chapter_7_bankruptcy_forms PDF form, Free download.

Content Preview



Form Name:   chapter_7_bankruptcy_forms
Tags:   chapter_7_bankruptcy_forms, UNITED STATES BANKRUPTCY
Posted By:  
Date:   8/6/2010
Size:   2MB
Type:   .PDF
     
DownloadImport into account

NOTICE: By downloading this form you agree to the TOS and Form Community Agreement.

UNITED STATES BANKRUPTCY COURTCentral District of CaliforniaCHAPTER 7PETITION FORMSApril 2010Chapter 7 Petition PackageIndexChapter 7 Petition Filing Information!Abbreviated Fee Schedule!Order of DocumentsChapter 7 Petition Forms!Chapter 7 Individual Debtor's Statement of Intention (Official Form B8)!Debtor’s Certification of Employment Income Pursuant to 11 U.S.C. § 521(a)(1)(B)(iv)!Declaration and Signature of Non-Attorney Bankruptcy Petition Preparer, if applicable (Official Form19 - Page 1)!Declaration Concerning Debtor's Schedules (Official Form B6 Declaration)!Declaration RE: Limited Scope of Appearance Pursuant to Local Bankruptcy Rule 2090-1 (LocalBankruptcy Rule Form F 2090-1.1)!Disclosure of Compensation of Attorney for Debtor (Official Form B203)!Disclosure of Compensation of Bankruptcy Petition Preparer!Exhibit "C" to Voluntary Petition (Official Form B1XC)!Exhibit D - Individual Debtor’s Statement of Compliance with Credit Counseling Requirement (Counseling usually MUST be obtained BEFORE filing, even if certificate is filed later)!Form 6. Schedules (Official Form B6)!Notice of Available Chapters!Notice to Debtor by Non-Attorney “Bankruptcy Petition Preparer”, if applicable (Official Form 19 - Page 2)!Schedule A - Real Property (Official Form B6A)!Schedule B - Personal Property (Official Form B6B)!Schedule C - Property Claimed as Exempt (Official Form B6C) !Schedule D - Creditors Holding Secured Claims (Official Form B6D)!Schedule E - Creditors Holding Unsecured Priority Claims (Official Form B6E)!Schedule F - Creditors Holding Unsecured Nonpriority Claims (Official Form B6F)!Schedule G - Executory Contracts and Unexpired Leases (Official Form B6G)!Schedule H - Codebtors (Official Form B6H)!Schedule I - Current Income of Individual Debtor(s) (Official Form B6I)!Schedule J - Current Expenditures of Individual Debtor(s) (Official Form B6J)!Statement of Current Monthly Income and Means Test Calculation (Official Form 22A)!Statement of Financial Affairs (Official Form 7)!Statement of Related Cases - Information required by Local Bankruptcy Rule 1015-2 (LocalBankruptcy Rule Form F 1015-2.1)!Statement of Social Security-Number(s) (or Other Individual Taxpayer-Identification Number (ITIN))(Official Form 21)!Statement Regarding Assistance of Non-Attorney with Respect to the Filing of Bankruptcy Case!Summary of Schedules and Statistical Summary of Certain Liabilities and Related Data (28 U.S.C.§ 159) (Official Form 6)!Verification of Creditor Mailing List!Voluntary Petition (Official Form B1)Chapter 7April 20101ABBREVIATED FEE SCHEDULE1EFFECTIVE 1/1/07The Bankruptcy Court will accept cash, U. S. Postal Service money orders, cashier’s checks issued by an acceptable financial institution,attorney or law firm checks (payable to the U. S. Bankruptcy Court) and American Express, Discover, MasterCard, and VISA for paymentof fees. Credit card transactions must be made in person by the cardholder; however, this does not apply to electronically fileddocuments. The Court does not accept personal checks or credit cards from debtors to pay fees. All attorney/law firm checks mustinclude a current pre-printed name, street address, telephone number, and California attorney bar number. Please do not send cashthrough the mail. The current fees for filing documents with the Bankruptcy Court are as follows:New Petition:Chapter 7$ 299.00Chapter 9$1,039.00Chapter 11 (not a Railroad)$1,039.00Chapter 11 (Railroad)$1,039.00Chapter 12 (Family Farmer)$ 239.00Chapter 13$ 274.00Chapter 15 (formerly Ancillary (Sec. 304))$1,039.00Case Reopening:2Chapter 7 $ 260.00Chapter 11$1,000.00Chapter 12$ 200.00Chapter 13$ 235.00Case Conversions:Chapter 7 to Chapter 13NoneChapter 7 to Chapter 11$ 755.00Chapter 11 to Chapter 7$ 15.00Chapter 13 to Chapter 11$ 765.00Chapter 13 to Chapter 7$ 25.00Amendments:Schedules "D" "E" "F"$ 26.00Master Mailing List (exceptions listed in “Miscellaneous Fee Schedule”)$ 26.00Motions:Motion to Compel Abandonment of Property$ 150.00Motion to Terminate, Annul, Modify, or Condition the Automatic Stay$ 150.00Motion to Withdraw Reference$ 150.00Other:Abstract of Judgment$ 9.00Appeal*$ 255.00Certification$ 9.00Complaint$ 250.00Cross-Appeal*$ 255.00Exemplification$ 18.00Filing or Indexing of Miscellaneous Paper$ 39.00Issuance of Out of District Subpoena$ 39.00Photocopies Made by Court Personnel (per page)$ 0.50Registration of Judgment from Another District$ 39.00Reproduction of Audio Recording (regardless of the medium)$ 26.00Retrieval of a Record from the NARA$ 45.00Returned Check Charge$ 45.00Search of Court Records (each name/item searched)$ 26.001.Issued in accordance with 28 U.S.C. § 1930(b) and F.R.B.P. 1006.2.The Court must collect this fee unless the reopening is to correct an administrative error or for actions related to thedebtor’s discharge.