CASB — Chapter 11 petition package

Source: https://www.casb.uscourts.gov/sites/casb/files/UPCh11NonIndPkg.pdf

Sparse pages use OCR; original PDF remains authoritative.

UNITED STATES BANKRUPTCY COURT

SOUTHERN DISTRICT OF CALIFORNIA

CHAPTER 11

PETITION PACKAGE

All Forms for Filing a

Chapter 11 Non-Individual Bankruptcy Case

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

April 2020 Chapter 11 Petition Package for Non-Individuals

Instructions For Bankruptcy Forms for Non-Individuals

U.S. Bankruptcy Court | December 2015 (Rev.
March 2019)

General Instructions ............................................................................................... 2

Overview of the bankruptcy forms and filing bankruptcy ................................................................ 3

Follow these privacy restrictions ..................................................................................................... 3

Understand the terms used in the forms ........................................................................................ 3

Things to remember when filling out and filing these forms ............................................................ 3

Filing amended forms ..................................................................................................................... 3

On what date was a debt incurred? ................................................................................................ 3

About the Process for Filing a Bankruptcy Case for Non-Individuals ................................................ 4

Instructions for Selected Forms ............................................................................. 6

Schedule A/B: Real and Personal Property (Official Form 206A/B) .................................................. 7

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) ....................... 9

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F) .............................. 11

Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G) ............................. 14

Glossary ................................................................................................................. 15

Definitions Used in the Forms for Non-Individuals Filing for Bankruptcy ......................................... 16

page 1

General Instructions

This document provides instructions for because information needed in a bankruptcy completing selected forms that entities other case is often different from that prescribed than individuals and municipalities filing for under generally accepted accounting principles. bankruptcy must submit to the U.S. Bankruptcy These instructions highlight some of the Court. All of the required forms can be differences between the bankruptcy documents downloaded without charge from: and accounting records. Debtors should complete all of the information required to thehttp://www.uscourts.gov/FormsAndFees/Forms/ best of their ability.BankruptcyForms.aspx. These instructions are not a substitute for legalThe instructions are designed to accompany the advice about bankruptcy and the requiredforms and are intended to help in understanding forms. Completing the forms is only a part ofwhat information is required to properly file. the bankruptcy process.The representatives of the debtor working on the forms should review each form and any Non-individual debtors must have an attorney to pertinent instructions before supplying the file for bankruptcy. Although the attorney may information for each form. prepare the forms using information supplied by the debtor, representatives of the debtor mustAlthough the forms often parallel how ensure that the forms are accurate and completebusinesses commonly keep their financial and must sign the forms under penalty ofrecords, it is not always possible to do so perjury.

Read This Important Warning

Non-individual debtors must be represented by an attorney.

Bankruptcy can have serious long-term financial and legal consequences, including loss of property. Only an attorney can give legal advice regarding the possible consequences of filing for bankruptcy and the various options that are available.

Entities may not file bankruptcy if they are not eligible to file or do not intend to file the documents necessary to complete the bankruptcy.

Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud 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.

General Instructions page 2

Overview of the bankruptcy forms Understand the terms used in the and filing bankruptcy forms

Use the forms in the 200 series if the debtor is a To understand terms used in the forms and the non-individual, such as a corporation, instructions, see the Glossary at the end of this partnership, or limited liability company (LLC). document. Forms in the 100 series are used by individuals or married couples. Sole proprietors must use Things to remember when fillingthe forms in the 100 series. out and filing these forms When a bankruptcy petition is filed, the U.S. Be as complete and accurate as possible.Bankruptcy Court opens a case. It is important that the answers to the questions on the forms If more space is needed, attach a separatebe complete and accurate so that the case sheet to the form. On the top of any pagesproceeds smoothly. A person who gives false added, write the debtor’s name and caseinformation in connection with a bankruptcy number, if known. Also identify the formcase could be charged with a federal crime, and and line number to which the additionalthe debtor may lose the benefits of filing for information applies.bankruptcy. Do not file these instructions with the Filing a bankruptcy case is not private. Anyone bankruptcy forms that the debtor files with has a right to see a debtor’s bankruptcy forms the court. after the debtor files them. In some circumstances, the bankruptcy court may issue a For the debtor’s records, be sure to keep a protective order to keep trade secrets or other copy of the debtor’s bankruptcy documents confidential proprietary information from being and all attachments that the debtor files. disclosed to the public. 11 U.S.C. § 107 and Bankruptcy Rule 9037. Filing amended forms

Follow these privacy restrictions Check the box on the top of the form to show that the debtor is submitting an amendment. Do not list a minor child’s full name on any form. Instead, fill in only the child’s initials and the full name and address of the child’s On what date was a debt incurred? parent or guardian. For example, write A.B., a minor child (John Doe, parent, 123 Main When a debt was incurred on a single date, fill St., City, State). 11 U.S.C. § 112; in the actual date that the debt was incurred. Bankruptcy Rules 1007(m) and 9037. When a debt was incurred on multiple dates, fill Do not list a person’s date of birth. in the range of dates. For example, if the debt is from a credit card, fill in the month and year of Do not list anyone’s full Social Security the first and last transactions, if known. number on any form.

General Instructions page 3

About the Process for Filing a Bankruptcy Case for Non-Individuals

To file for bankruptcy, the debtor must give the court several forms and documents. Some must be filed at the time the debtor files the case. Others may be filed up to 14 days later.

When the debtor files its bankruptcy case

The debtor must file the forms listed below on the date the debtor files its bankruptcy case. For copies of the forms listed here, go to http://www.uscourts.gov/FormsAndFees/Forms/BankruptcyForms.aspx.

Voluntary Petition for Non-Individuals Filing Form 204). Fill out this form only if the for Bankruptcy (Official Form 201). This debtor files under chapter 11. form opens the case. Directions for completing it are included in the form itself. Attachment to Voluntary Petition for Non-Individuals Filing for A list of names and addresses of all of the Bankruptcy Under Chapter 11 (Official debtor’s creditors, formatted as a mailing list Form 201A). This form is filed only by according to instructions from the bankruptcy non-individual debtors who file under court in which the debtor files. (The chapter 11 and who are required to file bankruptcy court may call this a creditor periodic reports (for example, Forms matrix or mailing matrix.) 10K and 10Q) with the Securities and Exchange Commission pursuant to Chapter 11 Cases: List of Creditors Who Section 13 or 15(d) of the Securities Have the 20 Largest Unsecured Claims Exchange Act of 1934. Against Debtor and Are Not Insiders (Official

When the debtor files its bankruptcy case or within 14 days after filing

The debtor must file the forms listed below with its Voluntary Petition for Non-Individuals Filing for Bankruptcy (Official Form 201) or within 14 days, or such additional time as the court may order, after filing. If the debtor does not do so, the case may be dismissed. Although it is possible to open a case by submitting only the documents listed under When the debtor files its bankruptcy case, the debtor should file the entire set of forms at one time to help its case proceed smoothly.

The debtor must fill out all of the forms completely even though some forms may ask similar questions.

The list below identifies the documents that all non-individuals must file as well as those that are specific to each chapter. For copies of the official forms, go to http://www.uscourts.gov/FormsAndFees/Forms/BankruptcyForms.aspx.

About the Process for Filing a Bankruptcy Case for Non-Individuals page 4

All non-individuals who file for bankruptcy must If a small business debtor files under chapter 11, file these forms and the forms for the specific the debtor must also file: chapter:

If the debtor files under chapter 11 and Schedules of Assets and Liabilities (Official

meets the criteria and debt limits outlined in Form 206) which includes these forms: 11 U.S.C. § 101(51D), the debtor qualifies

Schedule A/B: Real and Personal Property as a small business debtor and must file with (Official Form 206A/B) the petition its most recent Schedule D: Creditors Who Have Claims balance sheet, Secured by Property (Official Form 206D) statement of operations, Schedule E/F: Creditors Who Have cash-flow statement, and Unsecured Claims (Official Form 206E/F) federal income tax return. Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G) If the debtor does not have these documents, the Schedule H: Codebtors (Official debtor must file a statement made under penalty Form 206H) of perjury that the debtor has not prepared either a balance sheet, statement of operations, or cash- Summary of Assets and Liabilities flow statement or the debtor has not filed a for Non-Individuals (Official Form federal tax return. 206Sum). This form gives an overview of the totals on the schedules.

