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MOW 9040-1 (revised 05/07)

IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF MISSOURI In re: ) ) ) ) )

Case No.

SUMMARY OF EXHIBITS AND CERTIFICATE OF SERVICE The following exhibits in reference to the upon request: 1............... 2............... 3............... (Motion/Claim to be filed) are available

Respectfully submitted Date: ________________ ATTORNEY FOR ______________

CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of all documents supporting my (claim/motion) referenced above, including legible copies of all documents evidencing perfection of security interests have been served on the trustee and debtor's counsel this______day of _______, 20___. Copies of the above documents are available to other parties in interest upon request. _______________________________ Name Instructions: File with document or as an attachment to the document to which the exhibits pertain. ECF Event: If filed separately, Bankruptcy>Other>Summary of Exhibits