in the united states bankruptcy court for the …omnimgt.com/cmsvol2/pub_47269/705903_526.pdf ·...

IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

In re:

Chapter 11

MISSION COAL COMPANY, LLC, et al.,1 Case No. 18-04177-TOM11 Debtors.

(Jointly Administered)

CERTIFICATE OF SERVICE

I, Scott M. Ewing, depose and say that I am employed by Omni Management Group (“Omni”), the

Claims and Noticing Agent for the Debtors in the above-captioned cases. On December 21, 2018, at my direction and under my supervision, employees of Omni

Management Group caused true and correct copies of the following documents to be served via first-class mail, postage pre-paid, to the parties listed in Exhibit A attached hereto:

Notice of Deadlines for the Filing of Proofs of Claim, Including Requests for Payments Under

Section 503(B)(9) of the Bankruptcy Code2

Official Form 410: Proof of Claim2 Official Form 410: Instructions for Proof of Claim2

Dated: January 3, 2019

/s/ Scott M. Ewing_________ Scott M. Ewing Omni Management Group 5955 DeSoto Avenue, Suite 100 Woodland Hills, California 91367

(818) 906-8300

1 The Debtors in these chapter 11 cases, along with the last four digits of each Debtor’s federal tax identification number, include: Mission Coal Company, LLC (8465); Beard Pinnacle, LLC (0637); Oak Grove Land Company, LLC (6068); Oak Grove Resources, LLC (0300); Pinnacle Land Company, LLC (6070); Pinnacle Mining Company, LLC (7780); Seminole Alabama Mining Complex, LLC (6631); Seminole Coal Resources, LLC (1795); Seminole West Virginia Mining Complex, LLC (7858); Seneca Coal Resources, LLC (1816); and Seneca North American Coal, LLC (5102). The location of the Debtors’ service address is: 7 Sheridan Square, Suite 300, Kingsport, Tennessee 37660. 2 A copy of the Notice of Deadlines for the Filing of Proofs of Claim and Official Forms 410: Proof of Claim and Instructions are attached hereto as Exhibit B. Case 18-04177-TOM11 Doc 526 Filed 01/03/19 Entered 01/03/19 13:06:51 Desc

Main Document of 136

EXHIBIT A

Case 18-04177-TOM11 Doc 526 Filed 01/03/19 Entered 01/03/19 13:06:51 Desc Main Document of 136

Served 12/21/2018Mission Coal Company, LLC, et al. - U.S. Mail

2008 MILLWORK SUPPLY1451 11TH AVE SOUTHJASPER, AL 35501

2012 RETIREE BONUS ACOUNT TRUST126 TRIVETTE DRPIKEVILLE, KY 41501

3M COMPANYATTN: ED MCCREADY5457 W 79TH STINDIANAPOLIS, IN 46268

A & A RESOURCES INCP.O. BOX 190WARRIOR, AL 35180

A & A SUPPLIES INCP.O. BOX 94PREMIUM, KY 41845

A J CHILDERS9027 LIBERTY PKWYKIMBERLY, AL 35091

A L LEE CORPORATION2075 LESTER HWYP.O. BOX 99LESTER, WV 25865

A L LEE CORPORATIONC/O HAGER EQUIPMENT2075 LESTER HWYP.O. BOX 99LESTER, WV 25865

A L LEE CORPORATIONP.O. BOX 3463CHARLESTON, WV 25334

A S INTER SILESIA SP Z O OUL ZELANZNA 9KATOWICE, 40851POLAND

A.G. COMMERCIAL G.P.P.O. BOX 1735BRISTOL, TN 37621

AAA COMMERCIAL ICE SYS INC1788 HORSECREEK BLVDDORA, AL 35062

AAA COOPER TRANSPORTATIONP.O. BOX 102442ATLANTA, GA 30368

AAA ENVIRONMENTAL SERVICES1221 PINSON STP.O. BOX 170223BIRMINGHAM, AL 35217

AAA MINE SERVICE INC18 MOUNTAIN VIEW DRHAZARD, KY 41701

AAA MINE SERVICE UNDERGROUND INC18 MOUNTAIN VIEW DRHAZARD, KY 41701

AAA SEPTIC TANK SERVICEP.O. BOX 975PRINCETON, WV 24740

AAA SEPTIC TANK SERVICESP.O. BOX 975PRINCETON, WV 24740

AARDWOLF TERMITE AND PEST CONTROL3442 WARRIJOR RIVER ROADBESSEMER, AL 35023

AARON, SAMADDRESS REDACTED

ABBOTT, JORDAN KADDRESS REDACTED

ABBOTT, KEVIN AADDRESS REDACTED

ABRASION RESISTANT ALTERNATIVE425 5TH AVE NBESSEMER, AL 35020

ACCOUNTEMPS12400 COLLECTIONS CENTER DRCHICAGO, IL 60693

ACCOUNTING ECONOMICS & APPRAISAL GROUP1901 6TH AVE NORTH, SUITE 1620BIRMINGHAM, AL 35203

ACCOUNTING ECONOMICS & APPRAISAL GROUP LLCATTN: J LESTER ALEXANDER IIIREGIONS HARBERT PLAZA1901 6TH AVE N, STE 1620BIRMINGHAM, AL 35203

ACCOUNTING, ECONOMICS, APPRAISAL GROUP1901 6TH AVE NORTH, STE 1620BIRMINGHAM, AL 35203

ACE WORLD COMPANIES10200 JACKSBORO HWYFORT WORTH, TX 76135

ACKER, CHARLES CHRISTOPHERADDRESS REDACTED

ACKER, KEITH AADDRESS REDACTED

ACORD, BLAKE JADDRESS REDACTED

ACORD, JOEYADDRESS REDACTED

ACORD, JOSHUAADDRESS REDACTED

Page 1 of 125Case 18-04177-TOM11 Doc 526 Filed 01/03/19 Entered 01/03/19 13:06:51 Desc



