Request For Payment Of Pre-Conversion Administrative Expense {3002-2(c)}

LOCAL FORM 3002-2251REVISED 12/17UNITED STATES BANKRUPTCY COURTDISTRICT OF MINNESOTAIn re:Case No.Debtor(s).REQUEST FOR PAYMENT OF PRE-CONVERSION ADMINISTRATIVE EXPENSE The undersigned Claimant, pursuant to Local Rule 3002-2(c) states that:1. The Debtor filed a petition under Chapter of Title 11 of the United States Code on , .2. The Debtor222s case was converted to a case under Chapter 7 of Title 11 of the United States Codeon , .3. Prior to conversion of this case, Claimant provided goods and services which qualify as anadministrative expense under 11 U.S.C. 247503. These goods and services were in the nature of(describe briefly).4. The goods and services provided by Claimant prior to conversion of this case have a reasonablevalue of $ .5. During the administration of this case prior to conversion, the Debtor paid claimant $ forsuch goods and services. Accordingly, Claimant has an unpaid balance for such goods and servicesof $ .6. Attached are documents supporting Claimant222s request for payment.7. Claimant requests allowance of this Pre-conversion Administrative Expense in the amount of $ . Date: Signed: Print Name: Address: Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com