* If the Court of Appeals authorizes a direct appeal, or direct cross appeal, an additional fee of $200.00 will be collected by thebankruptcy clerk.Chapter 7April 20102Order of Documents - Chapter 7!An original and one copy is required at the time of filing.!Papers must be assembled into complete sets.!Pursuant to Local Bankruptcy Rule 1002-1(g)(2), even if certain of the schedules or statementsof Official Forms 6 (Schedules A through J) and 7 (Statement of Financial Affairs) are notapplicable to a debtor’s particular situation, they shall still be filed with either the notation "None"marked thereon or the applicable box checked indicating that there is nothing to report for thatparticular schedule or statement.!The first set must be the signed original.!Pursuant to Local Bankruptcy Rule 1002-1, papers presented to the Court for filing or lodgingmust be on white, letter size (8-1/2 x 11 inches), single-sided, medium weight paper.Petition documents shall be in the following order when filed:1.*Statement of Social Security-Number(s) (or Other Individual Taxpayer-IdentificationNumber (ITIN)) (required for individual debtors only, not corporations or partnerships)2.*Voluntary Petition (first three pages)3.Exhibit "C" to Voluntary Petition (if Exhibit "C" "yes" box is checked on page two of theVoluntary Petition)4.Exhibit D - Individual Debtor’s Statement of Compliance with Credit CounselingRequirement (Counseling usually MUST be obtained BEFORE filing, even if certificateis filed later) 5.Corporate Resolution Authorizing Filing of the Petition (if debtor is a corporation)6.Corporate ownership statement as specified in F.R.B.P. 1007(a)(1) [required forcorporations that are not a governmental unit]7.Statement of Related Cases [required by Local Bankruptcy Rule 1015-2(b)(2)]8.Notice of Available Chapters [required for individuals whose debts are primarily consumerdebts (11 U.S.C. § 342(b)]9.Summary of Schedules and Statistical Summary of Certain Liabilities and Related Data(28 U.S.C. § 159) (Official Form B6)10.Schedules A through J (for corporations, A, B, and D through H only)11.Declaration Concerning Debtor's Schedules*Required at the time of filingChapter 7April 2010312.Statement of Financial Affairs (Official Form 7)13.Chapter 7 Individual Debtor’s Statement of Intention (11 U.S.C. § 521) [must be filed within30 days from filing Petition (not required for corporations)]14.Statement Regarding Assistance of Non-Attorney with Respect to the Filing of BankruptcyCase (for persons not represented by counsel)15.Disclosure of Compensation of Bankruptcy Petition Preparer (for persons not representedby counsel and where a bankruptcy petition preparer prepared the paperwork)16.Declaration and Signature of Non-Attorney Bankruptcy Petition Preparer, if applicable(Official Form 19 - Page 1)17.Notice to Debtor by Non-Attorney “Bankruptcy Petition Preparer”, if applicable (OfficialForm 19 - Page 2)18.Disclosure of Compensation of Attorney for Debtor (for petitions of persons who arerepresented by legal counsel or where an attorney has prepared the paperwork)19.Declaration Re Limited Scope of Appearance Pursuant to Local Bankruptcy Rule 2090-1 (ifapplicable)20.Copies of all payment advices (pay stubs) or other evidence of payment received by thedebtor from any employer within 60 days before the filing of the petition. If the debtor(s)was self-employed or unemployed during the 60 days prior to the filing of the petition, thedebtor(s) should certify this fact and use the optional form Debtor’s Certification ofEmployment Income Pursuant to 11 U.S.C. § 521(a)(1)(B)(iv) to do so. This form can alsobe used to attach payment advices (pay stubs).21.Statement of Current Monthly Income and Means Test Calculation (Official Form B22A)22.Verification of Creditor Mailing List [Local Bankruptcy Rule 1007-2(d)]23.