Roman I

Appendix I - Report


Revised 5/91

EXECUTIVE OFFICE FOR UNITED STATES TRUSTEES

  Submission Date:____________
Indicate if:
______Original ______Revised 

ANNUAL REPORT AND ACCOUNT OF CHAPTER 13 STANDING TRUSTEE

For the Fiscal Year October 1, 19__, through
September 30, 19__

Trustee Name__________________   Address______________________
District_______________________  ____________________________ 
  Phone(___ )___________________  

STATEMENT OF 'TRUST' TRANSACTIONS AND BALANCES

       (Current year first)  
      199 199
I.
 
 
 
TRUST FUNDS PER BOOKS BEGINNING OF YEAR
 
  
 
 
 (a)
 
Pre-confirmation (if applicable)
 
 _________
 
_________
 
 
 
 
 
(b)
 
Confirmed cases
 
 
 
_________
 
_________
 
 
 
 
 
 
 
(c)
 
 
Interest reported in prior year, but
not yet transferred to expense funds
 
 
 
_________
 
_________
 
 
 
 
 
 
 
(d)
 
 
Other (itemize - add schedule
if more space is needed):
 
    
    ___________________________  ___________________
 
 
 
 
 
 
 
 
(e)
 
 
 
Total trust funds per books
beginning of year (a + b + c + d)
 
 
 
 
==========
 
 
=========
 
 
       (Current year first)  
      199 199
II.   TRUST FUNDS RECEIVED DURING YEAR   
  (a)
 
 
 
 
Gross payment from or on behalf of debtors,
including total amount of paychecks received
by Trustee [exclude fees received from debtors
on direct payments - show and identify
separately at II(c) and/or XII(c)]
 __________________
   (b)
 
Interest received on trust funds
(incl. CDs, U.S. securities, etc.)
  __________________
  (c)**
 
 
 
 
 
 
Deposits into trust account for fees received
from debtors on direct payments (you must attach
a schedule itemizing those cases detailing the
case number, case name, confirmation date, amount
of direct payment by debtor, date confirmation of
payment was obtained from the creditor and amount
of fee received)
 _________ _________
  (d)
 
Other receipts (itemize - attach schedule
if more space is needed):
   
    EXPLAIN: _______________________
 
_______________________________
 ___________________
  (e)
 
Total trust funds reciepts
(a + b + c + d)
  ===================
**Fees may not be received on payments made directly by debtors to creditor under plans confirmed on or after the date that 28 U.S.C. Section 586(e) (2) as became effective in the district in which the case was filed. See instructions for details.
          (Current year first)  
      199 199
III.   TRUST FUNDS REFUNDED DURING YEAR   
  (a) Refunds after confirmation:    
      (i) On cases closed   _________ _________
      (ii) On cases dismissed   _________ _________
      (iii)
 
On conversion of cases (including payments
(to chapter 7 trustees)
  _________ _________
      (iv)
 
 
Other (itemize - attach schedule
if more space is needed):
______________________
  _________ _________
    (b)
 
Total trust funds refunds on cases
after confirmation [i + ii + iii + iv]
  _________ _________
  (c) Refunds on cases with no confirmed plan  _________ _________
  (d) Total trust funds refunds[b + c]  ==================
       (Current year first)  
      199 199
IV.   TRUST FUND DISBURSEMENTS ON CASES WITH CONFIRMED PLANS  
  (a) Secured creditors  __________________
  (b) Priority creditors  __________________
  (c) Unsecured creditors  __________________
  (d) Debtor attorneys  __________________
  (e) Clerk's fees  __________________
  (f)
 
Other Administrative expenses
(excluding 503(b) awards to trustee)
  __________________
  (g)
 
Subtotal of above payments (total - other
than to Trustee) [a + b + c + d + e + f]
  __________________
  (h) Percentage fees transferred to expense fund  __________________
      (i)
 
Percentage fees on actual
disbursements (same as X(f)(iv)
  _________ _________
      (ii)
 
Percentage fees received from debtors
on direct payments
  _________ _________
    (i)
 
