Fill and Sign the Local Forms United States Bankruptcy Court for the Western

IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA LOCAL BANKRUPTCY FORM #19 +, . - Check here if this is an amended plan Chapter 13 Case No.: _____________ D#1 _____________________________ D#1 SSN: __________________________D#2 _____________________________ D#2 SSN: __________________________ PLAN SUMMARY COMBINED WITH NOTICE OF CLAIMS BY DEBTOR Total amount of $_________ per month shall be paid to the Trustee from future earnings as follows: Payments:D#1 D#2 By income attachment $ _______________ $ _______________ Directly by Debtor $________________ $________________By Automated Bank Transfer $________________ $________________ Estimated amount of additional plan funds from sale proceeds, etc.: $_________________ It is proposed that payments shall be made over a period of ____________months (total plan length) 1. LONG TERM CONTINUING SECURED DEBTS CURED AND REINSTATED, AND LIEN RETAINED. Name of Creditor Contractual monthly payment to be paidthroughout planAmount ofprepetitionarrears to becured underplanInterestrate to bepaid onarrears Months expectedto cure arrears(begin - end) Totalclaimamount 2. SECURED CLAIMS PAID IN FULL DURING TERM OF PLAN, ACCORDING TO ORIGINAL CONTRACT TERMS, WITH NO MODIFICATION OF CONTRACTUAL TERMS AND LIENS RETAINED UNTIL PAID Name of Creditor Principal paidInterestRateContractualmonthlypayment Plan monthclaimexpectedto be paidin fullAmount ofprepetitionarrears tobe cured Interestrate tobe paidonarrearsMonthsexpectedto curearrears(begin -end)Totalclaim 3. SECURED CLAIMS FULLY PAID ACCORDING TO MODIFIED TERMS AND LIENS RETAINED Name of Creditor Modified PrincipalBalanceInterestRate MonthlyPayment Month Paymentsto begin Number ofmonths 4. SECURED CLAIMS NOT PAID DUE TO 5. THE DEBTOR PROPOSES TO AVOID OR SURRENDER OF COLLATERAL AND LIMIT THE LIENS OF THE DATE TO BE SURRENDERED FOLLOWING CREDITORS 6. SECURED TAX CLAIMS FULLY PAID AND LIENS RETAINED Name of Creditor Total amount of secured tax claimInterest rateMonthlypayment Month payments tobegin Number ofmonths 7. PRIORITY TAX CLAIMS PAID IN FULL Name of Creditor Total amount ofpriority tax andinterest claimInterestrate Monthlypayment Monthpayments tobegin Number ofmonths 8. ADMINISTRATIVE PRIORITY CLAIMS FULLY PAID a. Percentage fees payable to the Chapter 13 Fee and Expense Fund shall be paid at the rate fixed by the United States Trustee not to exceed ten percent of distributions. b. Filing fees: the balance of $________________ shall be fully paid by the Trustee to the Clerk of Bankruptcy Court from the first available funds. c Attorney fees: payable to(name and address) ______________________________________________________________________________________________________. d. In addition to a retainer of $_____________ already paid by or on behalf of the debtor, the amount of $__________________. Distributions estimated to begin in month number: _______ for a totalof ________ months. e. Other professional fees: payable to (name and address) __________ __________________________________________________________________________.In addition to a retainer of $_______________ already paid by or on behalf of debtor, the amount of$___________. Distributions estimated to begin in month number: __________ for a total of __________months. 9. OTHER PRIORITY CLAIMS TO BE PAID IN FULL Name of Creditor Total amount of claimInterest rateMonthlypaymentMonth payments tobegin Number ofmonths 10. CLAIMS OF UNSECURED, NONPRIORITY CREDITORS SPECIALLY CLASSIFIED Name of Creditor PrincipalbalanceInterest rateMonthlypayments Arrearsto becured Interestrate onarrearsMonthpaymentto begin Numberofmonths 11. CLAIMS OF GENERAL, NONPRIORITY UNSECURED CREDITORS: Creditors not specifically identified in Parts 1 - 10, above, are included in this class. The estimated percentage of payment to general, unsecured creditors is ____________ % 2. Distributions to general, unsecured creditors expected to begin in month ________ of the plan term and tocontinue for ____________ months. The percentage of payment may change, based upon the total amount ofallowed claims.***************************************************************************************** The foregoing is an accurate summary of debtor's plan. The corresponding plan contains greater details, and should be consulted for further information. The statements in the plan constitute claims by debtorfor those secured and priority creditors provided to be paid therein. Pursuant to Rule 3004, such claimswill take effect one day after the §341 meeting unless the creditor has filed its own superseding claim.Name, address and telephone number of attorney for debtor (or debtor if not represented by attorney):_______________________________________________________________________________________________________________________________________