ACORD, JOSHUA BADDRESS REDACTED

ACTION SUPPLY PRODUCTS INC1065 MONTOUR WEST INDUST PARKCORAOPOLIS, PA 15108

ADAMS AND REESE LLPATTN: RICHARD CARMODY/RUSSELL RUTHERFORD1901 6TH AVENUE NORTHBIRMINGHAM, AL 35203

ADAMS MFG CO INCP.O. BOX 326RT 10MATHENY, WV 24860

ADAMS WHITE OLIVER SHORT & FORBUS LLPP.O. BOX 2069OPELIKA, AL 36803-2069

ADAMS, EDWARD LADDRESS REDACTED

ADAMS, JANIE AADDRESS REDACTED

ADAMS, RYAN WADDRESS REDACTED

ADAMS, STEVEN P.ADDRESS REDACTED

ADAMS, TIVUS WADDRESS REDACTED

ADDAIR, LEWIS EADDRESS REDACTED

ADDAIR, THOMAS MADDRESS REDACTED

ADKINS, ALLEN HADDRESS REDACTED

ADKINS, CHRIS AADDRESS REDACTED

ADKINS, CURTISADDRESS REDACTED

ADKINS, CURTIS LEEADDRESS REDACTED

ADKINS, DANA NADDRESS REDACTED

ADKINS, DAVID LADDRESS REDACTED

ADKINS, HUNTER LADDRESS REDACTED

ADKINS, JONATHAN GADDRESS REDACTED

ADKINS, KENNETH MADDRESS REDACTED

ADKINS, MATTHEW DADDRESS REDACTED

ADKINS, MATTHEW DAVIDADDRESS REDACTED

ADKINS, MELVIN DADDRESS REDACTED

ADKINS, RUSSELLADDRESS REDACTED

ADKINS, RUSSELL DADDRESS REDACTED

ADP LLCATTN: OLGA ROJO1851 N RESLEREL PASO, TX 79912

ADP LLCP.O. BOX 842875BOSTON, MA 02284-2875

ADT SECURITY SERVICES1600 OAKBROOK DR, STE 540NORCROSS, GA 30093

ADT SECURITY SERVICES4438 1501 YAMATO RDBOCA RATON, FL 33431

ADVANCE AUTO PARTS, INC702 US-60CEDAR GROVE, WV 25039

ADVANCE MINING SERVICES838 3RD STOAKMONT, PA 15139

ADVANCED LOCKSMITH & SECURITY1808 5TH AVE SJASPER, AL 35501




ADVANTAGE TECHNOLOGY LLCATTN: BJ EVANS950 KANAWHA BLVD ECHARLESTON, WV 25301

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AHR METALS INC20 DIVISION STBESSEMER, AL 35020

AIR PLACEMENT CEMENT COMPANYATTN: RICK HILL, ROUTE 50 EASTBRIDGEPORT, WV 26330

AIR PLACEMENT CEMENT COMPANYROUTE 50 EASTBRIDGEPORT, WV 26330

AIRGAS SOUTHATTN: LEYDALIS GARCIAW186 N11300 WHITNEY DRP.O. BOX 1010GERMANTOWN, WI 53022

AIRGAS SOUTHP.O. BOX 532609ATLANTA, GA 30353

AIRGAS STRATEGIC ACCOUNTSATTN: LEYDALIS GARCIAW186 N11300 WHITNEY DRP.O. BOX 1010GERMANTOWN, WI 53022

AIRGAS STRATEGIC ACCOUNTSW186 N11300 WHITNEY DRP.O. BOX 1010GERMANTOWN, WI 53022

AIRGAS USA LLC2610 18TH AVE NORTHBESSEMER, AL 35020

AKIN GUMP STRAUSS HAUER & FELD LLPATTN: KATHRYN DEMANDER1700 PACIFIC AVE, STE 4100DALLAS, TX 75201

AKIN GUMP STRAUSS HAUER & FELD LLPATTN: LISA BECKERMAN/ARIK PREISATTN: ALLISON MILLER/JASON RUBINONE BRYANT PARKBANK OF AMERICA TOWERNEW YORK, NY 10036-6745

AKIN GUMP STRAUSS HAUER & FELD LLPATTN: MARTY BRIMMAGE, JR./LACY LAWRENCE1700 PACIFIC AVE, SUITE 4100DALLAS, TX 75201

AKIN GUMP STRAUSS HAUER & FELD LLPATTN: MARTY L. BRIMMAGEATTN: LACY M. LAWRENCE1700 PACIFIC AVENUE, SUITE 4100DALLAS, TX 75201

AKIN, GUMP, STRAUSS, HAUER & FELD, LLCDEPT 7247- 6838PHILADELPHIA, PA 19170-6838

AL DEPT OF ENVIRONMENTAL MGMTP.O. BOX 301463MONTGOMERY, AL 36130-1463

AL DEPT OF REVENUECOLLECTION SERVICES DIVISIONP.O. BOX 327820MONTGOMERY, AL 36132

AL POWER COMPANYATTN: SCS SO FUEL ACCOUNTINGP.O. BOX 5S8816 - P.O. BOX 2641BIRMINGHAM, AL 35291

ALABAMA CENTER FOR OCCUPATIONALATTN: ANTHONY RICHEYMEDICINE & PREVENTION PC2018 BROOKWOOD MEDICAL CENTER DRSUITE G2BIRMINGHAM, AL 35209

