CACB — Chapter 7 (Non-Individual)

CACB — Chapter 7 (Non-Individual)¶

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/Ch7%20Non-IndividualPetitionPackage.pdf

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United States Bankruptcy Court Central District of California

Chapter 7

Petition Package (Non-Individual Debtors)

Requirements and Forms for Non-Individuals Filing a Chapter 7 Bankruptcy Case in the Central District of California

Revised December 1, 2025

Check the Court’s website www.cacb.uscourts.gov to verify that you are using the latest version of the Petition Package

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Table of Contents

Page

Introduction ................................................................................................. 1

Requirements for Non-Individuals Filing a Chapter 7 Bankruptcy Case ...... 2

Requirements for Master Mailing List of Creditors....................................... 4

Example of Format for Master Mailing List of Creditors ............................... 5

Definition of Terms ...................................................................................... 6

Introduction This Chapter 7 Petition Package includes the basic information and forms required for a non-individual debtor to file a voluntary chapter 7 bankruptcy case in the Central District of California, as specified in The Central Guide, Section 1-06.

The forms in this Petition Package are not fillable. You may retrieve fillable versions of the forms at http://www.uscourts.gov/forms/bankruptcy-forms.

Non-individual debtors must be represented by an attorney and should refer to the Instructions for Bankruptcy Forms for Non-Individuals, available on the Court’s website, under Petition Forms.

Attorneys filing through CM/ECF should refer to The Central Guide, Section 1-09.

Please note that court staff is prohibited from giving legal advice.

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Requirements for Non-Individuals Filing a Chapter 7 Bankruptcy Case

To file a chapter 7 bankruptcy case in the Central District of California, non- individual debtors:

MUST be represented by an attorney (LBR 9011-2(a)).
MUST pay the chapter 7 filing fee. Consult The Central Guide for fee amounts and payment methods.
MUST file the following documents, if applicable, at the bankruptcy court in the following order.

At a minimum, documents in this box (A, and B) MUST BE FILED, when applicable, or the bankruptcy filing will not be accepted.

A. Voluntary Petition for Non-Individuals Filing for Bankruptcy (Official Form 201) – this completed form must be signed by the authorized representative of the Debtor.

B. Master Mailing List of Creditors - this is not a form, it is a list of creditors’ names and addresses. Please see the Requirements for Master Mailing List of Creditors on page 4.

The Following Documents Must be Filed with the Voluntary Petition or within 14 days After Filing the Voluntary Petition

The following documents, if applicable, MUST also be filed at the bankruptcy court with the Voluntary Petition, or within 14 days after the filing of the Voluntary Petition. If the following documents are not filed within 14 days after the filing of the Voluntary Petition, the bankruptcy case may be dismissed. If that happens, you will lose whatever filing fee you paid, and your creditors will be able to resume collection activities against you.

C. Corporate Resolution Authorizing Filing of the Petition - this is not a form and is required only if the debtor is a corporation.

D. Corporate Ownership Statement (LBR form F 1007-4.CORP.OWNERSHIP.STMT) - this form is required only if the debtor is a corporation (other than a government unit) [LBR 1007-4].

E. Statement of Related Cases (LBR form F 1015-2.1.STMT.RELATED.CASES)

F. Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)

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G. Schedules A/B, D through H If any of the applicable schedules do not apply, the Debtor MUST print “None” on the form and file it with the other documents)

Schedule A/B: Assets – Real and Personal Property (Official Form 206A/B)

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)

Schedule H: Codebtors (Official Form 206H)

H. Declaration Under Penalty of Perjury for Non-Individual Debtors (Official Form 202)

I. Statement of Financial Affairs for Non-Individuals Filing For Bankruptcy
(Official Form 207)

J. Disclosure of Compensation of Attorney for Debtor
(Official Form 2030) – this form is required when an attorney represents the
debtor and/or prepared the bankruptcy filing documents.

K. Verification of Master Mailing List of Creditors [LBR 1007-1(a)] (LBR form F 1007-1.MAILING.LIST.VERIFICATION)

Optional Form with No Deadline for Filing

L. Debtor’s Request to Activate Electronic Noticing (DeBN)
(local form F 9036‐1.1.DeBN.ACTIVATE) – this is an optional form for the
debtor’s authorized representative to request orders and court-generated
notices by email (at no cost) through the DeBN program, instead of by U.S.
mail.

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Requirements for Master Mailing List of Creditors

A Master Mailing List of Creditors, with the names and addresses of the creditors, must be filed in all bankruptcy cases and must be submitted in the following format (see Example of Format for Master Mailing List on the next page):

Typed on blank, unlined, standard white 8-1/2 x 11 inch medium weight paper using uppercase and lowercase letter quality fonts, no smaller than 10 point nor greater than 14 point, in either Arial, Calibri, Cambria, Courier, Times New Roman, Helvetica, Geneva, or Letter Gothic.
Typed in a single column with no letters closer than 1-1/2 inches from any edge of the paper and left justified.
Typed with no more than 8 name/address blocks per page. Each block must consist of no more than 4 lines total for each name/address with at least 2 blank lines in between.
Master Mailing List pages must list the creditors from Schedules D, E, and F of the bankruptcy case filing. Use as many pages as needed. Do not include the debtor, joint debtor, U.S. Trustee, Internal Revenue Service, or Franchise Tax Board on the Master Mailing List.
Each line can be no more than 35 characters in length including spaces. The attention line, if any, must be included on the second line of the block. DO NOT INCLUDE ACCOUNT NUMBERS. The city, state (2-letter abbreviation in capital letters only, e.g., CA), and zip code must be on the last line. Nine-digit zip codes should be separated by a hyphen.
Do not use punctuation, except for one comma between city and state (for example Los Angeles, CA 90012).

