Monthly Financial Report (Chapter 11)

DEBTOR: CASE NUMBER: Form 2-A MONTHLY OPERATING REPORT CHAPTER 11 COVER SHEET For Period Ending _______________________ Accounting Method: Accrual Basis Cash Basis THIS REPORT IS DUE 14 DAYS AFTER THE END OF THE MONTH Debtor must attach each of the following reports/documents unless the U. S. Trustee Mark One Box for Each Required Document: Report/Document Attached Previously Waived has waived the requirement in writing. File the original with the Clerk of Court. Submit a duplicate, with original signature, to the U. S. Trustee. REQUIRED REPORTS/DOCUMENTS 1. Cash Receipts and Disursements Statement (Form 2-B) 2. Balance Sheet (Form 2-C) 3. Profit and Loss Statement (Form 2-D) 4. Supporting Schedules (Form 2-E) 5. Quarterly Fee Summary (Form 2-F) 6. Narrative (Form 2-G) 7. Bank Statements for All Bank Accounts IMPORTANT: Redact account numbers and remove check images 8. Bank Statement Reconciliations for all Bank Accounts I declare under penalty of perjury that the following Monthly Operating Report, and any attachments thereto are true, accurate and correct to the best of my knowledge and belief. Executed on: Print Name: Signature: Title: Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-B CASE NO: CASH RECEIPTS AND DISBURSEMENTS STATEMENT For Period: CASH FLOW SUMMARY to Current Month $ (1) $ Accumulated (1) 1. Beginning Cash Balance 2. Cash Receipts Operations Sale of Assets Loans/advances Other Total Cash Receipts 3. Cash Disbursements Operations Debt Service/Secured loan payment Professional fees/U.S. Trustee fees Other Total Cash Disbursements 4. Net Cash Flow (Total Cash Receipts less Total Cash Disbursements) 5 Ending Cash Balance (to Form 2-C) $ $ $ $ $ (2) $ (2) CASH BALANCE SUMMARY Financial Institution Petty Cash DIP Operating Account DIP State Tax Account DIP Payroll Account Other Operating Account Other Interest-bearing Account TOTAL (must agree with Ending Cash Balance above) $ $ Book Balance (2) (1) Accumulated beginning cash balance is the cash available at the commencement of the case. Current month beginning cash balance should equal the previous month's ending balance. (2) All cash balances should be the same. Page 1 of 3 Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-B CASE NO: CASH RECEIPTS AND DISBURSEMENTS STATEMENT For Period: ____________ to ___________ CASH RECEIPTS DETAIL (attach additional sheets as necessary) Date Payer Account No: Description $ Amount Total Cash Receipts $ (1) (1) Total for all accounts should agree with total cash receipts listed on Form 2-B, page 1 Page 2 of 3 Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-B CASE NO: CASH RECEIPTS AND DISBURSEMENTS STATEMENT For Period: to CASH DISBURSEMENTS DETAIL (attach additional sheets as necessary) Date Check No. Payee Account No: Description (Purpose) $ Amount Total Cash Disbursements $ (1) (1) Total for all accounts should agree with total cash disbursements listed on Form 2-B, page 1 Page 3 of 3 Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-C CASE NO: COMPARATIVE BALANCE SHEET For Period Ended: Current Month Petition Date (1) ASSETS Current Assets: Cash (from Form 2-B, line 5) Accounts Receivable (from Form 2-E) Receivable from Officers, Employees, Affiliates Inventory Other Current Assets :(List) $ $ Total Current Assets Fixed Assets: Land Building Equipment, Furniture and Fixtures $ $ $ $ Total Fixed Assets Less: Accumulated Depreciation ( $ )( $ ) Net Fixed Assets Other Assets (List): TOTAL ASSETS LIABILITIES Post-petition Accounts Payable (from Form 2-E) Post-petition Accrued Profesional Fees (from Form 2-E) Post-petition Taxes Payable (from Form 2-E) Post-petition Notes Payable Other Post-petition Payable(List): $ $ $ $ Total Post Petition Liabilities Pre Petition Liabilities: Secured Debt Priority Debt Unsecured Debt $ $ Total Pre Petition Liabilities TOTAL LIABILITIES OWNERS' EQUITY Owner's/Stockholder's Equity Retained Earnings - Prepetition Retained Earnings - Post-petition $ $ $ $ $ $ TOTAL OWNERS' EQUITY TOTAL LIABILITIES AND OWNERS' EQUITY listed on the Debtor's schedules. $ $ $ $ Page 1 of 1 Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com (1) Petition date values are taken from the Debtor's balance sheet as of the petition date or are the values DEBTOR: Form 2-D PROFIT AND LOSS STATEMENT For Period to Current Month CASE NO: Accumulated Total (1) $ Gross Operating Revenue Less: Discounts, Returns and Allowances $ ( $ ) ( $ ) Net Operating Revenue Cost of Goods Sold Gross Profit Operating Expenses Officer Compensation Selling, General and Administrative Rents and Leases Depreciation, Depletion and Amortization Other (list): $ $ $ $ Total Operating Expenses Operating Income (Loss) Non-Operating Income and Expenses Other Non-Operating Expenses Gains (Losses) on Sale of Assets Interest Income Interest Expense Other Non-Operating Income $ $ $ $ $ $ Net Non-Operating Income or (Expenses) Reorganization Expenses Legal and Professional Fees Other Reorganization Expense $ $ $ $ Total Reorganization Expenses Net Income (Loss) Before Income Taxes Federal and State Income Tax Expense (Benefit) NET INCOME (LOSS) $ $ $ $ $ $ (1) Accumulated Totals include all revenue and expenses since the petition date. Page 1 of 1 Rev. 12/10/2009 American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-E SUPPORTING SCHEDULES For Period: to CASE NO: POST PETITION TAXES PAYABLE SCHEDULE Beginning Balance (1) Income Tax Withheld: Federal $ State FICA Tax Withheld Employer's FICA Tax Unemployment Tax Federal State Sales, Use & Excise Taxes Property Taxes Accrued Income Tax: Federal State Other: TOTALS $ $ $ $ Amount Accrued Amount Paid Date Paid Check Number Ending Balance $ $ $ (1) For first report, Beginning Balance will be $0; thereafter, Beginning Balance will be Ending Balance from prior report. INSURANCE SCHEDULE Carrier Workers' Compensation General Liability Property (Fire, Theft) Vehicle Other (list): $ $ $ $ $ $ Amount of Coverage Expiration Date $ $ $ $ $ $ Page 1 of 2 Rev. 12/10/2009 Premium Paid Through American LegalNet, Inc. www.FormsWorkFlow.com DEBTOR: Form 2-E SUPPORTING SCHEDULES CASE NO: For Period: ________________ to ________________ ACCOUNTS RECEIVABLE AND POST PETITION PAYABLE AGING Due Under 30 days 30 to 60 days 61 to 90 days 91 to 120 days Over 120 days Total Post Petition Pre Petition Amounts Total Accounts Receivable Less: Bad Debt Reserve