CASB — Application for Individuals to Pay Filing Fees in Installments (CSD1006)

Source: https://www.casb.uscourts.gov/sites/casb/files/documents/forms/CSD1006_0.pdf

CSD 1006 [01/01/2023]

Name, Address, Telephone No. & I.D. No.

UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991

In Re

BANKRUPTCY NO.

Debtor.

APPLICATION FOR INDIVIDUALS TO PAY FILING FEES IN INSTALLMENTS

In accordance with FRBP 1006 and Local Rule 1006-4, application is made for permission to pay half the filing fee

at the time of filing with the balance of the fee in one final installment due within 30 days of petition file date (complete Part A by checking one of the four options). If you are unable to pay the first installment payment at time of filing, please complete Part B.

Part A:
Chapter 7 (payment of $169.00) Chapter 13 (payment of $156.50)
Chapter 11 (payment of $869.00) Chapter 12 (payment of $139.00)
Part B:
I propose to pay $0.00 with the petition, and pay the first installment (see fees above) 7 days from petition filing
date.
I will make my final payment of $ on or before 30 days from petition filing date.

I certify that I am unable to pay the filing fee except in installments and I understand the following:

I must pay my entire fee before I make any more payments or transfer any more property to an attorney, bankruptcy

petition preparer, or anyone else for services in connection with my bankruptcy case. I must pay the entire fee no later than 30 days after I first file for bankruptcy, unless the court later extends my deadline. My debts will not be discharged until my entire fee is paid. If I do not make my payment when it is due, my bankruptcy case may be dismissed, and my rights in other bankruptcy proceedings may be affected.

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Signature of Debtor 1 Signature of Debtor 2 Signature of Attorney Dated: Dated: Dated:

If this document is prepared by a Non-Attorney Bankruptcy Petition Preparer,

Official Form 119, Bankruptcy Petition Preparer’s Notice, Declaration, and Signature, must be completed and submitted with this Application.

Form of payment: Cash, pay.gov, money orders, or certified checks only; please do not mail cash. Personal checks of the debtor will not be accepted.