Fill and Sign the Adversary Proceeding Cover Sheet United States Form

B104 (FORM 104) (08/07) 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) □ Debtor □ U.S. Trustee/Bankruptcy Admin □ Creditor □ Other □ Trustee PARTY (Check One Box Only) □ Debtor □ U.S. Trustee/Bankruptcy Admin □ Creditor □ Other □ Trustee CAUSE OF ACTION (WRITE A BRIEF STATEMENT OF CAUSE OF ACTION, INCLUDING ALL U.S. STATUTES INVOLVED) NATURE OF SUIT (Number up to five (5) boxes starting with l ead cause of action as 1, first alternative cause as 2, second alternative cause as 3, etc.) FRBP 7001(1) – Recovery of Money/Property □ 11-Recovery of money/property - §542 turnover of property □ 12-Recovery of money/property - §547 preference □ 13-Recovery of money/property - §548 fraudulent transfer □ 14-Recovery of money/property - other FRBP 7001(2) – Validity, Priority or Extent of Lien □ 21-Validity, priority or extent of lien or other interest in property FRBP 7001(3) – Approval of Sale of Property □ 31-Approval of sale of property of estate and of a co-owner - §363(h) FRBP 7001(4) – Objection/Revocation of Discharge □ 41-Objection / revocation of discharge - §727(c),(d),(e) FRBP 7001(5) – Revocation of Confirmation □ 51-Revocation of confirmation FRBP 7001(6) – Dischargeability □ 66-Dischargeability - §523(a)(1),( 14),(14A) priority tax claims □ 62-Dischargeability - §523(a)(2), false pretenses, false representation, actual fraud □ 67-Dischargeability - §523(a)(4), fraud as fiduciary, embezzlement, larceny (continued next column) FRBP 7001(6) – Discharg eability (continued) □ 61-Dischargeability - §523(a)(5), domestic support □ 68-Dischargeability - §523(a)(6), willful and malicious injury □ 63-Dischargeability - §523(a)(8), student loan □ 64-Dischargeability - §523(a)(15), divorce or separation obligation (other than domestic support) □ 65-Dischargeability - other FRBP 7001(7) – Injunctive Relief □ 71-Injunctive relief – imposition of stay □ 72-Injunctive relief – other FRBP 7001(8) Subordination of Claim or Interest □ 81-Subordination of claim or interest FRBP 7001(9) Declaratory Judgment □ 91-Declaratory judgment FRBP 7001(10) Determination of Removed Action □ 01-Determination of removed claim or cause Other □ SS-SIPA Case – 15 U.S.C. §§78aaa et.seq. □ 02-Other (e.g. other actions that w ould have been brought in state court if unrelated to bankruptcy case) □ Check if this case involves a substantive issue of state law □ Check if this is asserted to be a class action under FRCP 23 □ Check if a jury trial is demanded in complaint Demand $ Other Relief Sought B104 (FORM 104) (08/07), Page 2 BANKRUPTCY CASE IN WHICH THIS ADVERSARY PROCEEDING ARISES NAME OF DEBTOR BANKRUPTCY CASE NO. DISTRICT IN WHICH CASE IS PENDING DIVISION OFFICE NAME OF JUDGE RELATED ADVERSARY PROCEEDING (IF ANY) PLAINTIFF DEFENDANT ADVERSARY PROCEEDING NO. DISTRICT IN WHICH ADVERSARY IS PENDING DIVISION OFFICE NAME OF JUDGE SIGNATURE OF ATTORNEY (OR PLAINTIFF) DATE PRINT NAME OF ATTORNEY (OR PLAINTIFF) INSTRUCTIONS The filing of a bankruptcy case creates an "estate" under th e jurisdiction of the bankruptcy court which consists of all of the property of the debtor, wherever that property is located. Because the bankruptcy estate is so extensive and the jurisdiction of the court so broad, there may be lawsuits over the property or property rights of the estate. There also may be lawsuits concerning the debtor’s discharge. If such a lawsu it is filed in a bankruptcy court, it is called an adversary proceeding. A party filing an adversary proceeding must also must complete and file Form 104, th e Adversary Proceeding Cover Sheet, unless the party files the adversary proceeding electroni cally through the court’s Case Management/Electronic Case Filing system (CM/ECF). (CM/ECF captures the information on Fo rm 104 as part of the filing process.) When completed, the cover sheet summarizes basic information on the adversar y proceeding. The clerk of court needs the information to process the adversary proceeding and prepare re quired statistical reports on court activity. The cover sheet and the information contained on it do not replace or supplement the filing and service of pleadings or other papers as required by law, the Bankruptcy Rules, or the local rules of court. The cover sheet, which is largely self- explanatory, must be completed by the pl aintiff’s attorney (or by the plaintiff if the plaintiff is not represented by an attorney). A separate cover sheet must be submitted to the clerk for each complaint filed. Plaintiffs and Defendants. Give the names of the plaintiffs and defendants exactly as they appear on the complaint. Attorneys. Give the names and addresses of the attorneys, if known. Party . Check the most appropriate box in th e first column for the plaintiffs and the second column for the defendants. Demand. Enter the dollar amount being demanded in the complaint. Signature. This cover sheet must be signed by the attorney of record in the box on the second page of the form. If the plaintiff is represented by a law firm, a member of the firm must sign. If the plaintiff is pro se, that is, not represented b y an attorney, the plaintiff must sign.