ALABAMA CENTER FOR OCCUPATIONALMEDICINE & PREVENTION PC2018 BROOKWOOD MEDICAL CENTER DRSUITE G2BIRMINGHAM, AL 35209

ALABAMA CNTR F/ OCCUPATIONAL MED2018 BROOKWOOD MED CENTER DRPOB, STE G-2BIRMINGHAM, AL 35209

ALABAMA CNTR F/ OCCUPATIONAL MED2018 BROOKWOOD MED CENTER DR, SUITE G-2BIRMINGHAM, AL 35209

ALABAMA COAL ASSN#2 OFFICE PARK CIR, SUITE 200BIRMINGHAM, AL 35223

ALABAMA DEPT OF ENV MGMTDEPT OF ENVIRO MGMT NPDES/EPAP.O. BOX 301463MONTGOMERY, AL 36130

ALABAMA DEPT OF PUBLIC HEALTHOFFICE OF RADIATION CONTROLP.O. BOX 303017MONTGOMERY, AL 36130

ALABAMA DEPT OF REVENUEATTN: BUSINESS & LICENSE TAX DIV. SEVERANCE TAP.O. BOX 327560MONTGOMERY, AL 36132-7560

ALABAMA DEPT OF REVENUEATTN: BUSINESS PRIVILEGE TAX SECTIONP.O. BOX 327431MONTGOMERY, AL 36132-7413

ALABAMA DEPT OF REVENUEATTN: SALES & USE TAX DIVISIONP.O. BOX 327710MONTGOMERY, AL 36132-7710

ALABAMA DEPT OF REVENUEBUSINESS PRIVILEGE TAX SECTIONP.O. BOX 327431MONTGOMERY, AL 36132

ALABAMA DEPT OF REVENUEP.O. BOX 327480MONTGOMERY, AL 36132




ALABAMA DEPT OF REVENUESALES USE & BUSINESS TAX DIVP.O. BOX 327560MONTGOMERY, AL 36132

ALABAMA DEPT OF REVENUESEVERANCE AND LICENSE SECTIONP.O. BOX 327560MONTGOMERY, AL 36132

ALABAMA DEPT. OF ENVIRONMENTAL MANAGEMENATTN: LANCE R. LEFLEUR, DIRECTORP.O. BOX 301463MONTGOMERY, AL 36130-1463

ALABAMA GAS CORPP.O. BOX 11407BIRMINGHAM, AL 35248

ALABAMA GRAPHICS & ENG SUPPLY2801 5TH AVE SOUTHBIRMINGHAM, AL 35233

ALABAMA INDUSTRIAL TRADES LLC3074 TERESA AVEBESSEMER, AL 35023

ALABAMA LOCK & KEY CO INCP.O. BOX 1056BIRMINGHAM, AL 35201

ALABAMA MEDIA GROUPDEPT 77571P.O. BOX 77000DETROIT, MI 48277-0571

ALABAMA POWERP.O. BOX 242BIRMINGHAM, AL 35292

ALABAMA POWERP.O. BOX 24415CANTON, OH 44701

ALABAMA POWER COMPANY600 NORTH 18TH STP.O. BOX 2641BIRMINGHAM, AL 35291

ALABAMA POWER COMPANY600 NORTH 18TH ST/17N-0043BIRMINGHAM, AL 35203

ALABAMA POWER COMPANYP.O. BOX 242BIRMINGHAM, AL 35292

ALABAMA SLING CENTER INCP.O. BOX 2031103 HOKE AVEDOLOMITE, AL 35061

ALABAMA STATE PORT AUTHORITYATTN: ACCOUNTINGP.O. BOX 1588MOBILE, AL 36633

ALABAMA STEEL SALES LLC6000 CURRY HWYJASPER, AL 35503

ALABAMA SURFACE MINING COMMISSIONATTN: G. MILTON MCCARTHYLEGAL DIVISIONP.O. BOX 2390JASPER, AL 35502-2390

ALABAMA SURFACE MINING COMMISSIONP.O. BOX 2390JASPER, AL 35502

ALABAMA SURFACE MINING COMMISSIONP.O. BOX 2390JASPER, AL 35502-2309

ALABAMA WARRIOR RAILROADP.O. BOX 790343BIN, 150077SAINT LOUIS, MO 63179-0343

ALDEENS MANUFACTURING COP.O. BOX 705PINEVILLE, WV 24874

ALDERMAN, ALVIS FADDRESS REDACTED

ALDRIDGE, DUSTIN KURTADDRESS REDACTED

ALENE C. SMITHC/O GATHINGS LAWATTN: LLOYD GATHINGS2204 LAKESHORE DR, STE 406BIRMINGHAM, AL 35209

ALEXANDER, JOSEPH PAULADDRESS REDACTED

ALEXANDER, MICHAEL CHADADDRESS REDACTED

ALIFF, JOSHUA SADDRESS REDACTED

ALLCOMM WIRELESS INC4116 1ST AVE NORTHBIRMINGHAM, AL 35222

ALLEN, ALEXANDER MADDRESS REDACTED

ALLEN, CHARLES MADDRESS REDACTED

ALLEN, CHRISTOPHER LADDRESS REDACTED

ALLEN, DERRICK CADDRESS REDACTED

ALLEN, HARRY DAVIDADDRESS REDACTED




ALLEY, WILLIAM DADDRESS REDACTED

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ALLIED ELECTRONICS INC5035 PLAINFIELD NE, STE EGRAND RAPIDS, MI 49525

ALLIED OFS LLCATTN: TAMMY SHARP950 E STATE HWY 114SOUTHLAKE, TX 76092

ALLRED, PHILLIP WADDRESS REDACTED

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AMERICAN BLOCK COMPANY INCP.O. BOX 5365PRINCETON, WV 24740

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AMICK II, WILLIAM DADDRESS REDACTED

AMICK, BUNDY WADDRESS REDACTED

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ANALABS INCP.O. BOX 1235CRAB ORCHARD, WV 25827

ANDERSON II, JOHN WADDRESS REDACTED

ANDERSON, BRIAN GADDRESS REDACTED

ANDERSON, CHRISTEN MADDRESS REDACTED

ANDRIGO, JOSEPH MADDRESS REDACTED

ANDRIGO, STEVEN MADDRESS REDACTED




ANGELL, CHARLES KADDRESS REDACTED

ANGELOFF, JAIMON RAYADDRESS REDACTED

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DULANEY II, ALLEN WADDRESS REDACTED




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EAST, WOLFORD SADDRESS REDACTED

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ELLEFSON OFF HIGHWAY INC8906 HWY 37IRON, MN 55751




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ELLIS, TONY LADDRESS REDACTED

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ELSWICK, LARRY DADDRESS REDACTED

EMBERG, DAVID AADDRESS REDACTED

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ENGLAND'S LANDSCAPING & EXCAVP.O. BOX 472MULLENS, WV 25882

ENTERPRISE WASTE OIL CO INC5201 N MIDDLEBROOK PIKEKNOXVILLE, TN 37921

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ERP ENVIRONMENTAL FUND, INC.15 APPLEDORE LANENATURAL BRIDGE, VA 24578

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ESCANO, MARK GADDRESS REDACTED

ESKINS, JESSE LADDRESS REDACTED

ESTATE OF FREDDY W SHUBERTADDRESS REDACTED

ESTATE OF RANDY N INGLEADDRESS REDACTED

ESTATE OF TURHAN E CARTERADDRESS REDACTED

ESTEP, JOSHUA GADDRESS REDACTED

ESTEP, TREVOR L.ADDRESS REDACTED

ESTES, RICKY AADDRESS REDACTED

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EVANS, GREGGORY BADDRESS REDACTED

EVANS, JOSEPH SADDRESS REDACTED

EVANS, MATTHEWADDRESS REDACTED

EVANS, PHILIP CHARLIEADDRESS REDACTED

EVANS, TERRY LADDRESS REDACTED




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EVERETT HANNAH LUMBER INCATTN: EVERETT HANNAHP.O. BOX 277VARNEY, WV 25696

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F S I MID STATE DIVISION INCATTN: PATTY DAVIS121 MIDDLE COLLISON RDMOUNT LOOKOUT, WV 26678

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FABICK MINING INCATTN: JOE DEVOUS9580 HWY 13 W.CARRIER MILLS, IL 62917

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FAIRCHILD INTERNATIONAL INCP.O. BOX 300GLEN LYN, VA 24093

FAIRCHILD INTERNATIONAL INCP.O. BOX 300GLEN LYNN, VA 24093

FAIRMONT SUPPLY COMPANY1136 COAL HERITAGE RDBLUEFIELD, WV 24701

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FARMER, GARY RADDRESS REDACTED

FARMER, JEFFREY LADDRESS REDACTED

FARRIS, TIMOTHYADDRESS REDACTED

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FASTENAL INDUSTRIAL &CONSTRUCTION SUPPLIES606 SOUTH EISENHOWER DRBECKLEY, WV 25801

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FDX CAPITAL LLC515 MADISON AVE, 24TH FLNEW YORK, NY 10022

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FIELDS, JOSHADDRESS REDACTED

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FIRST CLASS CLEANING LLCATTN: DERRICK LOWE661 STRIKER FORK RDCHAPMANVILLE, WV 25508

