Free Form 25 - Chapter 11 Application for Final - Nebraska

F25 (4/05) UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF NEBRASKA

IN THE MATTER OF:

Debtor

) ) ) ) ) )

CASE NO. BK CHAPTER

APPLICATION FOR FINAL DECREE AND FINAL ACCOUNTING/REPORT
Comes now the Debtor, by and through its undersigned attorney, and pursuant to the Confirmation Order, submits that the estate herein is fully administered and substantially consummated as follows:

1. That all claims or interests have been surrendered or released in accordance with the provisions of the plan except as shown in Schedule A attached hereto;

2. That substantially all of the property of the debtor has been transferred according to the provisions of the plan as shown in Schedule B attached hereto;

3. That the debtor or the debtor's successor has assumed the business or substantially all of the property dealt with by the plan as applicable;

4. That distribution has been commenced under the plan, and that payments to creditors and other interested parties have been completed as shown in Schedule C attached hereto; and

5. That there are no facts necessary to enable the Court to pass on the provisions of the final decree presented in Schedule D attached hereto.

WHEREFORE, the debtor herein prays for the entry of the Final Decree finding the Plan is effective and that the estate has been fully administered; and therefore, an order of the Court granting: a. discharge of the debtor, if applicable; b. any specific injunction or other equitable provisions as set forth in Schedule D, and c. the closing of the case.

DATED: Prepared and submitted by:

Attorney/Bar No.

Address

Phone No.

UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF NEBRASKA

IN THE MATTER OF:

Debtor

) ) ) ) ) )

CASE NO. BK CHAPTER

SCHEDULE A Names and addresses of the holders of claims or interests that have not been surrendered or released in accordance with the provisions of the plan: NATURE OF VALUE OF CLAIM OR INTEREST

NAMES

ADDRESS

UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF NEBRASKA

IN THE MATTER OF:

Debtor

) ) ) ) ) )

CASE NO. BK CHAPTER

SCHEDULE B

The following property of the debtor has been/will be transferred according to the provisions of the plan:

NATURE

VALUE

TRANSFERRED TO AND DATE OF TRANSFER

UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF NEBRASKA

IN THE MATTER OF:

Debtor

) ) ) ) )

CASE NO. BK CHAPTER

SCHEDULE C Information required to close case: -----------------------------------------------------------------------------------------------------------------------------------------------------% Dividend paid/to be paid under Plan Check if future payments are contemplated under Plan but percentage dividend is not determinable. -----------------------------------------------------------------------------------------------------------------------------------------------------TOTAL RECEIPTS AND DISTRIBUTIONS 1. Gross Receipts Total Disbursements Balance of Estate Funds ADMINISTRATIVE FEES AND EXPENSES: 2. Trustee's Compensation 3. Fee for Attorney for Trustee 4. Total Other Professional Fees and all Expenses a. Accountant's fees b. Auctioneer's fees c. Appraiser's fees d. Attorney for Debtor Creditor's Committee Other (name) e. Other (list) Total Costs of Administration DISTRIBUTIONS 5. Secured Creditors 6. Priority Creditors 7. Unsecured Creditors 8. Equity Security Holders 9. Other Distributions (including payments to debtor) Total Distributions

$ $ $

$ $ $ $ $ $ $ $ $ $ $

$ $ $ $ $ $

UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF NEBRASKA

IN THE MATTER OF:

Debtor

) ) ) ) ) )

CASE NO. BK CHAPTER

SCHEDULE D

Include here additional facts, if any, which are necessary to enable the Court to pass on any specific information or other equitable provisions requested in the final decree. If there are none, so indicate.