MTRUCTIONS FOR PROOF OF CLAIM FORAM
<br />The instructions and definitions below are general explan s ofthe law. In certain circumstances, such as banlauptcy cos filed voluntarily by the debtor, there may be exceptions
<br />to these general rules.
<br />Items to be completed in Proof of Claim form
<br />Name of Debtor, and Case Number;
<br />Fill in the name of the Debtor in the bankruptcy case, and the bankruptcy case number
<br />Name of Debtor
<br />Case Number
<br />Buffets Restaurants Holdings, Inc.
<br />12-10237
<br />Buffets Holdings, Inc.
<br />12-10238
<br />Buffets, Inc.
<br />12-10239
<br />Hometown Buffet, Inc.
<br />12-10240
<br />OCB Purchasing Co.
<br />12-10241
<br />OCB Restaurant Company, LLC
<br />12-10242
<br />Buffets Franchise Holdings, LLC
<br />12-10243
<br />Buffets Leasing Company, LLC
<br />12-10244
<br />Ryan's Restaurant Group, Inc.
<br />12-10245
<br />Ryan's Restaurant Leasing Company, LLC
<br />12-10246
<br />Hometown Leasing Company, LLC
<br />12-10247
<br />OCB Leasing Company, LLC
<br />12-10248
<br />Fire Mountain Restaurants, LLC
<br />12-10249
<br />Fire Mountain Leasing Company, LLC
<br />12-10250
<br />Tahoe Joe's, Inc.
<br />12-10251
<br />Tahoe Joe's Leasing Company, LLC
<br />12-10252
<br />Ifyour Claim is against multiple Debtors, complete a separate form for each Debtor.
<br />Creditor's Name and Address:
<br />Fill in the name of the person or entity asserting a claim and the name and address of the
<br />person who should receive notices issued during the bankruptcy case. A separate space is
<br />provided for the payment address if it differs from the notice address. The creditor has a
<br />continuing obligation to keep the court informed of its current address. See Federal Rule of
<br />Bankruptcy Procedure (FRBP) 2002(g).
<br />1. Amount of Claim as of Date Case Filed:
<br />State the total amount owed to the creditor on the date of the bankruptcy filing. Follow the
<br />instructions conceming whether to complete items 4 and 5. Check the box if interest or other
<br />charges are included in the claim.
<br />2. Basis for Claim:
<br />State the type of debt or how it was incurred. Examples include goods sold, money loaned,
<br />services performed, personal injury/wrongful death, car loan, mortgage note, and credit card
<br />If the claim is based on delivering health care goods or services, limit the disclosure of the
<br />goods or services so as to avoid embarrassment or the disclosure of confidential health care
<br />information. You maybe required to provide additional disclosure if an interested parry
<br />objects to the claim.
<br />3. Last Four Digits of Any Number by Which Creditor Identities Debtor:
<br />State only the last four digits of the debtor's account or other number used by the creditor to
<br />identify the debtor.
<br />3a. Debtor May Have Scheduled Account As:
<br />Report a change in the creditor's name, a transferred claim, or any other information
<br />that clarifies a difference between this proof of claim and the claim
<br />Debtor
<br />A debtor is the person, corporation, or other entity that has
<br />filed a bankruptcy case.
<br />Creditor
<br />A creditor is the person, corporation, or other entity owed a
<br />debt by the debtor on the date of the bankruptcy filing. See
<br />11 U.S.C. §101 (10).
<br />Claim
<br />A claim is the creditor's right to receive payment on a debt
<br />that was owed by the debtor on the date of the bankruptcy
<br />filing. See I 1 U.S.C. § 101 (5). A claim may be secured or
<br />unsecured.
<br />Proofof Claim
<br />A proof of claim is a form used by the creditor to indicate
<br />the amount of the debt owed by the debtor on the date of
<br />the bankruptcy filing. The creditor must file the form with
<br />the Claims Agent at one of the following addresses:
<br />If by First Class mail:
<br />Buffets Restaurants Claims Processing Center
<br />c/o Epiq Bankruptcy Solutions, LLC
<br />FDR Station, P.O. Box 5286
<br />New York, NY 10150.5286
<br />If by Hand Delivery or Overnight mail:
<br />Buffets Restaurants Claims Processing Center
<br />Go Epiq Bankruptcy Solutions, LLC
<br />757 Third Avenue, 3'a Floor
<br />New York, NY 10017
<br />4. Secured Claim:
<br />Check whether the claim is fully or partially secured. Skip this section if the claim is
<br />entirely unsecured. (See Definitions.) If the claim is secured, check the box for the nature
<br />and value of property that secures the claim, attach copies of lien documentation, and
<br />state, as of the date of the bankruptcy filing, the annual interest rate (and whether it is
<br />fixed or variable), and the amount past due on the claim.
<br />5. Amount of Claim Entitled to Priority Under 11 U.S.C. §507(a).
