CACB — Transfer of Claim Other Than for Security (2100AB)

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/2100AB_0.pdf

B2100A (Form 2100A) (12/15) United States Bankruptcy Court

_______________ District Of _______________

In re ______________________________, Case No. ________________

TRANSFER OF CLAIM OTHER THAN FOR SECURITY

A CLAIM HAS BEEN FILED IN THIS CASE or deemed filed under 11 U.S.C. § 1111(a). Transferee hereby gives evidence and notice pursuant to Rule 3001(e)(2), Fed. R. Bankr. P., of the transfer, other than for security, of the claim referenced in this evidence and notice.

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Name of Transferee Name of Transferor

Name and Address where notices to transferee Court Claim # (if known): should be sent: Amount of Claim: Date Claim Filed:

Phone: ______________________________ Phone: __________________________ Last Four Digits of Acct #: ______________ Last Four Digits of Acct. #: __________

Name and Address where transferee payments should be sent (if different from above):

Phone: _______________________________ Last Four Digits of Acct #: _______________

I declare under penalty of perjury that the information provided in this notice is true and correct to the best of my knowledge and belief.

By:__________________________________ Date:____________________________ Transferee/Transferee’s Agent

Penalty for making a false statement: Fine of up to $500,000 or imprisonment for up to 5 years, or both. 18 U.S.C. §§ 152 & 3571.

B2100B (Form 2100B) (12/15) United States Bankruptcy Court

_______________ District Of _______________

In re ______________________________, Case No. ________________

NOTICE OF TRANSFER OF CLAIM OTHER THAN FOR SECURITY

Claim No. _____ (if known) was filed or deemed filed under 11 U.S.C. § 1111(a) in this case by the alleged transferor. As evidence of the transfer of that claim, the transferee filed a Transfer of Claim Other than for Security in the clerk’s office of this court on ______ (date).

Name of Alleged Transferor Name of Transferee

Address of Alleged Transferor: Address of Transferee:

DEADLINE TO OBJECT TO TRANSFER

The alleged transferor of the claim is hereby notified that objections must be filed with the court within twenty-one (21) days of the mailing of this notice. If no objection is timely received by the court, the transferee will be substituted as the original claimant without further order of the court.

Date:_________ ______________________________ CLERK OF THE COURT