UNITED STATES BANKRUPTCY COURT

SOUTHERN DISTRICT OF NEW YORK

lnre:
INNKEEPERS USA
TRUST, et al
Debtors
)
) Chapter 11
) Case No. 10-13800 (SCC)
)
)
)
) Jointly Administered
PROOF OF EQUITY INTEREST IN
INNKEEPERS USA LIMITED PARTNERSHIP
CASE NO.l0-13794 {SCC)
Name of Equity Interest Holder:
Theodore L. Moss
Name and address where notices should be sent:
Theodore L. Moss
677 Forest Hill Rd.
Lake Forest, IL 60045
Telephone Number: 847/295-7581; E-mail: mossrnn@hotmail.com
1. Nature of Equity Security Interest as of Date Case Filed: I am the owner of Thirty
Thousand Eight Hundred and Fourteen (30,814) Series D Preferred Partnership Units in Debtor
Innkeepers USA Limited Partnership (3956).
2. Basis For Interest: I made the election to receive these 30,814 Series D Preferred Partnership
Units for my existing Units in Innkeepers USA Limited Partnership on or about June 6, 2007, in
connection with the Innkeepers USA Limited Partnership Election Package dated May 29, 2007,
which was provided in connection with Grand Prix Holdings LLC c/o Apollo Investment
Corporation merger transaction with Innkeepers USA Trust, Innkeepers USA Limited
Partnership, and Innkeepers Financial Corporation. The Election Package is not attached
because it was designated as confidential by Grand Prix Holdings LLC. No certificate
representing Unit ownership is attached because I understand Unit ownership is memorialized on
the books of Debtor Innkeepers USA Limited Partnership and not by certificate.
3. Debtor may have scheduled my interest as "Owner" of"O.l39% Percentage Of Interest". (See
attached Page I 2 of I 3 of Statement Of Financial Affairs for Debtor Innkeepers USA Limited
Partnership, Case No. 10-13794, Paragraph 21.a., with reference to Theodore L. Moss, marked
Exh!bit A)_ but this does not state Series D Interests.
/Jrrj
Theodore L. Moss
677 Forest Hill Rd.
Lake Forest, IL 60045
STATEMENT OF FINANCIAL AFFAIRS
!n rs Innkeepers USA limited Partnership
Case No.
21, Current P!"!rtnars, Offtlesrs, Directors and Shareholders
Er a. lfthe debtor ls a partnership, ilst the nature and percentage of partnership interest of each member of the partnership.
NAME AND ADDRESS
Innkeepers Financial Corporation
340 Royal Poinciana Way
Sul!e 306
Palm Beach, FL 33480
Innkeepers USA Trust
340 Royal Poinciana Way
Suite 305
Palm Beach, fL 33480
William J. Hamrick
c/c TMH Hotels, IMA Plaza #250
N. Water Slreet. Sul!e 325
Wichita, KS 67201
Theodore l. Moss
677 Foresl. Hills Road
Lake Forest. IL 60045
San Mateo Residence .AIIl&oclates, LP
8100 E. 22nd Street N., Bldg 500
Wichlla, KS 61226
Kentwood Residence Associates, LP
8100 E. 22nd Street N., Bldg 500
Wlclhlta, KS 67226
East lansing Reside11ce
11101.1 E. 22nd Street N., Bldg 500
Wichita, KS 67226
NATURE OF INTEREST
PERCENTAGE OF INTEREST
General Partner
Owner 99.633%
Owner 0.002%
Owner 0.139%
Owner 0.149%
Owner 0.069%
Owner 0.008%
b, If the debtor is a ccrporaticm, iisl all officers am:! directors ol the corporation, and each stockholder who dlreclly or indirectly owns,
controls, or holds 5 percenl or more of the voting or equily securities of !he corporation.
NAME AND ADDRESS TITLE
NATURE AND PERCENTAGE OF
STOCK OWNERSHIP
22. Former partners, officers, directors and shareholdern
a. If the debtor is a partnersl'lip, list each member who withdrew from the partnership wilhin one year immediately preceding the
commencement of thls case.
NAME
ADDRESS DATE OF WITHDRAWAL
b. If the debtor Is a corporation, lis! all officers, or directors whose relationship with the corporation !ermfmned within one year immediately
preceding the commem:ament of this case.
NAME AND ADDRESS
TITLE DATE OF TERMINATION
.EXHIBIT A TO PROOF OF INTEREST
OF TRFOOORE L. MOSS
Page 12 of 13
PROOF OF SERVICE
I, Theodore L. Moss, declare under penalties of peijury that I caused this Proof Of Equity
Interest to be served on the following in the manner and on the date indicated below:
James H.M. Sprayregen, P.C.
Kirkland & Ellis LLP
601 Lexington A venue
New York, New York 10022-4611
Facsimile: (212) 446-4900
Via Facsimile and First Class US. Mail
Anup Sathy, P.C.
Kirkland & Ellis LLP
300 North LaSalle Street
Chicago, Illinois 60654-3406
Via Messenger
Clerk of Court
United States Bankruptcy Court
One Bowling Green
New York, New York 10004-1408
Via Overnight FedEx Service (with CD-ROM)
Honorable Shelley C. Chapman
United States Bankruptcy Court
One Bowling Green
New York, New York 10004-1408
Via First Class US. Mail
Office of United States Trustee
Southern District ofNew York
33 Whitehall Street
21
81
Floor
New York, New York 10004
Via First Class US. Mail
Innkeepers USA Limited Partnership
c/o Innkeepers USA
340 Royal Poinciana Way, Suite 306
Palm Beach, Florida 33480
Via First Class US. Mail
Theodore L. Moss
Datect!Jut.f.zt'L , 2011