Application By Counsel To The Debtor For Compensation {17}

OFFICIAL LOCAL FORM 17 APPLICATION BY COUNSEL TO THE DEBTOR FOR COMPENSATION UNDER 11 U.S.C. SEC. 330(a) AND RULE 13-7(c) [COVER SHEET AND APPLICATION] (Appendices are subject to change. Check the Court's website for updates.) 264 American LegalNet, Inc. www.FormsWorkFlow.com THIS PAGE INTENTIONALLY LEFT BLANK 265 American LegalNet, Inc. www.FormsWorkFlow.com OFFICIAL LOCAL FORM NO. 17 UNITED STATES BANKRUPTCY COURT DISTRICT OF MASSACHUSETTS In re Case No. Chapter 13 Debtor/s APPLICATION BY COUNSEL TO THE DEBTOR FOR COMPENSATION UNDER 11 U.S.C. SEC. 330(a) AND RULE 13-7(c) [COVER SHEET] Debtor's Counsel: Address: BBO # Telephone #: Facsimile #: The Application for Compensation submitted for approval by :_____________( Counsel to Debtor; Special Counsel to Debtor). Prior Applications filed (Y/N). _____ If yes provide date of Order approving: If yes, provide total amount approved Payments to date Dates for which compensation is sought (ex. 1/1/2014-6/1/2014): Fees sought in the sum of Expenses sought in the sum of Total Fees and Expenses $_______________ $_______________ $_______________ $_______________ $_______________ You will receive a separate notice which will establish the bar date for filing objections, if any, to the Application for Compensation. 266 American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES BANKRUPTCY COURT DISTRICT OF MASSACHUSETTS In re Case No. Chapter Debtor/s APPLICATION BY COUNSEL TO THE DEBTOR FOR COMPENSATION UNDER 11 U.S.C. SEC. 330(a) AND RULE 13-7(c) Now comes _______________ and ________________, as counsel to the Debtor (each and together the "Applicant"), and pursuant to 11 U.S.C. § 330(a), Fed. R. Bankr. P. 2016 and MLBR 13-7 (c) respectfully submits the within Application for Compensation seeking approval of compensation in the sum of $________________. In support of the application, the Applicant submits the following: 1. On _________20__, ______________ (the "Debtor") commenced a Chapter 13 proceeding in the United States Bankruptcy Court for the District of Massachusetts. 2. The Applicant attaches hereto as Exhibit 1, in conformance with the provisions of MLBR 2016-1 and MLBR 13-7, a contemporaneous time record and expense report describing the specific services performed each day by each person. 3. I/we have rendered the services described in Exhibit 1 and have actually expended time without compensation except as disclosed in the form entitled "Disclosure of Compensation of Attorney for Debtor" pursuant to 11 U.S.C. § 329(a) and Fed. R. Bankr. P. 267 American LegalNet, Inc. www.FormsWorkFlow.com 2016(b) filed with the Bankruptcy Court or in accordance with the provisions of a confirmed Chapter 13 Plan. 4. The Applicant requests that compensation be allowed in the sum of [up to $10,000] for services to date and in the sum of $________ for expenses to date, for a total of $__________.00. Payment shall consist of (i) the funds received as a retainer in the amount of $____________.00 and (ii) the balance [through the confirmed Chapter 13 Plan] [outside of the Plan] on account of the fees sought under this application. 5. The Applicant attaches as Exhibit 2 a brief narrative description of services in support of the compensation requested. Wherefore, the Applicant prays that this Honorable Court enter an Order allowing the fees and expenses as requested herein in the sum of $____________.00 and for such further relief as is appropriate. DATED: Respectfully Submitted, /s/__________________________________ Attorney Address BBO# Telephone Email 268 American LegalNet, Inc. www.FormsWorkFlow.com