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FISH, LESLIE R.44 DEVON LANEFAYETTEVILLE, WV 25840

FISHER, ADAM RYANADDRESS REDACTED

FISHER, KRISTIE RADDRESS REDACTED

FISHER, THOMAS KADDRESS REDACTED

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FKC LAKE SHORE1695 ALLEN RDEVANSVILLE, IN 47710

FKC LAKE SHOREFRONTIER-KEMPER CONST1695 ALLEN RDEVANSVILLE, IN 47710

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FOLEY, BILLEY C.ADDRESS REDACTED

FOMBY, TONY LADDRESS REDACTED

FORREN, BARTON D.ADDRESS REDACTED

FORREN, MICHAEL LADDRESS REDACTED

FORTNER, DAVIDADDRESS REDACTED

FORTNER, MARCUS DADDRESS REDACTED

FOSTER SUPPLY INC4847 TEAYS VALLEY RDSCOTT DEPOT, WV 25560

FOSTER, JOSHUA DALEADDRESS REDACTED

FOSTER, THEODORE LADDRESS REDACTED

FOUCH, CHARLES PADDRESS REDACTED

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FOWLER, FORREST CADDRESS REDACTED

FOWLER, JAMES CADDRESS REDACTED

FOX, WILLIAM JASONADDRESS REDACTED

FRAME, AARON PADDRESS REDACTED

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FRANCIS ENTERPRISES INCP.O. BOX 2284WESTOVER, WV 26502

FRANKLIN, PAIGE1718 BREEDING LANEKINGSPORT, TN 37660

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FRANKLIN, WILLIAM CORYADDRESS REDACTED

FRAZEE, MARK DADDRESS REDACTED

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FREEDOM COURT REPORTING INC2031 SHADY CREST DRHOOVER, AL 35216

FRONTIERP.O. BOX 20550ROCHESTER, NY 14602-0550

FRONTIER KEMPER CONSTRUCTORS INC1695 ALLEN RDEVANSVILLE, IN 47710




FROST, DAVID SADDRESS REDACTED

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FUCHS LUBRICANTS COATTN: JOHNNA MCNETT801 E ROY FIRMAN HWYP.O. BOX 450WAYNESBURG, PA 15370

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FULLER, KENNETH DADDRESS REDACTED

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FURROW, KYLE T.ADDRESS REDACTED

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GAINES, DARMON EADDRESS REDACTED

GAINES, DEANDRE C.ADDRESS REDACTED

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GAI-TRONICS CORP AUSTDAC455 LOWRIES RUN RDPITTSBURGH, PA 15237

GALLAGHER COAL RESEARCH CENTER INC922 ROBERT C BYRD DRCRAB ORCHARD, WV 25827

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GARDNER, LANCE J.ADDRESS REDACTED

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GARRETT, JACOB EADDRESS REDACTED

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GATES SUPPLY363 RAGLAND RDBECKLEY, WV 25801

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GAULEY-ROBERTSONP.O. BOX 70HICO, WV 25854

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GE FAIRCHILD LLC33149 COLLECTION CENTER DRCHICAGO, IL 60693

GE OIL & GAS ESP INC5500 SE 59TH STOKLAHOMA CITY, OK 73135

GE TRANSPORTATION PARTS LLC550 ROBERT C BYRD DRSOPHIA, WV 25921

GE TRANSPORTATION PARTS LLCATTN: VIRGIL BUCHANANP.O. BOX 999SOPHIA, WV 25921

GE TRANSPORTATION PARTS LLCP.O. BOX 999SOPHIA, WV 25921

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GENERAL MACHINERY COMPANYATTN: BOBBY CANANT921 1ST AVE NORTHBIRMINGHAM, AL 35203

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GENTRY, KENNETH D.ADDRESS REDACTED

GENTRY, RICHARD BADDRESS REDACTED

GEORGE, MARK STEVENADDRESS REDACTED

GEORGE, TIMMY WADDRESS REDACTED

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GIAMBRONE, VINCENT JADDRESS REDACTED

GIBBONS P.C.ONE GATEWAY CENTERNEWARK, NJ 07102-5310

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GIBSON, GEORGE RADDRESS REDACTED

GIBSON, JOHNNY NADDRESS REDACTED

GIBSON, MICHAEL GADDRESS REDACTED

GIBSON, OTIS LADDRESS REDACTED

GIBSON, TIMOTHY LADDRESS REDACTED

GIBSON, VAN BADDRESS REDACTED

GILBERT, CHRIS LADDRESS REDACTED

GILBERT, DALEADDRESS REDACTED

GILLARD, MILES A.ADDRESS REDACTED

GILLIAND, BRANDON JADDRESS REDACTED

GILLIAND, JOHN D.ADDRESS REDACTED

GILLILAND, JAMES AADDRESS REDACTED

GILLISPIE, AARON DADDRESS REDACTED

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GILSON ENGINEERING SALES INC535 ROCHESTER RDPITTSBURGH, PA 15237




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GLASS SURGEON196 CONCORD HIGHLAND DRBESSEMER, AL 35023

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GLOVER, TRAYBEON DADDRESS REDACTED

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GOGGINS, RODNEY CADDRESS REDACTED

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GOODE, MARK AADDRESS REDACTED

GOODWIN, DALE AADDRESS REDACTED

GOODWIN, WILLIAM CADDRESS REDACTED

GOODYEAR, DAVID AADDRESS REDACTED

GORRIE-REGAN AND ASSOCIATES INC2927 CENTRAL AVEBIRMINGHAM, AL 35209

GOULD'S ELECTRIC MOTOR REPAIRP.O. BOX 100INDORE, WV 25111

GOULD'S ELECTRIC MOTOR REPAIR, INC.P.O. BOX 100INDORE, WV 25111

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GRACE EQUIPMENT CO43 CRANBERRY LANEMYRTLE, WV 25670

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GRAINGER INC101 N 46TH AVE WDULUTH, MN 55807

GRAINGER INC3000 7TH AVE WESTCHARLESTON, WV 25312

GRAINGER INCDEPT. 862892001PALATINE, IL 60038-0001

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GRANT, REGINALDADDRESS REDACTED




GRANTHAM, DAVID CADDRESS REDACTED

GRANUS, JACK RADDRESS REDACTED

GRAPHIC CONTROLS LLCCUSTOMER SERVICEP.O. BOX 1271BUFFALO, NY 14240

GRAVES, PATSY H8 GREENBRIER RIDGEBIRMINGHAM, AL 35242

GRAY II, ROGER DADDRESS REDACTED

GRAY, ADAM JUDDADDRESS REDACTED

GRAY, BRANDON RADDRESS REDACTED

GRAY, ROGER DADDRESS REDACTED

GRAY, WILLIAM GARRETTADDRESS REDACTED

GRAYBARATTN: SCOTT MCCOMBS1040 LONDON DRBIRMINGHAM, AL 35211

GRAYSVILLE CABLE REPAIR CO INC652 S MAIN STP.O. BOX 310GRAYSVILLE, AL 35073

GREAT MIDWEST INSURANCE COMPANY800 GESSNER, STE 600HOUSTON, TX 77024

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GREEN, RICHARD CHARLESADDRESS REDACTED