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

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

Disclosure of Compensation to Debtor’s Attorney Unless local rules provide otherwise, Director’s Form 2030 may be used.

About the Process for Filing a Bankruptcy Case for Non-Individuals page 5

Instructions for Selected Forms

Instructions for Selected Forms page 6

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

Schedule A/B: Assets – Real and Personal Understand the terms used in this form Property (Official Form 206A/B) requires debtors to list most of the property interests that Current value are involved in a bankruptcy case. All debtors In this form, the debtor must report the currentfiling for bankruptcy must honestly list value of the debtor’s interest in any propertyeverything they own or in which they have a that it owns in each category. Current value islegal, equitable, or future interest. Legal, sometimes called fair market value and, for thisequitable, or future interest are broad terms and form, it is the fair market value as of the date ofinclude all kinds of property interests in both filing the bankruptcy petition. Current value istangible and intangible property, whether or not how much the property is currently worth,anyone else has an interest in that property. which may be more or less than the amount the The information in this form is grouped by asset debtor paid for the property or the book value of category and, in general, follows the layout and the property. order of liquidity found in a balance sheet. Examples are included for some items and are meant to give debtors an idea of what to include Valuation method used for current value in the categories. The examples are not intended to be complete lists of everything within that In certain asset categories, the debtor must also category. provide the valuation method used to calculate the current value. Select a reasonable method An authorized representative of the debtor must that provides an accurate estimation of current verify under penalty of perjury that the value. information provided is true and correct. Bankruptcy Rule 1008. Examples of valuation methods may include:

If the debtor makes a false statement or Appraisal (provide the date the appraisal was conceals property, the debtor may be fined up to conducted); $500,000 or be imprisoned for up to 20 years or Comparable sales (for example, blue-book both. 18 U.S.C. §§ 152, 1341, 1519, and 3571. values or comparable sales provided by a broker); Revenue-based (for example, present value of revenue streams calculated for a hotel or apartment complex based on rents and available rooms);

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

Liquidation value (for example, the price of Depreciation and amortization expenses are the property when it is not allowed sufficient calculated using accounting procedures that allocate the cost of certain property over its time to sell in the open marketthis figure useful life. It represents the decline in value is typically provided by a professional); over time due to wear and tear, obsolescence, or Expert (for example, an accountant or other factors. advisor who has special expertise with regard to the property); How to list items on this form Replacement value (the cost of replacing the property); List items only once on this form; do not list Tax records (for example, the value assessed an item in more than one category. If an on the property by the county appraisal); item could fit into more than one category, select the category the debtor thinks is the Recent cost-based valuations (for example, most suitable and list the item there. For first-in first-out inventory valuation example, a car dealership may report method). vehicles under Part 4: Inventory instead of under Part 8: Machinery, equipment, and vehicles.Net book value of debtor’s interest (where available) List property held for resale in Part 4: Inventory. If the debtor separates If the debtor does not prepare a balance sheet manufactured items into raw materials, work for its financial records or for its tax returns, in progress, and finished goods, report those then it does not need to provide information in items in the categories provided as this column. appropriate. If the debtor only purchases items and holds them for resale and does not If the debtor prepares a balance sheet for its do any manufacturing, then report the items financial records or for its tax returns, then it under finished goods, not as raw materials or must also provide the net book value of debtor’s work in progress. interest for certain types of property. For The values reported on this form must matchpurposes of this form, use the book value the values reported on Schedule D:reported on the most recent balance sheet Creditors Who Have Claims Secured byprepared before filing this case. Property (Official Form 206D). Net book value is the carrying value of an asset In Schedule A/B, list any executory on the debtor’s books or financial records and is contracts or unexpired leases (for example, generally calculated by taking the original cost an unexpired lease for a building, a real of the property and subtracting depreciation or estate listing agreement, or leases for amortization expenses (if any). machinery or equipment). Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).

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

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

The people or organizations to whom the debtor A claim is unliquidated if the amount of the debt owes money are called its creditors. A claim is a cannot be readily determined, such as by creditor’s right to payment. referring to an agreement or by a simple computation. An unliquidated claim is one for Creditors may have different types of claims: which there may be a definite liability but where the amount of the claim has not been determined. Secured claims. Report these on Schedule D: Creditors Who Have Claims Secured by A claim is disputed if the debtor disagrees that it Property (Official Form 206D). owes all or a portion of the debt. Unsecured claims. Report these on A single claim can have one, more than one, or Schedule E/F: Creditors Who Have none of these characteristics. Unsecured Claims (Official Form 206E/F).

Creditors with secured claims may be able to get Do not omit any secured creditorspaid from specific property in which that creditor has a security interest, such as a mortgage or a In alphabetical order, list all creditors that havelien. That property is sometimes called collateral judgment liens, garnishments, statutory liens,for the debt. Creditors with unsecured claims do mortgages, deeds of trust, and purchase moneynot have rights against specific property, or the security interests or other consensual liensspecific property in which the creditor has rights against property of the debtor. These categoriesis not worth enough to pay the creditor in full. can be used to describe the lien.

The form is divided into parts. List a debt in

Claims may be contingent, unliquidated, Part 1 only once and list any other entities that or disputed should be notified about that debt in Part 2. For example, if an attorney is trying to collect a debt Many claims have a specific amount which the that the debtor owes to someone else, list the debtor clearly owes. But some claims are person to whom the debtor owes the debt in uncertain or become due only after the Part 1 and list the attorney in Part 2. bankruptcy petition is filed. All claims must be listed in the schedules, even if they are contingent, unliquidated, or disputed. A claim is contingent if the debtor is not obligated to pay it unless a particular event occurs after the bankruptcy petition is filed.

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) page 9

Determine the amount of each secured List a creditor in Schedule D even if it appears creditor’s claim or claims that no value exists to support that creditor’s secured claim, as long as the creditor has a To determine the amount of a secured claim, security interest in some property owned by the compare the amount of the claim to the value of debtor. If the claim is secured only by property the debtor’s interest in the property that is owned by a non-debtor, list the claim in collateral for the claim. If that value is greater Schedule E/F. than the amount of the claim, then the entire amount of the claim is secured. If there is more than one secured claim against the same property, the amount of the claim that If the value of the property that is collateral for is entitled to be paid first must be subtracted the claim is less than the amount of the claim, from the property value to determine how much the difference is unsecured. value remains for the next claim.

For example, if the outstanding balance due on For example, if a building worth $300,000 has a an equipment loan is $100,000 and the first mortgage of $200,000 and a second equipment is worth $80,000, the lender has a mortgage of $150,000, the first mortgage would secured claim of $80,000 and an unsecured claim be fully secured, and there would be $100,000 of of $20,000. In that situation, list the creditor only property value for the second mortgage, and the once on Schedule D: Creditors Who Have claim secured by the second mortgage would Claims Secured by Property (Official Form have an unsecured portion of $50,000. 206D). Do not list the creditor again on Schedule E/F: Creditors Who Have Unsecured $300,000 value of a building Claims (Official Form 206E/F). In addition, if - $200,000 first mortgage the case is a chapter 11 case and the creditor’s $100,000 remaining property value unsecured claim makes it one of the 20 largest unsecured creditors, the creditor must also be $150,000 second mortgage included on Chapter 11 or Chapter 9 Cases: List - $100,000 remaining property value of Creditors Who Have the 20 Largest $ 50,000 unsecured portion of second mortgage claim Unsecured Claims Who Are Not Insiders (Official Form 204).

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D) page 10

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

The people or organizations to whom the debtor 206D). Do not list the creditor again on owes money are called its creditors. A claim is Schedule E/F: Creditors Who Have Unsecured a creditor’s right to payment. Claims (Official Form 206E/F).

