Fill and Sign the Adversary Proceeding Form

B 104 (Rev. 2/92) ADVERSARY PROCEEDING COVER SHEET (Instructions on Reverse) ADVERSARY PROCEEDING NUMBER (Court Use Only) PLAINTIFFS       DEFENDANTS       ATTORNEYS (Firm Name, Address, and Telephone No.)       ATTORNEYS (If Known)       PARTY (Check one box only ) 1 U.S. PLAINTIFF 2 U.S. DEFENDANT 3 U.S. NOT A PARTY CAUSE OF ACTION (WRITE A BRIEF STATEMENT OF CAUSE OF ACTION, INCLUDING ALL U.S. STATUTES INVOLVED)       NATURE OF SUIT (Check the one most appropriate box only.) 456 To obtain a declaratory of a Chap. 11, Chap. 12, or Chap. 13 Plan judgment relating to any of Extent of a Lien or Other Interest in foregoing causes of action of a debt 11 U.S.C § 523 459 To determine a claim or cause of the interest of the estate and of a co- Action removed to a bankruptcy owner in property court or interest except where such subordination is provided in a plan 498 Other (specify) ORIGIN OF 1 Original 2 Removed 4 Reinstated 5 Transferred PROCEEDINGS Proceeding Proceeding or Reopened from Another (Check one box only. ) Bankruptcy Court CHECK IF THIS IS A CLASS ACTION UNDER F.R.C.P. 23 DEMAND $       OTHER RELIEF SOUGHT       JURY DEMAND Check only if demanded in complaint BANKRUPTCY CASE IN WHICH THIS ADVERSARY PROCEEDING ARISES NAME OF DEBTOR       BANKRUPTCY CASE NO.       DISTRICT IN WHICH CASE IS PENDING       DIVISIONAL OFFICE       NAME OF JUDGE       RELATED ADVERSARY PROCEEDING (IF ANY) PLAINTIFF       DEFENDANT       ADVERSARY PROCEEDING NO.       DISTRICT       DIVISIONAL OFFICE       NAME OF JUDGE       FILING FEE (Check one box only.) FEE ATTACHED FEE NOT REQUIRED FEE IS DEFERRED DATE       PRINT NAME       SIGNATURE OF ATTORNEY (OR PLAINTIFF) B104 ADVERSARY PROCEEDING COVER SHEET (Reverse Side) This cover sheet must be completed by the plaintif's attorney (or by the plaintif if the plaintif is not represented by an attorney) and submitted to the Clerk of the Court upon the fling of a complaint initiating an adversary proceeding. The cover sheet and the information contained on it do not replace or supplement the fling and service of pleadings or other papers as required by law, the Bankruptcy Rules, or the local rules of court. This form is required for the use of the Clerk of the Court to initiate the docket sheet and to prepare necessary indices and statistical records. A separate cover sheet must be submitted to the clerk of the court for each complaint fled. The form is largely self explanatory. Parties. Give the names of the parties to the adversary proceeding exactly as they appear on the complaint. Give the names and addresses of the attorneys if known. Following the heading "Party," check the appropriate box indicating whether the United States is a party named in the complaint. Cause of Action. Give a brief description of the cause of action including all federal statutes involved. For example, "Complaint by trustee to avoid a transfer of property by the debtor, 11 U.S.C. § 544.” Nature of Suit. Place an "X" in the appropriate box. Only one box should be checked. If the cause fts more than one category of suit, select the most defnitive. Origin of Proceedings. Check the appropriate box to indicate the origin of the case: 1. Original Proceeding. 2. Removed from a State or District Court. 4. Reinstated or Reopened. 5. Transferred from Another Bankruptcy Court Class Action. Place an “X” in this box if you are fling a class action under Rule 23, Fed. R. Civ. P., as made applicable by Rule 7023, Fed. R. Bankr. P. Demand. In this space enter the dollar amount being demanded I the complaint. If no monetary demand is made, enter “XXXX.” If the plaintif is seeking non-monetary relief, state the relief sought, such as injunction or foreclosure of a mortgage. Bankruptcy Case In Which This Adversary Proceeding Arises. Enter the name of the debtor and the docket number of the bankruptcy case from which the proceeding now being fled arose. Beneath, enter the district and divisional office where the case was fled, and the name of the presiding judge. Related Adversary Proceedings. State the names of the parties and the six digit adversary proceeding number from any adversary proceeding concerning the same two parties or the same property currently pending in any bankruptcy court. On the next line, enter the district where the related case is pending, and the name of the presiding judge. Filing Fee. Check one box. The fee must be paid upon fling unless the plaintif meets one of the following exceptions. The fee is not required if the plaintif is the United States government or the debtor. If the plaintif is the trustee or a debtor in possession, and there are no liquid funds in the estate, the fling fee may be deferred until there are funds in the estate. (In the event no funds are ever recovered for the estate, there will be no fee). There is no fee for adding a party after the adversary proceeding has been commenced. Signature. This cover sheet must be signed by the attorney of record in the box on the right of the last line of the form. If the plaintif is represented by a law frm, a member of the frm must sign. If the plaintif is pro se that is, not represented by an attorney, the plaintif must sign. The name of the signatory must be printed in the box to the left of the signature. The date of the signing must be indicated in the box on the far left of the last line.