CANB — Chapter 13 - Class 1 Checklist (NDC 1-3)

Source: https://www.canb.uscourts.gov/sites/default/files/forms/Class%201%20Checklist%2011-6-17%20final%20NDC%201-3.pdf

CLASS 1 CHECKLIST

PROVIDE TO TRUSTEE ONLY DO NOT FILE WITH THE COURT

Debtor Name(s): Bk Case #:

Property Address:

Residence Rental Other Describe:

Daytime Phone: ( ) Evening: ( )

Attorney name: (if any)

THE FOLLOWING INFORMATION MUST BE COMPLETED ON ALL CLAIMS LISTED IN CLASS 1. COMPLETE THIS FORM TO THE BEST OF YOUR ABILITY AND ATTACH THE PAYMENT COUPON OR STATEMENT THAT WAS SUPPLIED TO YOU FROM EACH CREDITOR.

Creditor Name:
Account #:
Payment Address:
Street Address

City State Zip
Creditor Phone Number (if known):
Regular Monthly Payment Amount: $ Current Interest Rate:
Monthly Payment Due Date:
Date Payment Late: Monthly Late Charge Amount: $

Is this a variable interest rate loan? Yes No
If yes, when is the next anticipated adjustment date?
Are property taxes included in the monthly payment? Yes No
Is insurance included in the monthly payment? Yes No
Is the loan due in full and payable in less than 5 years? Yes No
If yes, date due:

NDC 1-3 (11-6-17)