| Trustee: | _____________ | Blanket bond amount: | _____________ | |
| For Period Ending: | _____________ | Per case limit: | _____________ |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Case No. |
Case Name |
Date filed (f) or converted (c) to chapter 7 |
Total funds on deposit or invested (from Form 2) |
Amount of separate bond (if any) |
Gross value of remaining assets (from Form 1- excludes unknown values) |
Date of Actual Disposition by*: Final Report (TFR) Final Account (TDR) Report of No Distribution (NDR) Conversion (C) Dismissal (D) Reassignment (R) * If TFR not filed, insert estimated (e) TFR date. |
| TOTALS | _______ | _______ |
I certify that I have filed and reviewed Forms 1 and 2 for all cases listed above and that they are accurate and correct to the best of my knowledge.
Trustee's signature:___________________ Date signed: _________
Handbook for Chapter 7 Trustees
Effective 10/1/98
Page Last Updated on March 19, 1999.
United States Trustee Program/Department of Justice
usdoj-eoust/msd/vdp