Administrative expense allowances transferred
to expense fund
  _________ _________
  (j) Total disbursements [g + h(i) (ii) + i]  ==================
       (Current year first)  
      199 199
V.   TRUST FUND SUMMARY PER BOOKS FOR END OF YEAR  
  (a)
 
Trust funds per books beginning of
year [same as I(e)]
 __________________
  (b) Trust fund receipts [same as II(e)]  __________________
  (c) Trust fund refunds [same as III(d)]  (_______)(_______)
  (d)
 
Disbursements in cases with confirmed
plans [same as IV(j)]
 (_______) (_______)
  (e)
 
Interest and other receipts transferred
to expense funds:
   
      (i)
 
Received by trust fund in current
year [cannot exceed II(b)]
  _________ _________
      (ii)
 
Received by trust fund in prior year(s)
[cannot exceed I(c)]
  _________ _________
    (f)
 
Other (itemize - add schedule if more
space is needed):
     
    EXPLAIN: _______________________
 
_______________________________
 ___________________
  (g)
 
 
Total trust funds per books end of year
(a + b - c - d - e ï½± f) [same as VI(e),
VII(d), and VIII(e)]
  ====================
       (Current year first)  
      199 199
VI.   NATURE OF TRUST FUNDS PER BOOKS END OF YEAR   
  (a) Pre-confirmation  __________________
   (b)Confirmed Cases  __________________
  (c)
 
Interest not yet transferred to expense fund
[equals I(c) + II(b) - V(e) (i) (ii)]
 _________ _________
  (d)
 
Other (itemize - add schedule if more
space is needed):
   
    ___________________________  ___________________
  (e)
 
 
Total trust funds per books end of year
[a + b + c + d] [same as V(g), VII(d),
and VIII(e)]
  ==================
       (Current year first)  
      199 199
VII.   LOCATION OF TRUST FUNDS PER BOOKS END OF YEAR   
  (a)
 
In trust non-interest bearing checking accounts(s):
[itemize and indicate if U.S. Government insured]
   
    ___________________________  ___________________
    ___________________________  ___________________
   (b)
 
In trust interest bearing accounts(s):
[itemize and indicate if U.S. Government insured]
    
    ___________________________  ___________________
    ___________________________  ___________________
  (c)
 
 
Other instruments (itemize - attach schedule if
more space is needed): [indicate if
U.S. Government guaranteed]
    
    ___________________________  ___________________
    ___________________________  ___________________
  (d)
 
Total trust funds per books end of year
[a + b + c] [same as V(g), VI(e), and VIII(e)]
  ==================
       (Current year first)  
      199 199
VIII
 
  RECONCILIATION BETWEEN TRUST FUNDS PER BOOKS AND
PER BANKS END OF YEAR
  
  (a) Balance per banks  __________________
   (b)Deposits in transit  __________________
  (c) Outstanding checks (_______) (_______)
  (d)
 
Other reconciling items (itemize -
add schedule if more space is needed):
   
    ___________________________  ___________________
  (e)
 
Balance per books [a + b - c ï½± d]
[same as V(g), VI(e) and VII(d)]
  ===================
       (Current year first)  
      199 199
IX.   AGING OF TRUST FUNDS BALANCES PER BOOK - END OF YEAR   
    (a) Debtor receipts by month [same as II(a) - gross payments from or on behalf of debtors] 
    October  __________________
    November  __________________
    December _________ _________
    January _________ _________
    February _________ _________
    March _________ _________
    April _________ _________
    May _________ _________
    June _________ _________
    July _________ _________
    August _________ _________
    September _________ _________
  (b)
 
Total debtor receipts [total of
(a)] [same as II(a)]
    
        ================
  (c)
 
Trust funds per books, end of
year [same as V(g)
    
        ================
  (d)
 
 
 
 
Indicated number of months
receipts held per books, end of year
[add amounts in (a) from latest month
(September) to earliest month
(October), until same as (c)]
    
        ================
X.
 
