Claim Withdrawal Form

IMPORTANT NOTICE OF REDACTION RESPONSIBILITY: All filers must redact: Social Security or taxpayer-identification numbers; dates of birth; names of minor children; and financial account numbers, in compliance with Fed. R. Bankr. P. 9037. This requirement applies to all documents, including attachments.

IMPORTANT WARNING: A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571.

ACCEPT THE ABOVE RULES TO PROCEED:

I understand that, if I file, I must comply with the redaction rules. I have read this notice.

Read the instructions before filling out this form.

Debtor

20-21022 - Girardi Keese

Identify the Claim

1. Creditor Name and Address

2. Claim Number (if known)

3. Date Claim Filed

4. Total Amount of Claim Filed

Sign Below

The person completing this form must sign and date it.

I, the undersigned, am the above-referenced creditor, or an authorized signatory for the above-referenced creditor. I hereby withdraw the above-referenced claim and authorize the Clerk of this Court, or their duly appointed Claims Agent, to reflect this withdrawal on the official claims register for the above-referenced Debtor.

Executed on date 11/2/2025

Print the name of the person who is completing and signing this form

Acknowledge you are a human

Penalty for presenting fraudulent claim: Fine of up to $500,000 or imprisonment for up to 5 years, or both.
18 U.S.C. §§ 152, 157, and 3571.