Number range CHAPTER UNITED STATES BANKRUPTCY COURT

DISTRICT OF

DIVISION

IN RE: } CASE NUMBER

}

}

} JUDGE }

DEBTOR. } CHAPTER 11

DEBTOR\'S MONTHLY OPERATING REPORTS (BUSINESS)

FOR THE PERIOD

FROM TO

Comes now the above-named debtor and files its Monthly Operating Reports
in accordance with the Guidelines established by the United States
Trustee and FRBP 2015.

Attorney for Debtor's Signature

Debtor\'s Address Attorney\'s Address

and Phone Number: and Phone Number:

Note: The original Monthly Operating Report is to be filed with the
court and a copy simultaneously provided to the United States Trustee
Office. Monthly Operating Reports must be filed by the 20^th^ day of the
following month.

For assistance in preparing the Monthly Operating Report, refer to the
following resources:

1)  Instructions for Preparations of Debtor's Chapter 11 Monthly
    Operating Report

2)  Initial Filing Requirements

3)  Frequently Asked Questions (FAQs)

**[SCHEDULE OF RECEIPTS AND DISBURSEMENTS]{.underline}**

**FOR THE PERIOD BEGINNING AND ENDING**

Name of Debtor: Case Number

Date of Petition:

CURRENT CUMULATIVE

[MONTH]{.underline} [PETITION TO DATE]{.underline}

**1. FUNDS AT BEGINNING OF PERIOD (a) (b)**

**2. RECEIPTS:**

A. Cash Sales

Minus: Cash Refunds [(-)]{.underline}

Net Cash Sales

B. Accounts Receivable

> C. Other Receipts *(See MOR-3)*

(If you receive rental income,

you must attach a rent roll.)

**3. TOTAL RECEIPTS *(Lines 2A+2B+2C)***

**4. TOTAL FUNDS AVAILABLE FOR**

**OPERATIONS *(Line 1 + Line 3)***

**5. DISBURSEMENTS**

A. Advertising

B. Bank Charges

C. Contract Labor

D. Fixed Asset Payments (not incl. in "N")

E. Insurance

F. Inventory Payments (*See Attach. 2)*

G. Leases

H. Manufacturing Supplies

I. Office Supplies

J. Payroll - Net *(See Attachment 4B)*

K. Professional Fees (Accounting & Legal)

L. Rent

M. Repairs & Maintenance

N. Secured Creditor Payments *(See Attach. 2)*

O. Taxes Paid - Payroll *(See Attachment 4C)*

P. Taxes Paid - Sales & Use *(See Attachment 4C)*

Q. Taxes Paid - Other *(See Attachment 4C)*

R. Telephone

S. Travel & Entertainment

Y. U.S. Trustee Quarterly Fees

U. Utilities

V. Vehicle Expenses

W. Other Operating Expenses *(See MOR-3)*

**6. TOTAL DISBURSEMENTS *(Sum of 5A thru W)***

**7. ENDING BALANCE *(Line 4 Minus Line 6)*** (c) (c)

**I declare under penalty of perjury that this statement and the
accompanying documents and reports are true and correct to the best of
my knowledge and belief.**

This day of , 20 .

[(Signature)]{.underline}

(a)This number is carried forward from last month's report. For the
first report only, this number will be the

balance as of the petition date.

(b)This figure will not change from month to month. It is always the
amount of funds on hand as of the date of

the petition.

(c)These two amounts will always be the same if form is completed
correctly.

**MONTHLY SCHEDULE OF RECEIPTS AND DISBURSEMENTS** (cont'd)

**Detail of Other Receipts and Other Disbursements**

**OTHER RECEIPTS:**

Describe Each Item of Other Receipt and List Amount of Receipt. Write
totals on Page MOR-2, Line 2C.

Cumulative

[Description]{.underline} [Current Month]{.underline} [Petition to
Date]{.underline}

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

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

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

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

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

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

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

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

TOTAL OTHER RECEIPTS \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**"Other Receipts" includes Loans from Insiders and other sources (i.e.
Officer/Owner, related parties directors, related corporations, etc.).
Please describe below:**

**Source**

**[Loan Amount]{.underline} [of Funds]{.underline} [Purpose]{.underline}
[Repayment Schedule]{.underline}**

**OTHER DISBURSEMENTS:**

Describe Each Item of Other Disbursement and List Amount of
Disbursement. Write totals on Page MOR-2, Line 5W.

