B26 Periodic Report Regarding Value, Operations and Profitability of Entities in Which the Debtors Estate Holds a Substantial or Controlling Interest

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B26 (Official Form 26) (12/08) 
 	
United States Bankruptcy Court 	
__________________ District of _____________ 	
 	
In re	    ,	      Case  No. ____________________                               	
  Debtor     Chapter 11 
       
PERIODIC REPORT REGARDING VALUE,  OPERATIONS AND PROFITABILITY OF 
ENTITIES IN WHICH THE ESTATE OF [NAME OF DEBTOR] 	
HOLDS A SUBSTANTIAL OR CONTROLLING INTEREST	 	
 
This is the report as of __________on the value, operations and profitab\
ility of those 
entities in which the estate holds a substantial or controlling interest\
, as required by Bankruptcy 
Rule 2015.3.  The estate of [Name of Debtor] holds a substantial or controlling interest in the 
following entities:   
 	 
Name of Entity  	
 
Interest of the Estate  	
 
Tab # 	
 
  	 
 	 
 	
 
 	 
 	 
 	
 
 	
 
 	
 
 	
 
This periodic report (the “Periodic Report”) contains separate r\
eports (“Entity Reports”) on the 
value, operations, and profitability of each entity listed above.   
 	
Each Entity Report shall consist of three exhibits.  Exhibit A contains a valuation estimate 
for the entity as of a date not more than two years prior to the date of this report.  It also contains 
a description of the valuation method used.  Exhibit B contains a balance sheet, a statement of 
income (loss), a statement of cash flows, and a statement of changes in shareholders’ or partners’ 
equity (deficit) for the period covered by the Entity Report, along wi\
th summarized footnotes.  
Exhibit C contains a description of the entity’s business operations.  	
 
 	
THIS REPORT MUST BE SIGNED BY A REPRES ENTATIVE OF THE TRUSTEE OR DEBTOR IN 
POSSESSION.  	
  	
The undersigned, having reviewed the above listing  of entities in which the estate of [Debtor] 
holds a substantial or controlling interest, and being familiar with the Debtor’s financial affairs, 
verifies under the penalty of perjury that the listing is complete, accurate and truthful to the best 
of his/her knowledge.

B26 (Official Form 26) (12/08) – Cont. 
 	
2	
Date: ___________                                   
      _____________________________________ 
      Signature of Authorized Individual 
 
      _____________________________________ 
      Name of Authorized Individual 
 
      _____________________________________ 
      Title of Authorized Individual 
 
 
[If the Debtor is an individual or in a joint case] 
 
      Signature(s) of Debtor(s) (Individual/Joint) 
   
      _____________________________________ 
      Signature of Debtor 
  
      _____________________________________ 
      Signature of Joint Debtor

B26 (Official Form 26) (12/08) – Cont. 
 
    3
 
Exhibit A 
 	Valuation Estimate for [Name of Entity]	 	
 
 
[Provide a statement of the entity’s value and the value of the estate’s interest in the entity, 
including a description of the basis for the valuation, the date of the \
valuation and the valuation 
method used.  This valuation must be no more than two years old.  Indicate the source of this 
information.]

B26 (Official Form 26) (12/08) – Cont. 
 
    4
 
Exhibit B 
 	Financial Statements for [Insert Name of Entity]

B26 (Official Form 26) (12/08) – Cont. 
 
    5
 Exhibit 
B-1 
 Balance Sheet for [Name of Entity]  
  As of [date] 
 
[Provide a balance sheet dated as of the end of the most recent six-month period of the current 
fiscal year and as of the end of the preceding fis cal year. Indicate the source of this information.]

B26 (Official Form 26) (12/08) – Cont. 
 
    6
 
Exhibit B-2 
 	Statement of Income (Loss) for [Name of Entity]	 	
 Period ending [date] 
 	
[Provide a statement of income (loss) for the following periods:  
 
  (i) For the initial report: 	
    a. the period between the end of the  preceding fiscal year and the end of the 
most recent six-month period of the current fiscal year; and 
    b. the prior fiscal year.   	
  (ii) For subsequent reports, since the closing date of the last report\
. 
 
Indicate the source of this information.]

B26 (Official Form 26) (12/08) – Cont. 
 
    7
 
Exhibit B-3 
 	Statement of Cash Flows for [Name of Entity]	   	
  For the period ending [date] 
 	
 
[Provide a statement of changes in cash flows for the following periods:  
 
  (i) For the initial report: 	
    a. the period between the end of the  preceding fiscal year and the end of the 
most recent six-month period of the current fiscal year; and 
    b. the prior fiscal year.   	
  (ii) For subsequent reports, since the closing date of the last report\
. 
 
Indicate the source of this information.]

B26 (Official Form 26) (12/08) – Cont. 
 
    8
 
Exhibit B-4 
 Statement of Changes in Shareholders’/Partn ers’ Equity (Deficit) for [Name of Entity] 
 period ending [date] 
 	
 	
[Provide a statement of changes in shareholde rs’/partners equity (deficit) for the following 
periods:  
 
  (i) For the initial report: 	
    a. the period between the end of the  preceding fiscal year and the end of the 
most recent six-month period of the current fiscal year; and 
    b. the prior fiscal year.   	
  (ii) For subsequent reports, since the closing date of the last report\
. 
 
Indicate the source of this information.]

B26 (Official Form 26) (12/08) – Cont. 
 
    9	
Exhibit C 	
 	Description of Operations for [name of entity]	
 
[Describe the nature and extent of the estate’s interest in the entity. 
 
Describe the business conducted and intended to be conducted by the enti\
ty, focusing on the 
entity’s dominant business segment(s).  Indicate the source of this information.]