Small Business Monthly Operating Report
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4B 25C (Official Form 25C) (12/08)
U
S
B
C
NITED
TATES
ANKRUPTCY
OURT
__________ District of __________
In re
,
Case No.
Debtor
Small Business Case under Chapter 11
SMALL BUSINESS MONTHLY OPERATING REPORT
Month:
Date filed:
Line of Business:
NAISC Code:
IN ACCORDANCE WITH TITLE 28, SECTION 1746, OF THE UNITED STATES CODE, I DECLARE UNDER PENALTY OF
PERJURY THAT I HAVE EXAMINED THE FOLLOWING SMALL BUSINESS MONTHLY OPERATING REPORT AND THE
ACCOMPANYING ATTACHMENTS AND, TO THE BEST OF MY KNOWLEDGE, THESE DOCUMENTS ARE TRUE,
CORRECT AND COMPLETE.
RESPONSIBLE PARTY:
Original Signature of Responsible Party
Printed Name of Responsible Party
Questionnaire:
Yes
No
(All questions to be answered on behalf of the debtor.)
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1.
IS THE BUSINESS STILL OPERATING?
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2.
HAVE YOU PAID ALL YOUR BILLS ON TIME THIS MONTH?
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3.
DID YOU PAY YOUR EMPLOYEES ON TIME?
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4.
HAVE YOU DEPOSITED ALL THE RECEIPTS FOR YOUR BUSINESS INTO THE DIP ACCOUNT
THIS MONTH?
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5.
HAVE YOU FILED ALL OF YOUR TAX RETURNS AND PAID ALL OF YOUR TAXES THIS
MONTH
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6.
HAVE YOU TIMELY FILED ALL OTHER REQUIRED GOVERNMENT FILINGS?
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7.
HAVE YOU PAID ALL OF YOUR INSURANCE PREMIUMS THIS MONTH?
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8.
DO YOU PLAN TO CONTINUE TO OPERATE THE BUSINESS NEXT MONTH?
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9.
ARE YOU CURRENT ON YOUR QUARTERLY FEE PAYMENT TO THE U.S. TRUSTEE?
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10. HAVE YOU PAID ANYTHING TO YOUR ATTORNEY OR OTHER PROFESSIONALS THIS
MONTH?
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11. DID YOU HAVE ANY UNUSUAL OR SIGNIFICANT UNANTICIPATED EXPENSES THIS
MONTH?
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12. HAS THE BUSINESS SOLD ANY GOODS OR PROVIDED SERVICES OR TRANSFERRED ANY
ASSETS TO ANY BUSINESS RELATED TO THE DIP IN ANY WAY?
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13. DO YOU HAVE ANY BANK ACCOUNTS OPEN OTHER THAN THE DIP ACCOUNT?
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