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Example of Format for Master Mailing List of Creditors

Acme Auto Repair
1234 S Street
Los Angeles, CA 90005

Acme Hair Repair
Attn Herman
1234 S Ave
Los Angeles, CA 90005-0001

Acme Dental Clinic
745 Tungsten Boulevard
Hollywood, CA 90027

Acme Talent Agency
421 N Copper Canyon Way
Burbank, CA 91505-0002

Loans By Acme
7485 Chromium Circle
Beverly Hills, CA 90210

Acme And Sons Insurance
Attn D Acme
13363 Roads End Street Suite 25
Van Nuys, CA 91401

Acme Bar and Grill
114 Aluminum Alley
Chatsworth, CA 91313

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Definition of Terms

Automatic Stay – An injunction that automatically stops lawsuits, foreclosures, garnishments, and most collection activities against the debtor the moment a bankruptcy petition is filed.

Bankruptcy Code – The Bankruptcy Code is available online at http://law.abi.org/.

The Central Guide – The Central Guide serves as the administrative portion of the Local Bankruptcy Rules. It lists all the documents that must be prepared in order to file bankruptcy. The Central Guide also contains other useful information for the public, including filing fees and procedures, telephone numbers, clerical and mechanical rules, and instructions and guides for public access to court dockets, records, and court technology. The Central Guide is available online at https://www.cacb.uscourts.gov/the-central-guide

Debtor – An individual, a married couple, or non-individual that has filed a bankruptcy petition.

FRBP – The Federal Rules of Bankruptcy Procedure (FRPB) govern procedures for bankruptcy proceedings and are available online at http://law.abi.org.

Local Bankruptcy Rules (LBRs) – The Local Bankruptcy Rules, often referred to as LBRs, are a set of procedures and mandatory requirements for bankruptcy cases and proceedings in the Central District of California. LBRs also give parties and their attorneys instructions for getting their requests in front of the judge and list requirements for attorneys, trustees, and other parties who work for a bankruptcy estate.

Local Bankruptcy Rules Forms – Local Bankruptcy Rules Forms are approved for use by the Bankruptcy Court for the Central District of California and work in conjunction with the Local Bankruptcy Rules. LBR forms numbers are preceded with the letter “F” followed by the applicable LBR number. LBR forms are available online at www.cacb.uscourts.gov/forms.

Non-Individual – A corporation, partnership, unincorporated association, or trust.

Official Forms – Forms created by the United States Courts for national use and are available at www.uscourts.gov/forms/bankruptcy-forms. Many often used Official Forms are also available on the Court’s website at www.cacb.uscourts.gov/forms.

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Fill in this information to identify the case:

United States Bankruptcy Court for the:

Central District of California ____________________ District of _________________ (State) Case number (If known): _________________________ Chapter _____ Check if this is an amended filing

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy 04/25 If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor’s name and the case number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

Debtor’s name ______________________________________________________________________________________________________
All other names debtor used ______________________________________________________________________________________________________ in the last 8 years ______________________________________________________________________________________________________ ______________________________________________________________________________________________________

Include any assumed names,
trade names, and doing business ______________________________________________________________________________________________________
as names ______________________________________________________________________________________________________

Debtor’s federal Employer ___ ___ – ___ ___ ___ ___ ___ ___ ___ Identification Number (EIN)
Debtor’s address Principal place of business Mailing address, if different from principal place of business ______________________________________________ _______________________________________________ Number Street Number Street ______________________________________________ _______________________________________________ P.O. Box ______________________________________________ _______________________________________________ City State ZIP Code City State ZIP Code

Location of principal assets, if different from principal place of business ______________________________________________ County _______________________________________________ Number Street

_______________________________________________

_______________________________________________
City State ZIP Code

Debtor’s website (URL) ____________________________________________________________________________________________________

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1

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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP)) 6. Type of debtor Partnership (excluding LLP) Other. Specify: __________________________________________________________________

A. Check one:

Describe debtor’s business Health Care Business (as defined in 11 U.S.C. § 101(27A)) Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B)) Railroad (as defined in 11 U.S.C. § 101(44)) Stockbroker (as defined in 11 U.S.C. § 101(53A)) Commodity Broker (as defined in 11 U.S.C. § 101(6)) Clearing Bank (as defined in 11 U.S.C. § 781(3)) None of the above B. Check all that apply: Tax-exempt entity (as described in 26 U.S.C. § 501) Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C. § 80a-3) Investment advisor (as defined in 15 U.S.C. § 80b-2(a)(11)) C. NAICS (North American Industry Classification System) 4-digit code that best describes debtor. See http://www.uscourts.gov/four-digit-national-association-naics-codes . ___ ___ ___ ___
Under which chapter of the Check one: Bankruptcy Code is the Chapter 7 debtor filing? Chapter 9 Chapter 11. Check all that apply: Debtor’s aggregate noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than $3,424,000 (amount subject to adjustment on 4/01/28 and every 3 years after that). The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). If the debtor is a small business debtor, attach the most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return or if all of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B). The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and it chooses to proceed under Subchapter V of Chapter 11. A plan is being filed with this petition. Acceptances of the plan were solicited prepetition from one or more classes of creditors, in accordance with 11 U.S.C. § 1126(b). The debtor is required to file periodic reports (for example, 10K and 10Q) with the Securities and Exchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File the Attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11 (Official Form 201A) with this form. The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule 12b-2. Chapter 12
Were prior bankruptcy cases No filed by or against the debtor Yes. District _______________________ When _______________ Case number _________________________ within the last 8 years? MM / DD / YYYY If more than 2 cases, attach a separate list. District _______________________ When _______________ Case number _________________________ MM / DD / YYYY

