Request For Email Notification Of Debtor {MSSB-9036}

MSSB-9036 (07/2015) United States Bankruptcy Court Southern District of Mississippi In re: Bankruptcy No: Request for Email Notification of Debtor This is a free service that enables a debtor to receive court notices and orders from the bankruptcy court, via email instead of U.S. mail. A debtor must complete and file this form with the court to activate, update, or deactivate an email account. Joint debtors must each file a separate request. Section 1 - Activate a Debtor Email Account Pursuant to Fed. R. Bankr. P. 9036, I request delivery of court notices and orders to my email address, instead of U.S. mail. Select one: I am the Debtor. The Debtor is a business and I am its authorized representative. email: (Use CAPITAL letters) Name: Type or Print debtor's name and email address. Section 2 - Change/Update Debtor Email Account I request the following update(s) to my account. New email address: Use CAPITAL letters Acct. # I have a new bankruptcy case. Please review my account to ensure my name, email address, and mailing address match my new case. I request reactivation of my account so that I may receive court notices and orders via email instead of U.S. mail. Section 3 - Deactivate Debtor Email Account I request deactivation of my account. Debtor Agreement to Conditions 1. 2. 3. 4. I understand that my request is limited to email delivery of court notices and orders that are filed by the Bankruptcy Court. I will continue to receive documents filed by all other parties, such as trustee and creditors, via U.S. mail or in person pursuant to court rules. I understand by requesting email notification the court may email court notices and orders filed by the court in any bankruptcy court in which I am listed as a party with the same name and address associated with my email account. I understand that my Debtor Email account will not be activated and an account number assigned unless I complete the activation process, receive a confirmation email from the BNC, and click on the link in the confirmation email. I understand that the first time the Bankruptcy Court receives an email bounce-back (undeliverable email) my Debtor Email account will be automatically disabled; the Court will begin delivering court notices and orders to my mailing address on file with the court (via U.S. mail); and, if I wish to reactivate my Debtor Email account I must file an updated request form. I understand if I update my name or address in the above-referenced case a corresponding change will be made to my associated Debtor Email account. I understand that enrollment in Debtor Email is completely voluntary, and I may file a request to deactivate my account at any time. Acct. # I understand that by deactivating my account, I will receive court notices and orders by U.S. mail. 5. 6. I certify under penalty of perjury that I am the debtor or the debtor's authorized representative. I acknowledge that I have read and agree to the terms and conditions above and that neither the U.S. Bankruptcy Court nor the BNC bears any liability for errors resulting from the information I have submitted on this form. Date: Debtor's Signature Print Debtor's Name Phone No.: If not represented by an attorney) For more information visit the court's web page: www.mssb.uscourts.gov American LegalNet, Inc. www.FormsWorkFlow.com