Form 210a - Transfer Of Claim Other Than For Security Page 2
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2Form 210B (10/06)
United States Bankruptcy Court
_______________ District Of _______________
In re ______________________________,
Case No. ________________
NOTICE OF TRANSFER OF CLAIM OTHER THAN FOR SECURITY
Claim No. _____ (if known) was filed or deemed filed under 11 U.S.C. § 1111(a) in this case by the
alleged transferor. As evidence of the transfer of that claim, the transferee filed a Transfer of Claim
Other than for Security in the clerk’s office of this court on ______ (date).
Name of Alleged Transferor
Name of Transferee
Address of Alleged Transferor:
Address of Transferee:
~~DEADLINE TO OBJECT TO TRANSFER~~
The alleged transferor of the claim is hereby notified that objections must be filed with the court
within twenty (20) days of the mailing of this notice. If no objection is timely received by the court,
the transferee will be substituted as the original claimant without further order of the court.
Date:_________
______________________________
CLERK OF THE COURT
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