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 2

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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Are any bankruptcy cases No pending or being filed by a Yes. Debtor _____________________________________________ Relationship _________________________ business partner or an

affiliate of the debtor? District _____________________________________________ When __________________
List all cases. If more than 1, MM / DD / YYYY
attach a separate list. Case number, if known ________________________________

Why is the case filed in this Check all that apply: district? Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other district. A bankruptcy case concerning debtor’s affiliate, general partner, or partnership is pending in this district.
Does the debtor own or have No possession of any real Yes. Answer below for each property that needs immediate attention. Attach additional sheets if needed. property or personal property that needs immediate Why does the property need immediate attention? (Check all that apply.) attention? It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or safety. What is the hazard? _____________________________________________________________________ It needs to be physically secured or protected from the weather. It includes perishable goods or assets that could quickly deteriorate or lose value without attention (for example, livestock, seasonal goods, meat, dairy, produce, or securities-related assets or other options). Other _______________________________________________________________________________ Where is the property?_____________________________________________________________________ Number Street ____________________________________________________________________ _______________________________________ _______ ________________ City State ZIP Code Is the property insured? No Yes. Insurance agency ____________________________________________________________________ Contact name ____________________________________________________________________ Phone ________________________________ Statistical and administrative information
Debtor’s estimation of Check one: available funds Funds will be available for distribution to unsecured creditors. After any administrative expenses are paid, no funds will be available for distribution to unsecured creditors. 1-49 1,000-5,000 25,001-50,000
Estimated number of 50-99 5,001-10,000 50,001-100,000 creditors 100-199 10,001-25,000 More than 100,000 200-999

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 3

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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

$0-$50,000 $1,000,001-$10 million $500,000,001-$1 billion

Estimated assets $50,001-$100,000 $10,000,001-$50 million $1,000,000,001-$10 billion $100,001-$500,000 $50,000,001-$100 million $10,000,000,001-$50 billion $500,001-$1 million $100,000,001-$500 million More than $50 billion $0-$50,000 $1,000,001-$10 million $500,000,001-$1 billion
Estimated liabilities $50,001-$100,000 $10,000,001-$50 million $1,000,000,001-$10 billion $100,001-$500,000 $50,000,001-$100 million $10,000,000,001-$50 billion $500,001-$1 million $100,000,001-$500 million More than $50 billion

Request for Relief, Declaration, and Signatures

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

Declaration and signature of The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this authorized representative of petition. debtor I have been authorized to file this petition on behalf of the debtor. I have examined the information in this petition and have a reasonable belief that the information is true and correct. I declare under penalty of perjury that the foregoing is true and correct. Executed on _________________ MM / DD / YYYY _____________________________________________ _______________________________________________ Signature of authorized representative of debtor Printed name Title _________________________________________
Signature of attorney _____________________________________________ Date _________________ Signature of attorney for debtor MM / DD / YYYY

Printed name
_________________________________________________________________________________________________
Firm name
_________________________________________________________________________________________________
Number Street
____________________________________________________ ____________ ______________________________
City State ZIP Code

____________________________________ __________________________________________
Contact phone Email address

______________________________________________________ ____________
Bar number State

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 4

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Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & FOR COURT USE ONLY Email Address

Attorney for:

UNITED STATES BANKRUPTCY COURT

CENTRAL DISTRICT OF CALIFORNIA - SELECT DIVISION DIVISION

In re: CASE NO.: ADVERSARY NO.: CHAPTER: SELECT CHAPTER Debtor(s).

CORPORATE OWNERSHIP STATEMENT
PURSUANT TO FRBP 1007(a)(1)
Plaintiff(s), and 7007.1, and LBR 1007-4

[No hearing]
Defendant(s).

Pursuant to FRBP 1007(a)(1) and 7007.1, and LBR 1007-4, any corporation, other than a governmental unit, that is a debtor in a voluntary case or a party to an adversary proceeding or a contested matter shall file this Statement identifying all its parent corporations and listing any publicly held company, other than a governmental unit, that directly or indirectly own 10% or more of any class of the corporation’s equity interest, or state that there are no entities to report. This Corporate Ownership Statement must be filed with the initial pleading filed by a corporate entity in a case or adversary proceeding. A supplemental statement must promptly be filed upon any change in circumstances that renders this Corporate Ownership Statement inaccurate.

I, (Printed name of attorney or declarant) , the undersigned in the above-captioned case, hereby declare under penalty of perjury under the laws of the United States that the following is true and correct:

This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California.

December 2012 Page 1 F 1007-4.CORP.OWNERSHIP.STMT

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[Check the appropriate boxes and, if applicable, provide the required information.]

I have personal knowledge of the matters set forth in this Statement because:

l am the president or other officer or an authorized agent of the Debtor corporation

I am a party to an adversary proceeding I am a party to a contested matter I am the attorney for the Debtor corporation
a. The following entities, other than the Debtor or a governmental unit, directly or indirectly own 10% or more of any class of the corporation’s(s’) equity interests: [For additional names, attach an addendum to this form.]

b. There are no entities that directly or indirectly own 10% or more of any class of the corporation’s equity interest.

Date: By: Signature of Debtor, or attorney for Debtor

Name: Printed name of Debtor, or attorney for Debtor

This form is optional. It has been approved for use in the United States Bankruptcy Court for the Central District of California.