  RECONCILIATION BETWEEN TRUST DISBURSEMENTS UNDER PLANS AND
PERCENTAGE FEES
 
    Percentage fees are to be transferred only at the time of plan disbursements. [Lines (a) through (e) calculate the disbursements under plans to which each year's percentage fees apply. Lines (f)(1) through (f)(iv) reflect application of allowed percentage fee rates to the amount on line (e) to calculate actual percentage fees transferred on disbursement by the trustee. Constructive disbursements upon which a direct fee was received will not be reflected in Schedule X.]
         (Current year first)  
  199 199
   (a) Trust disbursements [same as IV(j)]  __________________
  (b)
 
 
   
Less item IV(h) (ii) and IV(i) [Percentage
fees do not apply to Section 503(b) awards
to trustee nor to fees received from debtors on
direct payments]
  __________________
  (c) Applicable trust disbursements [(a) - (b)]   __________________
  (d)
 
Other reconciling items (itemize - add
schedule if more space is needed):
  __________________
    ___________________________  ___________________
    ___________________________  __________________
    ___________________________  __________________
    ___________________________  __________________
  (e)
 
Trust disbursements as to which percentage
fees were transferred [c ± d]
  ==================
  (f) Percentage fee calculation:    
    (i)
 
 
Percentage(s) applied during year (percentages are those actually used provide footnote explanation if different than those authorized by Attorney General) and trust disbursement to which percentage fees applied.
  
DATES      TRUST    CALCULATED  
FROM TO  PERCENTAGE  DISBURSEMENTS   PERCENTAGE FEE  
______ ______  _________% x  $__________=   $___________ 
______ ______  _________% x  $__________=   $___________  
______ ______  _________% x   $__________=   $___________  
    (ii)
   
Totals from (f)(i) - [Insert at (a) trust disbursements to which percentages applied, and insert at (b) calculated percentage fees]
                         (a)$==========  (b)$___________  
      [same as X(e)]    
    (iii)
 
 
Other reconciling items [itemize -
add schedule if more space is needed]:
   
  _____________________________  _________ 
  _____________________________  _________ 
  _____________________________  _________ 
    (iv)
 
   
Actual percentage fees on actual disbursements
by trustee transferred [(f)(ii)(b) ± (f)(iii)]
[same as IV(h) (i)]
========= 


STATEMENT OF "EXPENSE" TRANSACTIONS AND BALANCES

       (Current year first)  
      199 199
XI.   EXPENSE FUNDS PER BOOKS BEGINNING OF YEAR   
  (a)
 
In expense non-interest bearing
account(s) if applicable
 __________________
   (b) In expense interest-bearing account(s)  __________________
  (c)
 
Other instruments (itemize - add schedule
if more space is needed):
   
    ___________________________  __________________
  (d)
 
Total expense funds per books beginning
of year [a + b + c]
  ==================
         (Current year first)  
  199 199
XII.   EXPENSE FUNDS RECEIVED DURING YEAR    
  (a)
 
Percentage fees transferred from trust funds
[same as IV(h)(i) and (ii)]
 __________________
  (b)
 
Administrative expense allowances transferred
from trust funds [same as IV(i)]
 __________________
  (c)**
 
 
 
 
 
 
 
 
 
(i)
 
 
 
 
 
 
 
 
 
Fees received directly from debtors on payments
under plans not made through the trustee and
deposited directly into trustee expense account.
(NOTE: Where receipts into the expense account
include fees received from debtors on direct
payments, you must attach a schedule itemizing
those cases detailing the case number, case name,
confirmation date, amount of direct payment by
debtor, date confirmation of payment was obtained
from the creditor and amount of fee received.
 __________________
   (ii)
 
 
Total amount of direct payments by debtor
to creditors for which direct fees reported
at II(c) and/or XII(c) (i) were received:
   
    ________________________________________
[The entry for the total amount of direct
payments from debtors to creditors should
be carried forward for the calculation of
the 5% compensation limitation at XVIII(b)]
   
  (d) Interest transferred from trust funds:  
    (i)
 
Received by trust fund in current year
[same as V(e)(ii)]:
 __________________
    (ii)
 
Received by trust fund in prior year(s)
[same as V(e)(ii)]
 __________________
  (e) Interest earned on expense funds  __________________
  (f)
 
Other receipts (itemize - add schedule if more
space is needed):
 __________________
    ___________________________  __________________
  (g)
 
Total expense fund receipts
[a + b + c + d + e ï½± f]
  ==================

**Fees may not be received on payments made directly by debtors to creditors under plans confirmed on or after November 26, 1987, in original United States Trustee districts. For other districts, see instructions for details.


