CACB — Schedule J-2: Expenses for Separate Household of Debtor 2 (106J2)

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/106J2.pdf

Fill in this information to identify your case:

Debtor 1 __________________________________________________________________ First Name Middle Name Last Name Check if this is:

Debtor 2 ________________________________________________________________ First Name Middle Name Last Name An amended filing (Spouse, if filing) A supplement showing postpetition chapter 13 United States Bankruptcy Court for the: ____________________ DistrictDistrict ofof____________________ expenses as of the following date: ________________ Case number ___________________________________________ MM / DD / YYYY (If known)

Official Form 106J-2

12/15Schedule J-2: Expenses for Separate Household of Debtor 2

Use this form for Debtor 2’s separate household expenses ONLY IF Debtor 1 and Debtor 2 maintain separate households. If Debtor 1 and Debtor 2 have one or more dependents in common, list the dependents on both Schedule J and this form. Answer the questions on this form only with respect to expenses for Debtor 2 that are not reported on Schedule J. Be as complete and accurate as possible. If more space is needed, attach another sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.

Part 1: Describe Your Household

1. Do you and Debtor 1 maintain separate households?

No. Do not complete this form. Yes

2. Do you have dependents? No Dependent’s relationship to Dependent’s Does dependent live Do not list Debtor 1 but list all Yes. Fill out this information for Debtor 2: age with you? other dependents of Debtor 2 each dependent .......................... regardless of whether listed as a No dependent of Debtor 1 on _________________________ ________ Yes Schedule J. No Do not state the dependents’ _________________________ ________ names. Yes _________________________ ________ No Yes _________________________ ________ No Yes _________________________ ________ No Yes

3. Do your expenses include No expenses of people other than yourself, your dependents, and Yes Debtor 1?

Part 2: Estimate Your Ongoing Monthly Expenses

Estimate your expenses as of your bankruptcy filing date unless you are using this form as a supplement in a Chapter 13 case to report expenses as of a date after the bankruptcy is filed.

Include expenses paid for with non-cash government assistance if you know the value of such assistance and have included it on Schedule I: Your Income (Official Form 106I.) Your expenses

4. The rental or home ownership expenses for your residence. Include first mortgage payments and $_____________________ any rent for the ground or lot. 4.

   If not included in line 4:

   4a. Real estate taxes 4a. $_____________________

   4b. Property, homeowner’s, or renter’s insurance 4b. $_____________________

   4c. Home maintenance, repair, and upkeep expenses 4c. $_____________________

   4d. Homeowner’s association or condominium dues 4d. $_____________________

Official Form 106J-2 Schedule J-2: Expenses for Separate Household of Debtor 2 page 1

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

Your expenses

$_____________________

5. Additional mortgage payments for your residence, such as home equity loans 5.

6. Utilities:

   6a. Electricity, heat, natural gas 6a. $_____________________

   6b. Water, sewer, garbage collection 6b. $_____________________

   6c. Telephone, cell phone, Internet, satellite, and cable services 6c. $_____________________

   6d. Other. Specify: _______________________________________________ 6d. $_____________________

7. Food and housekeeping supplies 7. $_____________________

8. Childcare and children’s education costs 8. $_____________________

9. Clothing, laundry, and dry cleaning 9. $_____________________

10. Personal care products and services 10. $_____________________

11. Medical and dental expenses 11. $_____________________

12. Transportation. Include gas, maintenance, bus or train fare. $_____________________

Do not include car payments. 12.

13. Entertainment, clubs, recreation, newspapers, magazines, and books 13. $_____________________

14. Charitable contributions and religious donations 14. $_____________________

    1 15. Insurance.

Do not include insurance deducted from your pay or included in lines 4 or 20.

15a. Life insurance 15a. $_____________________

15b. Health insurance 15b. $_____________________

15c. Vehicle insurance 15c. $_____________________

15d. Other insurance. Specify:_______________________________________ 15d. $_____________________

16. Taxes. Do not include taxes deducted from your pay or included in lines 4 or 20. Specify: ________________________________________________________ 16. $_____________________

17. Installment or lease payments:

    17a. Car payments for Vehicle 1 17a. $_____________________

    17b. Car payments for Vehicle 2 17b. $_____________________

    17c. Other. Specify:_______________________________________________ 17c. $_____________________

    17d. Other. Specify:_______________________________________________ 17d. $_____________________

18. Your payments of alimony, maintenance, and support that you did not report as deducted from your pay on line 5, Schedule I, Your Income (Official Form 106I). 18. $_____________________

19. Other payments you make to support others who do not live with you.

Specify:_______________________________________________________ 19. $_____________________

20. Other real property expenses not included in lines 4 or 5 of this form or on Schedule I: Your Income.

    20a. Mortgages on other property 20a. $_____________________

    20b. Real estate taxes 20b. $_____________________

    20c. Property, homeowner’s, or renter’s insurance 20c. $_____________________

    20d. Maintenance, repair, and upkeep expenses 20d. $_____________________

    20e. Homeowner’s association or condominium dues 20e. $_____________________

Official Form 106J-2 Schedule J-2: Expenses for Separate Household of Debtor 2 page 2

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

21. Other. Specify: _________________________________________________ 21. +$_____________________

22. Your monthly expenses. Add lines 5 through 21. The result is the monthly expenses of Debtor 2. Copy the result to line 22b of Schedule J to calculate the total expenses for Debtor 1 and Debtor 2. 22. $_____________________

23. Line not used on this form.

24. Do you expect an increase or decrease in your expenses within the year after you file this form?

    For example, do you expect to finish paying for your car loan within the year or do you expect your mortgage payment to increase or decrease because of a modification to the terms of your mortgage?

No. Yes. Explain here:

Official Form 106J-2 Schedule J-2: Expenses for Separate Household of Debtor 2 page 3
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