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Official Form 20B (12/03)

United States Bankruptcy Court
_______________ District Of _______________
In re __________________________________________, Set forth here all names including married, maiden, and trade names used by debtor within last 6 years.] Debtor ) ) ) ) ) )

Case No. ________________

Address ___________________________________________ ___________________________________________ Employer's Tax Identification (EIN) No(s). [if any]: ________ __________________________________________________ Last four digits of Social Security No(s).: ________________

)
) ) ) ) ) ) Chapter ___________

NOTICE OF OBJECTION TO CLAIM ____________________ has filed an objection to your claim in this bankruptcy case. Your claim may be reduced, modified, or eliminated. You should read these papers carefully and discuss them with your attorney, if you have one. If you do not want the court to eliminate or change your claim, then on or before your lawyer must: {If required by local rule or court order.} [File with the court a written response to the objection, explaining your position, at: {address of the bankruptcy clerk's office} If you mail your response to the court for filing, you must mail it early enough so that the court will receive it on or before the date stated above. You must also mail a copy to: {objector's attorney's name and address} {names and addresses of others to be served}] Attend the hearing on the objection, scheduled to be held on (date), (year) , at a.m./p.m. in Courtroom , United States Bankruptcy Court, {address}. If you or your attorney do not take these steps, the court may decide that you do not oppose the objection to your claim. (date) , you or

Date: _________________

Signature: _________________________ Name: Address: