1. Notice of Application : Notice of This Application Is Being Served on Required Parties

1. Notice of Application: Notice of this application is being served on required parties via (check one):

F 9013-1.2.OPPORTUNITY.HEARING.NOTICE; or

F 9013-1.1.HEARING.NOTICE

2. Debtor’s Counsel of Record: Applicant is counsel of record for the above-named Debtor.

3. LBR 3015-1(q)(6): LRB 3015-1(q)(6) is invoked because

a. Dismissed or Converted: This case was: dismissed, or converted from chapter 13 to chapter ;

b. Property on Hand: The chapter 13 trustee may possess undistributed property; and

c. Claim Prerequisites: Claim Prerequisites are met because this application will be filed and served on the chapter 13

trustee and other required parties within the 14-day holding period:

1. Date of order of dismissal or conversion (enter date):

2. Date 14 days after order of dismissal or conversion (enter date):

4. Prior Order Not Entered: This application is required because an order has not been entered approving any part of

thisclaim as anadministrative expense as required under LBR 3015-1(q)(6)(A)(i). Any fees and costs that have been

awarded by prior order of this court are not part of this claim.

5. Administrative Expense [11 U.S.C. § 503(b); LBR 3015-1(q)(6)(A)(i)]. This claim qualifies as an administrative

expense because it includes (check all that apply):

Unpaid fees and costs asserted under a Rights and Responsibilities Agreement (RARA) (see docket # );

Fees: $ Costs: $

Supplemental fees and costs for services not included in the base RARA fee; and/or

Fees: $ Costs: $

Fees and costs for services rendered under another fee agreement (attach a copy as Exhibit D):

Fees: $ Costs: $

TOTAL FEES: $ TOTAL COSTS: $ TOTAL OF CLAIM: $

6. Final Fee Application [LBR 2016-1(a)(1)]:Movant performed services that are required in the RARA and/or were

requested andneeded by the Debtor as follows:

1. LBR 2016-1(a)(1)(D)-(G) Statement:

1. Dates of Services: Start Date: End Date:

1. Statement of Services:

A. Presumptively Reasonable Fees. Of the fees requested in thisApplication, $ is for services

specified in Court Manual section 2.9(b) “Fees for Additional Services Without Filing a Detailed Fee

Application.” Exhibit A sets forth details ofservices provided, and the result of providing these services.

B. Hourly Fees. Of the fees requested in this Motion, $ is for services billed on an hourlybasis.

Exhibit A sets forth details of services provided, and the result of providing these services.

1. LBR 2016-1(a)(1)(H) Statement: Exhibit B is a statement of education and experience of all persons who performed services for which payment is requested in this application.

1. LBR 2016-1(a)(1)(J)-(K) Declarations:

1. Applicant (Exhibit C). Declaration from applicant pursuant to LBR 9013-1(i), indicating: (A) all services set forth

in the statement of services were necessary and performed; (B) the result of the performance; and (C) applicant

has reviewed the requirements of LBR 2016-1(a)(1) and the application complies with LBR 2016-1(a)(1).

2. Debtor (Exhibit D). Declarationfrom Debtor that Debtor reviewed the fee application and has no objection to it.

9. Request: Based on the foregoing, Applicant requests the application be granted and an allowance of fees and costs

bemade in the total amount of $ .

Date: Respectfully submitted,

.

Signature of (or on behalf of) Counsel of Record

.

Printed name of Signer

PROOF OF SERVICE OF DOCUMENT

I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is:

A true and correct copy of the foregoing document entitled: FEE APPLICATION IN “RARA” CHAPTER 13 CASE IN WHICH A PLAN WAS NOT CONFIRMED AND THE CASE WAS DISMISSED or CONVERTED

will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d); and (b) in the manner stated below:

1. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date)

, I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below:

Service information continued on attached page

2. SERVED BY UNITED STATES MAIL:
On (date) , I served the following persons and/or entities at the last known addresses in this bankruptcy case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and addressed as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed.

Service information continued on attached page

3. SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL(state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing to such service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed.

Service information continued on attached page

I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct.

This form is approved for use incases presided over by the Honorable Vincent P. Zurzolo, United States Bankruptcy Judge

January 2017Page 1VZAPP.CH13.RARA.FEES