3698 7e75880d 43e7 42c6 Ace2 24 11217 Bls Claim 15 Withdrawal Form — Doc. 1089
- Date
- 2025-05-27
Source document: 3698 7e75880d 43e7 42c6 Ace2 95b080650602 24 11217 Bls Claim 15 Withdrawal Form — Doc. 1089; document type: lender-materials.
Full text
United States Bankruptcy Court for the WITHDRAWAL OF CLAIM Debtor Name and Case Number: Creditor Name and Address: Court Claim Number (if known): Date Claim Filed: Total Amount of Claim Filed: I, the undersigned, am the above-referenced creditor, or an authorized signatory for the above-referenced creditor. I hereby withdraw the above-referenced claim and authorize the Clerk of this Court, or their duly appointed Claims Agent, to reflect this withdrawal on the official claims register for the above- referenced Debtor. Dated: ________________________ ___________________________________ Print Name: ________________________ Title (if applicable): __________________ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ DEFINITIONS Debtor The person, corporation, or other entity that has filed a bankruptcy case is called the debtor. Creditor A creditor is any person, corporation, or other entity to which the debtor owed a debt. Proof of Claim A form filed with the clerk of the bankruptcy court where the bankruptcy case was filed, to tell the bankruptcy court how much the debtor owed a creditor (the amount of the creditor's claim). ITEMS TO BE COMPLETED ON THIS WITHDRAWAL OF CLAIM Court, Name of Debtor and Case Number: Fill in the name of the federal judicial district where the bankruptcy case was filed (for example, Central District of California), the name of the debtor in the bankruptcy case, and the bankruptcy case number. If you received a notice of the case from the court, all of this information is near the top of the notice. Information about Creditor: Complete the section giving the name and address of the creditor that was listed on the previously filed Proof of Claim form. Information identifying the Claim that is to be withdrawn: Complete the section giving the court claim number, date claim was filed and total amount of claim filed to help identify the claim that is to be withdrawn. Sign and print the name and title, if any, of the creditor or other person authorized to file this withdrawal of claim (attach copy of power of attorney, if any). This form must be filed with the clerk of the bankruptcy court where the bankruptcy case was filed or, if applicable, with their duly appointed Claims Agent as per any procedure approved by the court in the above-referenced bankruptcy proceeding. Case 24-11217-BLS Doc 1089 Filed 05/27/25 Page 1 of 1
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- gov.uscourts.deb.193283.1089.0.pdf
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