Cumulative

[Description]{.underline} [Current Month]{.underline} [Petition to
Date]{.underline}

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

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

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

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

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

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

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

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

TOTAL OTHER DISBURSEMENTS \_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**NOTE: Attach a current Balance Sheet and Income (Profit & Loss)
Statement.**

**[ATTACHMENT 1]{.underline}**

**[MONTHLY ACCOUNTS RECEIVABLE RECONCILIATION AND AGING]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

ACCOUNTS RECEIVABLE AT PETITION DATE:

**ACCOUNTS RECEIVABLE RECONCILIATION**

(Include [all]{.underline} accounts receivable, pre-petition and
post-petition, including charge card sales which have not been
received):

Beginning of Month Balance [\$]{.underline} (a)

PLUS: Current Month New Billings

MINUS: Collection During the Month [\$]{.underline} (b)

PLUS/MINUS: Adjustments or Writeoffs [\$]{.underline} \*

End of Month Balance [\$]{.underline} (c)

\*For any adjustments or Write-offs provide explanation and supporting
documentation, if applicable:

**POST PETITION ACCOUNTS RECEIVABLE AGING**

(Show the total for each aging category for all accounts receivable)

0-30 Days 31-60 Days 61-90 Days Over 90Days Total

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$]{.underline} (c)

For any receivables in the "Over 90 Days" category, please provide the
following:

Receivable

[Customer]{.underline} [Date]{.underline} [Status]{.underline}
(Collection efforts taken, estimate of collectibility,

write-off, disputed account, etc.)

(a)This number is carried forward from last month's report. For the
first report only, this number will be

the balance as of the petition date.

(b)This must equal the number reported in the "Current Month" column of
Schedule of Receipts and

Disbursements (Page MOR-2, Line 2B).

(c)These two amounts must equal.

**[ATTACHMENT 2]{.underline}**

**[MONTHLY ACCOUNTS PAYABLE AND SECURED PAYMENTS REPORT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

In the space below list all invoices or bills incurred and not paid
[since the filing of the petition]{.underline}. [Do not]{.underline}
include amounts owed prior to filing the petition. In the alternative, a
computer generated list of payables may be attached provided all
information requested below is included.

**POST-PETITION ACCOUNTS PAYABLE**

Date Days

[Incurred]{.underline} [Outstanding]{.underline} [Vendor]{.underline}
[Description]{.underline} [Amount]{.underline}

TOTAL AMOUNT (b)

**☐ Check here if pre-petition debts have been paid. Attach an
explanation and copies of supporting**

**documentation.**

**ACCOUNTS PAYABLE RECONCILIATION (Post Petition Unsecured Debt Only)**

Opening Balance [\$]{.underline} (a)

PLUS: New Indebtedness Incurred This Month [\$]{.underline}

MINUS: Amount Paid on Post Petition

Accounts Payable This Month [\$]{.underline}

PLUS/MINUS: Adjustments [\$]{.underline} \*

Ending Month Balance [\$]{.underline} (c)

\*For any adjustments provide explanation and supporting documentation,
if applicable.

**SECURED PAYMENTS REPORT**

List the status of Payments to Secured Creditors and Lessors (Post
Petition Only). If you have entered into a modification agreement with a
secured creditor/lessor, consult with your attorney and the United
States Trustee Program prior to completing this section).

> Number Total

Date of Post Amount of

Secured Payment Amount Petition Post Petition

Creditor/ Due This Paid This Payments Payments

[Lessor]{.underline} [Month]{.underline} [Month]{.underline}
[Delinquent]{.underline} [Delinquent]{.underline}

TOTAL (d)

(a)This number is carried forward from last month's report. For the
first report only, this number will be zero.

(b, c)The total of line (b) must equal line (c).

(d)This number is reported in the "Current Month" column of Schedule of
Receipts and Disbursements (Page MOR-2, Line 5N).

**[ATTACHMENT 3]{.underline}**

**[INVENTORY AND FIXED ASSETS REPORT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

[**INVENTORY REPORT**]{.underline}

INVENTORY BALANCE AT PETITION DATE:

INVENTORY RECONCILIATION:

Inventory Balance at Beginning of Month [\$]{.underline} (a)

PLUS: Inventory Purchased During Month [\$]{.underline}

MINUS: Inventory Used or Sold [\$]{.underline}

PLUS/MINUS: Adjustments or Write-downs [\$]{.underline} \*

Inventory on Hand at End of Month [\$]{.underline}

METHOD OF COSTING INVENTORY:

\*For any adjustments or write-downs provide explanation and supporting
documentation, if applicable.

