Bankruptcy Attorney Packet

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1 Bankruptcy Attorney Packet Documents Enclosed: Reimbursement Guidelines for attorneys MVLS Memorandum of Preferred Process Server Litigation Fund Forms and Guidelines Sample Representation Agreement MVLS Case Guidelines MVLS financial guidelines for case acceptance - FYI Application for Waiver of the Chapter 7 Filing Fee MVLS Case Closure Form General Information: We strongly suggest that you have a written representation agreement between you and the client. A sample agreement is enclosed if you do not have one you regularly use. A significant number of MVLS clients have difficulty reading. As such, we suggest you try to determine the client s literacy level. If unsure, you may want to verbally review the Representation Agreement and other important documents with the client. It is important to set parameters for client contact early in your representation. If another legal issue arises for your client during your representation, please contact us. We will contact the client to get information to discern if the issue is one that we can assist with. If so, it will be your decision whether to represent the client in the additional matter. If you decide not to assist with the new matter, let us know; we may be able to refer the client s new matter to another panel attorney. If you have questions about this area of law or need assistance, call us to provide you with the contact information for an experienced mentor ready and willing to assist. Please note: Contact the paralegal assigned to this case with any questions or problems. Thank you again for helping us make pro bono count. Maryland Volunteer Lawyers Service 201 North Charles Street Suite 1400 Baltimore, MD Tel: (410) Fax: (443) info@mvlslaw.org

2 Guidelines Governing MVLS Reimbursement of Expenses The following guidelines govern MVLS reimbursement of expenses: 1. AVAILABILITY OF FUNDS Reimbursement is subject to the availability of funds for this purpose. 2. COURT COSTS The U.S. Bankruptcy Court should waive initial filing fees and costs in accordance with 11 U.S.C 109 (h)(4). We have included an APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS and an ORDER ON DEBTOR S APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE in your packet. If not waived, Clients are expected to pay the Bankruptcy filing fee. MVLS does not have funds for this purpose. 3. DEPOSITIONS AND EXPERT WITNESSES All efforts should be made to request reduced rates for depositions and transcripts. Costs of expert witnesses are reimbursed only where the attorney supports the request with a statement that there are no less costly alternatives available that would be acceptable under general standards of professional practice. Every effort should be made to negotiate a reduced fee from an expert witness. 4. APPEALS No costs are reimbursable in connection with an appeal from a lower to a higher court unless the appeal and the costs are approved by MVLS in advance. 5. REAL ESTATE FEES MVLS does not reimburse for real estate transfer or recordation fees. 6. DETAILS FOR REIMBURSEMENT REQUESTS Please submit receipts for any expenses that ordinarily provide receipts, such as parking. Include your name, address & tax identification number, the client s name and the MVLS client number on all requests. Please allow up to 30 days for payment to reach you.

3 MEMORANDUM TO: FROM: RE: MVLS Volunteer Attorneys Susan Francis, Esq. Deputy Director Preferred Process Server for MVLS Cases Many of the cases handled through MVLS will involve the need for a private process server. If your MVLS client is in need of service, MVLS has created a relationship with Expedited Courier Group of Baltimore, Maryland that should be of help. Expedited Courier Group provides a 20% discount on process service for all MVLS clients. To receive this discount, please contact their Baltimore office and state that the case was referred through MVLS. Also, you should mention the MVLS case number. The discount applies to MVLS pro bono and Judicare cases. The discount is not applicable to cases handled through another legal services organization. The contact information for Expedited is below: Amir Miremadi President Expedited Courier Group 200 St. Paul Street Suite #1 Baltimore, MD Baltimore: MD & DC: amir@expeditedcouriergroup.com If you have any questions, please contact me at your earliest convenience. Susan Francis, Esq. Deputy Director sfrancis@mvlslaw.org

4 August 15, 2013 Re: Litigation Fund Updated Forms and Guidelines Dear MLSC Grantee, As you are aware, the Pro Bono Resource Center of Maryland (PBRC) administers a Pro Bono / Judicare Litigation Fund, an annual grant funded by the Maryland Legal Services Corporation (MLSC). Below please find a brief update on the status of the Litigation Fund. Please update your records, case acceptance packets and website accordingly. Updated Forms and Guidelines. In July PBRC updated the policy and reimbursement request forms for the Pro Bono / Judicare Litigation Fund. In addition to the reimbursement request form, attorneys should submit a Mileage Tracking Sheet (Attachment A) (if applicable) and any and all receipts/documentation which support the claimed expenses. Copies of receipts are acceptable, but no request will be approved without full documentation and submission of all forms. The Pro Bono/Discounted Services Statement (formerly Attachment A) is no longer required. However, all legal service programs and pro bono attorneys are still encouraged to seek pro bono or discounted services prior to requesting reimbursement. Please find attached hard copy versions suitable for inclusion in new attorney case acceptance packets. Electronic versions are available at Eligibility. Any attorney who handles a Judicare or pro bono case through your or other MLSC-funded legal services programs may be eligible for reimbursement through the Litigation Fund. Restrictions apply, and there is no guarantee that requests will be approved. Reimbursements are based on the availability of funds and subject to review by PBRC. Please be advised that all FY2013 funds have been spent, so only expenses incurred on or after July 1, 2013 are currently eligible for reimbursement. Please keep this letter for your records, and thank you for all of your efforts to promote equal justice in Maryland. If you have any questions/comments, please do not hesitate to contact me at or abrinkmann@probonomd.org. Best regards, Annie Brinkmann, Esq. Director of Volunteer Services

5 Pro Bono / Judicare Litigation Fund Guidelines Administered by: PRO BONO RESOURCE CENTER OF MARYLAND, INC. (PBRC) 520 W. Fayette Street, Baltimore, MD *FUNDS ARE AVAILABLE TO JUDICARE AND PRO BONO ATTORNEYS HANDLING CASES THROUGH MLSC FUNDED AGENCIES ONLY. THERE IS NO GUARANTEE THAT REQUESTS WILL BE APPROVED. REIMBURSEMENTS ARE BASED ON THE AVAILABILITY OF FUNDS AND SUBJECT TO REVIEW by PBRC.* Note: These guidelines are subject to change. Please contact PBRC with any questions. 1. MAXIMUM ALLOWABLE LIMIT There are two caps: $1,000 per attorney per fiscal year, whether single fee or aggregate. $1,500 over the lifetime of a case, whether single fee or aggregate. 2. AVAILABILITY OF FUNDS Funds are limited. Reimbursement is subject to the availability of funds and is disbursed on a first come, first served basis. 3. SUBMISSION DEADLINES Requests must be submitted within 60 days of the incurred expense. Requests for reimbursement of expenses incurred on or before June 30th must be received by July 15th in order to be processed. 4. REQUEST PRO BONO OR DISCOUNTED SERVICES PRIOR TO SUBMISSION Since funds are limited, all legal service programs and pro bono attorneys are encouraged to seek pro bono or discounted services prior to requesting reimbursement. 5. CONTRIBUTIONS FROM OPPOSING PARTY The Litigation Fund was not intended to subsidize costs for the opposing party. Unless court rules indicate otherwise, pro bono attorneys are encouraged to seek contribution for discovery and other litigation costs from the opposing party. 6. DOCUMENTATION REQUIRED For each individual case: Fill out a separate Reimbursement Request Form, Mileage Tracking Sheet (Attachment A) (if applicable), and attach all receipts/documentation of your expenses. Required documentation includes receipts, invoices, billings of amounts payable, etc. Copies are acceptable, but no request will be approved without full documentation. There will be no reimbursement for expenditures of $10.00 or less. 7. COURT COSTS A Circuit Court will waive initial filing fees and costs in the case of a client s indigency in accordance with Rule 1-325(a). If a waiver was granted at the beginning of a domestic relations case, a modified affidavit must be filed at the conclusion of the case to waive final fees and costs, including those of a master or examiner, in accordance with Rule 2-603(e). At present, bankruptcy filing fees will not be reimbursed.