December 2012 Page 2 F 1007-4.CORP.OWNERSHIP.STMT

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STATEMENT OF RELATED CASES INFORMATION REQUIRED BY LBR 1015-2 UNITED STATES BANKRUPTCY COURT, CENTRAL DISTRICT OF CALIFORNIA

A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by or against the debtor, his/her spouse, his or her current or former domestic partner, an affiliate of the debtor, any copartnership or joint venture of which debtor is or formerly was a general or limited partner, or member, or any corporation of which the debtor is a director, officer, or person in control, as follows: (Set forth the complete number and title of each such of prior proceeding, date filed, nature thereof, the Bankruptcy Judge and court to whom assigned, whether still pending and, if not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A/B that was filed with any such prior proceeding(s).)
(If petitioner is a partnership or joint venture) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by or against the debtor or an affiliate of the debtor, or a general partner in the debtor, a relative of the general partner, general partner of, or person in control of the debtor, partnership in which the debtor is a general partner, general partner of the debtor, or person in control of the debtor as follows: (Set forth the complete number and title of each such prior proceeding, date filed, nature of the proceeding, the Bankruptcy Judge and court to whom assigned, whether still pending and, if not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A/B that was filed with any such prior proceeding(s).)
(If petitioner is a corporation) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by or against the debtor, or any of its affiliates or subsidiaries, a director of the debtor, an officer of the debtor, a person in control of the debtor, a partnership in which the debtor is general partner, a general partner of the debtor, a relative of the general partner, director, officer, or person in control of the debtor, or any persons, firms or corporations owning 20% or more of its voting stock as follows: (Set forth the complete number and title of each such prior proceeding, date filed, nature of proceeding, the Bankruptcy Judge and court to whom assigned, whether still pending, and if not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A/B that was filed with any such prior proceeding(s).)
(If petitioner is an individual) A petition under the Bankruptcy Reform Act of 1978, including amendments thereof, has been filed by or against the debtor within the last 180 days: (Set forth the complete number and title of each such prior proceeding, date filed, nature of proceeding, the Bankruptcy Judge and court to whom assigned, whether still pending, and if not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A/B that was filed with any such prior proceeding(s).)

I declare, under penalty of perjury, that the foregoing is true and correct.

Executed at , California Signature of Debtor 1

Date: Signature of Debtor 2

This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California.

October 2018 Page 1 F 1015-2.1.STMT.RELATED.CASES

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Fill in this information to identify the case:

Debtor name _________________________________________________________________

United States Bankruptcy Court for the:_______________________ District of ________ (State) Case number (If known): _________________________

Check if this is an amended filing

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals 12/15

Part 1: Summary of Assets

Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)

1a. Real property: $ ________________ Copy line 88 from Schedule A/B ......................................................................................................................................

1b. Total personal property: $ ________________ Copy line 91A from Schedule A/B ....................................................................................................................................

1c. Total of all property: $ ________________ Copy line 92 from Schedule A/B ......................................................................................................................................

Part 2: Summary of Liabilities

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D .............................................. $ ________________
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

3a. Total claim amounts of priority unsecured claims: Copy the total claims from Part 1 from line 5a of Schedule E/F ..................................................................................... $ ________________

3b. Total amount of claims of nonpriority amount of unsecured claims: $ ________________ Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F .......................................................... +
Total liabilities ...................................................................................................................................................................... $ ________________ Lines 2 + 3a + 3b

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals page 1

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Fill in this information to identify the case:

Debtor name __________________________________________________________________

United States Bankruptcy Court for the:_______________________ District of ________ (State) Case number (If known): _________________________ Check if this is an amended filing

Official Form 206A/B Schedule A/B: Assets — Real and Personal Property 12/15

Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest. Include all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts or unexpired leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.

For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.

Part 1: Cash and cash equivalents

Does the debtor have any cash or cash equivalents? No. Go to Part 2. Yes. Fill in the information below.

All cash or cash equivalents owned or controlled by the debtor Current value of debtor’s interest
Cash on hand $______________________
Checking, savings, money market, or financial brokerage accounts (Identify all)

Name of institution (bank or brokerage firm) Type of account Last 4 digits of account number 3.1. _________________________________________________ ______________________ ____ ____ ____ ____ $______________________ 3.2. _________________________________________________ ______________________ ____ ____ ____ ____ $______________________
Other cash equivalents (Identify all) 4.1. _____________________________________________________________________________________________________ $______________________ 4.2. _____________________________________________________________________________________________________ $______________________
Total of Part 1 $______________________ Add lines 2 through 4 (including amounts on any additional sheets). Copy the total to line 80.

Part 2: Deposits and prepayments

Does the debtor have any deposits or prepayments? No. Go to Part 3. Yes. Fill in the information below. Current value of debtor’s interest
Deposits, including security deposits and utility deposits

Description, including name of holder of deposit 7.1. ________________________________________________________________________________________________________ $______________________ 7.2._________________________________________________________________________________________________________ $_______________________

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 1

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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Prepayments, including prepayments on executory contracts, leases, insurance, taxes, and rent

Description, including name of holder of prepayment 8.1.___________________________________________________________________________________________________________ $______________________ 8.2.___________________________________________________________________________________________________________ $_______________________
Total of Part 2. $______________________ Add lines 7 through 8. Copy the total to line 81.

Part 3: Accounts receivable

Does the debtor have any accounts receivable? No. Go to Part 4. Yes. Fill in the information below. Current value of debtor’s interest
Accounts receivable

11a. 90 days old or less: ____________________________ – ___________________________ = ........ $______________________ face amount doubtful or uncollectible accounts 11b. Over 90 days old: ___________________________ – ___________________________ = ........ $______________________ face amount doubtful or uncollectible accounts
Total of Part 3 $______________________ Current value on lines 11a + 11b = line 12. Copy the total to line 82.

Part 4: Investments

Does the debtor own any investments? No. Go to Part 5. Yes. Fill in the information below. Valuation method Current value of debtor’s used for current value interest
Mutual funds or publicly traded stocks not included in Part 1 Name of fund or stock: 14.1. ________________________________________________________________________________ _____________________ $________________________ 14.2. ________________________________________________________________________________ _____________________ $________________________
Non-publicly traded stock and interests in incorporated and unincorporated businesses, including any interest in an LLC, partnership, or joint venture

Name of entity: % of ownership: 15.1._______________________________________________________________ % _____________________ $________________ 15.2._______________________________________________________________ % _____________________ $________________

Government bonds, corporate bonds, and other negotiable and non-negotiable instruments not included in Part 1

Describe: 16.1.________________________________________________________________________________ ______________________ $_______________________ 16.2.________________________________________________________________________________ ______________________ $_______________________
Total of Part 4 $______________________ Add lines 14 through 16. Copy the total to line 83.