GREENES BUSINESS MACHINES INC2169 ROCKY RIDGE RDHOOVER, AL 36216

GREER, CHRIS FADDRESS REDACTED

GREY, JOSHUA DAVIDADDRESS REDACTED

GRIFFIN, LOGAN JADDRESS REDACTED

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WILLIAMS, EARLADDRESS REDACTED

WILLIAMS, FRANKADDRESS REDACTED

WILLIAMS, FRANKIE SADDRESS REDACTED

WILLIAMS, GARRY AADDRESS REDACTED

WILLIAMS, JOHN DADDRESS REDACTED

WILLIAMS, JOHNNIE LOUISADDRESS REDACTED

WILLIAMS, MARCUS EADDRESS REDACTED

WILLIAMS, MICHAEL AADDRESS REDACTED

WILLIAMS, MICHAEL ANTONIOADDRESS REDACTED

WILLIAMS, MICHAEL TADDRESS REDACTED

WILLIAMS, MIKHAEL OADDRESS REDACTED

WILLIAMS, PHILLIP EADDRESS REDACTED

WILLIAMS, SHERMAN CADDRESS REDACTED

WILLIAMS, SHERMAN CHARLESADDRESS REDACTED

WILLIAMS, TEDDY JOEADDRESS REDACTED

WILLIAMSON AUTO SALESP.O. BOX 429MAN, WV 25635

WILLIAMSON DAILY NEWSP.O. BOX 690MIAMISBURG, OH 45343

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WILLIAMSTOWN SERVICES LLC773 FOREVER LANELIGONIER, PA 15658

WILLIS, GARY FADDRESS REDACTED

WILMINGTON SAVINGS FUND SOCIETY, FSBATTN: PRESIDENT/LEGAL DEPARTMENT500 DELAWARE AVENUEWILMINGTON, DE 19801

WILSON JR., WILLIAM ROYADDRESS REDACTED

WILSON MACHINE & WELDING INC4787 HWY 78CORDOVA, AL 35550

WILSON, BILLYADDRESS REDACTED

WILSON, CAROLYNADDRESS REDACTED

WILSON, PATRICK M.ADDRESS REDACTED

WILSON, SHANE EADDRESS REDACTED

WILSON, WILLIAM ROYADDRESS REDACTED

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WINFIELD RUBBER MFG CO INCP.O. BOX 1768WINFIELD, AL 35594

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WINFREY, JAMES RADDRESS REDACTED

WINGO, DEREK SADDRESS REDACTED




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WISEMAN, CHARLES EADDRESS REDACTED

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WITHROW, JOHN PAULADDRESS REDACTED

WMONGER LLCP.O. BOX 545SUMMERSVILLE, WV 26651

WOOD, CHARLES CADDRESS REDACTED

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WOOD, HUBERTA RADDRESS REDACTED

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WOOD, ROGERADDRESS REDACTED

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WOODS LAWN & LANDSCAPING333 PINE RUN FORK RDSUMMERSVILLE, WV 26661

WOODS, CHAD AADDRESS REDACTED

WOODS, JASONADDRESS REDACTED

WOODS, WESLEY EADDRESS REDACTED

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WOOLUM JR., CHARLES AADDRESS REDACTED

WOOLUM, CHARLES AADDRESS REDACTED

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WORKMAN JR., VERNON HADDRESS REDACTED

WORKMAN, BENJAMINADDRESS REDACTED

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WORKMAN, RAYMOND D.ADDRESS REDACTED

WORKSPACE INTERIORSP.O. BOX 809KINGSPORT, TN 37662

WORRELL, WILLIAM ARLEYADDRESS REDACTED

WPP LLC1201 LOUISIANA ST, STE 3400HOUSTON, TX 77002

WRIGHT JR., RANDALL L.ADDRESS REDACTED

WRIGHT XPRESS CONVEYOR & VULCANIZING LLC9430 US 23 SOUTHPIKEVILLE, KY 41501

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WRIGHT, BRANDON FADDRESS REDACTED

WRIGHT, CHRISTOPHER AADDRESS REDACTED

WRIGHT, CRAIG RADDRESS REDACTED

WRIGHT, JACK DADDRESS REDACTED

WRIGHT, JR., WILLIAM R.ADDRESS REDACTED

WRIGHT, RANDALL LADDRESS REDACTED

WRIGHT, WILLIAM R.ADDRESS REDACTED

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WRISTON, STANLEY LADDRESS REDACTED

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WV DEPT OF ENVIRONMENTAL PROTECTION116 INDUSTRIAL DROAK HILL, WV 25901

WV DEPT OF ENVIRONMENTAL PROTECTION601 57TH ST SECHARLESTON, WV 25304

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WV DIVISION OF MOTOR VEHICLESP.O. BOX 17710CHARLESTON, WV 25317

WV DIVISION OF NATURAL RESOURCES324 4TH AVE, RM 200CHARLESTON, WV 25303

WV DIVISION OF NATURAL RESOURCES324 4TH AVE, RM 200SOUTH CHARLESTON, WV 25303

WV DIVISION OF NATURAL RESOURCESOFFICE OF LAND & STREAMS324 4TH AVE RM 200SOUTH CHARLESTON, WV 25303

WV DIVISION OF NATURAL RESOURCESPUBLIC LAND CORP. OF W VA.BLDG 3, RM 6431900 KANAWHA BLVD EASTCHARLESTON, WV 25305

WV OFFICE MINERS' HEALTH891 STEWART STWELCH, WV 24801

WV OFFICE OF MINERS' HEALTH830 VIRGINIA AVEWELCH, WV 24801

WV OFFICE OF MINERS' HEALTHATTN: JENNIFER ELMORE830 VIRGINIA AVEWELCH, WV 24801

WV STATE FIRE MARSHAL'S OFFICE1207 QUARRIER ST 2ND FLCHARLESTON, WV 25301

WV STATE TAX DEPTINTERNAL AUDITING DIVISIONP.O. BOX 1826CHARLESTON, WV 25327

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WVU MINING & INDUSTRIAL EXTENSIONP.O. BOX 6070MINERAL RESOURCE BUILDINGMORGANTOWN, WV 26506

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XPRESS SERVICE & SALES INC12744 KINGSTON PIKE, STE 202KNOXVILLE, TN 37934




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YODER, TRAVIS BADDRESS REDACTED

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YOUNG, BILLY EADDRESS REDACTED

