FORM C
CERTIFICATION AND RECEIPT OF OPERATING
INSTRUCTIONS AND REPORTING REQUIREMENTS
FOR CHAPTER 11 CASES
I hereby certify that I have received from the Office of the
United States Trustee the Operating Instructions and Reporting
Requirements for Chapter 11 Cases in the matter of:
_______________________ ________________________
Name of Debtor Case No.
Date: _______________,19___ ________________________
Debtor
________________________
Title
________________________
Counsel for Debtor
Further, that I understand and agree to perform in accordance
with the instructions and requirements, and that I am authorized
to so certify on behalf of the estate.
Date: _____________,19__ ________________________
Debtor
________________________
Title
(Revised 6/92)