Creditors may have different types of claims: List a creditor in Schedule D even if it appears that no value exists to support that creditor’s Secured claims. Report these on Schedule D: secured claim. Creditors Who Have Claims Secured by Property (Official Form 206D). Unsecured claims. Report these on Claims may be contingent, unliquidated, Schedule E/F: Creditors Who Have or disputed Unsecured Claims (Official Form 206E/F). Many claims have a specific amount which the Creditors with unsecured claims do not have rights debtor clearly owes. But some claims are against specific property, or the specific property uncertain or become due only after the date the in which the creditor has rights is not worth bankruptcy petition is filed. All claims, whether enough to pay the creditor in full. they are certain or uncertain as of the date of the filing, must be listed in the schedules, even if Use Schedule E/F: Creditors Who Have the claims are contingent, unliquidated, or Unsecured Claims (Official Form 206E/F) to disputed. identify everyone who holds an unsecured claim against the debtor as of the date the bankruptcy A claim is contingent if the debtor is not petition is filed unless that creditor is already listed obligated to pay it unless a particular event on Schedule D: Creditors Who Have Claims occurs after the petition is filed. Secured by Property (Official Form 206D). A claim is unliquidated if the amount of the Creditors with secured claims have a right to debt cannot be readily determined, such as by take property from the debtor if the debtor does referring to an agreement or by a simple not pay them. They should be listed on computation. An unliquidated claim is one for Schedule D: Creditors Who Have Claims which there may be a definite liability but Secured by Property (Official Form 206D). where the amount of the claim has not been set.

If a secured creditor’s full claim exceeds the A claim is disputed if the debtor disagrees that value of the property securing that claim, the it owes all or a portion of the debt. creditor may have a secured claim for the value of the property and an unsecured claim for the A single claim can have one, more than one, or deficiency. In that situation, list the creditor none of these characteristics. only once on Schedule D: Creditors Who Have Claims Secured by Property (Official Form

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F) page 11

Unsecured claims may be either priority is a priority claim.* 11 U.S.C. § 507(a)(6). or nonpriority claims Deposits by individuals — If the debtor obtained from an individual a deposit for the What are priority unsecured claims? purchase, lease, or rental of property or In bankruptcy cases, priority unsecured claims services for the individual or the individual’s are those debts that the Bankruptcy Code family, the deposit may be a priority claim. requires to be paid before most other unsecured Unredeemed gift certificates are deposits. claims are paid. The most common priority The priority is limited to $3,025.* unsecured claims are certain tax debts. Priority 11 U.S.C. § 507(a)(7). unsecured claims include those the debtor owes Other categories exist.for: Taxes and certain other debts owed to the What are nonpriority unsecured claims? government—If the debtor owes certain federal, state, or local government taxes, Nonpriority unsecured claims are those debts customs duties, or penalties. that generally will be paid after priority 11 U.S.C. § 507(a)(8). unsecured claims are paid. The most common examples of nonpriority unsecured claims are Wages, salaries, and commissions—If the trade debts, bank loans, contract obligations, debtor owes wages, salaries, and and fees for professional services. commissions, including vacation, severance, and sick leave pay and those amounts were In Part 2, list every creditor owed money by the earned within 180 days before the debtor not listed before, regardless of the bankruptcy petition was filed or the debtor amount and even if the debtor plans to pay a ceased business. In either instance, only the particular debt. first $13,650 per claim is a priority claim.* 11 U.S.C. § 507(a)(4). What if a claim has both priority and Contributions to employee benefit plans—If nonpriority amounts? the debtor owes contributions to an employee benefit plan for services an If a claim has both priority and nonpriority employee rendered within 180 days before amounts, list that claim in Part 1 and show both the bankruptcy petition was filed, or within priority and nonpriority amounts. Do not list it 180 days before the debtor ceased business. again in Part 2. Only the first $13,650 per employee, less any amounts owed for wages, salaries, and On what date was a debt incurred? commissions, is a priority claim.* When a debt was incurred on a single date, fill 11 U.S.C. § 507(a)(5). in the actual date that the debt was incurred. Certain claims of farmers and fishermen— Only the first $6,725 per farmer or fisherman When a debt was incurred on multiple dates, fill in the range of dates. For example, if the debtor

• Subject to adjustment on 4/1/22, and every 3 years after that for cases begun on or after the date of adjustment. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F) page 12

has a line of credit with multiple draws, fill in transactions, if known. the month and year of the first and last

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F) page 13

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

Use Schedule G: Executory Contracts and real property; Unexpired Leases (Official Form 206G) to identify the debtor’s ongoing leases and certain Service provider agreements (for example, contracts. List all of the debtor’s executory maintenance contracts for office contracts and unexpired leases. equipment, and contracts for cell phones, personal electronic devices, internet, and Executory contracts are often described as cable); contracts between the debtor and another party in which neither party has performed all of the Sales contracts; requirements by the time the debtor files for Supplier or service contracts;bankruptcy. Unexpired leases are leases that are still in effect. Leases or timeshare contracts; The debtor must list all agreements that may Employment contracts;be executory contracts or unexpired leases, even if they are listed on Schedule A/B: Real estate listing agreements; Property (Official Form 206A/B) or Schedule E/F: Creditors Who Have Intellectual property license agreements Unsecured Claims, (Official Form 206 E/F) (such as copyright, patent, trademark, and including the following: industrial rights); Equipment leases; Development contracts; and Vehicle leases; Insurance contracts.

Leases for business or investment property State the contract number of any government (for example, office or warehouse space); contract.

Contracts to sell a building, land, or other

Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G) page 14

Glossary

Glossary page 15

Definitions Used in the Forms for Non-Individuals Filing for Bankruptcy

Here are definitions for some of the important terms used in the forms for non-individuals who are filing for bankruptcy. See Bankruptcy Basics (http://www.uscourts.gov/services-forms/ bankruptcy) for more information about filing for bankruptcy and other important terms.

Affiliate — As used in the Bankruptcy Code Amortization — 1. A non-cash accounting and Rules, an affiliate of the debtor is: method that allocates the cost of an intangible asset over its useful life. 2. Paying off a(a) an entity that directly or indirectly owns, liability in regular installments over a period controls, or holds with power to vote at least 20% of the outstanding voting of time. securities of the debtor (excluding entities that hold such securities in a fiduciary or Amortization schedule — A report that contains agency capacity without sole discretionary a listing of intangible assets and the amount of power to vote such securities or solely to amortization and accumulated amortization secure a debt, if the entity has not in fact that has been allocated over the life of those exercised such power to vote); assets. These reports are typically maintained for purposes of calculating tax deductions and(b) a corporation 20% or more of whose preparing tax returns. outstanding voting securities are directly or indirectly owned, controlled, or held with power to vote, by the debtor, or by an Annuity — A contract for the periodic entity that directly or indirectly owns, payment of money, either for the life of the controls, or holds with power to vote, 20% recipient or for a fixed number of years. or more of the outstanding voting securities of the debtor (again excluding Book value or net book value — The carrying entities that hold such securities in a value of an asset on the debtor’s books or fiduciary or agency capacity without sole financial records. This amount is generally discretionary power to vote such securities calculated by taking the original cost of the or solely to secure a debt, if the entity has property and subtracting depreciation or not in fact exercised such power to vote); amortization expenses (if any). (c) a person whose business is operated under a lease or operating agreement by a Causes of action — Claims where the debtor debtor, or person substantially all of asserts money or other relief from a third party whose property is operated under an or where a third party is entitled to money or operating agreement with the debtor; or other relief from the debtor. (d) an entity that operates the business or substantially all of the property of the debtor under a lease or operating agreement.

Definitions Used in the Forms for Non-Individuals page 16

Claim — A creditor’s right to payment, even if Depreciation schedule — A report that contingent, disputed, unliquidated, or contains a listing of tangible assets and the unmatured. amount of depreciation and accumulated depreciation that has been allocated over the life of those assets. These reports are typicallyCodebtor —A person or entity that may also maintained for purposes of calculating taxbe responsible for paying a claim against the deductions and preparing tax returns.debtor.

Discharge — A discharge in bankruptcyCollateral — Property that secures a debt. relieves a debtor from having to pay certain debts. For non-individuals, it applies only in

Contingent claim — Debt that is only payable certain chapter 11 and chapter 12 cases. if certain events occur.