YOUNG, DOUGLAS LADDRESS REDACTED

YOUNG, JEFFREY SADDRESS REDACTED

YOUNG, JOSEPH AADDRESS REDACTED

YOUNG, KENNETH HADDRESS REDACTED

YOUNGBLOOD, JOSHUAADDRESS REDACTED

YOUNGBLOOD, MICHAEL WADEADDRESS REDACTED

ZARMEN SP Z O OUL CHLODNA 51WARSZAWA, 00867POLAND

ZEE MEDICAL INCP.O. BOX 204683DALLAS, TX 75320

ZERVOS, JON MADDRESS REDACTED

ZERVOS, MICHAEL PADDRESS REDACTED

ZERVOS, MICHAEL P.7 SHERIDAN SQUARE, STE 300KINGSPORT, TN 37660

ZHENGZHOU COAL MINING MACHINERY (GROUP) CO. NO. 167, 9TH AVEZHENGHOU 450016CHINA

ZHENGZHOU COAL MINING MACHINERY CO LTDNO 105 HUASHAN RDZHENGZHOU CITY, 450013CHINA

ZINKAN ENTERPRISES INC1919 CASE PKWY NORTHTWINSBURG, OH 44087

ZMJ AMERICA INC885 PITTSBURGH RDBUTLER, PA 16002

ZMJ AMERICA INCATTN: AMANDA LILLIBRIDGE885 PITTSBURGH RDBUTLER, PA 16002

ZMJ AMERICA, INC.885 PITTSBURGH RDBUTLER, PA 16002

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ZOLFO COOPER LLC5 BECKER FARM RD, 4TH FLROSELAND, NJ 07068




Parties Served: 4092



EXHIBIT B


UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION ) In re: ) Chapter 11 ) MISSION COAL COMPANY, LLC, et al.,1 ) Case No. 18-04177-TOM11 ) Debtors. ) (Jointly Administered) )

NOTICE OF DEADLINES FOR THE FILING OF PROOFS OF CLAIM, INCLUDING REQUESTS FOR

PAYMENTS UNDER SECTION 503(B)(9) OF THE BANKRUPTCY CODE

THE CLAIMS BAR DATE IS JANUARY 18, 2019

THE GOVERNMENTAL CLAIMS BAR DATE IS APRIL 12, 2019

PLEASE TAKE NOTICE OF THE FOLLOWING:

Deadlines for Filing Proofs of Claim. On December 20, 2018, the United States Bankruptcy Court for the Northern District of Alabama (the “Court”) entered an order (the “Bar Date Order”) establishing certain deadlines for the filing of proofs of claim, including requests for payment under section 503(b)(9) of the Bankruptcy Code, in the chapter 11 cases of the following debtors and debtors in possession (together, the “Debtors”):

Debtor Case No. Mission Coal Company, LLC 18-04177

Beard Pinnacle, LLC 18-04178

Oak Grove Land Company, LLC 18-04179

Oak Grove Resources, LLC 18-04176

Pinnacle Land Company, LLC 18-04180

Pinnacle Mining Company, LLC 18-04181

Seminole Alabama Mining Complex, LLC 18-04182

Seminole Coal Resources, LLC 18-04183

Seminole West Virginia Mining Complex, LLC 18-04184

Seneca Coal Resources, LLC 18-04185

Seneca North American Coal, LLC 18-04186

1 The Debtors in these chapter 11 cases, along with the last four digits of each Debtor’s federal tax identification

number, include: Mission Coal Company, LLC (8465); Beard Pinnacle, LLC (0637); Oak Grove Land Company, LLC (6068); Oak Grove Resources, LLC (0300); Pinnacle Land Company, LLC (6070); Pinnacle Mining Company, LLC (7780); Seminole Alabama Mining Complex, LLC (6631); Seminole Coal Resources, LLC (1795); Seminole West Virginia Mining Complex, LLC (7858); Seneca Coal Resources, LLC (1816); and Seneca North American Coal, LLC (5102). The location of the Debtors’ service address is: 7 Sheridan Square, Suite 300, Kingsport, Tennessee 37660.


2

The Bar Dates. Pursuant to the Bar Date Order, all entities (except governmental units and other entities exempt from filing Proof(s) of Claim under the Bar Date Order), including individuals, partnerships, estates, and trusts who have a claim or potential claim against the Debtors that arose prior to October 14, 2018, no matter how remote or contingent such right to payment or equitable remedy may be, including requests for payment under section 503(b)(9) of the Bankruptcy Code, MUST FILE A PROOF OF CLAIM on or before January 18, 2019, at 5:00 p.m., prevailing Central Time (the “Claims Bar Date”). Governmental entities who have a claim or potential claim against the Debtors that arose prior to October 14, 2018, no matter how remote or contingent such right to payment or equitable remedy may be, MUST FILE A PROOF OF CLAIM on or before April 12, 2019, at 5:00 p.m., prevailing Central Time (the “Governmental Bar Date”).

EXCEPT FOR A PERSON OR ENTITY THAT IS EXEMPT FROM FILING A PROOF OF CLAIM UNDER THE BAR DATE ORDER, ANY PERSON OR ENTITY WHO FAILS TO FILE A PROOF OF CLAIM, INCLUDING ANY REQUEST FOR PAYMENT UNDER SECTION 503(B)(9) OF THE BANKRUPTCY CODE ON OR BEFORE THE CLAIMS BAR DATE OR GOVERNMENTAL BAR DATE, AS APPLICABLE, SHALL NOT BE TREATED AS A CREDITOR WITH RESPECT TO SUCH CLAIM FOR THE PURPOSES OF VOTING AND DISTRIBUTION ON ANY CHAPTER 11 PLAN.

Filing a Proof of Claim. Each Proof of Claim must be filed, including supporting documentation so as to be actually received by the Debtors’ claims agent, Omni Management Group (“Omni”).

If sent electronically, submission is to occur through the interface located at:

https://www.omnimgt.com/missioncoalpoc/

If sent by mail, send to:

Mission Coal Company, LLC, et al. Claims Processing c/o Omni Management Group 5955 DeSoto Ave., Suite 100 Woodland Hills, CA 91367

If sent by Overnight Courier or Hand Delivery, send to:

Mission Coal Company, LLC, et al. Claims Processing

c/o Omni Management Group 5955 DeSoto Ave., Suite 100 Woodland Hills, CA 91367

PROOFS OF CLAIM SUBMITTED BY FACSIMILE OR ELECTRONIC MAIL WILL NOT BE ACCEPTED.


3

Contents of Proofs of Claim. Each Proof of Claim must: (i) be legible; (ii) include a claim amount denominated in United States dollars using, if applicable, the exchange rate as of 5:00 p.m., prevailing Central Time, on the Commencement Date (and to the extent such claim is converted to United States dollars, state the rate used in such conversion); (iii) conform substantially with the Proof of Claim Form provided by the Debtors or Official Form 410; and (iv) be signed by the claimant or by an authorized agent or legal representative of the claimant on behalf of the claimant, whether such signature is an electronic signature or is ink. Please note that, except for any Master Proof of Claim (as defined in the Bar Date Order) (as defined in the Bar Date Order), each proof of claim must state a claim against only one Debtor, clearly indicate the specific Debtor against which the claim is asserted be filed on the claims register of such Debtor. Except for any Master Proof of Claim, to the extent more than one Debtor is listed on the proof of claim, a proof of claim is treated as if filed only against Mission Coal Company, or if a proof of claim is otherwise filed without identifying a specific Debtor, the proof of claim may be deemed as filed only against Mission Coal Company, LLC.

