February 22, 2017

Bankruptcy Forms


The forms listed below are in Adobe Acrobat PDF format. You must have a copy of Acrobat Reader in order to view or print these documents. The Acrobat format can be used in both Windows and Macintosh environments. If you don’t have a copy of Acrobat Reader, click here to download and install the most current version now.

To open a form below, click on the form name, in the Form column. To download a copy of a form, right click on the file name and select the browser’s option to save the link.

 

National Forms


Current Official Bankruptcy and Procedural Forms are found on the United States Courts Bankruptcy Forms Page (http://www.uscourts.gov/FormsAndFees/BankruptcyForms.aspx). Click the link to be re-directed to this site.

The following are National Forms that have been modified for use by the Eastern District of Virginia, have been included with Local Forms, below, and should be used instead of the National Form:

  • Application to Pay Filing Fee In Installments – Eastern District of Virginia
  • Form 312 – Notice of Hearing on Disclosure Statement
  • Form 313 – Order Approving Disclosure Statement and Fixing Hearing on Confirmation and Times for Filing Objections to Confirmation and Acceptances and Rejections of Plan
  • Form 420A - Notice of Motion (or Objection) [for Other than Alexandria]
  • Form 420aalx - Notice of [Motion to] [Objection to] [for Alexandria]
  • Form 420B - Notice of Objection to Claim [for Other than Alexandria]
  • Form 420balx - Notice of Objection to Claim [for Alexandria]
  • Form 2030edva – Disclosure of Compensation of Attorney for Debtor
  • Form 2030R13edva – Disclosure of Compensation of Attorney for Debtor in a Chapter 13 Case (Richmond Division Only)

Local Forms




Administrative


Form Description
onetime.pdf Credit Card One Time Authorization Form (one time use only)



Adversary Proceeding


Form Description
certsvc.pdf Certificate of Service of Summons
apncert.pdf Certification as to Good Faith Settlement and Mediation (Alexandria Division)
apninstr.pdf Instructions to Plaintiff/Plaintiff’s Counsel (Alexandria Division)
cpownstm.pdf Corporate Ownership Statement



Amendment


Form Description
amendins.pdf Instructions for Amendments to Petition, Lists, Statements, and Schedules
amendcs.pdf Amendment Cover Sheet to Accompany Any Amendment Filed by the Debtor to the Original Lists, Statements and/or Schedules
ntctoadd.pdf Notice to Creditor(s) (Re: Amendment)



Appeal


Form Description
appinsa.pdf Procedural Instructions on Appeals. Alexandria
appinsn.pdf Procedural Instructions on Appeals. Norfolk and Newport News
appinsr.pdf Procedural Instructions on Appeals. Richmond



Archive


Form Description
frccopyr.pdf Order for Copies of Bankruptcy Cases from National Archives & Records Administration
frcget.pdf Request for File From Federal Records Center



Attorney


Form Description
prohac.pdf Application to Qualify as a Foreign Attorney Under Local Bankruptcy Rule 2090-1(E)(2)
prohacr.pdf Application to Qualify as a Foreign Attorney Under Local Bankruptcy Rule 2090-1(E)(2) – RICHMOND DIVISION
thirdyrl.pdf Application to Qualify as a Third Year Law Student Permitted to Appear in the U.S. Bankruptcy Court for the Eastern District of Virginia
attyqual.pdf Application to Qualify as an Attorney for the U.S. Bankruptcy Court for the Eastern District of Virginia
attycert.pdf Attorney Certification [Chapter 7 Pro Bono Certification--RICHMOND, ONLY]
certwdva.pdf Certificate of Member of Bar of Western District of VA



Case Filing – All Chapters


Form Description
waiver.pdf Request for Waiver to File Conventionally
crditins.pdf Instructions for Creditor Matrix Diskette (Revised 9/10]
cscredit.pdf Cover Sheet for List of Creditors
crdwaiv.pdf Request for Waiver re: Creditor Matrix Diskette
geovenu.pdf Geographical Information Sheet — Cities and Counties in Eastern Eastern District of Virginia
103Aedva.pdf Form 3A – Application to Pay Filing Fee in Installments – Eastern District of Virginia
geninfo.pdf General Information Re: Eastern District of Virginia – Mailing Addresses, Locations, Hearing Requests , Hours of Operation & Obtaining Information
cpownstm.pdf Corporate Ownership Statement
prose.pdf Filing For Bankruptcy Without An Attorney–Guidelines & Requirements to Assist Pro Se (Self-Filer) Debtors
2090edva.pdf Certification Under Local Bankruptcy Rule 2090-1



