FORM 7 (9/97)
TRANSMITTTAL OF QUARTERLY
POST CONFIRMATION REPORT WITH CERTIFICATION
FOR THE QUARTER ENDED: _______________
In re: ) Case No.
)
) Chapter 11
)
Debtor ) Judge:
Debtor, affirms that:
1 . The attached Chapter 11 Post Confirmation Report for the
quarter ended ___________________, which includes the Total
Disbursement for Quarter, the Summary of Amounts Distributed
Under the Plan, and the Summary of Status on Consummation of
Plan has been reviewed and the report as prepared fairly and
accurately reflects the debtor's complete disbursement/
distribution activity and status for the period stated.
2. The individual responsible for preparing the attached report
was _____________________ whose title is _________________. Any
questions regarding the attached report should be directed to
___________________ at telephone number _______________.
3 . The debtor is in compliance with the provisions of the
confirmed Chapter 11 Plan except as listed below (Attach additional
documentation if necessary):___________________________________
_______________________________________________________________.
4. The undersigned is authorized to file this report on behalf
of the debtor.
It is certified hereby, under penalty of perjury, that the
information provided herein is true and correct to the
best of my knowledge and belief.
Debtor
Dated: _____________ By: _________________________
Signature
_________________________
Typed or printed name
_________________________
Title