UNITED STATES BANKRUPTCY COURT

WESTERN DISTRICT OF WASHINGTON

+-----------------------------------+-----------------------------------+
| In re:                            | Case No.                          |
+-----------------------------------+-----------------------------------+
|                                   | CHAPTER 13 PLAN                   |
|                                   |                                   |
|                                   | \_\_Original \_\_Amended          |
+-----------------------------------+-----------------------------------+
| Debtor(s).                        | #                                 |
|                                   |                                   |
|                                   | # Date: \_\_\                     |
|                                   | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------+-----------------------------------+
|                                   | #                                 |
+-----------------------------------+-----------------------------------+

1.  **[Plan Payments:]{.underline}**

No later than 30 days after the filing of the Plan or the order for
relief, whichever date is earlier, the Debtor(s) will commence making
payments to the Trustee as follows:

A.  AMOUNT: \$ \_\_\_\_\_\_\_\_; FREQUENCY: \_\_\_Monthly;
    \_\_\_Semi-Monthly; \_\_\_Bi-Weekly; \_\_\_Weekly

B.  TAX REFUNDS: Debtor(s) \_\_\_COMMITS; \_\_\_DOES NOT COMMIT; all tax
    refunds to funding the Plan. Committed refunds shall be paid in
    addition to the plan payment stated above. If no selection is made,
    tax refunds are committed.

C.  PAYMENTS: Plan payments shall be deducted from the Debtor(s) wages
    unless otherwise agreed to by the Trustee or ordered by the Court.

D.  OTHER:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**2. [Plan Duration:]{.underline}**

Debtor(s) estimate the Plan will run approximately \_\_\_\_\_ months.
Plan may be extended up to 60 months after the first payment is due if
necessary to complete the Plan.

**3. [Distribution of Plan Payments:]{.underline}**

The Trustee shall disburse funds received in the following order:

A. ADMINISTRATIVE EXPENSES:

1.  [Trustee]{.underline}. The percentage set pursuant to 28 USC
    §586(e).

2\. [Other administrative expenses]{.underline}. As allowed pursuant to
11 USC §§ 507(a)(2) or 707(b).

> 3\. [Attorney\'s Fees]{.underline}: Original attorney\'s fees of
> \$\_\_\_\_\_\_\_\_\_\_, of which \$\_\_\_\_\_\_\_\_\_\_ remains
> unpaid.
>
> Select applicable option: a. \_\_\_\_ Prior to all creditors; b.
> \_\_\_\_\_\_ Monthly payments of \$\_\_\_\_\_\_; c.\_\_\_\_ All
> remaining funds available after designated monthly payments to the
> following
> creditors:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
>
> If no selection is made, fees will be paid after monthly payments
> specified in Paragraphs 3B and 3C.
>
> d\. \_\_\_\_\_\_
> Other:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

B. CURRENT DOMESTIC SUPPORT OBLIGATION: Payments to creditors whose
claims are filed and allowed pursuant to 11 USC § 502(a) or court order
as follows (if left blank, no payments shall be made by the Trustee):

**[Creditor]{.underline} [Monthly amount]{.underline}**

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_

C. SECURED CLAIMS: Payments to creditors whose claims are filed and
allowed pursuant to 11

USC § 502(a) or court order, as stated below. Unless ranked otherwise,
payments to creditors will be

disbursed at the same level. Secured creditors shall retain their liens
until the payment of the underlying

debt, determined under nonbankruptcy law, or discharge under 11 USC §
1328, as appropriate. Secured

creditors, other than current mortgage payments and continuing payments
and except as provided in 26

> USC § 6621(a)(2) and 11 USC § 1322(b)(2) as limited by 11 USC §
> 1325(a), will be paid the amount of their claim or the value of their
> collateral, whichever is less, plus per annum uncompounded interest
> from the Petition filing date. Interest rate and monthly payment in
> the Plan control unless a creditor timely files an objection to
> confirmation. Value of collateral stated in the Proof of Claim
> controls unless otherwise ordered following timely objection to claim.
> The unsecured portion of any claim shall be paid as a nonpriority
> unsecured claim unless entitled to priority by law. **Any creditors
> holding allowed secured claims not** **specified below shall not
> receive payment from the Trustee.** If the interest rate is left
> blank, the applicable interest rate shall be 12%.
>
> 1\. [Payments That Will Continue Beyond The Term Of The
> Plan]{.underline} (Interest included in payments at contract rate, if
> applicable):

