CACB — Adversary No. _______________

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

UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In re: ________________________________, Case No. _______________

Adversary No. _______________

Debtor(s)

APPLICATION FOR ACCESS TO ELECTRONIC DROP BOX (For documents that do not require a filing fee only)

A. HOW THE PRO SE ELECTRONIC DROP BOX WORKS.

The Clerk of the United States Bankruptcy Court for the Central District of California has

implemented a Pro Se Electronic Drop Box (“EDB”) for the purpose of permitting a self-represented (without an attorney or “pro se") individual litigant to submit documents for filing electronically in bankruptcy cases and adversary proceedings pending in this District. Participation in this program is optional.

A self-represented individual litigant authorized to use the EDB will be issued an Electronic

Drop Box Link (“EDB Link” or “Link”); a married couple jointly authorized to use the EDB will be issued one EDB Link for both spouses. Use of the EDB Link to submit a document for filing, together with the individual's holographic signature using an ink pen (or if both spouses join in the document, signatures for each spouse), satisfies the signature requirement of Rule 9011-1(a) of the Federal Rules of Bankruptcy Procedure. All signatures must be made holographically using an ink pen before the document is submitted into the EDB Portal.

An EDB Link serves the same purpose as a user name and password. Individuals (including

couples) issued an EDB Link should keep the Link confidential the same as they would keep a sensitive user name and password confidential. Individuals issued an EDB Link are responsible for the use of the Link.

When a document is submitted to the EDB for filing, Bankruptcy Court personnel will review

the document and, if appropriate, will file the document on the case docket. The Court has the right to reject any document submitted to the EDB for filing. If a document submitted to the EDB for filing is rejected, the individual who submitted the document will be notified by U.S. mail or email.

Use of the EDB is a privilege not a right. The Court may revoke the privilege at any time.

B. APPLICANT(s)

________________________________ (Name of applicant) and ____________________________ (Name of applicant if married couple jointly applying) (“Applicant(s)”) hereby apply/ies to the Court for an Order granting access to the Court’s Pro Se EDB for the purpose of electronically submitting documents for filing in the above-captioned bankruptcy case.

In support of this application, Applicant(s) state(s):

1. I am a self-represented litigant (pro se) debtor or party in the above-captioned bankruptcy case.

   2. I understand that the use of an EDB Link the Court issues to me, together with my

holographic signature using an ink pen AND a digital photograph of my actual signature (attached to this Request Form) constitutes my signature under penalty of perjury and for purposes of Fed. R. Bankr. P. 9011-1(a) specifically provides: "Under no circumstances may a reproduction of the same holographic signature be used on multiples pages or in multiple documents. This means a signature stamp does not qualify as a legitimate holographic signature.

3. I understand and agree that I am responsible for assuring the security of my EDB Link. If

there is reason to suspect my EDB Link has been compromised, it is my responsibility to immediately notify the Clerk’s Office.

4. I understand that electronically submitting documents through the EDB is a privilege that

can be revoked at any time.

WHEREFORE, Applicant(s) respectfully request(s) that the Court grant this request for access

to the EDB in the above-captioned bankruptcy case. Respectfully submitted,

By: ________________________________________ Signature of Applicant

Mailing Address:______________________________

City:________________________________________

State:_______________________________________

Zip:_________________________________________

Telephone:___________________________________

Email:________________________________________

(If married couple jointly applying, both must sign)

By: ________________________________________ Signature of Applicant (if jointly applying)

Mailing Address:______________________________

City:________________________________________

State:_______________________________________

Zip:_________________________________________

Telephone:___________________________________

Email:________________________________________

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