Preview Employ Professional
Name, Address, Phone, Fax, Email Address of Filer:
Debtor: Joint Debtor:
Case No.: Chapter
APPLICATION TO EMPLOY PROFESSIONAL
[The professional's verification of disinterestedness must be attached. Attach supplemental statements about other items as necessary.]
Name of Professional: Type of Professional: To be employed by:
Trustee Debtor in Possession Committee: ____________________________
This professional is needed to carry out the undersigned's duties related to the following: Briefly state need for employment and describe the services to be rendered: If checked, employment is for specified special purpose only under 11 U.S.C. § 327(e). Briefly state reason for selection: Terms and conditions of employment: The undersigned hereby applies for an order approving the employment of the abovenamed professional as described above. To the best of the applicant's knowledge: [Check all that apply] This professional does not hold or represent an interest adverse to the estate, and has no connection with the debtor(s), creditors, any other party in interest, their respective attorneys and accountants, the United States Trustee, or any person employed in the Office of the United States Trustee, except to the extent described in any statement attached to this application. Employment is for a special purpose only; the attorney does not represent or hold any interest adverse to the debtor(s) or to the estate with respect to the matter on which the attorney is to be employed. Employment is by a committee; the professional does not represent any other entity having an adverse interest in connection with the case.
______________________________ /s/___________________________________ Date Applicant
hib_2014a 3/08 [ECF: Bankruptcy ... Motions/Applications ... Employ (Application)]
VERIFIED STATEMENT BY PROFESSIONAL
[Attach this statement to the Application to Employ Professional. If filed separately, attach a cover sheet with case caption.]
The undersigned hereby declares under penalty of perjury: [Check all that apply] I have no connection with the debtor(s), creditors, any other party in interest, their respective attorneys and accountants, the United States Trustee, or any person employed in the Office of the United States Trustee, except to the extent that I may be employed by a trustee in unrelated bankruptcy cases or proceedings. I am being employed for a special purpose only and do not represent or hold any interest adverse to the debtor(s) or to the estate with respect to the matter in which I am to be employed. I am being employed by a committee and do not represent any other entity having an adverse interest in connection with the case. The following disclosure is made regarding disinterestedness: _________________________ /s/___________________________________ Date Professional
hib_2014a 3/08 [ECF: Bankruptcy ... Motions/Applications ... Employ (Application)]