Disputed claim —A claim about which there is

Creditor matrix or mailing matrix — A list of a disagreement. A claim is disputed if the names and addresses of all of the debtor’s debtor disagrees that he or she owes all or a creditors, formatted as a mailing list according portion of the debt. to instructions from the bankruptcy court in which the debtor files the case. Doubtful or uncollectible accounts — Receivables that the debtor has little or no Creditor — The person or organization to expectation of collecting. This amount is whom the debtor owes money. deducted from total receivables to calculate the amount that the debtor reasonably expects Current value or fair market value — how will be collected on its receivables. much the property is worth, which may be more or less than the purchase price or the Executory contract — Often described as a book value. See the instructions for specific contract between the debtor and another party forms regarding whether the value requested is as to which neither the debtor nor the other as of the date of the filing of the petition, the party has performed all of the requirements by date the debtor completes the form, or some the time the bankruptcy case is filed. other date.

Goodwill — Amount of a purchase price that

Debt — Liability on a claim. exceeds the net tangible assets. It can also be the value of an intangible asset that has a Depreciation — A non-cash accounting quantifiable value in business. Examples method that allocates the cost of a tangible include a strong brand or reputation or, in an asset over its useful life. acquisition, goodwill.

Definitions Used in the Forms for Non-Individuals page 17

Gross income — A company’s gross revenue Negotiable instrument — A written and signed minus cost of goods sold. unconditional promise or order to pay a specified sum of money on demand or at a definite time payable to order or bearer.Gross revenue — Amount generated by all of Negotiable instruments include governmenta company’s operations before deductions for bonds, corporate bonds, personal checks,expenses. cashiers’ checks, promissory notes, and money orders. Insider — Insiders include officers, directors, and anyone in control of a corporate debtor Net operating loss (NOL) — Occurs whenand their relatives; general partners of a allowable tax deductions exceed taxablepartnership debtor and their relatives; affiliates income, resulting in negative taxable income.of a debtor and insiders of such affiliates, and NOLs can generally be used to recover pastany managing agent of a debtor. tax payments (carry-back) or reduce future tax11 U.S.C. § 101. payments (carry-forward).

Intangible assets — Types of property that are Non-individual debtor — A non-individualnot physical in nature and cannot be touched, entity such as a corporation, partnership, orseen, or held. Examples include intellectual limited liability company (LLC), on whoseproperty and name recognition. behalf or against whom a bankruptcy case is filed. Intellectual property — An intangible asset that consists of human knowledge and ideas. Non-negotiable instrument — FinancialExamples include patents, copyrights, instrument that cannot be transferred totrademarks, and software. another party by signing or delivering it.

Legal or equitable interest — Any interest of Nonpriority unsecured claim — Debt thatthe debtor in property, whether tangible or generally will be paid after priority unsecuredintangible, and whether or not anyone other claims are paid. Examples include amountsthan the debtor also has an interest in that due for products purchased, professionalproperty. services, and utilities.

Lien — A charge against or interest in Priority unsecured claim — Debt that theproperty to secure a debt. Bankruptcy Code requires to be paid before most other unsecured claims are paid. Nature of claim — The legal type of a claim, Examples include certain income tax debts not the factual basis for it. Examples include and certain employee wage claims. breach of contract, personal injury, malpractice, and fraud.

Definitions Used in the Forms for Non-Individuals page 18

Secured claim — A claim that may be satisfied Tangible asset — Types of property that have in whole or in part either physical form and can be seen, touched, or held. Examples include cash, machinery, through collateral, buildings, and land. through a charge against or an interest in the debtor’s property, or Unexpired lease — Lease that is in effect at the through a right of setoff. time the bankruptcy petition is filed.

Setoff — Occurs when a creditor pays itself Unliquidated claim — A debt for which the with money belonging to the debtor that it is amount cannot be readily determined, such as holding, or by canceling a debt it owes to the by referring to an agreement or by a simple debtor. computation.

Sole proprietorship — A business that a debtor owns as an individual, rather than a separate legal entity such as a corporation, partnership, or LLC. Sole proprietors must use the bankruptcy forms in the 100 series.

Definitions Used in the Forms for Non-Individuals page 19

CSD 1007 [07/01/23]

What is a Creditor Mailing List? If you would like to submit your petition electronically to the court, please click this eSR link.

Creating a Creditor List

When you file a voluntary petition under any bankruptcy chapter, you the debtor (or your attorney, if you use one) must prepare and submit to the court a mailing list called the creditor matrix, which is a list of creditors to whom you owe money. This mailing list contains all your creditors’ and/or equity security holders’ name(s) and addresses. As well as filing a list of creditors on paper and listing creditors in appropriate schedules, you are required to submit your creditor matrix electronically using one of the following options:

Option 1:

Enter your creditors using the court’s Online Creditor Entry program available at https://ecf.casb.uscourts.gov/cgi-bin/CreateCreditorMatrix.pl o From the court website https://www.casb.uscourts.gov/content/filing-without- attorney-pro-se-filing : Select Build Creditor Matrix.

Option 2: Save your creditor matrix to a USB flash drive in .txt format to provide to the intake clerk(s) at the courthouse. o Provide a file name for your flash drive that will be easy for you to remember and for the intake clerk to find.

Option 3:

Enter your creditors using the public computers in the courthouse.

Whether on paper or electronically, list your creditors and their mailing addresses in a single column, on the left margin, with at least one line between each creditor. See the example at the end of this form.

Each creditor entry is limited to five lines.

Do not include any symbols or special characters (|@#$%^&*( )_+?).

Do not include full account numbers or phone numbers. Do not list the amount owed. Do not include the debtor, joint debtor, U.S. Trustee, Internal Revenue Service, or Franchise Tax Board on the creditor matrix. The court maintains a list of current addresses of State and Federal Agencies on the Court Forms page of the court’s website as CSD 1271, in case you need that information for the list of creditors.

CSD 1007 [07/01/23]

Please read: You the debtor are responsible for ensuring that petitions, schedules, and statements, including the creditor matrix, are complete and correct before submitting them to the court. The court is not required to compare the names and addresses on the list of creditors with those on your petition schedules.

Samples of Correct format:

ABC Stores Attention: Mr. Smith 123 Bee ST Plain City, IN 11111

ABC Stores Attention: Mary Doe Smith Office Building Ste 123 456 Bee ST Plain City, IN 11111

John Smith 789 Bee ST Plain City, IN 11111

John Smith P.O. Box 1234 Plain City, IN 11111

CSD 1801 [12/01/16] Name, Address, Telephone No. & I.D. No.

UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991

In Re

BANKRUPTCY NO.

Debtor.

DECLARATION RE: ELECTRONIC FILING OF PETITION, SCHEDULES & STATEMENTS

PART I - DECLARATION OF PETITIONER

I [We] and ,

the debtor(s), hereby declare under penalty of perjury that the information I have given my attorney and the information provided in the electronically filed petition, statements, and schedules is true and correct. I consent to my attorney sending my petition, this declaration, statements and schedules to the United States Bankruptcy Court. I understand that this Declaration Re: Electronic Filing is to be filed with the Clerk once all schedules have been filed electronically but, in no event, no later than 14 days following the date the petition was electronically filed. I understand that failure to file the signed original of this Declaration will cause my case to be dismissed pursuant to 11 U.S.C. §707(a)(3) without further notice.

[If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter

7] I am aware that I may proceed under chapter 7, 11, 12 or 13 of 11 United States Code, understand the relief available under each such chapter, and choose to proceed under chapter 7. I request relief in accordance with the chapter specified in this petition.

[If petitioner is a corporation or partnership] I declare under penalty of perjury that the information provided

in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. The debtor requests relief in accordance with the chapter specified in this petition.

Dated:

Signed
*(Debtor) *(Joint Debtor)
*If filed electronically, pursuant to LBR 5005-4(C), the original debtor signature(s) in a scanned format is required.

PART II - DECLARATION OF ATTORNEY

I declare under penalty of perjury that I have informed the petitioner, if an individual, that [he or she] may proceed

under chapter 7, 11, 12 or 13 of Title 11, United States Code, and have explained the relief available under each such chapter. I further certify that I have delivered to the debtor the notice required by 11 U.S.C. §342(b). In a case in which § 707(b)(4)(D) applies, this signature also constitutes a certification that I have no knowledge after an inquiry that the information in the schedules is incorrect.