Electronic Signatures Permitted. Proofs of claim signed electronically by the claimant or an authorized agent or legal representative of the claimant may be deemed acceptable for purposes of claims administration. Copies of proofs of claim or proofs of claim sent by facsimile or electronic mail will not be accepted.

Section 503(b)(9) Requests for Payment. Any proof of claim and/or priority asserting a claim arising under section 503(b)(9) of the Bankruptcy Code must also (i) include the value of the goods delivered to and received by the Debtors in the 20 days prior to the Commencement Date; (ii) attach any documentation identifying the particular invoices for which such 503(b)(9) claim is being asserted; and (iii) attach documentation of any reclamation demand made to the Debtors under section 546(c) of the Bankruptcy Code (if applicable).

Additional Information. If you have any questions regarding the claims process and/or you wish to obtain a copy of the Bar Date Notice, a proof of claim form, the Bar Date Order, or certain other pleadings, orders, and notices, or related documents you may do so by: (a) calling the Debtors’ restructuring hotline at 888-585-6494 (toll free) or 818-906-8300 (international); and/or (b) visiting the Debtors’ restructuring website at: https://www.omnimgt.com/missioncoalpoc/.


UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF ALABAMA

Filed OnClaim Number on court claims registry (if known)

Proof of Claim

Debtor and Case Number:

From whom?

04/16

Official Form 410

Read the instructions before filling out this form. This form is for making a claim for payment in a bankruptcy case. Do not use this form to

make a request for payment of an administrative expense (other than claims arising under 11 U.S.C. § 503(b)(9)). Make such a request

according to 11 U.S.C. § 503.

Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents. Attach redacted copies of any documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements of running accounts, contracts, judgments,mortgages, and security agreements.

A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571.

Do not send original documents; they may be destroyed after scanning. If the documents are not available, explain in an attachment.

Fill in all the information about the claim as of the date the case was filed. That date is on the notice of bankruptcy (Form 309) that you received.

Part 1: Identify the Claim

Name of the current creditor (the person or entity to be paid for this claim)

Other names the creditor used with the debtor

Who is the current creditor?

Has this claim been acquired

from someone else?

No

Yes

Where should notices and

payments to the creditor be

sent?

Federal Rule of Bankruptcy Procedure (FRBP) 2002(g)

4.

3.

1.

2.

Does this claim amend one

already filed?No

Yes

Where should notices to the creditor be sent? Where should payments to the creditor be sent? (if

different)

Name

Number Street

City State ZIP Code

Contact Phone

Contact email

Contact Phone

Contact email

Uniform claim identifier for electronic payments in chapter 13 (if you use one)

MM / DD / YYYY

5. Do you know if anyone else

has filed a proof of claim for

this claim? Who made the earlier filing?

No

Yes

Name

Number Street

City State ZIP Code

Mission Coal Company, LLC - 18-04177

Oak Grove Resources, LLC - 18-04176

Beard Pinnacle, LLC - 18-04178

Oak Grove Land Company, LLC - 18-04179

Pinnacle Land Company, LLC - 18-04180

Pinnacle Mining Company, LLC - 18-04181

Seminole Coal Resources, LLC - 18-04183

Seneca Coal Resources, LLC - 18-04185

Seneca North American Coal, LLC - 18-04186

Seminole Alabama Mining Complex, LLC - 18-04182 Seminole West Virginia Mining Complex, LLC - 18-04184

Official Form 410 Proof of Claim Page 1Case 18-04177-TOM11 Doc 526 Filed 01/03/19 Entered 01/03/19 13:06:51 Desc


Nature of property:

Real Estate

Other

Motor Vehicle

Value of Property: $

Amount of the claim that is unsecured: $

$Amount of the claim that is secured:

Describe:

Annual Interest Rate: ____________%

Basis for perfection:

$

Amount necessary to cure any default as of the date of the petition:

6. Do you have any number you

use to identify the debtor?

Give Information About the Claim as of the Date the Case Was FiledPart 2:

Last 4 digits of the debtor's account or any number you use to identify the debtor:

No

Yes

7. How much is the claim?

Attach statement itemizing interest, fees, expenses, or other charges required by Bankruptcy Rule 3001(c)(2)(A).

No

Yes

Does this amount include interest or other charges?

8. What is the basis of the

claim?

Examples: Goods sold, money loaned, lease, services performed, personal injury or wrongful death, or credit card.

Attach redacted copies of any documents supporting the claim required by Bankruptcy Rule 3001(c).

Limit disclosing information that is entitled to privacy, such as health care information

9. Is all or part of the claim

secured?No

Yes The claim is secured by a lien on property

If the claim is secured by the debtor's principal residence, file a (Official Form 410-A) with this

Mortgage Proof of Claim

Attachment Proof of Claim

Attach redacted copies of documents, if any, that show evidence of perfection of a security interest (for example,a mortgage, lien, certificate of title, financing statement, or other document that shows the lien has been filed orrecorded.

$

(when case was filed)

10. Is this claim based on a

lease?

No

Yes Amount necessary to cure any default as of the date of the petition.

11. Is this claim subject to a

right of setoff?

No

Yes Identify the property:

(The sum of the secured and unsecured amounts should match the amount in line 7).

Fixed

Variable

$

12. Is this claim for the value

of goods received by the

debtor 20 days before the

commencement date of

this case (11 U.S.C.

§503(b)(9)).?

No

Yes Amount of 503(b)(9) Claim: $



Is all or part of the claim

entitled to priority under

11 U.S.C. § 507(a)?

13.

Check all that apply

No

Yes

Domestic support obligations (including alimony and child support) under 11 U.S.C. § 507(a)(1)(A) or (a)(1)(B).

Part 3:

Up to $2,850* of deposits toward purchase, lease, or rental of property or services for personal, family, or household use. 11 U.S.C. § 507(a)(7).

Wages, salaries, or commissions (up to $12,850*) earned within 180 days before the bankruptcy petition is filed or the debtor's business ends, whichever is earlier. 11 U.S.C. § 507(a)(4).

Taxes or penalties owed to governmental units. 11 U.S.C. § 507(a)(8).

Contributions to an employee benefit plan 11 U.S.C. § 507(a)(5).

$

$

$

$

$

Other. Specify subsection of 11 U.S.C. § 507(a)(___) that applies. $

Amount entitled to priority

* Amounts are subject to adjustment on 4/01/19 and every 3 years after that for cases begun on or after the date of adjustment.

