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

12. Is all or part of the claim ❑ No
entitled to priority under
11 U.S.C. § 507(a)? ❑Yes. Check one: Amount entitled to priority
A claim may be partly
priority and partly
nonpriority. For example,
in some categories, the
law limits the amount
entitled to priority.
13. Is all or part of the
claim entitled to
administrative priority
pursuantto
11 U.S.C. § 503(b)(9)?
Sign Below
❑ Domestic support obligations (including alimony and child support) under
11 U.S.C. § 507(a)(1)(A) or (a)(1)(B).
❑ Up to $2,775* of deposits toward purchase, lease, or rental of property or servicesfor
personal, family, or household use. 11 U.S.C. § 507(a)(7).
❑ Wages, salaries, or commissions (up to $12,475*) earned within 180 days beforethe
bankruptcy petition is filed or the debtor's business ends, whichever is earlier.
11 U.S.C. § 507(a)(4).
❑ Taxes or penalties owed to governmental units. 11 U.S.C. § 507(a)(8).
❑ Contributions to an employee benefit plan. 11 U.S.C. § 507(a)(5).
❑ Other. Specify subsection of 11 U.S.C. § 507(a)( ) that applies.
*Amounts are subject to adjustment on 4/01/16 and every 3 years after that for cases begun on or after the date of adjustment.
❑ No
❑ Yes. Indicate the amount of your claim arising from the value of any goods received
by the Debtor within 20 days before the date of commencement of the above case, in
which the goods have been sold to the Debtor in the ordinary course of such
Debtor's business. Attach documentation supporting such claim.
Please include the following: (i) the particular goods (the "503(b)(9) Goods") on which the 503(b)(9) Claim is
based, (ii) the date the 503(b)(9) Goods were delivered to the Debtors, (iii) the invoice numbers and/or purchase
order numbers applicable to the 503(b)(9) Goods be accompanied by the applicable invoice(s) and bill(s) of
lading or other documentation establishing proof of delivery and proof of the date of delivery.
The person completing
Check the appropriate box:
this proof of claim must
sign and date it.
❑ I am the creditor.
FRBP 9011(b).
❑ I am the creditor's attorney or authorized agent
If you file this claim
❑ I am the trustee, or the debtor, or their authorized agent. Bankruptcy Rule 3004.
electronically, FRBP
❑ I am a guarantor, surety, endorser, or other codebtor. Bankruptcy Rule 3005.
5005(a)(2) authorizes courts
to establish local rules
I understand that an authorized signature on this Proof of Claim serves as an acknowledgment that when calculatingthe
specifying what a signature
amount of the claim, the creditor gave the debtor credit for any payments received toward thedebt.
is.
I have examined the information in this Proof of Claim and have a reasonable belief that the information is true
A person who files a
and correct.
fraudulent claim could be
I declare under penalty of perjury that the foregoing is true and correct.
fined up to $500,000,
imprisoned for up to 5
years, or both.
Executed on date (mm/dd/yyyy)
18 U.S.C. §§ 152, 157, and
3571.
Signature
Print the name of the person who is completing and signing this claim:
Name
First name Middle name Last name
Title
Company
Identify the corporate servicer as the company if the authorized agent is a servicer.
Address
Number Street
City State ZIP Code
Contact phone Email
Official Form 410 Proof of Claim page 3