6 8. OFFICE EXPENSES The expenses involved must be non-routine cash expenditures outside the normal scope of office operations. There will be no reimbursement for such items as the value of secretarial time, local phone calls, minor numbers of copies made on office copiers or postage for routine correspondence. PBRC reserves the right to deny requests that are excessive. The following is the list of routine reimbursable items: Mileage: $0.50 per mile Substantial photocopies: up to $0.10 per page Faxes: $1.00 per page Large mailings and registered mail may be covered, but routine correspondence will not. 9. SERVICE OF PROCESS All legal service programs and attorneys are encouraged to seek pro bono or discounted services prior to requesting reimbursement. If pro bono services are not available, costs to hire a company in your area for service of process may be reimbursed. 10. DEPOSITIONS AND EXPERT WITNESSES Costs of expert witnesses are reimbursed only where the attorney supports the request with a statement that there were no less costly alternatives available that would have been acceptable under general standards of professional practice. Every effort should be made to negotiate a reduced fee from an expert witness. Prior approval of these expenses by PBRC is required to be considered for full reimbursement. 11. APPEALS Appellate costs will not be reimbursed without prior approval of the expenses by PBRC. 12. REAL ESTATE FEES Reimbursement will not be made for real estate transfer or recordation fees. 13. ATTORNEY TIME Due to the limited nature of the fund, reimbursement will not be made for specialized attorney time. How to Request Reimbursement from the Litigation Fund For each individual case: Fill out a separate Reimbursement Request Form, a Mileage Tracking Sheet (Attachment A) (if applicable), and attach all receipts/documentation of your expenses. Copies are acceptable. You can find these forms 1) online at 2) at your local MLSC-funded pro bono referral program by request; or 3) at the Pro Bono Resource Center by request. Submit your request to PBRC at the below address. Pro Bono Resource Center of Maryland, Inc. 520 West Fayette Street, Suite 300 Baltimore, MD ATTN: Pro Bono / Reduced Fee Litigation Fund Fax: Questions? Contact Annie Brinkmann, Esq. at: x3050 or abrinkmann@probonomd.org

7 PRO BONO / REDUCED FEE LITIGATION FUND REIMBURSEMENT REQUEST FORM Funds are available to Judicare and pro bono attorneys handling cases through MLSC-funded agencies only. There is no guarantee that requests will be approved. Reimbursements are based on the availability of funds and subject to review by PBRC. Sponsoring Agency: Attorney Name: Phone #: Firm: Attorney Mailing Address: Case Type: Pro Bono (Free) Judicare Low bono/reduced Fee Agency Case No.: Client Name: Court Case No.: Make Check Payable to: Checklist: All expenses were incurred within the last 60 days I sought pro bono or discounted services The following supporting documentation is attached: All receipts, invoices, billings of amounts payable Attachment A: Mileage tracking sheet* (if requesting mileage) *form available at Itemized List of Expenses: Comments: In the space below, provide an itemized list of expenses for which you are seeking payment through the Litigation Fund. Type of Expense (e.g. postage, mileage, discovery, etc.) Cost Description Date (1) $ (2) $ (3) $ (4) $ (5) $ (6) $ (7) $ (8) $ TOTAL REQUESTED $ Preapproval Only Reimbursement Direct Pay Attorney Signature: Date: Please review the Litigation Fund Policy (available at 111.probobomd.org/litigation-fund-policy) for requirements, restrictions, required forms, and additional information. For PBRC Use Only Lit Fund Request: 201 -LF Recommendation: [ ] Preapproval Only [ ] Approve in full [ ] Partial Approval [ ] Deny Comment(s): For PBRC Executive Director Use Only Final Decision: [ ] Preapproval Only [ ] Approve in full [ ] Partial Approval [ ] Deny Signature: Date: Check No.: Comment(s): PLEASE MAIL THIS FORM AND REQUIRED DOCUMENTATION TO: Litigation Fund / Pro Bono Resource Center of Maryland, Inc. 520 W. Fayette St, Baltimore, MD Questions? Contact Annie Brinkmann, Esq. at: x3050 or abrinkman@probonomd.org

