2016-04-22_GENERAL DOCUMENTS - C1994082

• Permit No: C1994082A
• IBM Index Class Name: General Documents
• Doc Date: 4/22/2016
• Doc Name: Notice of Deadlines for Filining Proof of Claim
• From: United State Bankruptcy Court
• To: DRMS
• Permit Index Doc Type: General Correspondence
• Email Name: MPB
• Email Name: JRS
• Email Name: JHB
• Media Type: D
• Archive: Yes

*Please see Schedule 1 for a complete list of Debtor Entities
Official Form 410
Proof of Claim
Read the instructions before filling out this form. This form is for making a claim for payment in a bankruptcy case. Do not use this form to
make a request for payment of an administrative expense. Make such a request according to 11 U.S.C. § 503.
Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents. Attach redacted copies of any
documents that support the claim, such as promissory notes, purchase orders, Invoices, itemized statements of running accounts, contracts, judgments,
mortgages, and security agreements. Do not send original documents; they may be destroyed after scanning. If the documents are not available,
explain In an attachment.
A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571.
Fill in all the information about the claim as of the date the case was filed. That date is on the notice of bankruptcy (Form 309) that you received.
® Identify the Claim
1.
Who is the current
creditor?
State of Colorado Department of Natural Resources
Name of the current creditor (the person or entity to be paid for this claim)
Other names the creditor used with the debtor
2.
Has this claim been
❑ No
acquired from
❑ Yes. From whom?
someone else?
3.
Where should notices
Where should notices to the creditor be sent?
Where should payments to the creditor be sent? (if
and payments to the
different)
creditor be sent?
State of Colorado Department of Natural Resources
Federal Rule of
1313 Sherman Street Room 215
Bankruptcy Procedure
Denver CO 80203
Name
(FRBP) 2002(g)
Number Street
City State ZIP Code
Contact phone
Contact phone
Contact email
Contact email
4.
Does this claim amend
❑ No
one already filed?
❑ Yes. Claim number on court claims registry (ifknown)
Filed on
MM / DD / YYYY
5.
Do you know if anyone
❑ No
else has filed a proof
❑ Yes. Who made the earlierfiling?
of claim for this claim?
MML ID: 1823085
Official Form 410 Proof of Claim page 1