Free D.N.J. LBR 2016-1, FEE APPLICATION COVER SHEET - New Jersey

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY D.N.J. LBR 2016-1, FEE APPLICATION COVER SHEET
IN RE: _________________________ CASE NO.: _____________________ CHAPTER: _____________________ APPLICANT: __________________________ CLIENT: __________________________

CASE FILED: __________________________

COMPLETION AND SIGNING OF THIS FORM CONSTITUTES A CERTIFICATION UNDER PENALTY OF PERJURY, PURSUANT TO 28 U.S.C. SECTION 1746. RETENTION ORDER(S) ATTACHED

SECTION 1 FEE SUMMARY
INTERIM FEE APPLICATION NO. TOTAL PREVIOUS FEE REQUESTED: TOTAL FEES ALLOWED TO DATE: TOTAL RETAINER (IF APPLICABLE) TOTAL HOLDBACK (IF APPLICABLE) TOTAL RECEIVED BY APPLICANT NAME OF PROFESSIONAL & TITLE OR FINAL FEE APPLICATION FEES EXPENSES $ $ $ $ $ $ $ $ $ $ HOURS RATE FEE

YEAR ADMITTED (OR YEARS OF PROFESSIONAL SERVICE)

1. 2. 3. 4. 5. 6. 7.

FEE TOTALS - PAGE 2 DISBURSEMENTS TOTALS - PAGE 3 TOTAL FEE APPLICATION

__________________ __________________ __________________

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SECTION II SUMMARY OF SERVICES HOURS SERVICES RENDERED a) Asset Analysis and Recovery b) Asset Disposition c) Business Operations d) Case Administration e) Claims Administration and Objections f) Employee Benefits/Pensions FEE

g) Fee/Employment Applications h) Fee/Employment Objections i) j) Financing Litigation (Other than Avoidance Action Litigation)

k) Avoidance Action Litigation l) Meetings of Creditors

m) Plan and Disclosure Statement n) Relief from Stay Proceedings o) Regulatory Compliance p) Travel q) Accounting/Auditing r) s) t) Business Analysis Corporate Finance and Valuation Data Analysis

u) Litigation Consulting v) Reconstruction Accounting w) Tax Issues x) Other (specify category) SERVICES TOTAL:

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SECTION III SUMMARY OF DISBURSEMENTS DISBURSEMENTS a) Computer Assisted Legal Research b) Facsimile (with rates) No. of Pages Rate per Page c) Long Distance Telephone d) In-House Reproduction Rate per Page No. of Pages e) Outside Reproduction f) Outside Research (Max. .20¢pg.) (Max. $1.00/pg.) AMOUNT

g) Filing/Court Fees h) Court Reporting i) j) Travel Courier & Express Carriers (e.g., Federal Express)

k) Postage l) Other (Explain)

DISBURSEMENTS TOTAL:

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SECTION IV CASE HISTORY (NOTE: Items 3 - 6 are not applicable to applications under 11 U.S.C. § 506)
(1) DATE CASE FILED: (2) CHAPTER UNDER WHICH CASE WAS COMMENCED: (3) DATE OF RETENTION: (ANNEX COPY OF ORDER(S)) IF LIMIT ON NUMBERS OF HOURS OR OTHER LIMITATIONS TO RETENTION, SET FORTH: (4) SUMMARIZE IN BRIEF THE BENEFITS TO THE ESTATE AND ATTACH SUPPLEMENTS AS NEEDED:

(5) ANTICIPATED DISTRIBUTION TO CREDITORS: (A) ADMINISTRATION EXPENSES: (B) SECURED CREDITORS (C) PRIORITY CREDITORS (D) GENERAL UNSECURED CREDITORS:

(6) FINAL DISPOSITION OF CASE AND PERCENTAGE OF DIVIDEND PAID TO CREDITOR (IF APPLICABLE): I certify under penalty of perjury that the foregoing is true and correct.

______________________________________ SIGNATURE OF APPLICANT DATE
Local Form 3 -rev. 8/1/06.jml

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