Local Bankruptcy Form 304, Notice 1
[Caption as in Bankruptcy Official Form No. 16B]
Notice
This Notice is to inform you that a Proof of Claim has been filed on your behalf in this case. The claim is filed as a(n) claim in the amount of $ ; a copy of the claim is attached to this Notice. Dated: Attorney's Address City, State, and Zip Code Telephone Number Certificate of Service The undersigned hereby certifies that on the date shown below, I served Notice upon the following creditors and/or attorneys by mailing a copy of same to them this day of , , each in a sealed envelope bearing the return address shown above. (Names of creditors or names of attorneys for creditors, with correct addresses and zip codes). Dated: Signature Printed Name Name of Firm Street Address City, State and Zip Code Telephone Number Signature of Attorney for Debtor
1
L.B.F. 304, rev. 12/1/99.