Application For Compensation And Reimbursement Of Expenses-Long Form (Chapter 13) {LBF 2016-3B}

L.B.F. 2016-3B 223Long Form224 Application of Counsel for Debtor for Compensation and Reimbursement of Expenses in Chapter 13 Case UNITED STATES BANKRUPTCY COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA In re: ) Chapter 13 ) Debtor(s) ) ) Bky. No. ) APPLICATION FOR COMPENSATION AND REIMBURSEMENT OF EXPENSES Name of applicant applies under 247 330 of the Bankruptcy Code for an award of compensation and reimbursement of actual, necessary expenses and represents: 1.Applicant is counsel for the debtor. 2.The debtor filed a petition under chapter 13 of the Bankruptcy Code on (date). 3.The debtor222s annualized current monthly income as set forth on Form B22C is: above median (the amount on line 15 is not less than the amount on line 16). below median (the amount on line 15 is less than the amount on line 16). 4.All services rendered and expenses incurred for which compensation or reimbursement isrequested were performed or incurred for or on behalf of the debtor, the services andexpenses were actual and necessary, and the compensation requested for those services isreasonable. 5.Applicant requests an award of compensation of $ for hours expendedon the initial consultation with client(s) and in providing before confirmation (a) the customary services of counseling and representing the chapter 13 debtor(s) including: analysis of the financial situation; preparation, review and filing with the court of all required documents; correspondence, telephone conversations and miscellaneous contact with creditors, the trustee, attorneys and other parties in interest; preparation for and attendance at 341(a) meeting; and (b) in representing the debtor(s) in connection with [check applicable item(s)]: cure of a residential mortgage default or other treatment of residential real property claims American LegalNet, Inc. www.FormsWorkFlow.com ownership and claims relating to other real property (specify the number of properties and describe the issues) motor vehicle loans or leases state or federal tax claims domestic support obligations student loans an operating business 20 or more creditors listed in Schedule F automatic stay litigation other litigation (describe) 6.[Optional. Applicant may supplement paragraph 5 with a description of those matters,whether or not they are listed in paragraph 5, that took an unusual amount of time tocomplete or involved complex legal or factual issues.] 7.Applicant requests that compensation be awarded at the following hourly rate(s): (Specifythe hourly rate for each person who provided services) 8.Applicant requests reimbursement of expenses in the amount of $ for thefollowing expenses: (Description of expenses) 9.The debtor paid Applicant $ prior to the filing of the petition. 10.A copy of the Applicant222s disclosure of compensation pursuant to Fed. R. Bankr. P.2016(b) is attached hereto as Exhibit 223A.224 11.None of the compensation paid to applicant will be shared with any person other than amember or regular associate of applicant222s law firm unless 11 U.S.C. 247504(c) applies. 12.Attached as Exhibit 223B224 is a copy of Applicant222s time records setting forth the dates andamount of time expended for the services performed on behalf of the debtor. American LegalNet, Inc. www.FormsWorkFlow.com WHEREFORE, Applicant requests an award of $ in compensation and of $ in reimbursement of actual, necessary expenses. Date: Signed: [Applicant222s name] 205205205205205205205205205 [Firm Name] 205205205205205205205205205205205.. [Address] 205205205205205205205205205205205205... [Phone No.] 205205205205205205205205205205205... [Fax No.] 205205205205205205205205205205205205... [E-mail address] 205205205205205205205205205205 American LegalNet, Inc. www.FormsWorkFlow.com