Dated:

Attorney for Debtor(s)

CSD 1801

Fill in this information to identify the case:

United States Bankruptcy Court for the:

____________________ 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 04/20 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.

1. Debtor’s name ______________________________________________________________________________________________________

2. All other names debtor used ______________________________________________________________________________________________________ in the last 8 years ______________________________________________________________________________________________________ ______________________________________________________________________________________________________

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

3. Debtor’s federal Employer ___ ___ – ___ ___ ___ ___ ___ ___ ___ Identification Number (EIN)

4. 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

5. Debtor’s website (URL) ____________________________________________________________________________________________________

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

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:

7. 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 . ___ ___ ___ ___

8. Under which chapter of the Check one: Bankruptcy Code is the Chapter 7 debtor filing? Chapter 9 A debtor who is a "small Chapter 11. Check all that apply: business debtor" must check the first sub-box. A debtor The debtor is a a small business debtor as defined in 11 U.S.C. § 101(51D), and its as defined in § 1182(1) who aggregate noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than $2,725,625. If this sub-box is selected, attach the most recent balance sheet, elects to proceed under statement of operations, cash-flow statement, and federal income tax return or if any of subchapter V of the chapter these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B). 11 (whether or not the debtor is a "small business debtor") The debtor is a debtor as defined in 11 U.S.C. § 1182(1), its aggregate noncontingent must check the second sub- liquidated debts (excluding debts owed to insiders or affiliates) are less than $7,500,000, box. and it chooses to proceed under Subchapter V of Chapter 11. If this sub-box is selected, attach the most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return, or if any of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B). 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

9. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

10. 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 ________________________________

11. 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.

12. 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

13. 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

14. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

15. 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

16. 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.

17. 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 _________________________________________

18. 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

Official Form 201A (12/15)

[If debtor is required to file periodic reports (e.g., forms 10K and 10Q) with the Securities and Exchange Commission
pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 and is requesting relief under chapter 11 of the
Bankruptcy Code, this Exhibit AA@shall be completed and attached to the petition.]

[Caption as in Form 416B]

Attachment to Voluntary Petition for Non-Individuals Filing for
Bankruptcy under Chapter 11

1. If any of the debtor=s securities are registered under Section 12 of the Securities Exchange Act of
1934, the SEC file number is _______________.

2. The following financial data is the latest available information and refers to the debtor=s condition on
______________.
a. Total assets $

b. Total debts (including debts listed in 2.c., below) $
c. Debt securities held by more than 500 holders
Approximate
number of
holders:

secured G unsecured G subordinated G $
secured G unsecured G subordinated G $
secured G unsecured G subordinated G $
secured G unsecured G subordinated G $
secured G unsecured G subordinated G $

d. Number of shares of preferred stock
e. Number of shares common stock

Comments, if any:

3. Brief description of debtor=s business:

4. List the names of any person who directly or indirectly owns, controls, or holds, with power to vote,
5% or more of the voting securities of debtor:

Official Form 201A Attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11

Fill in this information to identify the case and this filing:

Debtor Name __________________________________________________________________ United States Bankruptcy Court for the: ______________________ District of __________ (State) Case number (If known): _________________________

Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors 12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document, and the date. Bankruptcy Rules 1008 and 9011.

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud 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

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or
another individual serving as a representative of the debtor in this case.

I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:

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)
Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)
Amended Schedule ____

Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)

Other document that requires a declaration__________________________________________________________________________________

I declare under penalty of perjury that the foregoing is true and correct.
Executed on ______________ _________________________________________________________________________
MM / DD / YYYY Signature of individual signing on behalf of debtor

________________________________________________________________________
Printed name

______________________________________
Position or relationship to debtor

Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors

Fill in this information to identify the case:

Debtor name __________________________________________________________________
United States Bankruptcy Court for the: ______________________ District of _________
(State) Check if this is an
Case number (If known): _________________________ amended filing

Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders 12/15

A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20 largest unsecured claims.

Name of creditor and complete Name, telephone number, and Nature of the claim Indicate if Amount of unsecured claim mailing address, including zip code email address of creditor (for example, trade claim is If the claim is fully unsecured, fill in only unsecured contact debts, bank loans, contingent, claim amount. If claim is partially secured, fill in professional unliquidated, total claim amount and deduction for value of services, and or disputed collateral or setoff to calculate unsecured claim. government contracts) Total claim, if Deduction for Unsecured partially value of claim secured collateral or setoff 1

2

3

4

5

6

7

8

Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 1

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Name of creditor and complete Name, telephone number, and Nature of the claim Indicate if Amount of unsecured claim mailing address, including zip code email address of creditor (for example, trade claim is If the claim is fully unsecured, fill in only unsecured contact debts, bank loans, contingent, claim amount. If claim is partially secured, fill in professional unliquidated, total claim amount and deduction for value of services, and or disputed collateral or setoff to calculate unsecured claim. government contracts) Total claim, if Deduction for Unsecured partially value of claim secured collateral or setoff

9

10

11

12

13

14

15

16

17

18

19

20

Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 2

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

1. 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

2. 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 .............................................. $ ________________

3. 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 .......................................................... +

4. Total liabilities ...................................................................................................................................................................... $ ________________ Lines 2 + 3a + 3b

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

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

1. 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

2. Cash on hand $______________________

3. 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. _________________________________________________ ______________________ ____ ____ ____ ____ $______________________

4. Other cash equivalents (Identify all) 4.1. _____________________________________________________________________________________________________ $______________________ 4.2. _____________________________________________________________________________________________________ $______________________

5. 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

6. 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

7. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

   Description, including name of holder of prepayment 8.1.___________________________________________________________________________________________________________ $______________________ 8.2.___________________________________________________________________________________________________________ $_______________________

9. Total of Part 2. $______________________ Add lines 7 through 8. Copy the total to line 81.

Part 3: Accounts receivable

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

11. 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

12. Total of Part 3 $______________________ Current value on lines 11a + 11b = line 12. Copy the total to line 82.

Part 4: Investments

13. 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

14. Mutual funds or publicly traded stocks not included in Part 1 Name of fund or stock: 14.1. ________________________________________________________________________________ _____________________ $________________________ 14.2. ________________________________________________________________________________ _____________________ $________________________

15. 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._______________________________________________________________ % _____________________ $________________

16. Government bonds, corporate bonds, and other negotiable and non-negotiable instruments not included in Part 1 Describe: 16.1.________________________________________________________________________________ ______________________ $_______________________ 16.2.________________________________________________________________________________ ______________________ $_______________________

17. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 5: Inventory, excluding agriculture assets

18. 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)

19. Raw materials ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________

20. Work in progress ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________

21. Finished goods, including goods held for resale ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________

22. Other inventory or supplies ________________________________________ ______________ MM / DD / YYYY $__________________ ______________________ $______________________

23. Total of Part 5 $______________________ Add lines 19 through 22. Copy the total to line 84.

24. Is any of the property listed in Part 5 perishable? No Yes

25. 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______________

26. 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)

27. 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)

28. Crops—either planted or harvested ______________________________________________________________ $________________ ____________________ $______________________

29. Farm animals Examples: Livestock, poultry, farm-raised fish ______________________________________________________________ $________________ ____________________ $______________________

30. Farm machinery and equipment (Other than titled motor vehicles) ______________________________________________________________ $________________ ____________________ $______________________

31. Farm and fishing supplies, chemicals, and feed ______________________________________________________________ $________________ ____________________ $______________________

32. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

33. Total of Part 6. $______________________ Add lines 28 through 32. Copy the total to line 85.

34. Is the debtor a member of an agricultural cooperative? No Yes. Is any of the debtor’s property stored at the cooperative? No Yes

35. 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 $________________

36. Is a depreciation schedule available for any of the property listed in Part 6? No Yes

37. 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

38. 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)

39. Office furniture ______________________________________________________________ $________________ ____________________ $______________________

40. Office fixtures

______________________________________________________________ $________________ ____________________ $______________________

41. Office equipment, including all computer equipment and communication systems equipment and software ______________________________________________________________ $________________ ____________________ $______________________

42. 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___________________________________________________________ $________________ ____________________ $______________________