* Master Mailing List (in format required by Local Bankruptcy Rule 1007-2)To be filed along with the petition, but as separate documents:1.Certificate of Credit Counseling or a motion for determination by the court a)Debt Repayment Plan, if any (required if the debtor is an individual)2.Computer Readable Diskette (required for petition with over 100 creditors) [LocalBankruptcy Rule 1007-2(c)]*Required at the time of filingChapter 7April 20104Master Mailing List RequirementsPursuant to Local Bankruptcy Rule 1007-2, the mailing lists for new bankruptcy petitionsmust be submitted in the following format: 1.Typed on blank, unlined, standard white 8-1/2 x 11 inch bond paper usinguppercase and lowercase letter quality characters no smaller than 10 point norgreater than 14 point in either Arial, Courier, Times New Roman, or Helvetica.2.Typed in a single column with no letters closer than 1-1/2 inches from any edge ofthe paper and left justified.3.Typed with no more than 8 name/address blocks per page. Each block mustconsist of no more than 4 lines total for each name/address with at least 2 blanklines in between.4.Include a FIRST PAGE reserved only for: Debtor, Joint Debtor, Attorney forDebtor(s), Office of the United States Trustee. (See Exhibit 1.) All subsequentpages contain the remaining creditors from Schedules D, E, and F of the petition.5.Each line must be no more than 35 characters in length including spaces. Theattention line, if any, must be included on the second line of the block. DO NOTINCLUDE ACCOUNT NUMBERS. The city, state (2-letter abbreviation in capitalletters only, e.g., CA), and zip code must be on the last line. Nine-digit zip codesshould be separated by a hyphen. (See Exhibit 2.)6.Contains NO PUNCTUATION, except for one comma between city and state (forexample, Los Angeles, CA 90012).7.Provide page number on the back of each page.8.If a separate Equity Holders List is filed, it must comply with the above formatrequirements.9.For cases with more than 100 creditors, the printed Master Mailing List and, ifapplicable, the printed Equity Holders List must be submitted along with anon-returnable computer diskette of all entities. Technical requirements for thediskette are listed in Exhibit 3.Chapter 7April 20105Exhibit 1Debtor NameMailing AddressCity, State (2-letter abbreviation) Zip CodeSpouse of Debtor (if appropriate)Mailing AddressCity, CA Zip CodeAttorney of DebtorMailing AddressSuite NumberCity, State Zip CodeUnited States TrusteeAddressCity, State Zip CodeChapter 7April 20106Exhibit 2Acme Auto Repair1234 S StreetLos Angeles, CA 90005Acme Hair RepairAttn Herman1234 S AveLos Angeles, CA 90005-0001Acme Dental Clinic745 Tungsten BoulevardHollywood, CA 90027Internal Revenue ServiceAddressCity, State Zip CodeAcme Talent Agency421 N Copper Canyon WayBurbank, CA 91505-0002Loans By Acme7485 Chromium CircleBeverly Hills, CA 90210Acme And Sons InsuranceAttn D Acme13363 Hierro Street Suite 25Van Nuys, CA 91401Acme Bar and Grill114 Aluminum AlleyChatsworth, CA 91313Chapter 7April 20107Exhibit 3Technical Requirements for Diskette(100 or more creditors)Pursuant to Local Bankruptcy Rule 1007-2(c), for cases with more than 100 creditors thatare not electronically filed, the debtor or such person as the court may order, shall providethe clerk with the Master Mailing List in a court-approved electronic format (non-returnablecomputer diskette). The printed creditor matrix must be submitted along with thenon-returnable computer diskette containing the names and addresses of all entities shownin Schedules D, E, and F of the petition.!Computer-readable 3.5" virus-free diskette.!Label diskette with debtor’s name.!Text in ASCII-readable format. File name must be "Creditor.TXT".!No page breaks, miscellaneous characters, or other computer instructions are to beincluded in text.!Names and addresses of Debtor, Joint Debtor, Attorney for Debtor(s), and the Officeof the United States Trustee are specifically to be excluded from diskette contentsbut must still be submitted on the printed copy.Form B21 (Official Form 21) - (12/07)2007 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn re (set forth here all names including married, maiden, and tradenames used by the debtor within last 8 years):Debtor.FOR COURT USE ONLYAddress:Case No.:Chapter:Last four digits of Social Security Number(s):Complete Employer’s Tax Identification Number(s) (if any):STATEMENT OF SOCIAL-SECURITYNUMBER(S) (OR OTHER INDIVIDUALTAXPAYER-IDENTIFICATION NUMBER (ITIN))1.Name of Debtor (enter Last, First, Middle): (Check the appropriate box and, if applicable, provide the required information.)GDebtor has a Social Security Number and it is: - - (If more than one, state all.)GDebtor does not have a Social-Security Number but has an Individual Taxpayer-Identification Number (ITIN), and it is: .