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Forms
Administrative Forms
Instructional Documents
Local Forms
Forms created by and required (as applicable) only in the U.S. Bankruptcy Court for the Northern District of Florida. Chapter-specific forms are preceded by the chapter number in which they may be used. All other forms are not chapter specific and may be used in any chapter as applicable (e.g., LF-1).
Sample and Form Orders
The Local Sample Orders below are provided for your convenience. Highlighted areas in each document are required information and should be contained in your proposed order whether or not you choose to use the sample provided.
The following Local Form Orders are entered by the Clerk’s Office in accordance with Standing Order #5 and are provided here for your convenience due to the length of and complexity of each.
Official Forms for Filing Bankruptcy and/or Other National Forms
You may CLICK HERE to go directly to the USCourts.gov Bankruptcy Forms Page for PDF versions of the official bankruptcy forms, including the petition documents and the Proof of Claim form.
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Administrative Forms
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Form Description
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Credit Card One Time Authorization
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Credit Card Blanket Authorization - to initiate payments online
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| A6 | Application for Filing Agent Accounts in ECF | |
| A7 | Application for Login and Password to ECF-Child Support Creditor | |
| A8 | Copy Work Request | |
| A9 | Application for Admission to Registry of Mediators Qualified Under Florida Northern Mortgage Modification Mediation Program | |
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Archives Request
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Instructional Documents
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Instructional Documents
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Form Description
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Instructions for creating a Creditor Mailing Matrix
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| 3-Inst | ECF Group Permissions Explanations | |
| 4-Inst | Proposed Orders Guidelines | |
| 5-Inst | Certificate of Service - Instructions & Sample | |
Local Forms
Forms created by and required (as applicable) only in the U.S. Bankruptcy Court for the Northern District of Florida. Chapter-specific forms are preceded by the chapter number in which they may be used. All other forms are not chapter specific and may be used in any chapter as applicable (e.g., LF-1).
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Local Forms (any chapter)
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Form Description
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Debtor’s Statement of Assistance (pro se only)
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Corporate Ownership Statement
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| LF-3 | Motion for Referral to Mortgage Modification Mediation | |
| LF-3-PS | Motion for Referral to Mortgage Modification Mediation (Pro se) | |
| LF-4 | Certificate of Service | |
| LF-5 | Exhibit Tag/Cover Sheet | |
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Exhibit and Witness List
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Preferred Address Request for a Case Under 342(e)
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Statement of No Employer Income
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Notice of Change of Address of Debtor
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Motion for Waiver of Requirement to Comply with Credit Counseling Requirement
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Request for Notices by Creditor (not represented by an attorney)
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Notice of Appearance and Request for Notice (by attorney)
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Motion for Protective Order to Restrict Access and Allow for Redaction of Information
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Pro se Debtor’s 1019 Statement of No Change
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Verification of Creditor Mailing Matrix
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Chapter 7
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Form Description
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Report & Notice of Trustee’s Intention to Abandon Property of the Estate
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Report & Notice of Intention to Sell Property of the Estate
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Certificate/Affidavit for Adding Creditors to Schedules in a Closed Case
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Chapter 11
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Form Description
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Ballot Tabulation
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| 11-6 | Cover Sheet to an Application for Compensation in a Chapter 11 Case | |
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Individual Debtor(s)’ Motion for Entry of Discharge
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Statement/Certification Regarding Requirements for Discharge in a Chapter 11 Case
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| UST Forms | US Trustee Region 21 Forms Page |
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Chapter 12
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Form Description
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Summary of Operations - Family Farmer
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Monthly Cash Receipts & Disbursements
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Statement/Certification Regarding Requirements for Discharge in a Chapter 12 Case
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Chapter 13
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Form Description
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| 13-1 | Optional Plan Language | |
| 13-13 | Chapter 13 Debtor's Pre-Confirmation Statement | |
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Form Plan (Eff. 12/1/08)
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Annual Statement
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Motion to Modify Plan re: Annual Statement
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Supplement to Schedules I & J
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Agreed Motion to Abate
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Debtor’s Election to Abate
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Debtor’s Election to Use a Portion of Tax Refund
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Debtor’s Notice of Plan Payment Change Pursuant to Creditor’s Notice of Payment Change on Principal Mortgage
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Motion to Deem Mortgage Current
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| 13-34 | Secured Creditor's Notice of Payment Change | |
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Statement/Certification Regarding Requirements for Discharge in a Chapter 13 Case
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Notice of Scheduled Mortgage Mediation
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Sample and Form Orders
The Local Sample Orders below are provided for your convenience. Highlighted areas in each document are required information and should be contained in your proposed order whether or not you choose to use the sample provided.
| LSO-1 | Order Granting Motion to Determine Secured Status & Strip Junior Lien on Debtor's Principal Residence | |
| LSO-2 | Order Granting Motion for Relief from Stay | |
| LSO-3 | Order Sustaining Debtor's Objection to Claim | |
| LSO-4 | Order Granting Consent Motion to Extend Pretrial Deadlines | |
| LSO-11 | Order of Deposit and Investment |
The following Local Form Orders are entered by the Clerk’s Office in accordance with Standing Order #5 and are provided here for your convenience due to the length of and complexity of each.
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Order Establishing Duties of the Debtor and Chapter 13 Trustee, Adequate Protection of Secured Claims, Allowance of Administrative Expenses, and Confirmation Procedures (orddo)
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Order Granting Motion for Referral to Mortgage Modification Mediation (orrmmm)
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Official Forms for Filing Bankruptcy and/or Other National Forms
- File an Online Proof of Claim
- 342(b) Statement - Read Before Filing: B 201A (Clerk's Notice) and B 201B (Certification)
You may CLICK HERE to go directly to the USCourts.gov Bankruptcy Forms Page for PDF versions of the official bankruptcy forms, including the petition documents and the Proof of Claim form.