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RECEIVED FORM B10(Official Form 10)(4. 1) CT "' INSTRUI,TIONS FOR PROOF OF CLAIM FORM � The instructions and definitions below are general explanations of the law. In particular types of cases orcimumstances,such as bankruptcy $ tikes that are not filed voluntarily by a debtor,there may be exceptions to these general rules. OFHCE ----DEFINITIONS---- Debtor Secured Claim Unsecured Claim The person, corporation, or other entity that A claim is a secured claim to the extent that If a claim is not a secured claim it is an has filed a bankruptcy case is called the the creditor has lien on property of the unsecured claim. A claim may be partly debtor. debtor (collateral) that gives the creditor the secured and partly unsecured if the property on right to be paid from that property before. which a creditor has a lien is not worth enough Creditor creditors who do not have liens on the to pay the creditor in full. property. A creditor is any person,corporation, or other Unsecured Priority Claim entity to whom the debtor owed a debt on the Examples of liens are a mortgage on real date that the bankruptcy case was filed. estate and a security interest in a car, truck, Certain types of unsecured claims are given boat, television set,or other item of property. priority, so they arc to be paid in bankruptcy Proof of Claim A lien may have been obtained through a cases before most other unsecured claims (ff court proceeding before the bankruptcy case there is sufficient money or property available A form telling the bankruptcy court how began; in some states a court judgment is a to pay these claims). The most common types much the debtor owed a creditor at the time lien. In addition, to the extent a creditor also of priority claims are listed on the proof of the bankruptcy case was filed (the amount of owes money to the debtor (has a right of claim form. Unsecured claims that arc not the creditor's claim). This form must be filed setoff), the creditor's claim may be a secured specifically given priority status by the with the clerk of the bankruptcy court where el-aim.(See also Un.serured Claim bankruptcy laws ate classified as Unsecured the bankruptcy case was filed. Nonpriority Claims. Items to be completed in Proof of Claim form (if not already filled in) Court,Name of Debtor,and Case Number: 4.Total Amount of Claim at Time Case Filed: Fill in the name of the federal judicial district where the Fill in the total amount of the entire claim. If interest or other bankruptcy case was filed (for example, Central District of charees in addition to the principal amount of the claim are California), the time of the debtor in the bankruptcy case, and included, check the appropriate place on the form and attach an the bankruptcy case number. If you received a notice of the itemization of the interest and charges. case from the court, all of this information is near the top of the notice. S.Secured Claim: Check the appropriate place if the claim is a secured claim. You Information about Creditor: must state the type and value of property that is collateral for the Complete the section giving the time, address, and telephone claim, attach copies of the documentation of your lien, and slate the number of the creditor to whom the debtor owes money or amount past due on the claim as of the date the bankruptcy case was property, and the debtor's account number, if any. If anyone filed. A claim may be partly secured and partly unsecured. (See else has already filed a proof of claim relating to this debt,if you DEF=ONS,above). never received notices from the bankruptcy court about this case, if your address differs from that to which the court sent notice,or 6.Unsecured Priority Claim: if this proof of claim replaces or changes a proof of claim that was already filed,check the appropriate box on the form. Check the appropriate place if you have an unsecured priority claim, and state the amount entitled to priority. (See DEFINITIONS, 1.Basis for Claim: above). A claim may be partly priority and partly nonpriority if, for Check the type of debt for which the proof of claim is being example, the claim is for more than the amount given priority by the filed. If the type of debt is not listed, check"Other"and briefly law. Check the appropriate place to specify the type of priority describe the type of debt. If you were an employee of the claim. debtor, fill in your social security number and the dates of work for which you were not paid. 7.Credits: By signing this proof of claim, you am stating under oath that in 2.Date Debt Incurred: calculating the amount of your claim you have given the debtor Fill in the date when the debt first was owed by the debtor. credit for all payments received from the debtor. 3.Court Judgments: 8.Supporting Documents: If you have a court judgment for this debt, state the date the You must attach to this proof of claim form copies of documents that court entered the judgment. show the debtor owes the debt claimed or, if the documents are tau lengthy, a summary of those documents. If documents are not available, you must attach an explanation of why they are not available. 006819 74004006833023