8 PRO BONO / REDUCED FEE LITIGATION FUND ATTACHMENT A: Mileage Tracking Sheet Funds are available to Judicare and pro bono attorneys handling cases through MLSC-funded agencies only. There is no guarantee that requests will be approved. Reimbursements are based on the availability of funds and subject to review by PBRC Sponsoring Agency: Attorney Name: Client Name:. Date of Trip Miles $0.50 per mile Origination Address Destination Address Purpose PBRC-use only Total $ Attorney Signature Date: (Attachment A, Page of ) Please review the Litigation Fund Policy (available at for requirements, restrictions, required forms, and addition information For PBRC Use Only Lit Fund Request: 201 -LF ATTACH TO REIMBURSEMENT REQUEST FORM AND MAIL TO: Litigation Fund / Pro Bono Resource Center of Maryland, Inc. 520 W. Fayette St, Baltimore, MD ATTACHMENT A Questions? Contact Annie Brinkmann, Esq. at: x3050 or abrinkman@probonomd.org

9 Maryland Volunteer Lawyers Service Representation Agreement This Agreement for legal services is between, a volunteer attorney with the Maryland Volunteer Lawyers Service, Inc., hereinafter referred to as the Attorney, and, hereinafter referred to as the Client. I,, the Client, hereby authorize the Attorney to represent me as my lawyer in the following matter: and to obtain any information or documents necessary for such representation. I understand that this agreement does not require the Attorney to represent me in an appeal from the decision of the trial court or administrative hearing or in any other matter not specified in this Agreement. Client's Rights I have the right to be kept informed about any important developments in my case and to be consulted before the Attorney makes any important decision on my behalf. I also have the right to receive enough information to make an informed decision; to be consulted; and to agree to any settlement before my Attorney settles the case. Client's Responsibilities I will inform the Attorney and Maryland Volunteer Lawyers Service about any change in my address, my telephone number or my financial status. I will cooperate with the Attorney in the preparation and presentation of the case by always telling the truth and taking into consideration my Attorney's reasonable advice in making decisions about the case. I will keep all appointments with the Attorney in a timely fashion or notify the Attorney in advance if I am unable to keep an appointment. I will appear at my hearings and court appearances. I will avoid communication with opposing parties or opposing counsel unless my Attorney tells me that I can communicate with them. Attorney Obligations The Attorney will keep me informed of the progress of my case and will consult with me before making any significant decision on my behalf. The Attorney will keep all the information regarding my case confidential, except the Attorney may discuss the case with other attorneys and professionals whenever the Attorney determines it is necessary to obtain information to help handle the case. My Attorney will keep in strict confidence anything I tell my Attorney and any discussion my Attorney may have with other attorneys or professionals about the case. To the extent, if at all, that the attorney-client privilege would prohibit my Attorney from talking to the Maryland Volunteer Lawyers Service about my case, I specifically waive the privilege to that extent and hereby authorize my Attorney to discuss my case with Maryland Volunteer Lawyers Service.