XIII.
 
  ACTUAL AND NECESSARY EXPENSES PAID DURING YEAR
(All as defined and approved by U.S. Trustee)
  
     
Third
Party
Allocated
or Related
Party
 
Current
Total
 
Prior
Total
   Salaries, excluding Trustee
compensation shown at XIV(d)
__________ __________
   Employee Payroll taxes: __________ __________
   Employee Employment benefits: __________ __________
   Office rent __________ __________
   Utilities __________ __________
   Outside accounting services __________ __________
(g)  Computer services __________ __________
(h)  Audit services __________ __________
(i) Legal/consulting services __________ __________
(j) Telephone __________ __________
(k) Postage __________ __________
(l)  Office supplies __________ __________
(m)  Bond premiums: __________ __________
   (i)     Trustee __________ __________
   (ii)     Employees __________ __________
(n)  Clerk fees (not under plans) __________ __________
(o)
 
 Dues to professional
organizations
__________ __________
(p)  Publications __________ __________
(q)
 
 Insurance, other than
employment related
__________ __________
(r)  Conferences and seminars __________ __________
(s)
 
 Maintenance and service
agreements
__________ __________
(t)
 
 Photocopy services or
transcripts
__________ __________
(u)  Travel: __________ __________
   (i)     Transportation __________ __________
   (ii)     Lodging __________ __________
   (iii)    Meals __________ __________
   (iv)    Other (add schedule) __________ __________
(v)  Equipment/furniture rental __________ __________
(w)
 
 
 Equipment/furniture purchases
[excluding purchases from
surplus, shown at XIV(f)]
__________ __________
(x)
 
 
  Leasehold improvements
[excluding those paid from
surplus, show at XIV(f)]
__________ __________
(y)
 
 
 
  Other expenses paid (specify
third party or related party;
add schedule if more space
is needed):
__________ __________
   _______________________ __________ __________
   _______________________ __________ __________
   _______________________ __________ __________
(z)
 
  Total actual and necessary expenses
paid [add (a) through (y)]
========== ==========
       (Current year first)  
      199 199
XIV.   EXPENSE FUND SUMMARY PER BOOKS FOR YEAR   
  (a)
 
Expense fund per books beginning of year
[same as XI(d)]
 __________________
  (b) Expense fund receipts [same as XII(g)]   __________________
  (c) Expenses paid [same as XIII(z)]   (_______)(_______)
  (d)
 
Compensation paid to Trustee
(inclusive of 20% in benefits)
  (_______)(_______)
  (e)
 
Prior year(s) expense surplus paid to
U.S. Trustee for payment to U.S. Treasury
  (_______)(_______)
  (f)
 
 
Purchases and payments from expense fund surplus
[requires approval by U.S. Trustee]
(itemize - add schedule if more space is needed):
   
    ___________________________  ___________________
    ___________________________  ___________________
  (g)
 
 
 
Receipt from Standing Trustee personal funds
reimbursing current or prior year(s) operating
deficit(s), excess compensation, etc.
(itemize - add schedule if more space is needed):
   
    ___________________________  ___________________
  (h)
 
 
Paid to Standing Trustee to reimburse operating
deficit(s) for year(s) in which no compensation
was paid
  (_______)(_______)
  (i)
 
Other (itemize - add schedule if more space
is needed):
   
    ___________________________  ___________________
    ___________________________  ___________________
  (j)
 
 
Expense funds per books end of year
[a + b -c - d - e - f +g - h ï½± i]
[same as XV(d) and XVI(e)]
  ==================
       (Current year first)  
      199 199
XV.   LOCATION OF EXPENSE FUNDS PER BOOKS END OF YEAR   
  (a)
 
In expense non-interest bearing account(s):
[itemize and indicate if U.S. Government insured]
   
