Free Certification of Professional in Support of Application for Retention - New Jersey

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY
Caption in Compliance with D.N.J. LBR 9004-2(c)

In Re:

Case No.: Judge: Chapter:

_______________________ _______________________ _______________________

Recommended Local Form:

Followed

Modified

CERTIFICATION OF PROFESSIONAL IN SUPPORT OF APPLICATION FOR RETENTION OF PROFESSIONAL I, __________________________________, being of full age, certify as follows: 1. 2. I am seeking authorization to be retained as ______________________________. My professional credentials include:____________________________________ __________________________________________________________________ __________________________________________________________________

3.

I am a member of or associated with the firm of: __________________________ _________________________________________________________________.

4.

The proposed arrangement for compensation, including hourly rates, if applicable, is as follows:_______________________________________________________ __________________________________________________________________ _________________________________________________________________.

5.

To the best of my knowledge, after reasonable and diligent investigation, my connection with the debtor(s), creditors, any other party in interest, their respective attorneys and accountants, the United States trustee, or any person employed in the office of the United States trustee, is as follows: None Describe connection:____________________________________________ __________________________________________________________________ __________________________________________________________________

6.

To the best of my knowledge, after reasonable and diligent investigation, the connection of my firm, its members, shareholders, partners, associates, officers and/or employees with the debtor(s), creditors, any other party in interest, their respective attorneys and accountants, the United States trustee, or any person employed in the office of the United States trustee, is as follows: None Describe Connection: ____________________________________________ __________________________________________________________________ __________________________________________________________________

7.

To the best of my knowledge, my firm, its members, shareholders, partners, associates, officers and/or employees and I (check all that apply): do not hold an adverse interest to the estate. do not represent an adverse interest to the estate. are disinterested under 11 U.S.C. § 101(14). do not represent or hold any interest adverse to the debtor or the estate with respect to the matter for which I will be retained under 11 U.S.C. § 327(e). Other. Explain: ________________________________________________ __________________________________________________________________ __________________________________________________________________ 2

8.

If the professional is an auctioneer, a. A surety bond in accordance with D.N.J. LBR 2014-1(B)(2) is attached. Yes No

b. My qualifications and previous experience as an auctioneer include: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

c. Have you or any member of your firm ever been convicted of any criminal offense, other than motor vehicle violations? Yes No

If yes, explain:______________________________________________________

9.

If the professional is an auctioneer, appraiser or realtor, the location and description of the property is as follows: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are wilfully false, I am subject to punishment.

Date: ___________________________

________________________________ Signature of Professional ________________________________ Name of Professional
Rev. 7/1/04; jml

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