Creditor Filer Registration Form - Us Bankruptcy Court

Download a blank fillable Creditor Filer Registration Form - Us Bankruptcy Court in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Creditor Filer Registration Form - Us Bankruptcy Court with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

UNITED STATES BANKRUPTCY COURT

EASTERN AND WESTERN DISTRICTS OF ARKANSAS

CREDITOR FILER REGISTRATION FORM

In accordance with General Order 22, entities that desire authorization to file claims and related documents electronically

should complete this registration form.

“Organization” is the name of the Creditor entity on whose behalf an employee or agent (“Filer”) is to be issued a login and

password and authorization to file electronically. Complete a separate form for each corporation or other distinct legal

entity.

ORGANIZATION INFORMATION

Organization Name: ______________________________

Organization Tax ID#___________________________

Address: ______________________________________City/State/Zip: _______________________________________

Organization Contact Person: _________________________Organization Contact’s Phone #______________________

AUTHORIZED FILER INFORMATION

Authorized Filer’s name: ______________________________Filer’s E-mail: _________________________________

Filer’s Address (if different than Org): _____________________________ City/State/Zip: _______________________

Filer’s Phone #: ____________________________________ Fax #: _______________________________________

Other ECF Courts Filer is registered with: _____________________________________________________________

By submitting this registration form, the undersigned Creditor and filer agree as follows:

1) Rule 9011 of the Federal Rules of Bankruptcy Procedure and Official Form 10 require that every proof of claim be signed by the person authorized to

submit the proof of claim for filing (“Responsible Person”). Creditor will direct each of its Filers and each of its Responsible Persons to read and to

comply with the orders and procedural directions of the Court concerning the electronic filing of proofs of claim. Filer will check to be sure an image of

the signature of the Responsible Person or "/s/ responsible person" is attached to or part of each proof of claim filed electronically. The unique password

issued to a Filer registered to use the ECF system identifies that Filer to the court each time the Filer logs on to the ECF system. The use of a Filer's

password serves as and constitutes the signature of the Filer for purposes of indicating an understanding of and agreement to comply with the orders

and procedural directions of the court concerning the electronic filing of proofs of claim. Therefore, a Filer must protect and secure the password issued

by the court. If any reason exists to suspect the password has been compromised in any way, it is the duty and responsibility of the Filer to notify the

court immediately and the court will delete that password from the ECF system and issue a new password.

2) If the Filer ceases to be an employee of the Creditor on whose behalf the Filer was authorized to file or ceases for any reason to be authorized to file

electronically for that Creditor, the Filer will immediately inform the Clerk of the Court in writing that the Filer is no longer an authorized Filer and will

cease using the logon and password issued to that Filer. If any of the information provided by Filer on this form changes, Filer will promptly send an

amended registration form to the Clerk with the then current information. Furthermore, if a Filer ceases to be an employee or agent of the Creditor or for

any other reason ceases to be authorized to file electronically on behalf of the Creditor, the Creditor will promptly notify the Clerk.

3) The undersigned has read the Court’s Administrative Procedures for Electronically Filed Cases and Related Documents.

4) To the extent permitted under the applicable federal rules, registration shall constitute a request and an agreement to receive service of pleadings and

other papers electronically where service of pleadings and other papers is otherwise permitted by first class mail, postage prepaid. The undersigned

certifies under penalty of perjury that he or she is properly authorized to submit this Creditor Registration Form on behalf of the Organization identified

above.

_________________________________________________

___________________________________________

Filer’s Signature

Signature of Organization Contact

_________________________________________________

___________________________________________

Date

Organization Contact’s position with the Creditor Entity

Please mail to:

U.S. Bankruptcy Courthouse

For questions regarding creditor registration, call: