Periodic Report Regarding Value Operations And Profitability Of

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B26 (Official Form 26) (12/08)
United States Bankruptcy Court
__________________ District of _____________
In re
,
Case No. ____________________
Debtor
Chapter 11
PERIODIC REPORT REGARDING VALUE, OPERATIONS AND PROFITABILITY OF
ENTITIES IN WHICH THE ESTATE OF [NAME OF DEBTOR]
HOLDS A SUBSTANTIAL OR CONTROLLING INTEREST
This is the report as of __________on the value, operations and profitability of those
entities in which the estate holds a substantial or controlling interest, as required by Bankruptcy
Rule 2015.3. The estate of [Name of Debtor] holds a substantial or controlling interest in the
following entities:
Name of Entity
Interest of the Estate
Tab #
This periodic report (the “Periodic Report”) contains separate reports (“Entity Reports”) on the
value, operations, and profitability of each entity listed above.
Each Entity Report shall consist of three exhibits. Exhibit A contains a valuation estimate
for the entity as of a date not more than two years prior to the date of this report. It also contains
a description of the valuation method used. Exhibit B contains a balance sheet, a statement of
income (loss), a statement of cash flows, and a statement of changes in shareholders’ or partners’
equity (deficit) for the period covered by the Entity Report, along with summarized footnotes.
Exhibit C contains a description of the entity’s business operations.
THIS REPORT MUST BE SIGNED BY A REPRESENTATIVE OF THE TRUSTEE OR DEBTOR IN
POSSESSION.
The undersigned, having reviewed the above listing of entities in which the estate of [Debtor]
holds a substantial or controlling interest, and being familiar with the Debtor’s financial affairs,
verifies under the penalty of perjury that the listing is complete, accurate and truthful to the best
of his/her knowledge.

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