R11 Non-selection letter.frm

I, _______________________________________ DECLARE UNDER PENALTY OF PERJURY THAT I AM THE DULY AUTHORIZED REPRESENTATIVE OF THE DEBTOR IN POSSESSION DESIGNATED TO OPERATE THE BUSINESS OF ___________________________, AND AS SUCH I HEREBY ACKNOWLEDGE RECEIPT FROM THE UNITED STATES TRUSTEE OF THE OPERATING INSTRUCTIONS AND REPORTING REQUIREMENTS. I HAVE READ AND UNDERSTAND THE INSTRUCTIONS AND AGREE TO COMPLY WITH THEM.

I, _______________________________________, COUNSEL FOR THE DEBTOR IN POSSESSION, HAVE REVIEWED AND DISCUSSED THE OPERATING INSTRUCTIONS AND REPORTING REQUIREMENTS WITH THE SIGNATORY ABOVE.

Receipts may be identified by major categories. It is not necessary to list each transaction separately by name of customer or invoice number. You must, however, create a separate list for each bank account to which receipts were deposited during the month.

You must create a separate list for each bank account from which disbursements were made during the month.

ITEMIZE ALL POST-PETITION PAYABLES OVER 30 DAYS OLD ON A SEPARATE SCHEDULE AND FILE WITH THIS REPORT

Debtors in possession and trustees are required to pay all taxes incurred after the filing of their Chapter 11 petition on an as due basis. Please indicate whether the following post petition taxes or withholdings have been paid currently.

If any of the above have not been paid, state below the tax not paid, the amounts past due and the date of last payment.

Form 6123 (Rev. 06-97)	Department of the Treasury-Internal Revenue Service Verification of Fiduciary’s Federal Tax Deposit
Do not attach this Notice to your Return
TO		District Director, Internal revenue Service Attn: Chief, Special Procedures Function
FROM:		Name of Taxpayer
		Taxpayer Address
The following information is to notify you of Federal tax deposit(s)(FTD) as required by the United States Bankruptcy Court (complete sections 1 and/or 2 as appropriate):
Section 1 Taxes Reported on Form 941, Employer’s Quarterly Federal Tax Return			Form 941 Federal Tax Deposit (FTD) Information for the payroll period from to Payroll date Gross wages paid to employees $ Income tax withheld $ Social Security (Employer’s plus Employee’s share of Social Security Tax) $ Tax Deposited $ Date Deposited
Section 2 Taxes Reported on Form 940,Employer’s Annual Federal Unemployment Tax Return			Form 940 Federal Tax Deposit (FTD) Information for the payroll period from to Gross wages paid to employees $ Tax Deposited $ Date Deposited
Certification (Certification is limited to receipt or electronic transmittal of deposit only) This certifies receipt or electronic transmittal of deposits described below for Federal taxes as defined in Circular E, Employer’s Tax Guide (Publication 15)
Deposit Method ☐ Form 8109/8109B Federal Tax Deposit (FTD) coupon (check box) ☐ Electronic Federal Tax Payment System (EFTPS) Deposit
Amount (Form 941 Taxes				Date of Deposit	EFTPS acknowledgment number or Form 8109 FTD received by:
Amount (Form 940 Taxes				Date of Deposit	EFTPS acknowledgment number or Form 8109 FTD received by:
Depositor’s Employer Identification Number:					Name and Address of Bank
Under penalties of perjury, I certify that the above federal tax deposit information is true and correct
Signed: Date:
Name and Title (print or type)

I, _____________________________________________, acting as the duly authorized agent for the Debtor in Possession (Trustee) declare under penalty of perjury under the laws of the United States that I have read and I certify that the figures, statements, disbursement itemizations, and account balances as listed in this Monthly Report of the Debtor are true and correct as of the date of this report to the best of my knowledge, information and belief.

According to the accounts receivable records, you owe the above amount to the United States Trustee in unpaid quarterly fee charges. If you do not pay this debt or take other action described below before ______________, the United States Trustee will submit your debt to the U.S. Department of Treasury for further collection. Interest, penalties, and other charges for costs may be added to the amount you owe. Payment must be sent to the above address.

Once your debt is sent to the Department of Treasury, Treasury will take all authorized collection actions, including reporting the debt to credit reporting agencies and engaging private collection agencies as necessary. The debt will also be submitted to the Treasury Offset Program which means the debt will be deducted from eligible payments that are owed to you by the federal government, including but not limited to tax refunds. The Treasury Offset Program is authorized by the Debt Collection Act of 1982 and the Debt Collection Improvement Act of 1996. You may not receive another notice before your payment is offset.

Before we submit your debt to the Treasury Offset Program, we are required to tell you the following: (1) you may inspect and copy our records related to your debt; (2) you may request a review of our determination that you owe this debt; and (3) you may enter into a written repayment agreement if it is acceptable to the United States Trustee. If you are interested in these options, please send a written request to the above address.

If you make or provide any knowingly false or frivolous statements, representations, or evidence, you may be liable for penalties under the False Claims Act (31 U.S.C. §§ 286, 287, 1001, and 1002), or other applicable statutes.

If you have any questions about this letter or your rights, you should immediately contact your local field office at the above address.