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 2

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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 5: Inventory, excluding agriculture assets

Does the debtor own any inventory (excluding agriculture assets)? No. Go to Part 6. Yes. Fill in the information below.

General description Date of the last Net book value of Valuation method used Current value of physical inventory debtor's interest for current value debtor’s interest (Where available)
Raw materials ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________
Work in progress ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________
Finished goods, including goods held for resale ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________
Other inventory or supplies ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________
Total of Part 5 $______________________ Add lines 19 through 22. Copy the total to line 84.
Is any of the property listed in Part 5 perishable? No Yes
Has any of the property listed in Part 5 been purchased within 20 days before the bankruptcy was filed? No Yes. Book value _______________ Valuation method____________________ Current value______________
Has any of the property listed in Part 5 been appraised by a professional within the last year? No Yes

Part 6: Farming and fishing-related assets (other than titled motor vehicles and land)

Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)? No. Go to Part 7. Yes. Fill in the information below.

General description Net book value of Valuation method used Current value of debtor’s debtor's interest for current value interest (Where available)
Crops—either planted or harvested ______________________________________________________________ $________________ ____________________ $______________________
Farm animals Examples: Livestock, poultry, farm-raised fish ______________________________________________________________ $________________ ____________________ $______________________
Farm machinery and equipment (Other than titled motor vehicles) ______________________________________________________________ $________________ ____________________ $______________________
Farm and fishing supplies, chemicals, and feed ______________________________________________________________ $________________ ____________________ $______________________
Other farming and fishing-related property not already listed in Part 6 ______________________________________________________________ $________________ ____________________ $______________________

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 3

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Page 19¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Total of Part 6. $______________________ Add lines 28 through 32. Copy the total to line 85.
Is the debtor a member of an agricultural cooperative? No Yes. Is any of the debtor’s property stored at the cooperative? No Yes
Has any of the property listed in Part 6 been purchased within 20 days before the bankruptcy was filed? No Yes. Book value $_______________ Valuation method ____________________ Current value $________________
Is a depreciation schedule available for any of the property listed in Part 6? No Yes
Has any of the property listed in Part 6 been appraised by a professional within the last year? No Yes

Part 7: Office furniture, fixtures, and equipment; and collectibles

Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?

No. Go to Part 8. Yes. Fill in the information below.

General description Net book value of Valuation method Current value of debtor’s debtor's interest used for current value interest (Where available)

Office furniture ______________________________________________________________ $________________ ____________________ $______________________
Office fixtures

______________________________________________________________ $________________ ____________________ $______________________

Office equipment, including all computer equipment and communication systems equipment and software ______________________________________________________________ $________________ ____________________ $______________________
Collectibles Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects; china and crystal; stamp, coin, or baseball card collections; other collections, memorabilia, or collectibles 42.1___________________________________________________________ $________________ ____________________ $______________________ 42.2___________________________________________________________ $________________ ____________________ $______________________ 42.3___________________________________________________________ $________________ ____________________ $______________________
Total of Part 7. $______________________ Add lines 39 through 42. Copy the total to line 86.
Is a depreciation schedule available for any of the property listed in Part 7? No Yes
Has any of the property listed in Part 7 been appraised by a professional within the last year? No Yes

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 4

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Page 20¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 8: Machinery, equipment, and vehicles

Does the debtor own or lease any machinery, equipment, or vehicles? No. Go to Part 9. Yes. Fill in the information below.

General description Net book value of Valuation method used Current value of debtor's interest for current value debtor’s interest Include year, make, model, and identification numbers (i.e., VIN, (Where available) HIN, or N-number)

Automobiles, vans, trucks, motorcycles, trailers, and titled farm vehicles

47.1___________________________________________________________ $________________ ____________________ $______________________

47.2___________________________________________________________ $________________ ____________________ $______________________

47.3___________________________________________________________ $________________ ____________________ $______________________

47.4___________________________________________________________ $________________ ____________________ $______________________
Watercraft, trailers, motors, and related accessories Examples: Boats, trailers, motors, floating homes, personal watercraft, and fishing vessels

48.1__________________________________________________________ $________________ ____________________ $______________________

48.2__________________________________________________________ $________________ ____________________ $______________________
Aircraft and accessories

49.1__________________________________________________________ $________________ ____________________ $______________________

49.2__________________________________________________________ $________________ ____________________ $______________________

Other machinery, fixtures, and equipment (excluding farm machinery and equipment)

______________________________________________________________ $________________ ____________________ $______________________
Total of Part 8. $______________________ Add lines 47 through 50. Copy the total to line 87.
Is a depreciation schedule available for any of the property listed in Part 8? No Yes
Has any of the property listed in Part 8 been appraised by a professional within the last year? No Yes

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 5

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Page 21¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 9: Real property

Does the debtor own or lease any real property? No. Go to Part 10. Yes. Fill in the information below.
Any building, other improved real estate, or land which the debtor owns or in which the debtor has an interest Description and location of property Nature and extent Net book value of Valuation method used Current value of Include street address or other description such as of debtor’s interest debtor's interest for current value debtor’s interest Assessor Parcel Number (APN), and type of property in property (Where available) (for example, acreage, factory, warehouse, apartment or office building), if available. 55.1________________________________________ _________________ $_______________ ____________________ $_____________________

55.2________________________________________ _________________ $_______________ ____________________ $_____________________

55.3________________________________________ _________________ $_______________ ____________________ $_____________________

55.4________________________________________ _________________ $_______________ ____________________ $_____________________

55.5________________________________________ _________________ $_______________ ____________________ $_____________________

55.6________________________________________ _________________ $_______________ ____________________ $_____________________
Total of Part 9. $_____________________ Add the current value on lines 55.1 through 55.6 and entries from any additional sheets. Copy the total to line 88.
Is a depreciation schedule available for any of the property listed in Part 9? No Yes
Has any of the property listed in Part 9 been appraised by a professional within the last year? No Yes

Part 10: Intangibles and intellectual property

Does the debtor have any interests in intangibles or intellectual property? No. Go to Part 11. Yes. Fill in the information below.

