98

Effective July 1, 2012 In re IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF WYOMING Debtor. Case No. ________________ CHAPTER _________ APPLICATION TO PAY FILING FEE IN INSTALLMENTS 1. In accordance with Fed. R. Bankr. P. 1006, I apply for authority to pay the total filing fee in the amount of $______________ in installments, (Note: An initial payment of AT LEAST 25% of the fee due must accompany the application, prior to approval.) The court requires that an initial payment of a minimum of twenty-five percent (25%) accompany the application with a maximum of three (3) additional installments. The final installment shall be payable not later than 120 days from the date the petition is filed.

For cause shown, the court may extend the time of any installment, provided the last installment is paid not later than 180 days after filing the petition. Fed. R. Bankr. P. 1006(b)(2). 2. I submit (twenty-five percent (25% of the total as an initial payment with the bankruptcy petition, and the balance of $_________ in three (3) installments, (in cash or cashier’s check), as follows: $_________________ on or before _________________________ $_________________ on or before _________________________ $_________________ on or before _________________________ 3.

I certify that I am unable to pay the above filing fee except in installments. I further certify that until the filing fee is paid in full I will not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. 4. I understand that if I fail to pay any installment when due, my bankruptcy case may be dismissed and I may not receive a discharge of my debts. _____________________________ Signature of Attorney Date ___________________________________ Signature of Debtor Date _____________________________ Name of Attorney ___________________________________ Signature of Joint Debtor (if any) Date 99 Effective July 1, 2012