the plan in which such creditor/interest holder is treated, the amountof the claim or interest, and whether the ballot of the creditor/interest holder accepted or rejected the plan.Page 1 American LegalNet, Inc. www.FormsWorkFlow.com Pursuant to 11 U.S.C. 247 1126(c), only the actual ballots cast are counted to determinewhether a given class has accepted or rejected.4 That section further provides that a class willhave accepted the plan if voting creditors in such class holding at least two-thirds in amount andmore than one-half in number have accepted the plan. The form below tabulates the actualballots received by class, and for each such class, presents [plan proponent222s] assertion of thepercentage in number of class members accepting the plan and the percentage of the dollaramount of the class members accepting the plan.Class (per plandesignation)Classimpaired? [Yes/No]Total ballotsfiled bymembers ofclass; totalamount ($) ofballots filedNumber offiled ballotsaccepting theplan (A) andrejecting theplan (R)Percentage ofacceptingballots(in number)Amount offiled ballotsaccepting theplan (A) andrejecting theplan (R)Percentage ofacceptingballots(in amount)[Sample:Class IIIYes75 ballots(A) 4256% (A) $222,000 52%(unsecured)$425,500(R) 33 (R) $203,500Class IVNon/a------ 227 ---(secured)Class VYes1 ballotA100% $78,999 100%(secured)Class VIYes1 ballotR0% $85,675 0%(secured)Class VIIYes12 ballots(A) 758% (A) $22,000 69%(interests)$32,000(R) 5 (R) $10,000 4 See 7 Collier on Bankruptcy 2661126.04, 2661129.02[8] (Alan N. Resnick & Henry J. Sommer eds.,16th ed. 2010).Page 2 American LegalNet, Inc. www.FormsWorkFlow.com