Case Administration – General


Form Description
DeBNReqForm.pdf Debtor’s Electronic Noticing Request (DeBN)
copyreq.pdf Copy Request Form for Online (Electronic) and Paper-based Case Files , Certified Copies, or Government Agency Photocopies in paper-based Case Files
certexph.pdf Certification Regarding Request for Expedited Hearing
changead.pdf Change of Address
motionn.pdf Motion and Notice (Sample)
form420a.pdf Notice of Motion (or Objection) [for Other than Alexandria]
fm420Aalx.pdf Notice of [Motion to] [Objection to] [for Alexandria]
form420b.pdf Notice of Objection to Claim [for Other than Alexandria]
fm420Balx.pdf Notice of Objection to Claim [for Alexandria]
4272400ABALT.pdf Cover Sheet for Reaffirmation and Reaffirmation Agreement
rsmdivid.pdf Report of Deposit of Small Dividends
runclmfd.pdf Report of Deposit of Unclaimed Funds
W-9Instr.pdf Instructions for Completing Form W-9 With Addendum
W-9.pdf Form W-9 – Request for Taxpayer Identification Number and Certification
W-9Addendum.pdf Addendum to Form W-9 – Request for Taxpayer Identification Number and Certification
exhinst.pdf Instructions for Preparing Exhibit List and Pre-marking Exhibits
exhibi~2.pdf Instructions for Preparing Exhibit List and Pre-marking Exhibits (Alexandria)
exhlist.pdf Exhibit List



Chapter 11


Form Description
B25Binst.pdf Instructions for Disclosure Statement
B25B.pdf Disclosure Statement [SAMPLE FORM]
312edva.pdf Notice of Hearing on Disclosure Statement
313edva.pdf Order Approving Disclosure Statement and Fixing Hearing on Confirmation and Times for Filing Objections to Confirmation and Acceptances and Rejections of Plan
B25Ainst.pdf Instructions for Plan of Reorganization
B25A.pdf Plan of Reorganization [SAMPLE FORM]
ntccnfhr.pdf Notice of Hearing on Confirmation, Combined with Notice of Times for Filing Notice of Times for Filing Acceptances or Rejections to Plan and Objections to Confirmation
B26instr.pdf Instructions for Periodic Report Regarding Value, Operations and Profitability of Entities in Which the Debtor’s Estate Holds a Substantial or Controlling Interest
B26.pdf Periodic Report Regarding Value, Operations and Profitability of Entities in Which the Debtor’s Estate Holds a Substantial or Controlling Interest
crt1141d.pdf Debtor’s(s’) Certification of Compliance With 11 U.S.C. §1141(d)(5)
nfhg11sb.pdf Notice of Combined Hearing on Final Approval of Disclosure Statement & Confirmation of Plan – Small Business
B25C.pdf Small Business Monthly Operating Report
Chaptr11.pdf Closing Procedure for Chapter 11 Cases in Which Substantial Consummation has been Completed -**form and content provided by the Office of the U.S. Trustee



Chapter 13


Form Description
ch13pln2.pdf Chapter 13 Form of Plan and Related Motions (Mandatory Effective 12/1/09)
spcntc.pdf Special Notice to Secured Creditor
crtrqcnf.pdf Chapter 13 – Certification by Debtor(s) Requesting Confirmation of Plan and Compliance With Requirements of 11 U.S.C. Section 1325 [Richmond Division ONLY]
cert13pa.pdf Certification of Failure to Commence Payments Under Chapter 13 Plan
crtc1328.pdf Debtor’s(s’) Certification of Compliance With 11 U.S.C. § 1328 [Use for All Chapter 13 Cases Filed On or After 10/17/05]
loanmod.pdf Summary of Loan Modification (General Order 12-1)(Richmond)



Compensation/Fees


Form Description
2030edva.pdf Disclosure of Compensation of Attorney for Debtor
2030R13edva.pdf Disclosure of Compensation of Attorney for Debtor in a Chapter 13 Case (Richmond Division Only)
appcmp.pdf Application for Compensation of Attorney For Debtor(s)
appsucmp.pdf Application for Supplemental Compensation of Attorney For Debtor(s)
defercmp.pdf Notice to Defer Payment of Certain Fees
finstmt.pdf Financial Interest Disclosure Statement



Garnishment


Form Description
garnproc.pdf Procedures for Requesting a Garnishment
garnsugg.pdf Suggestion for Summons in Garnishment, for Use When Pursuing Execution of a Judgment Rendered in Bankruptcy Court
garnishr.pdf Garnishment Summons Form for Use when Pursuing Execution of a Judgment Rendered in Bankruptcy Court
garnexmt.pdf Notice to Judgment Debtor; How to Claim Exemptions from Garnishment
garnord.pdf Procedure for Release of Funds Held Under Garnishment (2 Exhibits)



Hearing/Meeting


Form Description
ntchrg.pdf Notice of Hearing in a Bankruptcy Case
ntchrg2.pdf Notice of Hearing in an Adversary Proceeding or Contested Matter
nrschrg.pdf Notice of Rescheduled Hearing in a Bankruptcy Case
nrschrg2.pdf Notice of Rescheduled Hearing in an Adversary Proceeding or Contested Matter
nrsch341.pdf Notice of Rescheduled Meeting of Creditors
nrsctrl.pdf Notice of Rescheduled Trial



Order/Judgment


Form Description
odepinv.doc Order Directing Deposit of Funds into the Court Registry
odisb.doc Order Directing Disbursement of Funds in Court Registry
oextsty.pdf Order Extending Stay (Norfolk and Newport News Divisions)
orsfmb.pdf Order Granting Relief From Stay [SO No. 10-2, Form B]
jtadmino.pdf Order for Joint Administration
ounclmfd.pdf Order for Return of Unclaimed Funds
corsfma.pdf Consent Order Modifying Automatic Stay [SO No. 10-2, Form A]
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