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MOW 1007-1.4 (05/07)

UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF MISSOURI

IN RE:

Debtor(s)

) ) ) ) ) )

Case No.

STATEMENT OF CHAPTER 7 BUSINESS OPERATIONS

In a Chapter 7 case in which the debtor is operating a business at the time of filing, the following information is required: (1) Chief Operating Officer or other contact person

Type Name and Title (2) Address of Business

Type Street, City, State and Zip Code (3) Telephone Number(s) where Chief Operating Officer or other contact person can be reached

Type Telephone Number(s)

(4)

Business no longer in operation

.

Signature cc: U.S. Trustee

Instructions: File as a separate document on the date the voluntary petition is filed. ECF Event: Bankruptcy>Other>Statement of Chapter 7 Business Operations