**INVENTORY AGING**

Less than 6 6 months to Greater than Considered

months old 2 years old 2 years old Obsolete [Total
Inventory]{.underline}

\_\_\_\_\_\_% \_\_\_\_\_\_% \_\_\_\_\_\_\_% [%]{.underline}
[-]{.underline} [100%\*]{.underline}

\* Aging Percentages must equal 100%.

☐ Check here if inventory contains perishable items.

**Description of Obsolete Inventory:**

**FIXED ASSET REPORT**

FIXED ASSETS FAIR MARKET VALUE AT PETITION DATE: (b)

(Includes Property, Plant and Equipment)

BRIEF DESCRIPTION (First Report Only):

FIXED ASSETS RECONCILIATION:

Fixed Asset Book Value at Beginning of Month [\$]{.underline} (a)(b)

MINUS: Depreciation Expense [\$]{.underline}

PLUS: New Purchases [\$]{.underline}

PLUS/MINUS: Adjustments or Write-downs [\$]{.underline} \*

Ending Monthly Balance [\$]{.underline}

\*For any adjustments or write-downs, provide explanation and supporting
documentation, if applicable.

BRIEF DESCRIPTION OF FIXED ASSETS PURCHASED OR DISPOSED OF DURING THE
REPORTING PERIOD:

(a)This number is carried forward from last month's report. For the
first report only, this number will be the

balance as of the petition date.

(b)Fair Market Value is the amount at which fixed assets could be sold
under current economic conditions.

Book Value is the cost of the fixed assets minus accumulated
depreciation and other adjustments.

**[ATTACHMENT 4A]{.underline}**

**[MONTHLY SUMMARY OF BANK ACTIVITY - OPERATING ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

Attach a copy of current month bank statement and bank reconciliation to
this Summary of Bank Activity. If bank accounts other than the three
required by the United States Trustee Program are necessary, permission
must be obtained from the United States Trustee prior to opening the
accounts. Additionally, use of less than the three required bank
accounts must be approved by the United States Trustee.

NAME OF BANK: BRANCH:

ACCOUNT NAME: ACCOUNT NUMBER:

PURPOSE OF ACCOUNT: [OPERATING]{.underline}

Ending Bank Balance per Bank Statement [\$]{.underline}

Plus Total Amount of Outstanding Deposits [\$]{.underline}

Minus Total Amount of Outstanding Checks and other debits
[\$]{.underline} \*

Minus Service Charges [\$]{.underline}

Ending Balance per Check Register [\$]{.underline} \*\*(a)

**\*Debit cards are used by**

**\*\*If Closing Balance is negative, provide explanation**:

**The following disbursements were paid in Cash (do not includes items
reported as Petty Cash on Attachment 4D:** ( ☐ Check here if cash
disbursements were authorized by United States Trustee)

Date Amount Payee Purpose Reason for Cash Disbursement

**TRANSFERS BETWEEN DEBTOR IN POSSESSION ACCOUNTS**

"Total Amount of Outstanding Checks and other debits", listed above,
includes:

\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Transferred to Payroll Account

\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Transferred to Tax Account

\(a\) The total of this line on Attachment 4A, 4B and 4C plus the total
of 4D must equal the amount reported as

"Ending Balance" on Schedule of Receipts and Disbursements (Page MOR-2,
Line 7).

**[ATTACHMENT 5A]{.underline}**

**[CHECK REGISTER - OPERATING ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

NAME OF BANK: BRANCH:

ACCOUNT NAME:

ACCOUNT NUMBER:

PURPOSE OF ACCOUNT: [OPERATING]{.underline}

Account for all disbursements, including voids, lost checks, stop
payments, etc. In the alternative, a computer generated check register
can be attached to this report, provided all the information requested
below is included.

> CHECK

[DATE NUMBER PAYEE PURPOSE AMOUNT]{.underline}

TOTAL\$

**[ATTACHMENT 4B]{.underline}**

**[MONTHLY SUMMARY OF BANK ACTIVITY - PAYROLL ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

Attach a copy of current month bank statement and bank reconciliation to
this Summary of Bank Activity.

