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AO 320, Bankruptcy Notice Provider Application

The following bankruptcy application form has to be completed as it is without any kind of alteration or modification.

 

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AO 320
(Rev. 06/15)	
U	NITED 	STATES 	C	OURTS 	B	ANKRUPTCY 	C	OURTS	
Notice Provider Application	
Pursuant to Fed. R. Bankr. P. 2002(g)(4) and 9001(9)	
This Application is provided by the United States Bankruptcy Courts and may not be altered or changed
in any manner.
Applicant Information
Firm/Company Name
Address Line 1
Address Line 2
Address Line 3
City, State, Zip
Contact Name
Phone No.
Contact E-mail Address
By completing this form, the Applicant affirms that it:
1. Understands and will comply with Rule 2002(g)(4) of the Federal Rules of Bankruptcy
Procedure for providing notices to entities; 
2. Possesses the equipment, personnel and other resources for providing notices to entities,
pursuant to Rule 2002(g)(4), in a timely and professional manner; 
3.  Will maintain appropriate records for all mailing lists and notices received and transmitted
pursuant to Rule 2002(g)(4); and
4.  Possesses ample capacity to handle anticipated noticing volumes.	
Page 1 of  3

AO 320
(Rev. 06/15)	
U	NITED 	STATES 	C	OURTS 	B	ANKRUPTCY 	C	OURTS	
Notice Provider Application	
Pursuant to Fed. R. Bankr. P. 2002(g)(4) and 9001(9)	
The Applicant submits the following references as to the Applicant's capability and past performance:
REFERENCE #1
Firm/Company Name
Address Line 1
Address Line 2
Address Line 3
City, State, Zip
Contact Name
Phone No.
Contact E-mail Address
REFERENCE #2
Firm/Company Name
Address Line 1
Address Line 2
Address Line 3
City, State, Zip
Contact Name
Phone No.
Contact E-mail Address
REFERENCE #3
Firm/Company Name
Address Line 1
Address Line 2
Address Line 3
City, State, Zip
Contact Name
Phone No.
Contact E-mail Address	
Page 2 of  3

AO 320
(Rev. 06/15)	
U	NITED 	STATES 	C	OURTS 	B	ANKRUPTCY 	C	OURTS	
Notice Provider Application	
Pursuant to Fed. R. Bankr. P. 2002(g)(4) and 9001(9)	
The Applicant should list work provided in any Bankruptcy Court district:
Bankruptcy Court
District Name
District Name
District Name
District Name
District Name
Authorization
I am an authorized officer of the named applicant company. I declare, under penalty of perjury,  that I am
duly authorized to affirm the information submitted above.
Name
Signature
Corporate Officer Title
Date
Please fax the completed application to the Administrative Office of the United States Courts, Court
Services Office at (202) 502-1588. A list of approved notice providers will be posted on the Judiciary’s public
website at www.uscourts.gov.	
 If you have any questions regarding the status of your application, please contact
the Court Services Office at (202) 502-1500.  	
Page 3 of  3
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