Certification Regarding Calculation Of Amount Form - United States Bankruptcy Court District Of New Jersey Page 2

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Advances through __________________________ for:
100.00
Real Estate Taxes:
$ _________________
100.00
Insurance premiums:
$ _________________
Other:
$ _________________
100.00
Sub-Total of Advances:
$ _________________
500.00
Less Escrow Monies:
($ ________________)
Net Advances:
$ _________________
100.00
Interest on advances from ____________ to ________________:
$ _________________
100.00
Other charges (specify __________________________________):
$ _________________
500.00
Less unearned interest:
($_________________)
TOTAL DUE AS OF _______________________:
$ _________________
Date of last payment: _______________________
II. EQUITY ANALYSIS (When appropriate)
100,000.00
Estimated fair market value of real estate as of _______________________ :
$ _________________*
*Source: _____________________________
(e.g. appraisal, tax bill/assessment, contract of sale, debtor’s schedules, etc.)
Liens on the real estate:
5,000.00
1. Real estate taxes as of ___________________ :
$__________________
2. First Mortgage (principal and interest), as of ________________ :
$ __________________
50,000.00
10,000.00
3. Second Mortgage (principal and interest), as of ______________ :
$ __________________
5,000.00
4. Other (specify on separate exhibit):
$ __________________
TOTAL LIENS :
($ _________________)
APPARENT EQUITY AS OF ______________________:
$ __________________**
** If negative, insert zero (0).
I certify under penalty of perjury that the above is true.
Date: _______________________________
________________________________
Signature
rev.8/1/15
2
 

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