General description Net book value of Valuation method Current value of debtor's interest used for current value debtor’s interest (Where available) 60. Patents, copyrights, trademarks, and trade secrets ______________________________________________________________ $_________________ ______________________ $____________________ 61. Internet domain names and websites ______________________________________________________________ $_________________ ______________________ $____________________ 62. Licenses, franchises, and royalties ______________________________________________________________ $_________________ ______________________ $____________________

Customer lists, mailing lists, or other compilations ______________________________________________________________ $_________________ ______________________ $____________________
Other intangibles, or intellectual property ______________________________________________________________ $________________ _____________________ $____________________
Goodwill ______________________________________________________________ $________________ _____________________ $____________________
Total of Part 10. $____________________ Add lines 60 through 65. Copy the total to line 89.

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 6

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Page 22¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C. §§ 101(41A) and 107)? No Yes
Is there an amortization or other similar schedule available for any of the property listed in Part 10? No Yes
Has any of the property listed in Part 10 been appraised by a professional within the last year? No Yes

Part 11: All other assets

Does the debtor own any other assets that have not yet been reported on this form? Include all interests in executory contracts and unexpired leases not previously reported on this form. No. Go to Part 12. Yes. Fill in the information below. Current value of debtor’s interest
Notes receivable Description (include name of obligor) _______________ – __________________________ = $_____________________ ______________________________________________________ Total face amount doubtful or uncollectible amount
Tax refunds and unused net operating losses (NOLs)

Description (for example, federal, state, local)

_________________________________________________________________________________ Tax year ___________ $_____________________

Tax year ___________ $_____________________ _________________________________________________________________________________
Tax year ___________ $_____________________
Interests in insurance policies or annuities ______________________________________________________________ $_______________________
Causes of action against third parties (whether or not a lawsuit has been filed)

______________________________________________________________ $_______________________ Nature of claim ___________________________________ Amount requested $________________
Other contingent and unliquidated claims or causes of action of every nature, including counterclaims of the debtor and rights to set off claims

______________________________________________________________ $_______________________ Nature of claim ___________________________________ Amount requested $________________

Trusts, equitable or future interests in property

______________________________________________________________ $_____________________
Other property of any kind not already listed Examples: Season tickets, country club membership

____________________________________________________________ $_____________________ ____________________________________________________________ $_____________________ 78. Total of Part 11. $_____________________ Add lines 71 through 77. Copy the total to line 90.

Has any of the property listed in Part 11 been appraised by a professional within the last year? No Yes

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 7

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Page 23¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 12: Summary

In Part 12 copy all of the totals from the earlier parts of the form.

Type of property Current value of Current value
personal property of real property

Cash, cash equivalents, and financial assets. Copy line 5, Part 1. $_______________
Deposits and prepayments. Copy line 9, Part 2. $_______________
Accounts receivable. Copy line 12, Part 3. $_______________
Investments. Copy line 17, Part 4. $_______________
Inventory. Copy line 23, Part 5. $_______________
Farming and fishing-related assets. Copy line 33, Part 6. $_______________
Office furniture, fixtures, and equipment; and collectibles. $_______________ Copy line 43, Part 7.
Machinery, equipment, and vehicles. Copy line 51, Part 8. $_______________
Real property. Copy line 56, Part 9. . .................................................................................. $________________
Intangibles and intellectual property. Copy line 66, Part 10. $_______________
All other assets. Copy line 78, Part 11. + $_______________
Total. Add lines 80 through 90 for each column. ........................... 91a. $_______________ 91b. $________________ +
Total of all property on Schedule A/B. Lines 91a + 91b = 92. ........................................................................................... $__________________

Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 8

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Page 24¶

Fill in this information to identify the case:

Debtor name __________________________________________________________________ United States Bankruptcy Court for the: ______________________ District of _________ (State) Case number (If known): _________________________ Check if this is an amended filing Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property 12/15 Be as complete and accurate as possible.

Do any creditors have claims secured by debtor’s property? No. Check this box and submit page 1 of this form to the court with debtor’s other schedules. Debtor has nothing else to report on this form. Yes. Fill in all of the information below. Part 1: List Creditors Who Have Secured Claims Column A Column B 2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one Amount of claim Value of collateral secured claim, list the creditor separately for each claim. Do not deduct the value that supports this of collateral. claim

2.1 Creditor’s name Describe debtor’s property that is subject to a lien __________________________________________ ___________________________________________________ $__________________ $_________________ Creditor’s mailing address ___________________________________________________

________________________________________________________ ___________________________________________________
________________________________________________________ Describe the lien
__________________________________________________
Creditor’s email address, if known Is the creditor an insider or related party?
No
_________________________________________ Yes
Date debt was incurred __________________ Is anyone else liable on this claim?
No
Last 4 digits of account Yes. Fill out Schedule H: Codebtors (Official Form 206H).
number ___ ___ ___ ___

