Free Compensation And Reimbursement Of Expenses - Pennsylvania

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Local Bankruptcy Form 2016-3 Application for Compensation or Reimbursement of Expenses



Bankruptcy No.

................... APPLICATION FOR
first, second, etc. as applicable

COMPENSATION AND REIMBURSEMENT OF EXPENSES Of.....................................................
name of applicant, professional capacity

entity represented or engaged by

For THE PERIOD ................ THROUGH ................

................................................................................ in accordance
Name of applicant, professional capacity, and entity represented or engaged by

with F.R.B.P. 2016 applies under 330 of the Code for an award of compensation and reimbursement of actual, necessary expenses and represents:

Part A Preliminary Statement 1. 2. Applicant is [professional capacity] for [entity represented or engaged by]. All services rendered and expenses incurred for which compensation or reimbursement is requested were performed or incurred for or on behalf of [entity represented or engaged by]. The services described in this Application are actual, necessary services and the compensation requested for those services is reasonable. The expenses described in this Application are actual, necessary expenses. [Additional numbered paragraphs may be used by the Applicant to set forth other statements or information.] Part B General Information 1. Period xx/xx/xx to xx/xx/xx Final Application ________ Interim Application ________ Fees Expenses Total 2. General Information a. Date case filed: xx/xx/xx b. Date application to approve employment filed: xx/xx/xx c. Date employment approved: xx/xx/xx d. First date services rendered in the case: xx/xx/xx

3. 4.

Requested $________ $________ $________

e. Compensation request is under 330: _____ Yes _____ No If other statutory basis, specify: ________ f. Any fees awarded will be paid from the estate: ______ Yes ______ No If no, state the source of payment of any fee that is awarded. ________________________________________ g. This application is for a period less than 120 days after the filing of the case or less than 120 days after the end of the period of the last application. _____ Yes _____ No

If yes, state date and terms of court order allowing filing at shortened intervals. Order date: xx/xx/xx Terms, if any,_______________________________________________ ___________________________________________________________ 3. Prior Applications First Application Period xx/xx/xx to xx/xx/xx Date of Order xx/xx/xx Requested Fees Expenses $________ $________ Allowed $________ $________ Paid $________ $________ Due $________ $________

Second Application Period Date of Order xx/xx/xx xx/xx/xx to xx/xx/xx Fees $________ $________ Expenses Grand Totals $ $________ $ $________

$________ $ $________

$_________ $ $_________

4. Attorneys' Billing for Current Period Name _______________ etc. Grand Total 5. Paralegals Billing for Current Period Name _______________ Grand Totals 6. Billing Rates a. Are any of the billing rates different than the billing rates set forth in your last application? _____ Yes _____ No b. If yes, indicate whose billings rates are different and explain why? _____________________________________________________________ __________________________________________________________________ __________________________________________________________________ Part C Billing Summary 1. Description of Services. Provide adequate detail appropriate for the amount of time billed and the nature and variety of the services rendered. Hours ________ ________ Billing Rate ________ Total ________ $ ________ Admitted ________ etc. Hours _____ etc. _____ Billing Rate ________ etc. Total $________ etc. $________

2. Detail of Hours Expended. Set forth in list form or attach a list that shows the name of the professional or paraprofessional, date, activity, and time expended. The list may be organized in either of two ways. (a) By each professional or paraprofessional in chronological order for the application period; or (b) By day in chronological order showing all professionals or paraprofessionals that billed time on a particular day during the application period. * * * * * * *

Category Reporting. If category reporting of time expended is required under L.B.R. 2016-3(c), only categories for which services were rendered during the period covered by the application should be included. A separate Description of Services and Detail of Hours Expended shall be provided for each category. Part D Expense Summary Set forth in list form or attach a list that shows the type of expenses for which reimbursement is sought. For each type of expense either (a) state the amount of the expense that is calculated using the applicant's in-house actual cost or the actual amount billed by a third party provider, or (b) explain how the amount of the expense is calculated.

WHEREFORE, Applicant requests an award of $ ___________ in compensation and of $ ____________ in reimbursement of actual, necessary expenses.


Signed:_________________________ Applicant By: ____________________________ Name Address Phone No. ( ) Fax No. ( )