    ___________________________  ___________________
    ___________________________  ___________________
  (b)
 
In expense interest bearing account(s):
[itemize and indicate if U.S. Government insured]
   
    ___________________________  ___________________
    ___________________________  ___________________
  (c)
 
 
In other instruments (itemize - add schedule if
more space is needed) [specify the rate of interest,
and indicate if U.S. Government insured]
   
    ___________________________  ___________________
    ___________________________  ___________________
  (d)
 
Total expense funds per books end of year
[a + b + c] [same as XIV(j) and XVI(e)]
  ====================
          
        
XVI.   RECONCILIATION BETWEEN EXPENSE FUNDS PER BOOKS AND PER BANKS END OF YEAR
  (a) Balance per banks  __________________
   (b) Deposits in transit  __________________
  (c) Outstanding checks _________ _________
  (d)
 
Other reconciling items (itemize - add
schedule if more space is needed):
   
    ___________________________  ___________________
    ___________________________  ___________________
  (e)
 
Balance per books [a+ b - c ï½± d]
[same as XIV(j) and XV(d)]
  ==================
       (Current year first)  
  199 199
XVII. FUNDS AVAILABLE FOR COMPENSATION (OPERATING DEFICIT)  
 (a) Expense fund receipts [same as XII(g)]  __________________
   (b)
 
 
Add current year interest remaining in trust funds
at end of year; and not included in XVII(a) above
[II(b) - V(e) (i)]
  __________________
  (c)
 
 
Less prior year(s) interest transferred from trust
to expense funds during year, and included in
XVII(a) above [same as V(e) (ii) and XII(d) (ii)]
 (_______) (_______)
  (d) Less expenses paid [same as XIII(z)]  (_______) (_______)
  (e)
 
Other (itemize - add schedule if more
space is needed):
   
    ___________________________  ___________________
    ___________________________  ___________________
  (f)
 
 
Funds available for compensation
(inclusive of 20% in benefits)
or (operating deficit) [a + b - c - d ï½± e]
  ===================
         (Current year first)  
  199 199
XVIII. COMPENSATION LIMITATION  
  Maximum compensation pursuant to 28 U.S.C.
ァ586 (e)(1)(a), as shown below:
 
  ================
    (a)
 
5% of net receipts under confirmed plans
[II(a)] - [III(d)] x 5%
======== ========
  (b)
 
5% of constructive receipts under plans
[XII(c) (ii)] x 5%
================
  (c)
 
 
Funds available for compensation
(inclusive of 20% in benefits)
[same as XVII(f), but not less than zero]
================
  (d) Maximum compensation fixed by Attorney General ================
  (e) Compensation paid trustee [same as XIV(d)] ================
  (f)
 
Allowable compensation
[lesser of (a) + (b), (c) or (d)]
  (                 )
========
(                 )
========
  (g)
 
Excess compensation paid
[(e) - (f), but not less than zero]
  ================
  (h) Excess payable from Trustee personal funds to: ================
   (i)
 
 
U.S. Trustee, pursuant to 28 U.S.C.
ァ 586 (e)(2) -[(e) - [(a) + (b)],
not less than zero]
================
   (ii)
 
 
Trusteeship expense funds
[(e) - lower of (c), or (d),
but not less than zero]
================


Note:   If (e) is grater than (a) + (b), the trustee shall in accordance with 28 U.S.C. §586(e)(2),pay personal funds such excess amount to the United States Trustee for payment to the United States Treasury. If (e) is greater than (c), or (d) the trustee shall, from personal funds, pay such excess amount back into the expense fund.
       (Current year first)  
      199 199
XIX.   SURPLUS EXPENSE FUNDS   
  (a)
 
Express funds per books end of year
[same as XIV(j)]
 __________________
  (b)
 
Less 25% of actual and necessary expenses,
authorized to be retained [25% of XIII(z)]
  (_______)(_______)
  (c) Other (add schedule if more space is needed):    
    ___________________________  ___________________
  (d)
 
Surplus expense funds [a - b ï½± c,
but not less than zero]
  ===================
            
