Fill and Sign the Pa Debtor Form

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: By income attachment Directly by Debtor By Automated Bank Transfer D#1 $       $       $       D#2 $       $       $       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 paid throughout plan Amount of prepetition arrears to be cured under plan Interest rate to be paid on arrears Months expected to cure arrears (begin - end) Total claim amount                                                                                                             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 paid Interest Rate Contractual monthly payment Plan month claim expected to be paid in full Amount of prepetition arrears to be cured Interest rate to be paid on arrears Months expected to cure arrears (begin - end) Total claim                                                                                                                                                                   3. SECURED CLAIMS FULLY PAID ACCORDING TO MODIFIED TERMS AND LIENS RETAINED Name of Creditor Modified Principal Balance Interest Rate Monthly Payment Month Payments to begin Number of months                                                                                                             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 claim Interes t rate Monthly payment Month payments to begin Number of months                                                                                                             7. PRIORITY TAX CLAIMS PAID IN FULL Name of Creditor Total amount of priority tax and interest claim Interest rate Monthly payment Month payments to begin Number of months                                                                                                             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 $       . D istributions estimated to begin in month number:       for a total of       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 claim Interest rate Monthly payment Month payments to begin Number of months                                                                                                             10. CLAIMS OF UNSECURED, NONPRIORITY CREDITORS SPECIALLY CLASSIFIED Name of Creditor Principal balance Interest rate Monthly payments Arrears to be cured Interest rate on arrears Month payment to begin Number of months                                                                                                                                                 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       % Distributions to general, unsecured creditors expected to begin in month       of the plan term and to continue for       months. The percentage of payment may change, based upon the total amount of allowed 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 debtor for those secured and priority creditors provided to be paid therein. Pursuant to Rule 3004, such claims will 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):