Do multiple creditors have an interest in the As of the petition filing date, the claim is: same property? Check all that apply. No Contingent Yes. Specify each creditor, including this creditor, Unliquidated and its relative priority. Disputed ___________________________________ ___________________________________ 2.2 Creditor’s name Describe debtor’s property that is subject to a lien __________________________________________ ___________________________________________________ $__________________ $_________________ Creditor’s mailing address ___________________________________________________ ________________________________________________________ ___________________________________________________ ________________________________________________________ Describe the lien __________________________________________________ Creditor’s email address, if known Is the creditor an insider or related party? No _________________________________________ Yes Date debt was incurred __________________ Is anyone else liable on this claim? No Last 4 digits of account Yes. Fill out Schedule H: Codebtors (Official Form 206H). number ___ ___ ___ ___ Do multiple creditors have an interest in the As of the petition filing date, the claim is: same property? Check all that apply. No Contingent Yes. Have you already specified the relative Unliquidated priority? Disputed No. Specify each creditor, including this creditor, and its relative priority. _________________________________ _________________________________ Yes. The relative priority of creditors is specified on lines _____ 3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional $________________ Page, if any.

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property page 1 of ___

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Page 25¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Column A Column B

Part 1: Additional Page Amount of claim Value of collateral Do not deduct the value that supports this of collateral. claim Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page.

2._ Creditor’s name Describe debtor’s property that is subject to a lien

__________________________________________ ___________________________________________________
$__________________ $_________________
___________________________________________________
Creditor’s mailing address

Creditor’s email address, if known Is the creditor an insider or related party?
No
_________________________________________ Yes

Date debt was incurred __________________ Is anyone else liable on this claim?
No
Last 4 digits of account Yes. Fill out Schedule H: Codebtors (Official Form 206H).
number ___ ___ ___ ___

Do multiple creditors have an interest in the As of the petition filing date, the claim is:
same property? Check all that apply.

No Contingent Unliquidated Yes. Have you already specified the relative Disputed priority? No. Specify each creditor, including this creditor, and its relative priority. _______________________________ _______________________________ _______________________________

Yes. The relative priority of creditors is specified on lines _____

2._ Creditor’s name Describe debtor’s property that is subject to a lien

___________________________________________________
$__________________ $_________________
Creditor’s mailing address ___________________________________________________

Creditor’s email address, if known Is the creditor an insider or related party?
No
_________________________________________ Yes
Date debt was incurred __________________ Is anyone else liable on this claim?
No
Last 4 digits of account Yes. Fill out Schedule H: Codebtors (Official Form 206H).
number ___ ___ ___ ___

Do multiple creditors have an interest in the As of the petition filing date, the claim is:
same property? Check all that apply.

Official Form 206D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page ___ of ___

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Page 26¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 2: List Others to Be Notified for a Debt Already Listed in Part 1

List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection agencies, assignees of claims listed above, and attorneys for secured creditors. If no others need to be notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page.

On which line in Part 1 Last 4 digits of Name and address did you enter the account number
related creditor? for this entity

__________________________________________________________________________________________________________________

____________________________________________________________________________ Line 2. __ ___ ___ ___ ___

Form 206D Official Part 2 of Schedule D: Creditors Who Have Claims Secured by Property page ___ of ___

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Page 27¶

Fill in this information to identify the case:

Debtor __________________________________________________________________

United States Bankruptcy Court for the: ______________________ District of __________
(State)
Case number ___________________________________________
(If known)
Check if this is an
amended filing

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 12/15 Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured claims. List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Assets - Real and Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and 2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1: List All Creditors with PRIORITY Unsecured Claims

Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507). No. Go to Part 2. Yes. Go to line 2.
List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than 3 creditors with priority unsecured claims, fill out and attach the Additional Page of Part 1. Total claim Priority amount

2.1 Priority creditor’s name and mailing address As of the petition filing date, the claim is: $______________________ $_________________ __________________________________________________________________ Check all that apply. Contingent ___________________________________________ Unliquidated ___________________________________________ Disputed Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)

2.2 Priority creditor’s name and mailing address As of the petition filing date, the claim is: $______________________ $_________________ __________________________________________________________________ Check all that apply. Contingent ___________________________________________ Unliquidated ___________________________________________ Disputed Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)qqqqq

2.3 Priority creditor’s name and mailing address As of the petition filing date, the claim is: $______________________ $_________________ __________________________________________________________________ Check all that apply. Contingent ___________________________________________ Unliquidated ___________________________________________ Disputed Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of ___

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Page 28¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 1. Additional Page

Copy this page if more space is needed. Continue numbering the lines sequentially from the previous page. If no additional PRIORITY creditors exist, do not fill out or submit this page. Total claim Priority amount

2._ Priority creditor’s name and mailing address $______________________ $_________________ As of the petition filing date, the claim is: Check all that apply. _________________________________________________________________ Contingent Unliquidated ___________________________________________ Disputed ___________________________________________ Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)

2._ Priority creditor’s name and mailing address $______________________ $_________________ As of the petition filing date, the claim is: Check all that apply. Contingent _________________________________________________________________ Unliquidated ___________________________________________ Disputed ___________________________________________ Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)

2._ Priority creditor’s name and mailing address As of the petition filing date, the claim is: $______________________ $_________________ Check all that apply. _________________________________________________________________ Contingent ___________________________________________ Unliquidated Disputed ___________________________________________ Date or dates debt was incurred Basis for the claim: __________________________________ _________________________________

Last 4 digits of account Is the claim subject to offset?
number ___ ___ ___ ___ No
Yes
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 29¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill out and attach the Additional Page of Part 2. Amount of claim

3.1 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. $________________________________ ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________

Date or dates debt was incurred ___________________ Is the claim subject to offset?
No
Last 4 digits of account number ___ ___ ___ ___ Yes