I,_____________________________________________ acting as the duly authorized agent for the Debtor In Possession (Trustee) (Plan Administrator) declare under penalty of perjury under the laws of the United States that I have read and certify that the figures, statements, disbursement itemizations, and account balances as listed in this U.S. Trustee Quarterly Fee Statement are true and correct as of the date of this report to the best of my knowledge, information and belief.

* For periods subsequent to plan confirmation, this includes payments pursuant to the confirmed plan as well as all other disbursements.

3. If not, on a separate schedule, state the name, address and telephone number of each unpaid creditor, the amount due and the reason payment was not made.

I,_____________________________________________ acting as the duly authorized agent under the confirmed plan declare under penalty of perjury under the laws of the United States that I have read and certify that the information listed in this U.S. Trustee Quarterly Report on Status of Plan Payments is true and correct as of the date of this report to the best of my knowledge, information and belief.

The United States Trustee is responsible for supervising the administration of cases under chapters 7, 11, 12, and 13 of the United States Bankruptcy Code. 28 U.S.C. §586. To fulfill this responsibility, the U.S. Trustee has issued Guidelines for Debtors-in-Possession. The Guidelines impose certain administrative and reporting responsibilities on chapter 11 debtors-in-possession. In addition, there are other requirements imposed by law, including a requirement to pay U.S. Trustee quarterly fees. The U.S. Trustee’s staff is available to assist debtors-in-possession in fulfilling these requirements. In addition, it is frequently necessary for members of the U.S. Trustee’s staff to contact debtors concerning missing documents, incomplete forms, and other administrative matters. Many debtors-in-possession and attorneys prefer that these administrative matters be handled directly between the debtor and the U.S. Trustee’s staff. Others prefer that all such contacts be made through counsel. We need to know how you and your client would like these matters to be handled.

_____ We direct that all contacts between the U.S. Trustee’s staff concerning the administrative requirements of the U.S. Trustee, including completion of operating reports, insurance, banking arrangements, payment and calculation of quarterly fees, may be made directly between the U.S. Trustee and the debtor-in-possession.

_____ We direct that all contacts between the U.S. Trustee’s staff concerning this case, including all administrative matters, be conducted through counsel for the debtor-in-possession.

Case Name: __________________________________________ Date Filed: ___________________________________

Case Number: ________________________________________ NAICS Code:___________________________________

Month (or portion) covered by this report: _____________________ http://www.census.gov/epcd/naics02/naico602.htm

IN ACCORDANCE WITH TITLE 28, SECTION 1746, OF THE UNITED STATES CODE, I DECLARE UNDER PENALTY OF PERJURY THAT I HAVE EXAMINED THIS U.S. TRUSTEE BASIC MONTHLY OPERATING REPORT AND THE ACCOMPANYING ATTACHMENTS ON BEHALF OF THE CHAPTER 11 DEBTOR AND, TO THE BEST OF MY KNOWLEDGE, THIS REPORT AND RELATED DOCUMENTS ARE TRUE, CORRECT AND COMPLETE.

_____________________________________________ ______________________________________

The debtor is required to provide financial reports prepared by or for the debtor in addition to the information required by this form. The U.S. Trustee may permit the debtor to eliminate duplicative information. No such permission is valid unless in writing.

QUESTIONNAIRE:	YES	NO
1. IS THE BUSINESS STILL OPERATING?	□	□
2. DID YOU SELL ANY ASSETS OTHER THAN INVENTORY THIS MONTH?	□	□
3. HAVE YOU PAID ANY BILLS YOU OWED BEFORE YOU FILED BANKRUPTCY?	□	□
4. DID YOU PAY ANYTHING TO YOUR ATTORNEY OR OTHER PROFESSIONALS THIS MONTH?	□	□
5. DID YOU PAY ALL YOUR BILLS ON TIME THIS MONTH?	□	□
6. DID YOU PAY YOUR EMPLOYEES ON TIME?	□	□
7. HAVE YOU FILED ALL OF YOUR RETURNS AND PAID ALL OF YOUR TAXES THIS MONTH?	□	□
8. DID YOU PAY ALL OF YOUR INSURANCE PREMIUMS THIS MONTH?	□	□
9. DID ANY INSURANCE COMPANY CANCEL YOUR POLICY THIS MONTH?	□	□
10. HAVE YOU BORROWED MONEY FROM ANYONE THIS MONTH?	□	□
11. DO YOU HAVE ANY BANK ACCOUNTS OPEN OTHER THAN THE DIP ACCOUNT?	□	□
12. DID YOU HAVE ANY UNUSUAL OR SIGNIFICANT UNANTICIPATED EXPENSES THIS MONTH?	□	□
	Yes	No
13. DID YOU DEPOSIT ALL MONEY FOR YOUR BUSINESS INTO THE DIP ACCOUNT THIS MONTH?	□	□
14. DID THE BUSINESS SELL ANY GOODS OR PROVIDE SERVICES TO ANY BUSINESS RELATED TO THE DIP IN ANY WAY?	□	□
15. DO YOU PLAN TO CONTINUE TO OPERATE THE BUSINESS NEXT MONTH?	□	□
16. ARE YOU CURRENT ON YOUR QUARTERLY FEE PAYMENT TO THE UST?	□	□

TAXES