Free Request for Claims Register - New Jersey

UNITED STATES BANKRUPTCY COURT District of New Jersey

REQUEST FOR CLAIMS REGISTER TO: Deputy Clerk

Please provide the undersigned with a claims register for the case listed below. _____ I have included an attorney/business check "not to exceed $5.00" and a self-addressed, stamped envelope. _____ I am a Pro Se party. Please call me so I may make arrangements to pay the copy fee. Debtor's Name: ________________________________________ Case No.: _____________________________________________

Your name: ____________________________________ Company/Law Firm: ____________________________________ Address: ____________________________________ ____________________________________ Telephone No.: ____________________________________ A copy of this form and the requested claims register was forwarded to the above party via: ____ ____ Regular mail In person The copy fee for this request is:________________

Deputy Clerk's initials: ______________________ Date: _____________________________________