United States Bankruptcy Court District of Massachusetts
File Claim
Case Number
Example: 14-00002
 
Name of Creditor
Filed by

IMPORTANT NOTICE OF REDACTION RESPONSIBILITY: All filers must redact Social Security or taxpayer-identification numbers; dates of birth; names of minor children; and financial account numbers, in compliance with Fed. R. Bankr. P. 9037. This requirement applies to all documents, including attachments.

DOCUMENTATION: The filer shall comply with the requirements of Fed. R. Bankr. P. 3001(c) and (d) regarding the attachment of documentation in electronic format sufficient to establish the validity and status of the filing.

SIGNATURE: Documents filed electronically shall constitute the filer’s approved signature shall have the same effect as if the filer signed a paper copy and the provisions of 18 U.S.C. §152 shall apply to such filing.

IMPORTANT WARNING: A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both.
18 U.S.C. §§ 152, 157, and 3571.

I understand that, if I file, I must comply with the redaction rules. I have read this notice.

NOTE: This form should not be used to make a claim for an administrative expense arising after the commencement of the case. A "request" for payment of an administrative expense may be filed pursuant to 11 U.S.C. § 503.

Installed Version: 7