<br />If any portion of the claim falls into any category shown, check the appropriate boxes)
<br />and state the amount entitled to priority. (See Definitions.) A claim may be partly priority
<br />and partly non-priority. For example, in some of the categories, the law limits the amount
<br />entitled to priority.
<br />6. Amount of Claim that qualifies as an Administrative Expense under 11
<br />U.S.C. §503(b)(9)
<br />State the value of any goods received by the debtor within 20 days before the date
<br />of commencement in which the goods have been sold to the debtor in the ordinary course
<br />of the debtor's business.
<br />7. Credits:
<br />An authorized signature on this proof of claim serves as an acknowledgment that when
<br />calculating the amount of the claim, the creditor gave the debtor credit for any payments
<br />received toward the debt.
<br />8. Documents:
<br />Attach redacted copies of any documents that show the debt exists and a lien secures the
<br />debt. You must also attach copies of documents that evidence perfection of any security
<br />interest. You may also attach a summary in addition to the documents themselves. FRBP
<br />3001(c) and (d). If the claim is based on delivering health care goods or services, limit
<br />disclosing confidential health care information. Do not send original documents, as
<br />attachments may be destroyed after scanning.
<br />9. Date and Signature:
<br />The individual completing this proof of claim must sign and date it. FR13P 9011. If the
<br />claim is filed electronically, FRBP 5005(a)(2) authorizes courts to establish local rules
<br />specifying what constitutes a signature. If you sign this form, you declare under penalty of
<br />perjury that the information provided is true and correct to the best of your knowledge,
<br />information, and reasonable belief. Your signature is also a certification that the claim
<br />meets the requirements of FRBP 9011(b). Whether the claim is filed electronically or in
<br />person, if your name is on the signature line, you are responsible for the declaration. Print
<br />the name and title, if any, of the creditor or other person authorized to file this claim. State
<br />the filer's address and telephone number if it differs from the address given on the top of
<br />the form for purposes of receiving notices. If the claim is filed by an authorized agent,
<br />attach a complete copy of any power of attorney, and provide both the name of the
<br />individual filing the claim and the name of the agent. If the authorized agent is a servicer,
<br />identify the corporate servicer as the company. Criminal penalties apply for making a
<br />false statement on a proof of claim.
<br />Secured Claim Under 11 U.S.C. §506(a)
<br />A secured claim is one backed by a lien on property of the
<br />debtor. The claim is secured so long as the creditor has the
<br />right to be paid from the property prior to other creditors.
<br />The amount of the secured claim cannot exceed the value
<br />of the property. Any amount owed to the creditor in excess
<br />of the value of the property is an unsecured claim.
<br />Examples of liens on property include a mortgage on real
<br />estate or a security interest in a car. A lien may be
<br />voluntarily granted by a debtor or may be obtained through
<br />a court proceeding. In some states, a courtjudgment is a
<br />lien. A claim also may be secured if the creditor owes the
<br />debtor money (has a right to setoff).
<br />Unsecured Claim
<br />An unsecured claim is one that does not meet the
<br />requirements of a secured claim. A claim may be partly
<br />unsecured if the amount of the claim exceeds the value of
<br />the property on which the creditor has a hen.
<br />Claim Entitled to Priority Under 11 U.S.C. §507(x)
<br />Priority claims are certain categories of unsecured claims
<br />that are paid from the available money or property in a
<br />bankruptcy case before other unsecured claims.
<br />Redacted
<br />A document has been redacted when the person filing it
<br />has masked, edited out, or otherwise deleted, certain
<br />information. A creditor should redact and use only the last
<br />four digits of any social -security, individual's tax
<br />identification, or financial -account number, all but the
<br />initials of a minor's name and only the year of any
<br />person's date of birth.
<br />Evidence of Perfection
<br />Evidence of perfection may include a mortgage, lien,
<br />certificate of title, financing statement, or other document
<br />showing that the lien has been filed or recorded.
<br />INFORMATION
<br />Acknowledgment of Filing of Claim
<br />To receive acknowledgment of your filing, you may either
<br />enclose a stamped self-addressed envelope and a copy of this
<br />proof of claim or you may access the Claims Agent's system
<br />Qutu'//dm.ePigI LcomBaIToIs) to view your filed proof of
<br />claim.
<br />Offers to Purchase a Claim
<br />Certain entities are in the business ofpurehasing claims for
<br />an amount less than the face value of the claims. One or more
<br />of these entities may contact the creditor and offer to
<br />purchase the claim. Some of the written communications
<br />from these entities may easily be confused with official court
<br />documentation or communications from the debtor. These
<br />entities do not represent the bankruptcy court or the debtor.
<br />The creditor has no obligation to sell its claim. However, if
<br />the creditor decides to sell its claim, any transfer of such
<br />claim is subject to FRBP 3001(a), any applicable provisions
<br />of the Bankruptcy Code (I 1 U.S.C. § 101 et seq.), and any
<br />applicable orders of the bankruptcy court.
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