10 Attorney Fees The Attorney will represent me in the above matter without charging attorney's fees so long as I remain eligible to receive free legal services under the Maryland Volunteer Lawyers Service's eligibility guidelines. If my financial eligibility changes so that I no longer qualify to receive free legal services under Maryland Volunteer Lawyers Service's guidelines, the Attorney may enter into a new fee arrangement with me for the remainder of the representation, but not for the services rendered before the change in my eligibility. If attorney's fees are awarded in any action brought by the Attorney on my behalf, the Attorney will have the exclusive right to any such fees, and I will have no claim on any such fees except for such amounts that exceed the Attorney's reasonable and customary fees. Should these fees come into my possession for any reason, I will promptly remit them in full to the Attorney. Case Costs and Other Expenses The Attorney is not responsible for paying any court costs, bonds, filing fees, fines, judgments, assessments, or any other costs or expenses imposed on or incurred by me in connection with this case. Maryland Volunteer Lawyers Service may reimburse my Attorney for covered costs and expenses that total over $10.00 incurred in connection with the matters referred to Attorney by Maryland Volunteer Lawyers Service or another pro bono program, to the extent that these costs are not waived by the appropriate agency or court. I understand that Maryland Volunteer Lawyers Service will not reimburse costs of appeal, matters not specifically referred to the Attorney on pro bono basis, and filing fees in bankruptcy cases. I understand that I will be responsible for payment of costs and expenses not waived by a court or not reimbursed by Maryland Volunteer Lawyers Service. Termination of Representation I have the absolute right to terminate this agreement for any reason at any time by writing to the Attorney. I understand that if I do so, only in extraordinary circumstances will Maryland Volunteer Lawyers Service find me another attorney. The Attorney may also terminate this agreement (in writing) either with my consent or for good cause. Good cause includes my failure to comply with this Agreement, my refusal to cooperate with the Attorney or to follow the Attorney's advice on a material matter, my failure to truthfully disclose the amount of my income, or any other fact or circumstance that would result in Attorney's representation being unlawful, unethical, or impractical. The Attorney may also terminate this Agreement if further representation would be useless or unreasonable or if the nature of my case has changed significantly from the facts that I initially presented. This agreement is the entire agreement between Client and Attorney, and can be changed only with both Attorney and Client agreeing in writing. Signature of Client Date Signature of Attorney Date

11 MEMORANDUM TO: MVLS Community FROM: Bonnie A. Sullivan, Esq., Executive Director DATE: December 1, 2013 RE: MVLS Case Guidelines MVLS is committed to placing clients with volunteer attorneys for any civil issue not precluded by funders so long as the clients meet all income and asset guidelines. Seasoned paralegals are empowered to utilize their judgment and reserve the right to deny services to clients with a history of violent tendencies. MVLS does not place cases in the following areas: Criminal law (we do expungements) Class Action lawsuits Appeals (we do 1 st time administrative appeals) Fee Generating Cases Social Security, SSI or SSDI denials Guidelines for specific matters: This section is designed to provide additional guidance. Just because no specific guidelines are listed below, we may still take the case so long as it is not precluded based on the list above. For example, we do adoptions, name changes, immigration status changes, school suspensions and wage claims, mortgage foreclosure, foreclosure mediation, powers of attorney, etc. WE PLACE LARGE NUMBERS OF FAMILY LAW MATTERS General guidelines for ALL family law matters: Client may not have any CPS/DSS findings against him or her and open investigations must be closed No affirmative appeals Modification cases (there must be a material change in circumstances) Contempt or defense of contempt cases only on a case by case determination Third party custody only on a case by case basis Absolute divorce - Parties must be separated for a minimum of 12 months, unless there are allegations of domestic violence or the other party has already filed Limited divorce Case by case basis

12 GENERAL CIVIL MATTERS Name Change Bankruptcy Client must have documentation to show the name that he or she has been using (school records, medical records, etc.) Chapter 7 and Chapter 13 eligible (13 s are generally foreclosure project cases) Client may own one home and one car. Client can have no more than $5K in assets ($10K for a couple) Client must have a minimum of $10K of dischargeable debt (no minimum for foreclosure/bankruptcy issues) Collection Deed Change Client must be the defendant Must be for the purpose of adding or removing a person s name If removing the name of a living party from the deed, that party must consent Landlord/Tenant Probate of Estates Public Benefits Tax Controversies Tort Client must have been a tenant or a non-commercial landlord Must be small estate (less than $50K) No representation for second appeals Tax controversy must be income tax-related. Amount in controversy generally should not be greater than $50,000 (not including interest unless there is dispute about interest) for any one tax year. Client must have documentation of some sort defining the nature of the problem for which client seeks assistance. Client must be the defendant Uninsured Motor Tort Client and vehicle must be uninsured at the time of the accident

