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UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) )

Case No. _______________ INDIVIDUAL DEBTOR'S APPLICATION TO PAY FILING FEES IN INSTALLMENTS

Debtor(s)

In accordance with Fed. Bankruptcy Rule 1006, application is made for permission to pay all the fees for filing on the following terms: a. If a CHAPTER 12 or 13 CASE - $_______ with the filing of the petition and the balance of $_______ no later than 45 days from the entry date of an order authorizing installment payment. OR b. If a CHAPTER 7 or 11 CASE - $_______ with the filing of the petition and the balance of $_______ in ____ installments as follows: $_______ no later than 28 days from the entry date of an order authorizing installment payment. $_______ no later than 56 days from the entry date of an order authorizing installment payment. $_______ no later than 84 days from the entry date of an order authorizing installment payment. I certify that I am unable to pay all the filing fees except in installments. I further certify that I will not make any additional payment or transfer any additional property for services in connection with this case until all filing fees are paid in full. I UNDERSTAND MY CASE MAY BE PROMPTLY DISMISSED, AND I MAY NOT RECEIVE A DISCHARGE OF MY DEBTS, IF I FAIL TO PAY ANY AMOUNT ON TIME. Dated: _________ Signed: ______________________________________ Applicant Signed: ______________________________________ Applicant Applicant's Mailing Address: ____________________________________________ ____________________________________________

110 (8/8/08)