Sign Below

A claim may be partly priority and partly nonpriority. For example, in some categories, the law limits the amount entitled to priority.

The person completing

this proof of claim must

sign and date it.

If you file this claim electronically, FRBP 5005(a)(2) authorizes courts to establish local rules specifying what a signature is.

A person who files a

fraudulent claim could be

fined up to $500,000,

imprisoned for up to 5

years, or both.

18 U.S.C. §§ 152, 157, and

3571.

I am the creditor.

Check the appropriate box:

I am the creditor's attorney or authorized agent.

I am the trustee, or the debtor, or their authorized agent. Bankruptcy Rule 3004.

I am the guarantor, surety, endorser, or other codebtor. Bankruptcy Rule 3005.

I understand that an authorized signature on this

amount of the claim, the creditor gave the debtor credit for any payments received toward the debt.

Proof of Claim serves as an acknowlegment that when calculating the

I declare under penalty of perjury that the foregoing is true and correct.

I have examined the information in this Proof of Claim and have a reasonable belief that the information is true

and correct.

Executed on date

MM / DD / YYYY

Signature

Print the name of the person who is completing and signing this claim:

NameFirst Name Middle Name Last Name

Title

CompanyIdentify the corporate servicer as the company if the authorized agent is a servicer.

Address

Contact Phone Email

Number Street

City State ZIP Code

FRBP 9011(b).



Official Form 410

Instructions for Proof of Claim United States Bankruptcy Court 12/15

These instructions and definitions generally explain the law. In certain circumstances, such as bankruptcy cases that debtors

do not file voluntarily, exceptions to these general rules may apply. You should consider obtaining the advice of an attorney,

especially if you are unfamiliar with the bankruptcy process and privacy regulations.

How to fill out this form

Fill in all of the information about the claim as of the

date the case was filed.

Fill in the caption at the top of the form.

If the claim has been acquired from someone else,

then state the identity of the last party who owned the claim or was the holder of the claim and who transferred it to you before the initial claim was filed.

Attach any supporting documents to this form.

Attach redacted copies of any documents that show that the debt exists, a lien secures the debt, or both. (See the definition of redaction on the next page.)

Also attach redacted copies of any documents that show perfection of any security interest or any assignments or transfers of the debt. In addition to the documents, a summary may be added. Federal Rule of Bankruptcy Procedure (called “Bankruptcy Rule”) 3001(c) and (d).

Do not attach original documents because

attachments may be destroyed after scanning.

If the claim is based on delivering health care goods

or services, do not disclose confidential health care

information. Leave out or redact confidential

information both in the claim and in the attached

documents.

A Proof of Claim form and any attached documents

must show only the last 4 digits of any social security

number, individual’s tax identification number, or

financial account number, and only the year of any

person’s date of birth. See Bankruptcy Rule 9037.

For a minor child, fill in only the child’s initials and the

full name and address of the child’s parent or

guardian. For example, write A.B., a minor child (John Doe, parent, 123 Main St., City, State). See Bankruptcy Rule 9037.

Confirmation that the claim has been filed

To receive confirmation that the claim has been filed, either enclose a stamped self-addressed envelope and a copy of this form or go to the court’s PACER system (www.pacer.psc.uscourts.gov) to view the filed form.

Understand the terms used in this form

Administrative expense: Generally, an expense that arises after a bankruptcy case is filed in connection with operating, liquidating, or distributing the bankruptcy estate. 11 U.S.C. § 503.

Claim: A creditor’s right to receive payment for a debt that the debtor owed on the date the debtor filed for bankruptcy. 11 U.S.C. §101 (5). A claim may be secured or unsecured.

A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157 and 3571.


Creditor: A person, corporation, or other entity to whom a debtor owes a debt that was incurred on or before the date the debtor filed for bankruptcy. 11 U.S.C. §101 (10).

Debtor: A person, corporation, or other entity who is in bankruptcy. Use the debtor’s name and case number as shown in the bankruptcy notice you received. 11 U.S.C. § 101 (13).

Evidence of perfection: Evidence of perfection of a security interest may include documents showing that a security interest has been filed or recorded, such as a mortgage, lien, certificate of title, or financing statement.

Information that is entitled to privacy: A Proof of Claim form and any attached documents must show only the last 4 digits of any social security number, an individual’s tax identification number, or a financial account number, only the initials of a minor’s name, and only the year of any person’s date of birth. If a claim is based on delivering health care goods or services, limit the disclosure of the goods or services to avoid embarrassment or disclosure of confidential health care information. You may later be required to give more information if the trustee or someone else in interest objects to the claim.

Priority claim: A claim within a category of unsecured claims that is entitled to priority under 11 U.S.C. §507(a). These claims are paid from the available money or property in a bankruptcy case before other unsecured claims are paid. Common priority unsecured claims include alimony, child support, taxes, and certain unpaid wages.

Proof of claim: A form that shows the amount of debt the debtor owed to a creditor on the date of the bankruptcy filing. The form must be filed in the district where the case is pending.

Redaction of information: Masking, editing out, or deleting certain information to protect privacy. Filers must redact or leave out information entitled to privacy on the Proof of Claim form and any attached documents.

Secured claim under 11 U.S.C. §506(a): A claim backed by a lien on particular property of the debtor. A claim is secured to the extent that a creditor has the right to be paid from the property before other creditors are paid. The amount of a secured claim usually cannot be more than the value of the particular property on which the creditor has a lien. Any amount owed to a creditor that is more than the value of the property normally may be an unsecured claim. But exceptions exist; for example, see 11 U.S.C. § 1322(b) and the final sentence of 1325(a).

Examples of liens on property include a mortgage on real estate or a security interest in a car. A lien may be voluntarily granted by a debtor or may be obtained through a court proceeding. In some states, a court judgment may be a lien.

Setoff: Occurs when a creditor pays itself with money belonging to the debtor that it is holding, or by canceling a debt it owes to the debtor.

Uniform claim identifier: An optional 24-character identifier that some creditors use to facilitate electronic payment.

Unsecured claim: A claim that does not meet the requirements of a secured claim. A claim may be unsecured in part to the extent that the amount of the claim is more than the value of the property on which a creditor has a lien.

Offers to purchase a claim

Certain entities purchase claims for an amount that is less than the face value of the claims. These entities may contact creditors offering to purchase their claims. Some written communications from these entities may easily be confused with official court documentation or communications from the debtor. These entities do not represent the bankruptcy court, the bankruptcy trustee, or the debtor. A creditor has no obligation to sell its claim. However, if a creditor decides to sell its claim, any transfer of that claim is subject to Bankruptcy Rule 3001(e), any provisions of the Bankruptcy Code (11 U.S.C. § 101 et seq.) that apply, and any orders of the bankruptcy court that apply.

Do not file these instructions with your form.


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