This form contains 57 fields organized into 20 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Case
Chapter ComboBox
Select the applicable bankruptcy chapter under which the case is filed.
Case Number Text
Enter the case number associated with the bankruptcy proceeding (maximum of 12 characters).
Max length: 12 characters
Case Details
Case Number Text
Enter the case number as assigned, using up to 12 characters.
Max length: 12 characters
Chapter ComboBox
Select the bankruptcy chapter under which the case has been filed.
Case Information
Debtor's Name Text
Enter the full name of the debtor involved in the case.
Case Number Text
Enter the case number (up to 12 characters) as assigned by the court.
Max length: 12 characters
Chapter ComboBox
Select the bankruptcy chapter under which the case is filed.
Certificate of Service
Enter Date Date
Enter the applicable date relevant to the certificate of service (or another related date) as indicated on the form.
Enter Partys Name and Address Text
Enter the party's name and address as it should appear for service purposes.
Dated Date
Enter the date on which the certificate of service was signed.
Contact
Print name Text
Enter the printed name of the person submitting or signing the form.
Address Text
Enter the mailing or residential address associated with the contact information.
Phone Text
Provide a phone number where you can be contacted regarding this case.
Email Text
Enter your email address for further communications regarding this application.
Address Text
Enter the address associated with the signing party. This may be used for service or identification purposes.
Court Info
and United Text
This field contains part of the court’s formal name (e.g., 'and United'). Confirm or complete the court title as needed.
Court Office
Office ComboBox
Select the appropriate office location from the provided list (e.g., Brooklyn or Central Islip, New York) where the case is being processed.
Brooklyn, New York Central Islip, New York
Debtor
Name of Debtor(s) Text
Enter the name(s) of the debtor(s) involved in the bankruptcy proceeding.
Debtor Info
Debtor's Name Text
Enter the debtor's name as it is officially recorded in the case documentation.
General
should not enter an Order to Text
undefined Text
Hearing Information
Enter Hearing Date Date
Enter the hearing date when the case will be addressed by the court.
Enter Date Date
Enter the date associated with the hearing as indicated by the court’s schedule.
Time ComboBox
Select the time designation (a.m. or p.m.) for the scheduled hearing.
p.m. a.m.
on the date of Date
Specify the date related to the event mentioned, likely reinforcing the hearing date.
Select Correct Hearing Judge ComboBox
Select the correct hearing judge from the dropdown list. This ensures the proper judge is assigned to the case.
Courtroom ComboBox
Select the courtroom where the hearing will take place from the provided options.
860 960 3585 2554 3529 3577 970
Select Court Site ComboBox
Choose the appropriate court site (location) from the available selections.
271 Cadman Pl., East. Brooklyn, New York 11201 290 Federal Plaza, Central Islip, New York 11722
Judge
Judge ComboBox
Select the judge assigned to the case from the provided list of options.
Chief Judge Trust Judge Grossman Judge Lord Judge Scarcella Judge Stong Judge Mazer-Marino
Miscellaneous
Order/Relief Description Text
Enter a brief, specific description of the order or relief referenced (i.e., what order the Court would otherwise enter) that explains why the Court should not enter that order.
Order
Enter Date Order Signed Date
Enter the date on which the order was signed. Use the appropriate date format as specified.
Order Details
ORDERED that Text
Detail the order or instructions being granted by the court. This field should capture the outcome or mandate of the motion.
Enter Date Order Signed Date
Enter the date on which the order was signed. Ensure the format matches the court’s requirements.
Party Information
Movant Text
Enter the name of the movant (the party initiating the motion).
Relief
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [1 Text
Provide the details of the relief requested in the motion (part 1). Explain specifically what order you are requesting the Bankruptcy Judge to grant.
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [2 Text
Provide additional details of the relief requested in the motion (part 2). Explain the specifics of what order you are asking the Bankruptcy Judge to grant.
Enter Reason Text
Provide the reason for the relief you are requesting, explaining the basis for the motion.
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [1 Text
Provide the details of the relief requested in the motion (duplicate entry, part 1). Explain what order is being requested.
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [1 Text
Provide the details of the relief requested in the motion (duplicate entry, part 1). Ensure that the specific order being requested is clear.
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [1 Text
Provide the details of the relief requested in the motion (duplicate entry, part 1). Clarify what order you need the Bankruptcy Judge to grant.
Enter Reason Text
Enter the reason for requesting relief. Provide additional context or explanation if needed.
Enter Reason Text
Enter the reason for requesting relief. Detail any additional supporting allegations or explanations.
Enter Reason Text
Enter the reason for requesting relief. Clarify the grounds on which you seek the order.
Enter Reason Text
Enter the reason for requesting relief. Provide further explanation of the basis for the motion.
Enter Reason Text
Enter the reason for requesting relief. Include any necessary details to support your request.
Enter Reason Text
Enter the reason for requesting relief. Add any supplementary information that explains your request for the order.
Relief Request
Enter Reason Text
Provide a reason for the relief requested. This field asks for a justification or explanation related to the motion.
Enter Reason Text
Provide a reason for the relief requested. This field asks for a justification or explanation related to the motion.
Enter Reason Text
Provide a reason for the relief requested. This field asks for a justification or explanation related to the motion.
Lord, Bankruptcy Judge, to consider the motion for an Order granting relief as follows [1 Text
Compose the directive for the Bankruptcy Judge to consider the motion for an order granting relief. Include the detailed relief being requested.
Enter Reason Text
Provide the specific reason for the relief requested. Be concise and focused on the justification.
Enter Reason Text
Provide the specific reason for the relief requested. Be concise and focused on the justification.
Enter Reason Text
Provide the specific reason for the relief requested. Be concise and focused on the justification.
Service Deadline
served on or before the end of the business day on [1 Date
Enter the first service deadline date by which the document must be served (i.e., by close of business).
served on or before the end of the business day on [2 Date
Enter the second service deadline date, if applicable, indicating the latest day to complete service.
the Movant on or before Date
Enter the deadline date by which the document must be served on the movant.
Trustee Info
upon the Trustee at Text
Provide the address details for the Trustee. This is where related documents or notices should be sent.