43. Total of Part 7. $______________________ Add lines 39 through 42. Copy the total to line 86.

44. Is a depreciation schedule available for any of the property listed in Part 7? No Yes

45. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 8: Machinery, equipment, and vehicles

46. 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)

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

    47.1___________________________________________________________ $________________ ____________________ $______________________

    47.2___________________________________________________________ $________________ ____________________ $______________________

    47.3___________________________________________________________ $________________ ____________________ $______________________

    47.4___________________________________________________________ $________________ ____________________ $______________________

48. Watercraft, trailers, motors, and related accessories Examples: Boats, trailers, motors, floating homes, personal watercraft, and fishing vessels

    48.1__________________________________________________________ $________________ ____________________ $______________________

    48.2__________________________________________________________ $________________ ____________________ $______________________

49. Aircraft and accessories

49.1__________________________________________________________ $________________ ____________________ $______________________

49.2__________________________________________________________ $________________ ____________________ $______________________

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

    ______________________________________________________________ $________________ ____________________ $______________________

51. Total of Part 8. $______________________ Add lines 47 through 50. Copy the total to line 87.

52. Is a depreciation schedule available for any of the property listed in Part 8? No Yes

53. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 9: Real property

54. Does the debtor own or lease any real property? No. Go to Part 10. Yes. Fill in the information below.

55. 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________________________________________ _________________ $_______________ ____________________ $_____________________

56. 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.

57. Is a depreciation schedule available for any of the property listed in Part 9? No Yes

58. 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

59. 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 ______________________________________________________________ $_________________ ______________________ $____________________ 63. Customer lists, mailing lists, or other compilations ______________________________________________________________ $_________________ ______________________ $____________________ 64. Other intangibles, or intellectual property ______________________________________________________________ $________________ _____________________ $____________________ 65. Goodwill ______________________________________________________________ $________________ _____________________ $____________________

66. 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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C. §§ 101(41A) and 107)? No Yes
68. Is there an amortization or other similar schedule available for any of the property listed in Part 10? No Yes
69. 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

70. 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

71. Notes receivable Description (include name of obligor) _______________ – __________________________ = $_____________________ ______________________________________________________ Total face amount doubtful or uncollectible amount

72. Tax refunds and unused net operating losses (NOLs)

    Description (for example, federal, state, local) _________________________________________________________________________________ Tax year ___________ $_____________________

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    Tax year ___________ $_____________________ _________________________________________________________________________________
    Tax year ___________ $_____________________

73. Interests in insurance policies or annuities ______________________________________________________________ $_______________________

74. Causes of action against third parties (whether or not a lawsuit has been filed)

    ______________________________________________________________ $_______________________ Nature of claim ___________________________________ Amount requested $________________

75. 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 $________________

76. Trusts, equitable or future interests in property

    ______________________________________________________________ $_____________________

77. 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.

79. 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

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

80. Cash, cash equivalents, and financial assets. Copy line 5, Part 1. $_______________

81. Deposits and prepayments. Copy line 9, Part 2. $_______________

82. Accounts receivable. Copy line 12, Part 3. $_______________

83. Investments. Copy line 17, Part 4. $_______________

84. Inventory. Copy line 23, Part 5. $_______________

85. Farming and fishing-related assets. Copy line 33, Part 6. $_______________

86. Office furniture, fixtures, and equipment; and collectibles. $_______________ Copy line 43, Part 7.

87. Machinery, equipment, and vehicles. Copy line 51, Part 8. $_______________

88. Real property. Copy line 56, Part 9. . .................................................................................. $________________

89. Intangibles and intellectual property. Copy line 66, Part 10. $_______________

90. All other assets. Copy line 78, Part 11. + $_______________

91. Total. Add lines 80 through 90 for each column. ........................... 91a. $_______________ 91b. $________________ +

92. 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

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.

1. 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

secured claim, list the creditor separately for each claim. Amount of claim Value of collateral
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 ___

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
___________________________________________________
________________________________________________________
________________________________________________________ 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 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 ___________________________________________________

___________________________________________________
________________________________________________________
________________________________________________________ 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 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 _____

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

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. __ ___ ___ ___ ___

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

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

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507). No. Go to Part 2. Yes. Go to line 2.

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 ___

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) (_____)

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 ___

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

3. 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 ___

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

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.__ 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.__ 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.__ 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 ___

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Part 3: List Others to Be Notified About Unsecured Claims

4. 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 ___

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 ________________ ___ ___ ___ ___ _________________________________________________________________ _________________________________

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

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

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

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

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

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

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

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

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

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

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

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

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

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

5. 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 ___

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.

1. 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).

2. 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 ___

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 ____________________________________ _________________________________________________________

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._ 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._ 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._ 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._ 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._ 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 ___ of ___

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.

1. 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

2. 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 ___

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 ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

2.__ _____________________ ________________________________________________________ _____________________ D Street E/F ________________________________________________________ G ________________________________________________________ City State ZIP Code

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

Fill in this information to identify your case: Debtor 1 First Name Middle Name Last Name Debtor 2 (Spouse, if filing) First Name Middle Name Last Name United States Bankruptcy Court for the: District of Case number oe (If known) O) Check if this is an amended filing Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy 04/22 Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.

| Part 4: Give Details About Your Marital Status and Where You Lived Before

4. What is your current marital status? Q) Married Q) Not married
5. During the last 3 years, have you lived anywhere other than where you live now? QO No O) Yes. List all of the places you lived in the last 3 years. Do not include where you live now. Debtor 1: Dates Debtor1 Debtor 2: Dates Debtor 2 lived there lived there QO) same as Debtor 1 U1 same as Debtor 1 From From Number Street Number Street To To City State ZIP Code City State ZIP Code QO) same as Debtor 1 U1 same as Debtor 1 From From Number Street Number Street To To City State ZIP Code City State ZIP Code
6. Within the last 8 years, did you ever live with a spouse or legal equivalent in a community property state or territory? (Community property States and territories include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, and Wisconsin.) QO No Q) Yes. Make sure you fill out Schedule H: Your Codebtors (Official Form 106H).

| Part 2: Explain the Sources of Your Income

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 1

Debtor 1 First Name Middle Name Last Name Case number (if known), 4. Did you have any income from employment or from operating a business during this year or the two previous calendar years? Fill in the total amount of income you received from all jobs and all businesses, including part-time activities. If you are filing a joint case and you have income that you receive together, list it only once under Debtor 1. QO) No Q] Yes. Fill in the details. From January 1 of current year until the date you filed for bankruptcy: For last calendar year: (January 1 to December 31, YYYY For the calendar year before that: (January 1 to December 31, YYYY Debtor 1 Sources of income Check all that apply. Qa Wages, commissions, bonuses, tips Q Operating a business Q Wages, commissions, bonuses, tips Q Operating a business QO Wages, commissions, bonuses, tips ) Q Operating a business Gross income (before deductions and exclusions) 5. Did you receive any other income during this year or the two previous calendar years? Include income regardless of whether that income is taxable. Examples of other income are alimony; child support; Social Security, unemployment, and other public benefit payments; pensions; rental income; interest; dividends; money collected from lawsuits; royalties; and gambling and lottery winnings. If you are filing a joint case and you have income that you received together, list it only once under Debtor 1. Debtor 2 Sources of income Check all that apply. Q Wages, commissions, bonuses, tips Q Operating a business Q Wages, commissions, bonuses, tips Q Operating a business Q Wages, commissions, bonuses, tips Q Operating a business. List each source and the gross income from each source separately. Do not include income that you listed in line 4. QO) No Q) Yes. Fill in the details. From January 1 of current year until the date you filed for bankruptcy: For last calendar year: (January 1 to December 31, ) yyYY For the calendar year before that: (January 1 to December 31, YYYY Official Form 107 Debtor 1 Sources of income Describe below. Gross income from each source (before deductions and exclusions) Debtor 2 Sources of income Describe below. Statement of Financial Affairs for Individuals Filing for Bankruptcy Gross income (before deductions and exclusions) Gross income from each source (before deductions and exclusions) page 2

