UNITED STATES BANKRUPTCY COURT

SOUTHERN DISTRICT OF NEW YORK

ONE BOWLING GREEN

NEW YORK, NY 10004-1408

NOTICE: WITHDRAWAL OF THE REFERENCE – RECEIPT FROM THE BANKRUPTCY COURT

United States District Court

Southern District of New York

500 Pearl Street

Room 200

New York, NY 10007

Re:	Bankruptcy Case:	[enter case name here]

Bankruptcy Case Number:	__-_____(___)

Adversary Proceeding:	[name(s) of Plaintiff(s)]

v.

[name(s) of Defendant(s)]

Adversary Proceeding Number:	__-_____

District Court Civil Case Number:	CV-_______

Receipt Number:	_____________ (required)

A Motion to Withdraw the Reference has been filed in the above referenced case. The fee of $176.00 has been paid to the Bankruptcy Court and assigned the above receipt number.

Attached hereto are the following required documents for filing with the District Court:

1.	1 paper copy of the Motion to Withdraw the Reference;

2.	3 completed Civil Cover Sheets;

3.	Statement under FRCP 7.1; and

4.	A copy of this notice indicating the receipt number from the Bankruptcy Court and the Civil Number that has been assigned by the U.S. District Court.

Submitted By:

INSTRUCTIONS TO FILER: YOU MUST DELIVER THIS NOTICE AND THE ABOVE-
LISTED ITEMS TO THE UNITED STATES DISTRICT COURT TO COMPLETE THE FILING OF THE MOTION TO WITHDRAW THE REFERENCE. FOR ADDITIONAL INFORMATION, REFER TO THE INSTRUCTIONS APPEARING ON THE BANKRUPTCY COURT'S WEBSITE.

NOTE: A District Court Civil Case Number must be assigned to the above matter before delivery of this notice and the required documents to the District Court. Do not file with the District Court without first obtaining the Civil Case Number from the Bankruptcy Court's Appeals and Judgments Clerk. Be sure to include the receipt number for payment of the $176.00 filing fee in Bankruptcy Court.