FORM 6 (6/92)
MONTHLY STATEMENT OF COMPENSATION
The following information is to be provided for each
shareholder, officer, director, manager, insider, or owner
that is employed by the debtor in possession. Attach additional
pages if necessary.
Name: ____________________________ Capacity: ___ Principal
___ Officer
___ Director
___ Insider
Detailed Description of Duties: _______________________________
_______________________________________________________________
_______________________________________________________________
Current Compensation Paid: Weekly or Monthly
_______ _______
Current Benefits Received:
Health Insurance _______ _______
Life Insurance _______ _______
Retirement _______ _______
Company Vehicle _______ _______
Entertainment _______ _______
Travel _______ _______
Other Benefits _______ _______
CURRENT TOTAL: _______ _______
Dated: ____________ _____________________________________
Principal, Officer, Director, Insider