Report On Ballots And Administrative Expenses (Chapter 11)

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.United States Bankruptcy CourtJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)District of ConnecticutIn re:Case No:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Debtor(s)Chapter 11THE PEOPLE OF THE STATE OF NEW YORK TOREPORT ON BALLOTS AND ADMINISTRATIVE EXPENSESImpairedNumberAmount orNumberNumberAmountNumberAmountNumberAmountNeededNeeded unimpairedEligibleVotingVotingAcceptAcceptRejectRejectFor Conf.For Conf.GREETINGS:Class 1: Class 2: Class 3: Class 4: Class 5: Class 6: Class 7: Class 8: Class 9: Class 10: Class 11: Class 12: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forClass:Stockholders: Total number Number Voting Number AcceptsOffice and P.O. AddressPLEASE INDICATE ABOVE, UNDER EACH CLASS, WETHER SECURED, PRIORITY, OR UNSECUREDTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>