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B 250E (6/91)

United States Bankruptcy Court
_______________ District Of
In re _________________________ Debtor Case No. ___________ Chapter ____________ _______________

SUMMONS TO DEBTOR IN INVOLUNTARY CASE
To the above named debtor: A petition under title 11, United States Code was filed against you on _____________________
(date)

in this bankruptcy court, requesting an order for relief under chapter ______ of the Bankruptcy Code (title 11 of the United States Code). YOU ARE SUMMONED and required to file with the clerk of the bankruptcy court a motion or answer to the petition within 20 days after the service of this summons. A copy of the petition is attached.
Address of Clerk

At the same time, you must also serve a copy of your motion or answer on petitioner's attorney.
Name and Address of Petitioner's Attorney

If you make a motion, your time to serve an answer is governed by Federal Rule of Bankruptcy Procedure 1011(c). If you fail to respond to this summons, the order for relief will be entered.
______________________________________________________ Clerk of the Bankruptcy Court

_______________________ Date

By:___________________________________________________ Deputy Clerk

_____________________________________________________________________________________________________________________ *Set forth all names, including trade names, used by the debtor within the last 6 years. (Fed. R .Bankr. P. 1005).

Case No._________________________

CERTIFICATE OF SERVICE

I of** certify: That I am, and at all times hereinafter mentioned was more than 18 years of age; That on the day of ,19 I served a copy of the within summons, together with the petition filed in this case, on

the debtor in this case, by [describe here the mode of service]

the said debtor at

I certify under penalty of perjury that the foregoing is true and correct.

Executed on _____________________________ [Date]

_________________________________________ [Signature]

__________________________________________________________________________________
**State mailing address.