(If more than one, state all.)GDebtor does not have either a Social-Security Number or an Individual Taxpayer-Identification Number (ITIN).2.Name of Joint Debtor (enter Last, First, Middle): (Check the appropriate box and, if applicable, provide the required information.)GJoint Debtor has a Social Security Number and it is: - - (If more than one, state all.)GJoint Debtor does not have a Social-Security Number but has an Individual Taxpayer-Identification Number (ITIN) and itis: . (If more than one, state all.)GJoint Debtor does not have either a Social-Security Number or an Individual Taxpayer-Identification Number (ITIN).I declare under penalty of perjury that the foregoing is true and correct. Signature of DebtorDate Signature of Joint DebtorDate*Joint debtors must provide information for both spouses.Penalty for making a false statement: Fine of up to $250,000 or up to 5 years imprisonment or both. 18 U.S.C. §§ 152 and 3571.Form B1 (Official Form 1) - (Rev. 04/10)2010 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAVoluntary PetitionName of Debtor (if individual, enter Last, First, Middle):Name of Joint Debtor (Spouse) (Last, First, Middle):All Other Names used by the Debtor in the last 8 years(include married, maiden, ano trade names):All Other Names used by the Joint Debtor in the last 8 years(include married, maiden, and trade names):Last four digits of Soc. Sec. or Individual-Taxpayer I.D. (ITIN) No./Complete EIN(if more than one, state all):Last four digits of Soc. Sec. or Individual-Taxpayer I.D. (ITIN) No./Complete EIN(if more than one, state all):Street Address of Debtor (No. & Street, City, and State):Street Address of Joint Debtor (No. & Street, City, and State):ZIP CODEZIP CODECounty of Residence or of the Principal Place of Business:County of Residence or of the Principal Place of Business:Mailing Address of Debtor (if different from street address):Mailing Address of Joint Debtor (if different from street address):ZIP CODEZIP CODELocation of Principal Assets of Business Debtor (if different from street address above):ZIP CODEType of Debtor (Form of Organization)(Check one box.)‰Individual (includes Joint Debtors)See Exhibit D on page 2 of this form‰Corporation (includes LLC and LLP)‰Partnership‰Other (if debtor is not one of the aboveentities, check this box and state typeof entity below) Nature of Business(Check one box.)‰Health Care Business‰Single Asset Real Estate as defined in 11U.S.C. § 101 (51B)‰Railroad‰Stockbroker‰Commodity Broker‰Clearing Bank‰Other Tax-Exempt Entity(Check one box, if applicable)‰Debtor is a tax-exempt organization underTitle 26 of the United States Code (theInternal Revenue Code.)Chapter of Bankruptcy Code Under Which the Petition is Filed (Check one box) ‰ Chapter 7‰Chapter 11 ‰Chapter 15 Petition for Recognition‰ Chapter 9‰Chapter 12of a Foreign Main Proceeding ‰ Chapter 13 ‰Chapter 15 Petition for Recognitionof a Foreign Nonmain ProceedingNature of Debts(Check one box.)‰Debts are primarily consumer debts, defined in11 U.S.C. § 101(8) as “incurred by an individualprimarily for a personal, family, or house-holdpurpose.”‰Debts are primarily business debts.Filing Fee (Check one box)‰Full Filing Fee attached‰Filing Fee to be paid in installments (Applicable to individuals only). Must attach signedapplication for the court’s consideration certifying that the debtor is unable to pay fee exceptin installments. Rule 1006(b). See Official Form 3A.‰Filing Fee waiver requested (Applicable to chapter 7 individuals only). Must attachsigned application for the court’s consideration. See Official Form 3B.Chapter 11 Debtors: Check one box:‰Debtor is a small business debtor as defined in 11 U.S.C. § 101(51D).‰Debtor is not a small business debtor as defined in 11 U.S.C. § 101 (51D).Check if:‰Debtor’s aggregate noncontingent liquidated debts (excluding debts owed to insiders oraffiliates) are less than $2,343,300. (amount subject to adjustment on 04/01/13 and every threeyears thereafter).Check all applicable boxes:‰A plan is being filed with this petition‰Acceptances of the plan were solicited prepetition from one or more classes of creditors, inaccordance with 11 U.S.C. § 1126(b)Statistical/Administrative Information‰Debtor estimates that funds will be available for distribution to unsecured creditors.