US Trustee Basic Monthly Operating Report (Small Business)

U.S. Trustee Basic Monthly Operating Report Case Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Case N u m b e r : - - - - - - - - - - - - - - - Date F i l e d : - - - - - - - - - - - - SIC C o d e : - - - - - - - - - - - - - - Month (or portion) covered by this r e p o r t : - - - - - - - IN ACCORDANCE WITH TITLE 28, SECTION 1746, OF THE UNITED STATES CODE, I DECLARE UNDER PENAL TY OF PERJURY THAT I HAVE EXAMINED THIS U.S. TRUSTEE BASIC MONTHLY OPERATING REPORT AND THE ACCOMPANYING ATTACHMENTS ON BEHALF OF THE CHAPTER 11 DEBTOR AND, TO THE BEST OF MY KNOWLEDGE, THIS REPORT AND RELATED DOCUMENTS ARE TRUE, CORRECT AND COMPLETE. ORIGINAL SIGNATURE OF RESPONSIBLE PARTY DATE REPORT SIGNED PRINTED NAME OF RESPONSIBLE PARTY AND POSITION WITH DEBTOR The debtor is required to provide financial reports prepared by or for the debtor in addition to the information required by this form. The U.S. Trustee may permit the debtor to eliminate duplicative information. No such permission is valid unless in writing. QUESTIONNAIRE: 1. IS THE BUSINESS STILL OPERATING? 2. DID YOU SELL ANY ASSETS OTHER THAN INVENTORY THIS MONTH? YES NO D D D D D D D D D D D D D D D D D D D D D D D D 3. HAVE YOU PAID ANY BILLS YOU OWED BEFORE YOU FILED BANKRUPTCY? 4. DID YOU PAY ANYTHING TO YOUR ATTORNEY OR OTHER PROFESSIONALS THIS MONTH? 5. DID YOU PAY ALL YOUR BILLS ON TIME THIS MONTH? 6. DID YOU PAY YOUR EMPLOYEES ON TIME? 7. HAVE YOU FILED ALL OF YOUR RETURNS AND PAID ALL OF YOUR TAXES THIS MONTH? 8. DID YOU PAY ALL OF YOUR INSURANCE PREMIUMS THIS MONTH? 9. DID ANY INSURANCE COMPANY CANCEL YOUR POLICY THIS MONTH? 10. HAVE YOU BORROWED MONEY FROM ANYONE THIS MONTH? 11. DO YOU HAVE ANY BANK ACCOUNTS OPEN OTHER THAN THE DIP ACCOUNT? 12. DID YOU HAVE ANY UNUSUAL OR SIGNIFICANT UNANTICIPATED EXPENSES THIS MONTH? 1 American LegalNet, Inc. www.FormsWorkFlow.com Yes 13. DID YOU DEPOSIT ALL MONEY FOR YOUR BUSINESS INTO THE DIP ACCOUNT THIS MONTH? 14. DID THE BUSINESS SELL ANY GOODS OR PROVIDE SERVICES TO ANY BUSINESS RELATED TO THE DIP IN ANY WAY? 15. DO YOU PLAN TO CONTINUE TO OPERATE THE BUSINESS NEXT MONTH? 16. ARE YOU CURRENT ON YOUR QUARTERLY FEE PAYMENT TO THE UST? No D D D D D D D D TAXES DO YOU HAVE ANY PAST DUE TAX RETURNS OR PAST DUE POST-PETITION TAX OBLIGATIONS? IF YES, PLEASE PROVIDE A WRITIEN EXPLANATION INCLUDING WHEN SUCH RETURNS WILL BE FILED, OR WHEN SUCH PAYMENTS WILL BE MADE AND THE SOURCE OF THE FUNDS FOR THE PAYMENT. (Exhibit A) D D INCOME PLEASE SEPARATELY LIST ALL OF THE INCOME YOU RECEIVED FOR THE MONTH. THE LIST SHOULD INCLUDE ALL INCOME FROM CASH AND CREDIT TRANSACTIONS. [If you use an automated accounting system, please attach a copy of the Income Statement and Balance Sheet.] TOTAL INCOME (Exhibit 8) EXPENSES PLEASE SEPARATELY LIST ALL EXPENSES PAID BY CASH OR BY CHECK FROM YOUR BANK ACCOUNTS PAID THIS MONTH. INCLUDE THE DATE PAID, WHO WAS PAID THE MONEY, THE PURPOSE AND THE AMOUNT. [If you use an automated accounting system, please attach a copy of the Disbursements Journal, otherwise attach a copy of the check register. ] TOTAL EXPENSES (Exhibit C) CASH PROFIT INCOME FOR THE MONTH (TOTAL FROM EXHIBIT B) EXPENSES FOR THE MONTH (TOTAL FROM EXHIBIT C) (Subtract The Total from Exhibit C from the Total of Exhibit B) CASH PROFIT FOR THE MONTH 2 American LegalNet, Inc. www.FormsWorkFlow.com UNPAID BILLS PLEASE ATIACH A LIST OF ALL DEBTS (INCLUDING TAXES) WHICH YOU HAVE INCURRED SINCE THE DATE YOU FILED BANKRUPTCY BUT HAVE NOT PAID. THE LIST MUST INCLUDE THE DATE THE DEBT WAS INCURRED, WHO IS OWED THE MONEY, THE PURPOSE OF THE DEBT AND WHEN THE DEBT IS DUE. TOTAL PAYABLES (Exhibit D) MONEY OWED TO YOU PLEASE ATIACH A LIST OF ALL AMOUNTS OWED TO YOU BY YOUR CUSTOMERS FOR WORK YOU HAVE DONE OR THE MERCHANDISE YOU HAVE SOLD. YOU SHOULD INCLUDE WHO OWES YOU MONEY, HOW MUCH IS OWED AND WHEN IS PAYMENT DUE. TOTAL RECEIVABLES (EXHIBJTE) BANKING INFORMATION PLEASE ATIACH A COPY OF YOUR LATEST BANK STATEMENT FOR EVERY ACCOUNT YOU HAVE AS OF THE DATE OF THIS FINANCIAL REPORT. EMPLOYEES NUMBER OF EMPLOYEES WHEN THE CASE WAS FILED? NUMBER OF EMPLOYEES AS OF THE DATE OF THIS MONTHLY REPORT? PROFESSIONAL FEES TOTAL PROFESSIONAL FEES APPROVED BY THE COURT DURING THIS REPORTING PERIOD? TOTAL PROFESSIONAL FEES APPROVED BY THE COURT SINCE THE FILING OF THE CASE? TOTAL PROFESSIONAL FEES INCURRED BY OR ON BEHALF OF THE DEBTOR DURING THIS REPORTING PERIOD? TOTAL PROFESSIONAL FEES INCURRED BY OR ON BEHALF OF THE DEBTOR SINCE THE FILING OF THE CASE? PROFESSIONAL FEES INCURRED BY OR ON BEHALF OF THE DEBTOR RELATED TO BANKRUPTCY DURING THIS REPORTING PERIOD? PROFESSIONAL FEES INCURRED BY OR ON BEHALF OF THE DEBTOR RELATED TO BANKRUPTCY SINCE THE FILING OF THE CASE? 3 American LegalNet, Inc. www.FormsWorkFlow.com PROJECTIONS COMPARE YOUR ACTUAL INCOME, EXPENSES AND THE CASH PROFIT TO THE PROJECTIONS FOR THE FIRST 180-DAYS OF YOUR CASE PROVIDED ATTHE INITIAL DEBTOR INTERVIEW. PROJECTED INCOME FOR THE MONTH: ACTUAL INCOME FOR THE MONTH (EXHIBIT B): DIFFERENCE BETWEEN PROJECTED AND ACTUAL INCOME: PROJECTED EXPENSES FOR THE MONTH: TOTAL ACTUAL EXPENSES FOR THE MONTH (EXHIBIT C): DIFFERENCE BETWEEN PROJECTED AND ACTUAL EXPENSES: PROJECTED CASH PROFIT FOR THE MONTH: ACTUAL CASH PROFIT FOR THE MONTH (TOTAL FROM EXHIBIT B MINUS TOTAL FROM EXHIBIT C) DIFFERENCE BETWEEN PROJECTED AND ACTUAL CASH PROFIT: [If actual cash profit was 90% or less of projected cash profit, please attach a detailed written explanation.] 4 American LegalNet, Inc. www.FormsWorkFlow.com