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

| Part 3: | List Certain Payments You Made Before You Filed for Bankruptcy

6. Are either Debtor 1’s or Debtor 2’s debts primarily consumer debts? QO) No. Neither Debtor 1 nor Debtor 2 has primarily consumer debts. Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by an individual primarily for a personal, family, or household purpose.” During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $7,575* or more? U1 No. Go to line 7. UO) Yes. List below each creditor to whom you paid a total of $7,575* or more in one or more payments and the total amount you paid that creditor. Do not include payments for domestic support obligations, such as

• Subject to adjustment on 4/01/25 and every 3 years after that for cases filed on or after the date of adjustment. child support and alimony. Also, do not include payments to an attorney for this bankruptcy case. Q) Yes. Debtor 4 or Debtor 2 or both have primarily consumer debts. During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $600 or more? U1 No. Go to line 7. Q) Yes. List below each creditor to whom you paid a total of $600 or more and the total amount you paid that creditor. Do not include payments for domestic support obligations, such as child support and alimony. Also, do not include payments to an attorney for this bankruptcy case. Official Form 107 Dates of Total amount paid Amount you still owe payment $ $. Creditor's Name Number Street City State ZIP Code $ $. Creditor's Name Number Street City State ZIP Code $ $. Creditor's Name Number — Street City State ZIP Code Statement of Financial Affairs for Individuals Filing for Bankruptcy Was this payment for... Q Mortgage QO) car Q) credit cara () Loan repayment Q Suppliers or vendors Q) other Q Mortgage OQ) car Q) credit cara Q) Loan repayment Q Suppliers or vendors Q) other Q Mortgage QO) car Q) credit cara Q) Loan repayment Q Suppliers or vendors Q) other page 3

Debtor 1 Case number (if known), First Name Middle Name Last Name 7. Within 1 year before you filed for bankruptcy, did you make a payment on a debt you owed anyone who was an insider? Insiders include your relatives; any general partners; relatives of any general partners; partnerships of which you are a general partner; corporations of which you are an officer, director, person in control, or owner of 20% or more of their voting securities; and any managing agent, including one for a business you operate as a sole proprietor. 11 U.S.C. § 101. Include payments for domestic support obligations, such as child support and alimony. QO) No Q) Yes. List all payments to an insider. Dates of Total amount Amount you still Reason for this payment payment paid owe $ $ Insider's Name Number — Street City State ZIP Code $, $ Insider's Name Number — Street City State ZIP Code 8. Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account of a debt that benefited an insider? Include payments on debts guaranteed or cosigned by an insider. QO No Q) Yes. List all payments that benefited an insider. Dates of Total amount Amount you still Reason for this payment payment paid owe Include creditor's name

• $ $, insider's Name Number — Street City State ZIP Code Insider's Name Number — Street City State ZIP Code Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 4

Debtor 1 Case number (if known), First Name Middle Name Last Name } Part 4:| Identify Legal Actions, Repossessions, and Foreclosures 9. Within 1 year before you filed for bankruptcy, were you a party in any lawsuit, court action, or administrative proceeding? List all such matters, including personal injury cases, small claims actions, divorces, collection suits, paternity actions, support or custody modifications, and contract disputes. QO No Q) Yes. Fill in the details. Nature of the case Court or agency Status of the case Case title Court Name 1) Pending Q On appeal Number — Street O) Concluded Case number City State ZIP Code Case title CoutName Cd Pending Ol on appeal Number Street Q) Concluded Case number City’ State ZIP Code 10. Within 1 year before you filed for bankruptcy, was any of your property repossessed, foreclosed, garnished, attached, seized, or levied? Check all that apply and fill in the details below. Q) No. Go to line 11. O) Yes. Fill in the information below. Describe the property Date Value of the property Creditor's Name Number — Street Explain what happened QO) Property was repossessed. Q Property was foreclosed. Q Property was garnished. City State ZIP Code Q Property was attached, seized, or levied. Describe the property Date Value of the property Creditor's Name Number Street Explain what happened Property was repossessed. Property was foreclosed. Pr wi rnished. City State ZIP Code operty was garnished OOOO Property was attached, seized, or levied. Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 5

Debtor 1 Case number (if known), First Name Middle Name Last Name 11. Within 90 days before you filed for bankruptcy, did any creditor, including a bank or financial institution, set off any amounts from your accounts or refuse to make a payment because you owed a debt? OU No QO) Yes. Fill in the details. Describe the action the creditor took Date action Amount was taken Creditor's Name $ Number Street City State ZIP Code Last 4 digits of account number: XXXX- 12. Within 1 year before you filed for bankruptcy, was any of your property in the possession of an assignee for the benefit of creditors, a court-appointed receiver, a custodian, or another official? QO No QO) Yes

| Part 5: | List Certain Gifts and Contributions

13.Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person? QO No Q) Yes. Fill in the details for each gift. Gifts with a total value of more than $600 Describe the gifts Dates you gave Value per person the gifts $. Person to Whom You Gave the Gift $ Number Street City State ZIP Code Person's relationship to you Gifts with a total value of more than $600 Describe the gifts Dates you gave Value per person the gifts $ Person to Whom You Gave the Gift $ Number Street City State ZIP Code Person's relationship to you Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 6

Debtor 1 Case number (if known), First Name Middle Name. Last Name 14.Within 2 years before you filed for bankruptcy, did you give any gifts or contributions with a total value of more than $600 to any charity? QO No Q) Yes. Fill in the details for each gift or contribution. Gifts or contributions to charities Describe what you contributed Date you Value that total more than $600 contributed $. Charity’s Name Number Street City State ZIP Code rare: | List Certain Losses 15. Within 1 year before you filed for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, fire, other disaster, or gambling? O) No Q) Yes. Fill in the details. Describe the property you lost and Describe any insurance coverage for the loss Date of your Value of property how the loss occurred . . loss lost Include the amount that insurance has paid. List pending insurance claims on line 33 of Schedule A/B: Property. $

| Part 7: | List Certain Payments or Transfers

16. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you consulted about seeking bankruptcy or preparing a bankruptcy petition? Include any attorneys, bankruptcy petition preparers, or credit counseling agencies for services required in your bankruptcy. QO No C) Yes. Fill in the details. Description and value of any property transferred Date payment or Amount of payment transfer was Person Who Was Paid made Number Street $ $. City State ZIP Code Email or website address Person Who Made the Payment, if Not You Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 7

Debtor 1 Case number (if known), First Name Middle Name Last Name Description and value of any property transferred Person Who Was Paid Number — Street City State ZIP Code Email or website address Person Who Made the Payment, if Not You Date payment or Amount of transfer was made payment 17. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone who promised to help you deal with your creditors or to make payments to your creditors? Do not include any payment or transfer that you listed on line 16. QO) No Q] Yes. Fill in the details. Description and value of any property transferred Person Who Was Paid Number Street City’ State ZIP Code Date payment or Amount of payment transfer was made 18. Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property transferred in the ordinary course of your business or financial affairs? m Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property). Do not include gifts and transfers that you have already listed on this statement. QO) No Q) Yes. Fill in the details. Description and value of property Describe any property or payments received Date transfer transferred or debts paid in exchange was made Person Who Received Transfer Number Street City State ZIP Code Person’s relationship to you Person Who Received Transfer Number Street City State ZIP Code Person's relationship to you Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 8

Debtor 1 Case number (if known), First Name Middle Name Last Name 19.Within 10 years before you filed for bankruptcy, did you transfer any property to a self-settled trust or similar device of which you are a beneficiary? (These are often called asset-protection devices.) QO) No Q) Yes. Fill in the details. Description and value of the property transferred Date transfer was made Name of trust List Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units 20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed, sold, moved, or transferred? Include checking, savings, money market, or other financial accounts; certificates of deposit; shares in banks, credit unions, brokerage houses, pension funds, cooperatives, associations, and other financial institutions. O) No Q Yes. Fill in the details. Last 4 digits of account number Type of account or Date account was Last balance before instrument closed, sold, moved, closing or transfer or transferred Name of Financial Institution XXXX=__ __ O checking _ $ Number Street Q) savings Q Money market Qa Brokerage City State ZIP Code O other XXXX=, Q Checking $ Name of Financial Institution Q Savings Number Street Q Money market Q Brokerage O otter. City State ZIP Code 21. Do you now have, or did you have within 1 year before you filed for bankruptcy, any safe deposit box or other depository for securities, cash, or other valuables? QO No O) Yes. Fill in the details. Who else had access to it? Describe the contents Do you still have it? O No Name of Financial Institution Name QO Yes Number Street Number Street City State ZIP Code City State ZIP Code Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 9

Debtor 1 Case number (if known), First Name Middle Name Last Name 22. Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy? O No Q Yes. Fill in the details. Who else has or had access to it? Describe the contents Do you still have it? ONo Name of Storage Facility Name O yes Number Street Number Street CityState ZIP Code City State ZIP Code Part Identify Property You Hold or Control for Someone Else 23. Do you hold or control any property that someone else owns? Include any property you borrowed from, are storing for, or hold in trust for someone. O No Q Yes. Fill in the details. Where is the property? Describe the property Value Owners Name $ Number Street Number Street City State ZIP Code City State ZIP Code Give Details About Environmental Information For the purpose of Part 10, the following definitions apply: = Environmental law means any federal, state, or local statute or regulation concerning pollution, contamination, releases of hazardous or toxic substances, wastes, or material into the air, land, soil, surface water, groundwater, or other medium, including statutes or regulations controlling the cleanup of these substances, wastes, or material. = Site means any location, facility, or property as defined under any environmental law, whether you now own, operate, or utilize it or used to own, operate, or utilize it, including disposal sites. = Hazardous material means anything an environmental law defines as a hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, contaminant, or similar term. Report all notices, releases, and proceedings that you know about, regardless of when they occurred. 24.Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental law? QO) No Q Yes. Fill in the details. Governmental unit Environmental law, if you know it Date of notice Name of site Governmental unit Number Street Number Street City State ZIP Code City State ZIP Code Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 10

Debtor 1 Case number (if known), First Name Middle Name Last Name 25. Have you notified any governmental unit of any release of hazardous material? QO No O Yes. Fill in the details. Governmental unit Environmental law, if you know it Date of notice Name of site Governmental unit Number Street Number Street City State ZIP Code City State ZIP Code 26. Have you been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders. QO No Q Yes. Fill in the details. Status of the Court or agency Nature of the case CD Case title, Court Name O Pending O on appeal Number Street UO) concluded Case number City State ZIP Code

| Part 11: | Give Details About Your Business or Connections to Any Business

27. Within 4 years before you filed for bankruptcy, did you own a business or have any of the following connections to any business? UO) Asole proprietor or self-employed in a trade, profession, or other activity, either full-time or part-time QO A member of a limited liability company (LLC) or limited liability partnership (LLP) QO) A partner in a partnership UO An officer, director, or managing executive of a corporation UO An owner of at least 5% of the voting or equity securities of a corporation U No. None of the above applies. Go to Part 12. Q) Yes. Check all that apply above and fill in the details below for each business. Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN. Business Name EIN; Number Street Name of accountant or bookkeeper Dates business existed From To City State ZIP Code Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN. Business Name EIN; = Number Street Name of accountant or bookkeeper Dates business existed From To City State ZIP Code Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 11

Debtor 1 Case number (if known), First Name Middle Name Last Name Employer Identification number Do not include Social Security number or ITIN. Describe the nature of the business Business Name EIN: 0 -_ Number Street Name of accountant or bookkeeper Dates business existed From ____s‘To City State ZIP Code 28. Within 2 years before you filed for bankruptcy, did you give a financial statement to anyone about your business? Include all financial institutions, creditors, or other parties. QO) No Q) Yes. Fill in the details below. Date issued Name MM/DD/YYYY Number Street City State ZIP Code

| rare 12 Sion Below

I have read the answers on this Statement of Financial Affairs and any attachments, and | declare under penalty of perjury that the answers are true and correct. | understand that making a false statement, concealing property, or obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571. x x Signature of Debtor 1 Signature of Debtor 2 Date Date Did you attach additional pages to Your Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107)? QO No QO Yes Did you pay or agree to pay someone who is not an attorney to help you fill out bankruptcy forms? OQ No QO) Yes. Name of person. . Attach the Bankruptcy Petition Preparer’s Notice, Declaration, and Signature (Official Form 119). Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 12

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Name of the person who supervised the taking of the inventory Date of The dollar amount and basis (cost, market, or
inventory other basis) of each inventory
______________________________________________________________________ _______ $___________________

Name and address of the person who has possession of inventory records

27.2. ______________________________________________________________________
Name
______________________________________________________________________
Street
______________________________________________________________________
______________________________________________________________________
City State ZIP Code

28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other people in control of the debtor at the time of the filing of this case.

    Name Address Position and nature of any % of interest, if any interest ____________________________ _____________________________________________ ____________________________ _______________ ____________________________ _____________________________________________ ____________________________ _______________ ____________________________ _____________________________________________ ____________________________ _______________ ____________________________ _____________________________________________ ____________________________ _______________ ____________________________ _____________________________________________ ____________________________ _______________

29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in control of the debtor, or shareholders in control of the debtor who no longer hold these positions? No Yes. Identify below.

    Name Address Position and nature of Period during which any interest position or interest was held ____________________________ _____________________________________________ ______________________ From _____ To _____ ____________________________ _____________________________________________ ______________________ From _____ To _____ ____________________________ _____________________________________________ ______________________ From _____ To _____ ____________________________ _____________________________________________ ______________________ From _____ To _____

30. Payments, distributions, or withdrawals credited or given to insiders Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses, loans, credits on loans, stock redemptions, and options exercised? No Yes. Identify below.

    Name and address of recipient Amount of money or Dates Reason for description and value of providing the value property

30.1. ______________________________________________________________ _________________________ _____________ ____________
Name
______________________________________________________________
Street _____________
______________________________________________________________
______________________________________________________________ _____________
City State ZIP Code
Relationship to debtor _____________
______________________________________________________________ _____________

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 13

Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Name and address of recipient
__________________________ _____________ ______________

30.2 ______________________________________________________________
Name _____________
______________________________________________________________
Street _____________
______________________________________________________________
______________________________________________________________ _____________ City State ZIP Code

Relationship to debtor _____________

______________________________________________________________

31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes? No Yes. Identify below.

    Name of the parent corporation Employer Identification number of the parent corporation ______________________________________________________________ EIN: ___ ___ – ___ ___ ___ ___ ___ ___ ___

32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund? No Yes. Identify below.

    Name of the pension fund Employer Identification number of the pension fund ______________________________________________________________ EIN: ___ ___ – ___ ___ ___ ___ ___ ___ ___

Part 14: Signature and Declaration

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud 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.

I have examined the information in this Statement of Financial Affairs and any attachments 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
___________________________________________________________ Printed name _________________________________________________
Signature of individual signing on behalf of the debtor

Position or relationship to debtor ____________________________________

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached? No Yes

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 14

CSD 2030 [12/01/15]Name, Address, Telephone No. & I.D. No.

UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA

325 West F Street, San Diego, California 92101-6991

In Re

BANKRUPTCY NO.

Debtor.

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

1. Pursuant to 11 U.S.C. § 329(a) and Federal Rule of Bankruptcy Procedure 2016(b), I certify that I am the attorney for the above-named debtor(s) and that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows:

For legal services, I have agreed to accept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Prior to the filing of this statement I have received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Balance Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

2. The source of the compensation paid to me was:

   Debtor Other (specify)

3. The source of compensation to be paid to me is:

   Debtor Other (specify)

4. I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm.

   I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm.

   A copy of the agreement, together with a list of the names of the people sharing in the compensation, is attached.

5. In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, including:

   a. Analysis of the debtor's financial situation, and rendering advice to the debtor in determining whether to file a petition in bankruptcy;

   b. Preparation and filing of any petition, schedules, statement of affairs and plan which may be required;

   c. Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;

CSD [Continued on Page 2] 2030

CSD (Page 2) [12/01/15] 2030

d. Representation of the debtor in adversary proceedings and other contested bankruptcy matters;

e. [Other provisions as needed]

6. By agreement with the debtor(s), the above-disclosed fee does not include the following services:

   CERTIFICATION

   I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for representation of the debtor(s) in this bankruptcy proceeding.

DATED:

(Typed Name and Signature)

(Name of Law Firm)

CSD 2030