‰Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for distributionto unsecured creditors.THIS SPACE FORCOURT USE ONLYEstimated Number of Creditors 1-50-100-200-1,000-5,001-10,00125,001-50,001-OVER49991999995,000 10,00025,00050,000100,000100,000‰‰ ‰ ‰ ‰ ‰ ‰ ‰‰ ‰Estimated Assets$0 to $50,001 to $100,001 to$500,001 to $1,000,001 to $10,000,001 to$50,000,001 to$100,000,001 $500,000,001 More$50,000$100,000$500,000$1 million$10 million $50 million$100 million to $500 million to $1 billion$1 billion ‰‰‰‰ ‰‰‰ ‰‰ ‰Estimated Liabilities$0 to$50,001 to $100,001 to $500,001 to $1,000,001 to $10,000,001$50,000,001 to $100,000,001$500,000,001 More than $50,000$100,000$500,000$1 million$10 millionto $50 million$100 millionto $500 millionto $1 billion$1 billion‰‰‰‰ ‰‰‰ ‰ ‰‰Form B1 (Official Form 1) (Rev.04/10)2010 USBC, Central District of CaliforniaVoluntary Petition(This page must be completed and filed in every case.)Name of Debtor(s):FORM B1, Page 2Prior Bankruptcy Case Filed Within Last 8 Years (If more than two, attach additional sheet)LocationWhere Filed:Case Number:Date Filed:LocationWhere Filed:Case Number:Date Filed:Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor (If more than one, attach additional sheet)Name of Debtor:Case Number:Date Filed:District:Relationship: Judge:Exhibit A(To be completed if debtor is required to file periodic reports (e.g., forms 10Kand 10Q) with the Securities and Exchange Commission pursuant to Section13 or 15(d) of the Securities Exchange Act of 1934 and is requesting reliefunder chapter 11.)‰Exhibit A is attached and made a part of this petition.Exhibit B(To be completed if debtor is an individual whose debts are primarily consumer debts.)I, the attorney for the petitioner named in the foregoing petition, declare that I haveinformed the petitioner that [he or she] may proceed under chapter 7, 11, 12, or 13 of title11, 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).X Signature of Attorney for Debtor(s)DateExhibit CDoes the debtor own or have possession of any property that poses or isalleged to pose a threat of imminent and identifiable harm to public health orsafety?‰Yes, and Exhibit C is attached and made a part of this petition.‰NoExhibit D(To be completed by every individual debtor. If a joint petition is filed, each spouse mustcomplete and attach a separate Exhibit D.)‰Exhibit D completed and signed by the debtor is attached and made a part of thispetition.If this is a joint petition:‰Exhibit D also completed and signed by the joint debtor is attached and made a part ofthis petition.Information Regarding the Debtor - Venue (Check any applicable box)‰Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this District for 180 days immediately preceding the dateof this petition or for a longer part of such 180 days than in any other District.‰There is a bankruptcy case concerning debtor’s affiliate, general partner, or partnership pending in this District.‰Debtor is a debtor in a foreign proceeding and has its principal place of business or principal assets in the United States in this District, or has no principalplace of business or assets in the United States but is a defendant in an action or proceeding [in a federal or state court] in this District, or the interests of theparties will be served in regard to the relief sought in this District.Certification by a Debtor Who Resides as a Tenant of Residential PropertyCheck all applicable boxes.‰Landlord has a judgment against the debtor for possession of debtor’s residence. (If box checked, complete the following.) (Name of landlord that obtained judgment) (Address of landlord)‰Debtor claims that under applicable nonbankruptcy law, there are circumstances under which the debtor would be permitted to cure the entire monetarydefault that gave rise to the judgment for possession, after the judgment for possession was entered, and‰Debtor has included in this petition the deposit with the court of any rent that would become due during the 30-day period after the filingof the petition.‰Debtor certifies that he/she has served the Landlord with this certification (11 U.S.C. § 362(1)).Form B1 (Official Form 1) (Rev. 04/10)2008 USBC, Central District of CaliforniaVoluntary Petition(This page must be completed and filed in every case)Name of Debtor(s):FORM B1, Page 3SignaturesSignature(s) of Debtor(s) (Individual/Joint)I declare under penalty of perjury that the information provided in this petition is true and correct.