CACB — Notice of Postpetition Mortgage Fees, Expenses, and Charges (410S2)

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/410S2.pdf

Fill in this information to identify the case:

B 10 (Supplement 2) (12/11) (post publication draft) Debtor 1 __________________________________________________________________

Debtor 2 ________________________________________________________________ (Spouse, if filing)

United States Bankruptcy Court for the: ______________________ District of __________ (State) Case number ___________________________________________

Official Form 410S2 Notice of Postpetition Mortgage Fees, Expenses, and Charges 12/16

If the debtor’s plan provides for payment of postpetition contractual installments on your claim secured by a security interest in the debtor's principal residence, you must use this form to give notice of any fees, expenses, and charges incurred after the bankruptcy filing that you assert are recoverable against the debtor or against the debtor's principal residence.

File this form as a supplement to your proof of claim. See Bankruptcy Rule 3002.1.

Name of creditor: _______________________________________ Court claim no. (if known): __________________

Last 4 digits of any number you use to ____ ____ ____ ____ identify the debtor’s account:

Does this notice supplement a prior notice of postpetition fees, expenses, and charges? No Yes. Date of the last notice: //_____

Part 1: Itemize Postpetition Fees, Expenses, and Charges

Itemize the fees, expenses, and charges incurred on the debtor’s mortgage account after the petition was filed. Do not include any escrow account disbursements or any amounts previously itemized in a notice filed in this case. If the court has previously approved an amount, indicate that approval in parentheses after the date the amount was incurred.

Description Dates incurred Amount

1. Late charges _________________________________ (1) $ __________

2. Non-sufficient funds (NSF) fees _________________________________ (2) $ __________

3. Attorney fees _________________________________ (3) $ __________

4. Filing fees and court costs _________________________________ (4) $ __________

5. Bankruptcy/Proof of claim fees _________________________________ (5) $ __________

6. Appraisal/Broker’s price opinion fees _________________________________ (6) $ __________

7. Property inspection fees _________________________________ (7) $ __________

8. Tax advances (non-escrow) _________________________________ (8) $ __________

9. Insurance advances (non-escrow) _________________________________ (9) $ __________

10. Property preservation expenses. Specify:_______________ _________________________________ (10) $ __________

11. Other. Specify:____________________________________ _________________________________ (11) $ __________

12. Other. Specify:____________________________________ _________________________________ (12) $ __________

13. Other. Specify:____________________________________ _________________________________ (13) $ __________

14. Other. Specify:____________________________________ _________________________________ (14) $ __________

The debtor or trustee may challenge whether the fees, expenses, and charges you listed are required to be paid. See 11 U.S.C. § 1322(b)(5) and Bankruptcy Rule 3002.1.

Official Form 410S2 Notice of Postpetition Mortgage Fees, Expenses, and Charges page 1

Debtor 1 _______________________________________________________ Case number (if known) _____________________________________ First Name Middle Name Last Name

Part 2: Sign Here

The person completing this Notice must sign it. Sign and print your name and your title, if any, and state your address and telephone number.

Check the appropriate box.

I am the creditor. I am the creditor’s authorized agent.

I declare under penalty of perjury that the information provided in this claim is true and correct to the best

of my knowledge, information, and reasonable belief.

__________________________________________________ Date //___
Signature

Print: _________________________________________________________ Title ___________________________ First Name Middle Name Last Name

Company _________________________________________________________

Address _________________________________________________________ Number Street ___________________________________________________ City State ZIP Code

Contact phone (______) _____– _________ Email ________________________

Official Form 410S2 Notice of Postpetition Mortgage Fees, Expenses, and Charges page 2