UNITED STATES BANKRUPTCY COURT
MIDDLE DISTRICT OF FLORIDA
APPLICATION FOR SEARCH OF BANKRUPTCY RECORDS
Name of individual or business that is the subject of the search:
Social Security No. or Employers Tax ID Number of subject:
Please search your records for the following information regarding the individual or business named above:
pending or closed bankruptcy cases in this district;
pending or closed adversary proceeding;
judgments/evidence of satisfaction of judgments; and
other [describe briefly] ____________________________________________________________________________
Please search for the period from __________________________ to _____________________________.
A fee of $26.00 is charged for each name or item searched. Payment by check or money order must be enclosed.
An additional fee of $9.00 is required for certification. Please do not send cash through the mail.
Name, address, and telephone number of the person requesting the search:
CERTIFICATE OF SEARCH
The undersigned deputy clerk hereby certifies the following results of a diligent search of the records of the Court:
[Check only the items for which a search was requested and the prescribed fee paid.]
Case filed on _______________________________
Closed on _________________________
Subject is a party to the following proceeding:
Adversary Proceeding Number _________________ , filed on _________________________.
Closed on ________________________
Dismissed on __________________________
Final Judgment entered on _______________________________
Case Number of related Bankruptcy Case __________________________________
Clerk of Court