Form 401 - Chapter 15 Petition For Recognition Of A Foreign Proceeding Page 3

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Debtor
_______________________________________________________
Case number
_____________________________________
(if known)
Name
Why is venue proper in this
Check one:
12.
district?
Debtor’s principal place of business or principal assets in the United States are in this district.
Debtor does not have a place of business or assets in the United States, but the following
action or proceeding in a federal or state court is pending against the debtor in this district:
___________________________________________________________________________.
If neither box is checked, venue is consistent with the interests of justice and the convenience
of the parties, having regard to the relief sought by the foreign representative, because:
___________________________________________________________________________.
Signature of foreign
13.
I request relief in accordance with chapter 15 of title 11, United States Code.
representative(s)
I am the foreign representative of a debtor in a foreign proceeding, the debtor is eligible for the
relief sought in this petition, and I am authorized to file this petition.
I have examined the information in this petition and have a reasonable belief that the
information is true and correct.
I declare under penalty of perjury that the foregoing is true and correct,
________________________________________________
_______________________________________________
Signature of foreign representative
Printed name
Executed on
__________________
MM / DD / YYYY
________________________________________________
_______________________________________________
Signature of foreign representative
Printed name
Executed on
__________________
MM / DD / YYYY
Signature of attorney
14.
Date
_________________________________________________
_________________
Signature of Attorney for foreign representative
MM
/ DD / YYYY
_________________________________________________________________________________________________
Printed name
_________________________________________________________________________________________________
Firm name
_________________________________________________________________________________________________
Number
Street
____________________________________________________
__________________________________________
City
State
ZIP Code
____________________________________
__________________________________________
Contact phone
Email address
______________________________________________________ ____________
Bar number
State
Official Form 401
Chapter 15 Petition for Recognition of a Foreign Proceeding
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