3.2 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. $________________________________ ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________ Date or dates debt was incurred ___________________ Is the claim subject to offset? No Last 4 digits of account number ___ ___ ___ ___ Yes

3.3 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. $________________________________ ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________ Date or dates debt was incurred ___________________ Is the claim subject to offset? No Last 4 digits of account number ___ ___ ___ ___ Yes

3.4 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: $________________________________ Check all that apply. ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________

Date or dates debt was incurred ___________________ Is the claim subject to offset?
No
Last 4 digits of account number ___ ___ ___ ___ Yes

3.5 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: $________________________________ Check all that apply. ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________ Date or dates debt was incurred ___________________ Is the claim subject to offset? No Last 4 digits of account number ___ ___ ___ ___ Yes

3.6 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: $________________________________ Check all that apply. ____________________________________________________________ Contingent Unliquidated ____________________________________________________________ Disputed ____________________________________________________________ Basis for the claim: ________________________ Date or dates debt was incurred ___________________ Is the claim subject to offset? No Last 4 digits of account number ___ ___ ___ ___ Yes

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 30¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 2: Additional Page

Copy this page only if more space is needed. Continue numbering the lines sequentially from the Amount of claim previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.

3.__ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. $________________________________ ___________________________________________________________ Contingent Unliquidated Disputed ___________________________________________________________ Liquidated and neither contingent nor disputed ___________________________________________________________ Basis for the claim: ________________________

Date or dates debt was incurred ___________________ Is the claim subject to offset?
No
Last 4 digits of account number ___ ___ ___ ___ Yes

___________________________________________________________
Basis for the claim: ________________________
Date or dates debt was incurred ___________________ Is the claim subject to offset?
No
Last 4 digits of account number ___ ___ ___ ___ Yes

3.__ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: $________________________________ Check all that apply. ___________________________________________________________ Contingent Unliquidated ___________________________________________________________ Disputed ___________________________________________________________ Basis for the claim: ________________________ Date or dates debt was incurred ___________________ Is the claim subject to offset? No Last 4 digits of account number ___ ___ ___ ___ Yes

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 31¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 3: List Others to Be Notified About Unsecured Claims

List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies, assignees of claims listed above, and attorneys for unsecured creditors. If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page.

Name and mailing address On which line in Part 1 or Part 2 is the Last 4 digits of related creditor (if any) listed? account number, if any

4.1. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.2. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.3. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.4. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.5. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.6. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.7. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.8. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.9. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.10. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.11. ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

4.12. Line _____ ___________________________________________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________ _________________________________________________________________

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 32¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 3: Additional Page for Others to Be Notified About Unsecured Claims

Name and mailing address On which line in Part 1 or Part 2 is the Last 4 digits of
related creditor (if any) listed? account number,
if any

4.__ ___________________________________________________________________________________________________ Line _____ _________________________________________________________________ Not listed. Explain ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 33¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 4: Total Amounts of the Priority and Nonpriority Unsecured Claims

Add the amounts of priority and nonpriority unsecured claims.

Total of claim amounts

5a. Total claims from Part 1 5a. $_____________________________

$_____________________________5b. Total claims from Part 2 5b. +

5c. Total of Parts 1 and 2 5c. $_____________________________ Lines 5a + 5b = 5c.

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___

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Page 34¶

Fill in this information to identify the case:

Debtor name __________________________________________________________________

United States Bankruptcy Court for the:______________________ District of _______ (State) Case number (If known): _________________________ Chapter _____

Check if this is an amended filing

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases 12/15

Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, numbering the entries consecutively.

Does the debtor have any executory contracts or unexpired leases? No. Check this box and file this form with the court with the debtor’s other schedules. There is nothing else to report on this form. Yes. Fill in all of the information below even if the contracts or leases are listed on Schedule A/B: Assets - Real and Personal Property (Official Form 206A/B).
List all contracts and unexpired leases State the name and mailing address for all other parties with whom the debtor has an executory contract or unexpired lease

State what the contract or ____________________________________ _________________________________________________________ 2.1 lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

State what the contract or ____________________________________ _________________________________________________________ 2.2 lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

State what the contract or ____________________________________ _________________________________________________________ 2.3 lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

State what the contract or ____________________________________ _________________________________________________________ 2.4 lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

State what the contract or ____________________________________ _________________________________________________________ 2.5 lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases page 1 of ___

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Page 35¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Additional Page if Debtor Has More Executory Contracts or Unexpired Leases

Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page.

List all contracts and unexpired leases State the name and mailing address for all other parties with
whom the debtor has an executory contract or unexpired lease

State what the contract or ____________________________________ _________________________________________________________

2._ lease is for and the nature of the debtor’s interest ____________________________________ _________________________________________________________ _________________________________________________________ State the term remaining ____________________________________ _________________________________________________________ List the contract number of ____________________________________ _________________________________________________________ any government contract

State what the contract or ____________________________________ _________________________________________________________

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases page ___ of ___

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Page 36¶

Fill in this information to identify the case:

Debtor name __________________________________________________________________

United States Bankruptcy Court for the:_______________________ District of ________ (State) Case number (If known): _________________________

Check if this is an amended filing

Official Form 206H Schedule H: Codebtors 12/15

Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach the Additional Page to this page.

Does the debtor have any codebtors? No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form. Yes
In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule on which the creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.

Column 1: Codebtor Column 2: Creditor

Check all schedules Name Mailing address Name that apply:

2.1 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

2.2 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

2.3 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

2.4 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

2.5 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

2.6 _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G

________________________________________________________
City State ZIP Code

Official Form 206H Schedule H: Codebtors page 1 of ___

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Page 37¶

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Additional Page if Debtor Has More Codebtors

Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page.

Column 1: Codebtor Column 2: Creditor

Check all schedules Name Mailing address Name that apply:

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G