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Administrative Forms

Administrative Forms
Form Description
Credit Card One Time Authorization
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
Archives Request


Instructional Documents

Instructional Documents
Form Description
Instructions for Creating a Mailing Matrix
3-Inst   ECF Group Permissions Explanations
4-Inst   Proposed Order Guidelines
5-Inst   Certificate of Service - Instructions & Sample
6-Inst   Style Guide - Florida Northern District


Local and Sample Forms

Local forms are 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).

Local Forms (any chapter)
Form Description
Debtor’s Statement of Assistance (pro se only)
Corporate Ownership Statement
LF-3   Motion for Referral to Mortgage Modification Mediation (Rev. 07/18)
LF-3-PS   Motion for Referral to Mortgage Modification Mediation (Pro se) (Rev. 07/18)
LF-4   Certificate of Service
LF-5   Exhibit Tag/Cover Sheet
Exhibit List
LF-7   Statement of Need for Emergency Hearing
LF-8   Motion to Extend or Impose Stay
LF-9   Affidavit in Support of Motion to Extend or Impose Stay
LF-10   Negative Notice Legend
LF-11   Notice of Change of Address for Creditor
Preferred Address Request for a Case Under 342(e)
Statement of No Employment Income
Notice of Change of Address of Debtor
Motion for Waiver of Requirement to Comply with Credit Counseling Requirement
Request for Notices by Creditor (not represented by an attorney)
Notice of Appearance and Request for Notice (by attorney)
Pro se Debtor’s 1019 Statement of No Change
Verification of Creditor Mailing Matrix
Matrix/List of Creditors NEW (5/20)
LF-37    Motion to Change Hearing Venue of Panama City Division Case
LF-37-PS    Motion to Change Hearing Venue of Panama City Division Case (Pro Se)


Chapter 7
Form Description
Report & Notice of Trustee’s Intention to Abandon Property of the Estate
Report & Notice of Intention to Sell Property of the Estate
Certificate and Affidavit for Adding Creditors to Schedules in a Closed Case


Chapter 11
Form Description
Ballot Tabulation
11-6   Cover Sheet to an Application for Compensation in a Chapter 11 Case
Individual Debtor(s)’ Motion for Entry of Discharge
Statement/Certification Regarding Requirements for Discharge in a Chapter 11 Case
UST Forms   US Trustee Region 21 Forms Page


Chapter 12 
Form Description
Summary of Operations - Family Farmer


Monthly Cash Receipts & Disbursements
12-13   Chapter 12 Debtor's Pre-Confirmation Statement (New 4/20)
Statement/Certification Regarding Requirements for Discharge in a Chapter 12 Case


Chapter 13 
Form Description
13-1   Optional Plan Language
13-13   Chapter 13 Debtor's Pre-Confirmation Statement (Revised 4/20)
Chapter 13 Plan (Eff. 12/1/17) (.pdf)
NOTE: The Chapter 13 Plan form on this page may appear slightly different than forms submitted by filers who use petition preparation software to create the document. The software vendors have been authorized to conditionally "collapse" blank tables in sections of the form which are not applicable (i.e., the filer checks "None").
13-21   Chapter 13 Plan (Eff. 12/1/17) (.rtf)
NOTE: Filers are authorized to remove blank tables in sections of the form which are not applicable (i.e., where the filer checks "None") to reduced the number of pages in the document and to save noticing costs.
Annual Statement
Motion to Modify Plan re: Annual Statement
Supplement to Schedules I & J
Agreed Motion to Abate
Debtor’s Election to Abate
Debtor’s Election to Use a Portion of Tax Refund
Debtor’s Notice of Plan Payment Change Pursuant to Creditor’s Notice of Payment Change on Principal Mortgage
Motion to Deem Mortgage Current
13-34   Secured Creditor's Notice of Payment Change
Statement/Certification Regarding Requirements for Discharge in a Chapter 13 Case
Notice of Scheduled Mortgage Mediation


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-5   Order Granting Motion to Avoid Lien
LSO-6   Order Granting Motion to Sell Property
LSO-7   Order Granting Motion for Final Decree (Ch 11)
LSO-8   Order Granting Motion to Administratively Close Individual Chapter 11 Case NEW (6/20)
LSO-9   Order Granting Motion for Entry of Chapter 11 Discharge NEW (8/20)
LSO-11   Order of Deposit and Investment
LSO-12   Order Granting Motion to Change Hearing Venue of Panama City Division Case
LSO-13   Order Granting Motion to Modify Plan Under CARES Act NEW (10/20)

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.

Order Establishing Duties of the Debtor and Chapter 13 Trustee, Adequate Protection of Secured Claims, Allowance of Administrative Expenses, and Confirmation Procedures (orddo)
Order Granting Motion for Referral to Mortgage Modification Mediation (orrmmm) (Rev. 07/25/18)


Official Forms for Filing Bankruptcy and/or Other National Forms

This link will direct you to the Northern District of Florida National Forms Explanation Page which provides guidance to locate the form(s) on the U.S. Court's National Forms website.

You may CLICK HERE to go directly to the Bankruptcy Forms Page for PDF versions of the official bankruptcy forms, including the petition documents and the Proof of Claim form.


U.S. Trustee's Office Forms

Forms applicable to your case and maintained by the United States Trustee's Office may be found at