NAME OF BANK: BRANCH:

ACCOUNT NAME: ACCOUNT NUMBER:

PURPOSE OF ACCOUNT: [PAYROLL]{.underline}

Ending Balance per Bank Statement[\$]{.underline}

Plus Total Amount of Outstanding Deposits[\$]{.underline}

Minus Total Amount of Outstanding Checks and other
debits[\$]{.underline} \*

Minus Service Charges[\$]{.underline}

Ending Balance per Check Register[\$]{.underline} \*\*(a)

**\*Debit cards must not be issued on this account.**

**\*\*If Closing Balance is negative, provide explanation:**

The following disbursements were paid by Cash: ( ☐ Check here if cash
disbursements were authorized by

United States Trustee)

Date Amount Payee Purpose Reason for Cash Disbursement

The following non-payroll disbursements were made from this account:

Date Amount Payee Purpose Reason for disbursement from this account

(a)The total of this line on Attachment 4A, 4B and 4C plus the total of
4D must equal the amount reported as

"Ending Balance" on Schedule of Receipts and Disbursements (Page MOR-2,
Line 7).

**[ATTACHMENT 5B]{.underline}**

**[CHECK REGISTER - PAYROLL ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

NAME OF BANK: BRANCH:

ACCOUNT NAME:

ACCOUNT NUMBER:

PURPOSE OF ACCOUNT: [PAYROLL]{.underline}

Account for all disbursements, including voids, lost payments, stop
payment, etc. In the alternative, a computer generated check register
can be attached to this report, provided all the information requested
below is included.

CHECK

[DATE]{.underline} [NUMBER]{.underline} [PAYEE]{.underline}
[PURPOSE]{.underline} [AMOUNT]{.underline}

TOTAL\$

**[ATTACHMENT 4C]{.underline}**

**[MONTHLY SUMMARY OF BANK ACTIVITY - TAX ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

Attach a copy of current month bank statement and bank reconciliation to
this Summary of Bank Activity.

NAME OF BANK: BRANCH:

ACCOUNT NAME: ACCOUNT NUMBER:

PURPOSE OF ACCOUNT: [TAX]{.underline}

Ending Balance per Bank Statement [\$]{.underline}

Plus Total Amount of Outstanding Deposits [\$]{.underline}

Minus Total Amount of Oustanding Checks and other debits
[\$]{.underline} \*

Minus Service Charges [\$]{.underline}

Ending Balance per Check Register [\$]{.underline} \*\*(a)

**\*Debit cards must not be issued on this account.**

**\*\*If Closing Balance is negative, provide explanation:**

The following disbursements were paid by Cash: ( ☐ Check here if cash
disbursements were authorized by

United States Trustee)

Date Amount Payee Purpose Reason for Cash Disbursement

The following non-tax disbursements were made from this account:

Date Amount Payee Purpose Reason for disbursement from this account

(a)The total of this line on Attachment 4A, 4B and 4C plus the total of
4D must equal the amount reported as

"Ending Balance" on Schedule of Receipts and Disbursements (Page MOR-2,
Line 7).

**[ATTACHMENT 5C]{.underline}**

**[CHECK REGISTER - TAX ACCOUNT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

NAME OF BANK: BRANCH:

ACCOUNT NAME: A CCOUNT NO:

PURPOSE OF ACCOUNT: [TAX]{.underline}

Account for all disbursements, including voids, lost checks, stop
payments, etc. In the alternative, a computer-generated check register
can be attached to this report, provided all the information requested
below is included.

CHECK

[DATE]{.underline} [NUMBER]{.underline} [PAYEE]{.underline}
[PURPOSE]{.underline} [AMOUNT]{.underline}

TOTAL (d)

SUMMARY OF TAXES PAID

Payroll Taxes Paid (a)

Sales & Use Taxes Paid (b)

Other Taxes Paid (c)

TOTAL (d)

\(a\) This number is reported in the "Current Month" column of Schedule
of Receipts and Disbursements

(Page MOR-2, Line 5O).

\(b\) This number is reported in the "Current Month" column of Schedule
or Receipts and Disbursements

(Page MOR-2, Line 5P).

\(c\) This number is reported in the "Current Month" column of Schedule
of Receipts and Disbursements

(Page MOR-2, Line 5Q).

\(d\) These two lines must be equal.

