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B 261A (8/96)

United States Bankruptcy Court
________________________District Of_____________________
In re _________________________________________, Debtor ) ) ) ) ) ) ) ) ) )

Case No. ___________________ Chapter ____________________

_______________________________________, Plaintiff v. _______________________________________, Defendant

Adv. Proc. No. ______________

JUDGMENT BY DEFAULT

Default was entered against defendant ___________________________________________
(name)

on _________________. The plaintiff has requested entry of judgment by default and has filed an
(date)

affidavit of the amount due and stating that this defendant is not in the military service. Furthermore, it appears from the record that this defendant is not an infant or incompetent person. Therefore, pursuant to Fed. R. Civ. P. 55(b)(1), as incorporated by Fed. R. Bankr. P. 7055, judgment is entered against this defendant in favor of the plaintiff as follows:

_________________________ (Date)

_________________________________________________________ (Clerk of the Bankruptcy Court)