[If petitioner is an individual whose debts are primarily consumer debts and has chosen to fileunder chapter 7] I am aware that I may proceed under chapter 7, 11, 12 or 13 of title 11, UnitedStates Code, understand the relief available under each such chapter, and choose to proceedunder chapter 7. [If no attorney represents me and no bankruptcy petition preparer signs thepetition] I have obtained and read the notice required by 11 U.S.C. § 342(b).I request relief in accordance with the chapter of title 11, United States Code, specified in thispetition.X________________________________________________________Signature of DebtorX________________________________________________________Signature of Joint Debtor________________________________________________________Telephone Number (If not represented by attorney) DateSignature of AttorneyX______________________________________________________Signature of Attorney for Debtor(s)______________________________________________________Printed Name of Attorney for Debtor(s)______________________________________________________Firm Name______________________________________________________Address____________________________________________________________________________________________________________Telephone Number DateBar Number*In a case in which § 707(b)(4)(D) applies, this signature also constitutes a certification that theattorney has no knowledge after an inquiry that the information in the schedules is incorrectSignature of Debtor (Corporation/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 of title 11, United States Code,specified in this petition.X________________________________________________________Signature of Authorized Individual________________________________________________________Printed Name of Authorized Individual________________________________________________________Title of Authorized Individual DateSignature of a Foreign RepresentativeI declare under penalty of perjury that the information provided in this petition is true and correct,that I am the foreign representative of a debtor in a foreign main proceeding, and that I amauthorized to file this petition. (Check only one box.)‰I request relief in accordance with chapter 15 of title 11, United States Code. Certified copiesof the documents required by 11 U.S.C. § 1515 are attached.‰Pursuant to 11 U.S.C. § 1511, I request relief in accordance with the chapter of title 11specified in this petition. A certified copy of the order granting recognition of the foreign mainproceeding is attached.X (Signature of Foreign Representative) (Printed Name of Foreign Representative) DateSignature of Non-Attorney Bankruptcy Petition Preparer I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor witha copy of this document and the notices and information required under 11 U.S.C. §§ 110(b),110(h), and 342(b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C.§ 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I havegiven the debtor notice of the maximum amount before preparing any document for filing for adebtor or accepting any fee from the debtor, as required in that section. Official Form 19 isattached.____________________________________________________________Printed Name and title, if any, of Bankruptcy Petition Preparer____________________________________________________________Social Security number (If the bankruptcy petition preparer is not an individual, state the SocialSecurity number of the officer, principal, responsible person or partner of the bankruptcy petitionpreparer.) (Required by 11 U.S.C. § 110.) Address X DateSignature of bankruptcy petition preparer or officer, principal, responsible person, or partner whoseSocial Security number is provided above.Names and Social Security numbers of all other individuals who prepared or assisted in preparingthis document unless the bankruptcy petition preparer is not an individual.If more than one person prepared this document, attach additional sheets conforming to theappropriate official form for each person.A bankruptcy petition preparer’s failure to comply with the provisions of title 11 and the FederalRules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18U.S.C. § 156.Form B1, Exhibit C - (9/01)2001 USBC, Central District of CaliforniaExhibit “C”[If, to the best of the debtor’s knowledge, the debtor owns or has possession of property that poses or is alleged to pose a threatof imminent and identifiable harm to the public health or safety, attach this Exhibit “C” to the petition.][Caption as in Form 16B]Exhibit “C” to Voluntary Petition1.Identify and briefly describe all real or personal property owned by or in possession of the debtor that, to the best of thedebtor’s knowledge, poses or is alleged to pose a threat of imminent and identifiable harm to the public health or safety(attach additional sheets if necessary):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2.With respect to each parcel of real property or item of personal property identified in question 1, describe the nature andlocation of the dangerous condition, whether environmental or otherwise, that poses or is alleged to pose a threat