    
XX.   PAYABLE TO U.S. TRUSTEE AND/OR REIMBURSEMENT TO EXPENSE FUNDS
 (a) Excess compensation to be paid:  
  (i)
 
 
From standing trustee to the U.S.
Trustee, pursuant to 28 U.S.C.§586
(e)(2)[same as XVIII(h)(i)]
_________ _________
  (ii)
 
 
From standing trustee to reimburse
expense funds of trusteeship
[same as XVIII(h)(ii)]
_________ _________
 (b) Surplus expense funds [same as XIX(d)] _________ _________
 (c)
 
&nbsp
Portion of surplus expense funds [item XX(b)]
allowed to be retained by trustee
(by direction of EOUST)
(_______)(_______)
 (d) Surplus payable to U.S. Trustee  __________________
       (Current year first)  
      199 199
XXI.   UNREIMBURSED OPERATING DEFICITS CARRYFORWARD   
  (a)
 
 
 
 
Accumulated unreimbursed operating deficit
carry forward at beginning of year, approved
by U.S. Trustee (by year generated) [equal
to any year's "operating deficit" calculated
as shown in Schedule XVII]:
 
  199__  __________________
  199__  __________________
  199__  __________________
   (b) Total beginning of year carryforward [sum of (a)]  ___________________
   (c)
 
Reimbursed to Trustee during year [same as XIV(h)]  ___________________
   (d)
 
Operating deficit generated during year
[same as XVII(f), if any]
 ___________________
   (e)
 
Carryforward disallowed by U.S. Trustee
during year (explain on footnote page)
 ___________________
  (f)
 
Accumulated unreimbursed operating
deficits, end of year [b - c + d - e]
  ================
Note:   If no compensation was recieved, and there is a deficit, that deficit may be carried forward. To the extent any compensation was improperly paid and a deficit generated in the same fiscal year, the allowable deficit must be reduced by the compensation paid and the compensation returned to the expense funds.
       (Current year first)  
      199 199
XXII.   BONDING REQUIREMENT   
  (a)
 
 
 
 
Average monthly bank balance for the prior
three months (balance per-banks, excluding
investments subject to the United States
Trustee's counter-signature for withdrawal,
not per books for all trust and expense accounts)
  ===================
   (b) Bond amount as of year end  __________________
  (c) Required trustee bond: Enter 150% of (a)  __________________
  (d) Bond over (under) required amount [b - c]  ===================
  (e)
 
 
Are employees who have access to receipts or disbursements of cash or negotiable instruments, or to the financial records of the office bonded?
______YES    ______NO
  Are they covered under the standing trustee bond or by a separate employees fidelity or honesty bond? (Indicate which type of bond and the amount]
  TYPE ________________________  AMOUNT $__________
         (Current year first)  
  199 199
XXIII.   CASES HANDLED    
  (a) Cases active, start of period  __________________
   (b) New cases filed during fiscal year(+)  __________________
  (c) Adjustments during fiscal year:  
       i) Cases transferred in (+)  __________________
       ii) Cases converted from another chapter (+) __________________
       iii) Cases transferred out (-)  __________________
       iv) Conversions to another chapter (-) __________________
       v) Dismissals (-)  __________________
  Total adjustment (+) or (-)  __________________
   (d)
 
Cases closed by the Court on completion of the
plan or hardship discharge (-)
===================
   (e) Cases active, end of period (a+bï½±c-d)  ===================
Note:   The entry for "Cases active, end of period" should be carried forward as the number of "Cases active, start of period" in the next fiscal year.

STANDING TRUSTEES CERTIFICATION TO REPORT AND ACCOUNT

         I hereby certify under penalty of perjury that the information contained herein is true and correct, and request that this report and account be examined and approved by the United States Trustee and the Attorney General of the United States or his delegate.

  ___________________________________________
CHAPTER 13 STANDING TRUSTEES SIGNATURE

DATED:___________________________________

REVIEWED BY:

_______________________________
UNITED STATES TRUSTEE OFFICE

REVIEWED BY:

_________________________
UNITED STATES TRUSTEE

Updated May 7, 2015

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