**[Rank]{.underline} [Creditor]{.underline} [Nature of Debt]{.underline}
[Property]{.underline} [Monthly Payment]{.underline}**

\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_

2\. [Mortgage Arrearage /Property Tax Arrearage Payments]{.underline}:

**Periodic Arrears to be Interest**

**[Rank]{.underline} [Payment]{.underline} [Creditor]{.underline}
[Property]{.underline} [Cured]{.underline} [Rate]{.underline}**

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

3\. [Other Claims Secured by Personal Property]{.underline}:

(a). Unless written consent to the alternative treatment as set forth
below is filed with the court, the trustee shall pay the contract
balance as stated in the Proof of Claim for a purchase-money security
interest in any motor vehicle acquired for the personal use of the
debtor(s) **within 910 days** preceding the filing date of the Petition
or in other personal property acquired within **one year** preceding the
filing date of the Petition as follows. Debtor(s) stipulate that
pre-confirmation adequate protection payments shall be paid by the
Trustee as specified. If no amount is specified, the Trustee shall pay
the amount stated as the "Equal Periodic Payment".

(i). Payment of contractual balance

**Equal Description Pre-Confirmation Periodic of Adequate Protection
Interest**

**[Rank]{.underline} [Payment]{.underline} [Creditor]{.underline}
[Collateral]{.underline} [Payment]{.underline} [Rate]{.underline}**

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

> (ii). Proposed Alternative Treatment, which shall not be binding upon
> the creditor without
>
> written consent filed with the court.

**Equal Debtor(s) Description Pre-Confirmation**

**Periodic Value of of Adeq. Protection Interest**

**[Rank]{.underline} [Payment]{.underline} [Creditor]{.underline}
[Collateral]{.underline} [Collateral]{.underline} [Payment]{.underline}
[Rate]{.underline}**

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

(b). The following secured claims are **not** for a motor vehicle
acquired for the personal use of the Debtor(s) within 910 days preceding
the filing date of the Petition and are **not** for other personal
property acquired within one year preceding the filing date of the
Petition. Debtor(s) stipulate that pre-confirmation adequate protection
payments shall be paid by the Trustee as specified. If no amount is
specified, the Trustee shall pay the amount stated as the "Equal
Periodic Payment".

**Equal Debtor(s) Description Pre-Confirmation**

**Periodic Value of of Adeq. Protection Interest**

**[Rank]{.underline} [Payment]{.underline} [Creditor]{.underline}
[Collateral]{.underline} [Collateral]{.underline} [Payment]{.underline}
[Rate]{.underline}**

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

\_\_\_\_ \$\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_ \_\_\_%

D. PRIORITY CLAIMS: Payment in full, on a pro rata basis, of filed and
allowed claims entitled to priority in the order stated in 11 USC §
507(a).

E. NONPRIORITY UNSECURED CLAIMS: From the balance remaining after the
above payments, the

Trustee shall pay filed and allowed nonpriority unsecured claims as
follows:

1.  Specially Classified Unsecured Claims. The Trustee shall pay prior
    to other nonpriority unsecured

> claims as follows:
>
> **[Amount of]{.underline} [Percentage]{.underline} [Reason for
> Special]{.underline}**
>
> **[Rank]{.underline} [Creditor]{.underline} [Claim]{.underline} [To be
> Paid]{.underline} [Classification]{.underline}**
>
> \_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_% \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> \_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_% \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> 2\. Other Unsecured Claims. The Debtor(s) will pay 100% to claimants
> in this class, or pay projected disposable income for no less than the
> Applicable Commitment Period of either 36 or 60 months as stated below
> **(choose a. or b., but not both):**

(a). % paid to unsecureds: 100% \_\_\_\_ **OR**

(b). Pursuant to 11 USC § 1325(b), debtor(s) projected disposable income
during the applicable

commitment period of no fewer than \_\_\_\_ months totals
\$\_\_\_\_\_\_\_\_, and not less than that total amount shall be
distributed to allowed nonpriority unsecured claims. Plan would thus
yield approximately \_\_\_\_% to nonpriority unsecureds. Percentage may
vary depending upon funds available after payments required under
Paragraphs 3A-3E1 and upon total of claims filed.