ofimminent and identifiable harm to the public health or safety (attach additional sheets if necessary):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Official Form 1- Exhibit D (Rev 12/09) Page 12009 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn re:Debtor(s).CHAPTER:CASE NO.:EXHIBIT D - INDIVIDUAL DEBTOR’S STATEMENT OF COMPLIANCE WITHCREDIT COUNSELING REQUIREMENTWarning: You must be able to check truthfully one of the five statements regarding creditcounseling listed below. If you cannot do so, you are not eligible to file a bankruptcy case, and the courtcan dismiss any case you do file. If that happens, you will lose whatever filing fee you paid, and yourcreditors will be able to resume collection activities against you. If your case is dismissed and you fileanother bankruptcy case later, you may be required to pay a second filing fee and you may have to takeextra steps to stop creditors’ collection activities.Every individual debtor must file this Exhibit D. If a joint petition is filed, each spouse must complete andfile a separate Exhibit D. Check one of the five statements below and attach any documents as directed.1. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a creditcounseling agency approved by the United States trustee or bankruptcy administrator that outlined theopportunities for available credit counseling and assisted me in performing a related budget analysis, and I havea certificate from the agency describing the services provided to me. Attach a copy of the certificate and a copyof any debt repayment plan developed through the agency. 2. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a creditcounseling agency approved by the United States trustee or bankruptcy administrator that outlined theopportunities for available credit counseling and assisted me in performing a related budget analysis, but I do nothave a certificate from the agency describing the services provided to me. You must file a copy of a certificatefrom the agency describing the services provided to you and a copy of any debt repayment plan developed throughthe agency no later than 14 days after your bankruptcy case is filed.3. I certify that I requested credit counseling services from an approved agency but was unable toobtain the services during the seven days from the time I made my request, and the following exigentcircumstances merit a temporary waiver of the credit counseling requirement so I can file my bankruptcy case now.[Summarize exigent circumstances here.] If your certification is satisfactory to the court, you must still obtain the credit counseling briefingwithin the first 30 days after you file your bankruptcy petition and promptly file a certificate from theagency that provided the counseling, together with a copy of any debt management plan developedthrough the agency. Failure to fulfill these requirements may result in dismissal of your case. Anyextension of the 30-day deadline can be granted only for cause and is limited to a maximum of 15 days.Your case may also be dismissed if the court is not satisfied with your reasons for filing your bankruptcycase without first receiving a credit counseling briefing.Official Form 1- Exhibit D (Rev 12/09) Page 22009 USBC, Central District of California4. I am not required to receive a credit counseling briefing because of: [Check the applicablestatement.] [Must be accompanied by a motion for determination by the court.] Incapacity. (Defined in 11 U.S.C. § 109(h)(4) as impaired by reason of mental illness or mentaldeficiency so as to be incapable of realizing and making rational decisions with respect to financialresponsibilities.); Disability. (Defined in 11 U.S.C. § 109(h)(4) as physically impaired to the extent of being unable,after reasonable effort, to participate in a credit counseling briefing in person, by telephone, orthrough the Internet.); Active military duty in a military combat zone.5. The United States trustee or bankruptcy administrator has determined that the credit counselingrequirement of 11 U.S.C. § 109(h) does not apply in this district.I certify under penalty of perjury that the information provided above is true and correct.Signature of Debtor: ________________________________Date: This form is mandatory by Order of the United States Bankruptcy Court for the Central District of California.January 2009F 1015-2.1STATEMENT OF RELATED CASESINFORMATION REQUIRED BY LOCAL BANKRUPTCY RULE 1015-2UNITED STATES BANKRUPTCY COURT, CENTRAL DISTRICT OF CALIFORNIA1.A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by or againstthe debtor, his/her spouse, his or her current or former domestic partner, an affiliate of the debtor, any copartnership orjoint venture of which debtor is or formerly was a general or limited partner, or member, or any corporation of which thedebtor is a director, officer, or person in control, as follows: (Set forth the complete number and title of each such of priorproceeding, date filed, nature thereof, the Bankruptcy Judge and court to whom assigned, whether still pending and, if not,the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A that was filed with any suchprior proceeding(s).) 