13 Client Income Eligibility Guidelines Please note that clients must be within 50% of Maryland Median Income to be eligible for services. July 1, 2013 through June 30, 2014 Family Size Annual Income Monthly Income Weekly Income 1 $27,390 $2,283 $ ,818 2, ,246 3, ,674 4,390 1, ,102 5,092 1, ,530 5,794 1, ,110 5,926 1, ,690 6,058 1, ,270 6,189 1, ,851 6,321 1,459

14 B3B (Official Form 3B) (11/11) APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS The court fee for filing a case under chapter 7 of the Bankruptcy Code is $306. If you cannot afford to pay the full fee at the time of filing, you may apply to pay the fee in installments. A form, which is available from the bankruptcy clerk s office, must be completed to make that application. If your application to pay in installments is approved, you will be permitted to file your petition, generally completing payment of the fee over the course of four to six months. If you cannot afford to pay the fee either in full at the time of filing or in installments, you may request a waiver of the filing fee by completing this application and filing it with the Clerk of Court. A judge will decide whether you have to pay the fee. By law, the judge may waive the fee only if your income is less than 150 percent of the official poverty line applicable to your family size and you are unable to pay the fee in installments. You may obtain information about the poverty guidelines at or in the bankruptcy clerk s office. Required information. Complete all items in the application, and attach requested schedules. Then sign the application on the last page. If you and your spouse are filing a joint bankruptcy petition, you both must provide information as requested and sign the application. B3B (Official Form 3B) (11/11) -- Cont.

15 UNITED STATES BANKRUPTCY COURT District of In re: Case No. Debtor(s) (if known) APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS Part A. Family Size and Income 1. Including yourself, your spouse, and dependents you have listed or will list on Schedule I (Current Income of Individual Debtors(s)), how many people are in your family? (Do not include your spouse if you are separated AND are not filing a joint petition.) 2. Restate the following information that you provided, or will provide, on Line 16 of Schedule I. Attach a completed copy of Schedule I, if it is available. Total Combined Monthly Income (Line 16 of Schedule I): $ 3. State the monthly net income, if any, of dependents included in Question 1 above. Do not include any income already reported in Item 2. If none, enter $0. $ 4. Add the Total Combined Monthly Income reported in Question 2 to your dependents monthly net income from Question 3. $ 5. Do you expect the amount in Question 4 to increase or decrease by more than 10% during the next 6 months? Yes No If yes, explain. Part B. Monthly Expenses 6. EITHER (a) attach a completed copy of Schedule J (Schedule of Monthly Expenses), and state your total monthly expenses reported on Line 18 of that Schedule, OR (b) if you have not yet completed Schedule J, provide an estimate of your total monthly expenses.

16 $ 7. Do you expect the amount in Question 6 to increase or decrease by more than 10% during the next 6 months? Yes No If yes, explain. Part C. Real and Personal Property EITHER (1) attach completed copies of Schedule A (Real Property) and Schedule B (Personal Property), OR (2) if you have not yet completed those schedules, answer the following questions. 8. State the amount of cash you have on hand. $ 9. State below any money you have in savings, checking, or other accounts in a bank or other financial institution. Bank or Other Financial Institution: Type of Account such as savings, checking, CD: Amount: $ $ B3B (Official Form 3B) (11/11) -- Cont. 10. State below the assets owned by you. Do not list ordinary household furnishings and clothing. Home Address: Value: $ Amount owed on mortgages and liens: $ Other real estate Address:

17 Value: $ Amount owed on mortgages and liens: $ Motor vehicle Model/Year: Value: $ Amount owed: $ Motor vehicle Model/Year: Value: $ Amount owed: $ Other Description Value: $ Amount owed: $ 11. State below any person, business, organization, or governmental unit that owes you money and the amount that is owed. Name of Person, Business, or Organization that Owes You Money Amount Owed $ $ Part D. Additional Information. 12. Have you paid an attorney any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes No