**4.** **[Secured Property Surrendered]{.underline}**:

The secured property described below will be surrendered to the
following named creditors on confirmation. Upon confirmation, all
creditors to which the debtor is surrendering property pursuant to this
paragraph are granted relief from the automatic stay to enforce their
security interest against the property including taking possession and
sale.

**[Creditor]{.underline}** **[Property to be Surrendered]{.underline}**

**5**. **[Executory Contracts and Leases]{.underline}**:

The Debtor(s) will assume or reject executory nonresidential contracts
or unexpired leases as noted below. Assumption will be by separate
motion and order, and any cure and/or continuing payments will be paid
directly by the Debtor(s) under Paragraph 6, unless otherwise specified
in Paragraph 10 with language designating that payments will be made by
the Trustee, the amount and frequency of the payments, the ranking level
for such payments with regard to other creditors, the length of the term
for continuing payments and the interest rate, if any, for cure
payments. Any executory contract or unexpired lease not assumed pursuant
to 11 USC § 365(d) is rejected. If rejected, the Debtor(s) shall
surrender any collateral or leased property and any duly filed and
allowed unsecured claim for damages shall be paid under Paragraph 3E2.

**[Contract/Lease]{.underline}** **[Assumed or Rejected]{.underline}**

**6.** **[Payments Made by Debtor(s) and not by the
Trustee:]{.underline}**

The following creditors shall be paid directly by the Debtor(s)
according to the terms of the contract or support or withholding order,
and shall receive no payments from the Trustee. (Payment stated shall
not bind any party)

A. DOMESTIC SUPPORT OBLIGATIONS: The claims of the following creditors
owed domestic support obligations shall be paid directly by the
Debtor(s) as follows:

**[Creditor]{.underline}** **[Current Monthly Support
Obligation]{.underline}** **[Monthly Arrearage Payment]{.underline}**

\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

B. OTHER DIRECT PAYMENTS:

**[Creditor]{.underline}** **[Nature of Debt]{.underline}** **[Amount of
Claim]{.underline}** **[Monthly Payment]{.underline}**

\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**7.** **[Revestment of Property]{.underline}**

Unless otherwise provided in Paragraph 10, during the pendency of the
plan all property of the estate as defined by 11 USC § 1306(a) shall
remain vested in the Debtors, except that earnings and income necessary
to complete the terms of the Plan shall remain vested in the Trustee
until discharge. The Debtor(s) shall not, without approval of the Court,
sell or otherwise dispose of or transfer real property other than in
accordance with the terms of the confirmed Plan.

**8.** **[Liquidation Analysis Pursuant to 11 USC §
1325(a)(4)]{.underline}**

No less than \$\_\_\_\_\_\_\_ shall be distributed to priority and
nonpriority unsecured claims. Under 11 USC §§ 1325(a)(4) and 726(a)(5),
interest on allowed unsecured claims under Paragraphs 3D and 3E shall be
paid at the rate of \_\_\_\_\_\_% per annum from the Petition filing
date (no interest shall be paid if left blank).

**9.** **[Certification]{.underline}**:

A. The Debtor(s) certifies that all post-petition Domestic Support
Obligations have been paid in full on the date of this Plan and will be
paid in full at the time of the confirmation hearing. Debtor
acknowledges that timely payment of such post-petition Domestic Support
Obligations is a condition of Plan confirmation pursuant to 11 USC §
1325(a)(8).

B. The Debtor(s) or their attorney certifies that this Plan does not
alter the provisions of Local Bankruptcy Form 13-3 except as follows:

**10.** **[Other Plan Provisions]{.underline}**: (must be separately
numbered)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Attorney for Debtor(s) DEBTOR Last 4 digits SS# Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date DEBTOR Last 4 digits SS# Date