File Administrative Expense Claim - Sherman/Grayson Hospital, LLC

Administrative Expense Proof of Claim

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.

Administrative Expense Claims Bar Date: June, 08, 2026 at 4:00 PM (Prevailing Eastern Time).

Debtor

Sherman/Grayson Hospital, LLC

Name of Creditor (the person or entity to whom the debtor owes money or property)

Check box if you are aware that anyone else has filed a proof of claim relating to your administrative expense claim. Attach copy of statement giving particulars.

Check box if this claim replaces or amends a previously filed administrative expense claim.

Name and Addresses Where Notices Should be Sent:

Should payments to the creditor be sent to a different address?

1. BASIS FOR CLAIM:

2. DATE DEBT WAS INCURRED (IF KNOWN):

3. DESCRIPTION OF CLAIM (IF KNOWN):

4. TOTAL AMOUNT OF CLAIM:

5. CREDITS AND SETOFFS: The amount of all payments on this claim has been credited and deducted for purpose of making this proof of claim. In filing this claim, claimant has deducted all amounts that claimant owes to debtor.

6. SUPPORTING DOCUMENTS: Attach copies of supporting documents, such as promissory notes, purchase orders, invoices, itemized statements of running accounts, contracts, court judgements, or evidence of security interests. Do not send original documents. If the documents are not available, explain. If the documents are voluminous, attach a summary.

Click below to attach documentation (see instructions) .

Attach…

Executed on date 5/18/2026

Sign and print the name and title, if any, of the creditor or other person authorized to file this Claim (attach copy of power of attorney, if any).

Print the name of the person who is completing and signing this claim:

Acknowledge you are a human

Verify debtor name prior to submitting claim to be filed.

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.