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  • Exhibit 5 Sample Proof Of Claim Form

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Case 2:10-md-02179-CJB-SS Document 6427-7 Filed 05/03/12 Page 1 of 29 EXHIBIT 5 Case 2:10-md-02179-CJB-SS Document 6427-7 Filed 05/03/12 Page 2 of 29 MEDICAL BENEFITS CLASS ACTION SETTLEMENT PROOF.

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A proof of claim is a form used by the creditor to indicate the amount of the debt owed by the debtor on the date of the bankruptcy filing. The creditor must file the form with the clerk of the same bankruptcy court in which the bankruptcy case was filed. Secured Claim Under 11 U.S.C. § 506 (a)

What information does a proof of claim ask for? Debtor's name. Bankruptcy case number. Your contact information (including mailing address) Amount owed as of the petition date (the date the bankruptcy case was filed) Why the money is owed (loan, lease, services performed, etc.) Type of claim (secured vs.

A proof of claim is a statement filed with the bankruptcy court listing debts owed by the debtor to a particular creditor.

A proof of claim is a form submitted by a creditor in order to receive money from a debtor who has filed for bankruptcy. The document provides notice of the claim to all of the other relevant parties involved in the bankruptcy, including the court, the debtor, and any other creditors.

A proof of claim form is the official bankruptcy form a creditor must file before getting paid in a bankruptcy case. The proof of claim form tells the bankruptcy trustee the type of claim the creditor asserts and how much the filer owes the creditor.

Examples: Goods sold, money loaned, lease, services performed, personal injury or wrongful death, or credit card. Attach redacted copies of any documents supporting the claim required by Bankruptcy Rule 3001(c). Limit disclosing information that is entitled to privacy, such as health care information.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232