18 If yes, how much have you paid? $ 13. Have you promised to pay or do you anticipate paying an attorney in connection with your bankruptcy case? Yes No If yes, how much have you promised to pay or do you anticipate paying? $ 14. Have you paid anyone other than an attorney (such as a bankruptcy petition preparer, paralegal, typing service, or another person) any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes No If yes, how much have you paid? $ 15. Have you promised to pay or do you anticipate paying anyone other than an attorney (such as a bankruptcy petition preparer, paralegal, typing service, or another person) any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes No If yes, how much have you promised to pay or do you anticipate paying? $ 16. Has anyone paid an attorney or other person or service in connection with this case, on your behalf? Yes No If yes, explain. B3B (Official Form 3B) (11/11) -- Cont. 17. Have you previously filed for bankruptcy relief during the past eight years? Yes No Case Number (if known) Year filed Location of filing Did you obtain a discharge? (if known) Yes No Don't know Yes No Don't know 18. Please provide any other information that helps to explain why you are unable to pay the filing fee in installments. 19. I (we) declare under penalty of perjury that I (we) cannot currently afford to pay the filing fee in full or in installments and that the foregoing information is true and correct. Executed on:

19 Date Signature of Debtor Date Signature of Codebtor DECLARATION AND SIGNATURE OF BANKRUPTCY PETITION PREPARER (See 11 U.S.C. 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. 110(b), 110(h), and 342(b); and (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required under that section. Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social-Security No. (Required by 11 U.S.C. 110.) If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and socialsecurity number of the officer, principal, responsible person, or partner who signs the document. Address x Signature of Bankruptcy Petition Preparer Date Names and Social-Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not an individual: If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer s failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. 110; 18 U.S.C. 156.B3B (Official Form 3B) (11/11) -- Cont.

20 UNITED STATES BANKRUPTCY COURT District of In re: Case No. Debtor(s) ORDER ON DEBTOR S APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE Upon consideration of the debtor s Application for Waiver of the Chapter 7 Filing Fee, the court orders that the application be: [ ] GRANTED. This order is subject to being vacated at a later time if developments in the administration of the bankruptcy case demonstrate that the waiver was unwarranted. [ ] DENIED. The debtor shall pay the chapter 7 filing fee according to the following terms: $ on or before $ on or before $ on or before $ on or before Until the filing fee is paid in full, the debtor shall not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. IF THE DEBTOR FAILS TO TIMELY PAY THE FILING FEE IN FULL OR TO TIMELY MAKE INSTALLMENT PAYMENTS, THE COURT MAY DISMISS THE DEBTOR S CASE. [ ] SCHEDULED FOR HEARING. A hearing to consider the debtor s Application for Waiver of the Chapter 7 Filing Fee shall be held on at am/pm at. (address of courthouse) IF THE DEBTOR FAILS TO APPEAR AT THE SCHEDULED HEARING, THE COURT MAY

21 DEEM SUCH FAILURE TO BE THE DEBTOR S CONSENT TO THE ENTRY OF AN ORDER DENYING THE FEE WAIVER APPLICATION BY DEFAULT. BY THE COURT: DATE: United States Bankruptcy Judge

22 Maryland Volunteer Lawyers Service --- General Pro Bono Case Closure MVLS is required to furnish to its grantors and the Court of Appeals information about closed pro bono cases referred to attorneys in private practice. Your completion of this form, including the approximate number of hours spent and the result achieved, will help us comply with grant requirements and will ensure that you receive recognition for the services you performed. Attorney Name: Client Name: Total Attorney Hours at Closure: Date: MVLS Case Number: Total Dollar Value at Closure: Was this a good story? Yes No Are you ready for another referral? Yes Not yet Reason Case Closed (please check one): Advice and Brief service (30 minutes or less) Counseling Referral to other agency Insufficient merit to proceed Client withdrew, did not return Negotiated settlement (without litigation) Negotiated settlement (with litigation) Brief summary of the legal issues and the results achieved: Administrative agency decision Uncontested court decision Contested court decision Appeals Change of eligibility status Other: Extensive services (over 20 hours) please explain in the comments section below Comments (attach extra sheet if necessary): Please return this form to: Michelle Swift Maryland Volunteer Lawyers Service 201 North Charles Street Suite 1400 Baltimore, MD Tel: (443) Fax: (443) mswift@mvlslaw.org

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