**[ATTACHMENT 4D]{.underline}**

**[INVESTMENT ACCOUNTS AND PETTY CASH REPORT]{.underline}**

**INVESTMENT ACCOUNTS**

Each savings and investment account, i.e. certificates of deposits,
money market accounts, stocks and bonds, etc., should be listed
separately. Attach copies of account statements.

Type of Negotiable

[Instrument]{.underline} [Face Value]{.underline} [Purchase
Price]{.underline} [Date of Purchase]{.underline} [Current]{.underline}

[Market Value]{.underline}

TOTAL (a)

**[PETTY CASH REPORT]{.underline}**

The following Petty Cash Drawers/Accounts are maintained:

(Column 2) (Column 3) (Column 4)

Maximum Amount of Petty Difference between

Location of Amount of Cash Cash On Hand (Column 2) and

[Box/Account]{.underline} [in Drawer/Acct.]{.underline} [At End of
Month]{.underline} [(Column 3)]{.underline}

**TOTAL [\$ ]{.underline}**(b)

**For any Petty Cash Disbursements over \$100 per transaction, attach
copies of receipts. If there are no receipts, provide an explanation**

**TOTAL INVESTMENT ACCOUNTS AND PETTY CASH(a + b) [\$]{.underline} (c)**

(c)The total of this line on Attachment 4A, 4B and 4C plus the total of
4D must equal the

amount reported as "Ending Balance" on Schedule of Receipts and
Disbursements (Page

MOR-2, Line 7).

**[ATTACHMENT 6]{.underline}**

**[MONTHLY TAX REPORT]{.underline}**

Name of Debtor: Case Number:

Reporting Period beginning and ending

**TAXES OWED AND DUE**

Report all unpaid post-petition taxes including Federal and State
withholding FICA, State sales tax, property tax, unemployment tax, State
workmen\'s compensation, etc.

Name of Date Date Last

Taxing Payment Tax Return Tax Return

[Authority]{.underline} [Due]{.underline} [Description]{.underline}
[Amount]{.underline} [Filed]{.underline} [Period]{.underline}

TOTAL \$

**[ATTACHMENT 7]{.underline}**

**[SUMMARY OF OFFICER OR OWNER COMPENSATION]{.underline}**

**SUMMARY OF PERSONNEL AND INSURANCE COVERAGES**

Name of Debtor: Case Number:

Reporting Period beginning and ending

Report all forms of compensation received by or paid on behalf of the
Officer or Owner during the month. Include car allowances, payments to
retirement plans, loan repayments, payments of Officer/Owner's personal
expenses, insurance premium payments, etc. Do not include reimbursement
for business expenses Officer or Owner incurred and for which detailed
receipts are maintained in the accounting records.

Payment

[Name of Officer or Owner]{.underline} [Title]{.underline}
[Description]{.underline} [Amount Paid]{.underline}

**PERSONNEL REPORT**

Full Time Part Time

Number of employees at beginning of period

Number hired during the period

Number terminated or resigned during period

Number of employees on payroll at end of period

**CONFIRMATION OF INSURANCE**

List all policies of insurance in effect, including but not limited to
workers\' compensation, liability, fire, theft, comprehensive, vehicle,
health and life. For the first report, attach a copy of the declaration
sheet for each type of insurance. For subsequent reports, attach a
certificate of insurance for any policy in which a change occurs during
the month (new carrier, increased policy limits, renewal, etc.).

Agent Date

and/or Phone Policy Coverage Expiration Premium

[Carrier]{.underline} [Number]{.underline} [Number]{.underline}
[Type]{.underline} [Date]{.underline} [Due]{.underline}

**The following lapse in insurance coverage occurred this month:**

Policy Date Date

Type Lapsed Reinstated Reason for Lapse

1.  Check here if U. S. Trustee has been listed as Certificate Holder
    for all insurance policies.

**[ATTACHMENT 8]{.underline}**

**[SIGNIFICANT DEVELOPMENTS DURING REPORTING PERIOD]{.underline}**

Information to be provided on this page, includes, but is not limited
to: (1) financial transactions that are not reported on this report,
such as the sale of real estate ***(attach closing statement)***; (2)
non-financial transactions, such as the substitution of assets or
collateral; (3) modifications to loan agreements; (4) change in senior
management, etc. Attach any relevant documents.

We anticipate filing a Plan of Reorganization and Disclosure Statement
on or before .