2.(If petitioner is a partnership or joint venture) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Actof 1978 has previously been filed by or against the debtor or an affiliate of the debtor, or a general partner in the debtor,a relative of the general partner, general partner of, or person in control of the debtor, partnership in which the debtor isa general partner, general partner of the debtor, or person in control of the debtor as follows: (Set forth the completenumber and title of each such prior proceeding, date filed, nature of the proceeding, the Bankruptcy Judge and court towhom assigned, whether still pending and, if not, the disposition thereof. If none, so indicate. Also, list any real propertyincluded in Schedule A that was filed with any such prior proceeding(s).) 3.(If petitioner is a corporation) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 haspreviously been filed by or against the debtor, or any of its affiliates or subsidiaries, a director of the debtor, an officer ofthe debtor, a person in control of the debtor, a partnership in which the debtor is general partner, a general partner of thedebtor, a relative of the general partner, director, officer, or person in control of the debtor, or any persons, firms orcorporations owning 20% or more of its voting stock as follows: (Set forth the complete number and title of each such priorproceeding, date filed, nature of proceeding, the Bankruptcy Judge and court to whom assigned, whether still pending, andif not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A that was filed withany such prior proceeding(s).) 4.(If petitioner is an individual) A petition under the Bankruptcy Reform Act of 1978, including amendments thereof, has beenfiled by or against the debtor within the last 180 days: (Set forth the complete number and title of each such priorproceeding, date filed, nature of proceeding, the Bankruptcy Judge and court to whom assigned, whether still pending, andif not, the disposition thereof. If none, so indicate. Also, list any real property included in Schedule A that was filed withany such prior proceeding(s).) I declare, under penalty of perjury, that the foregoing is true and correct.Executed at , California. DebtorDated Joint DebtorStatement of Related Cases Information Required byF 1015-2.1Local Bankruptcy Rule 1015-2 - Page 2 of 3In reDebtor.CASE NUMBER:This form is mandatory by Order of the United States Bankruptcy Court for the Central District of California.January 2009F 1015-2.1NOTE: When using this form to indicate service of a proposed order, DO NOT list any person or entity in Category I. Proposed orders do not generate an NEF because only orders that have been entered are placed on a CM/ECF docket.PROOF OF SERVICE OF DOCUMENTI am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is:A true and correct copy of the foregoing document described as will be served or was served (a) on the judgein chambers in the form and manner required by LBR 5005-2(d), and (b) in the manner indicated below:I. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (“NEF”) - Pursuant to controlling GeneralOrder(s) and Local Bankruptcy Rule(s) (“LBR”), the foregoing document will be served by the court via NEF and hyperlink tothe document. On ________________________ I checked the CM/ECF docket for this bankruptcy case or adversaryproceeding and determined that the following person(s) are on the Electronic Mail Notice List to receive NEF transmission atthe email addressed indicated below: Service information continued on attached pageII. SERVED BY U.S. MAIL OR OVERNIGHT MAIL (indicate method for each person or entity served):On _________________________ I served the following person(s) and/or entity(ies) at the last known address(es) in thisbankruptcy case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United StatesMail, first class, postage prepaid, and/or with an overnight mail service addressed as follow. Listing the judge here constitutesa declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached pageIII. SERVED BY PERSONAL DELIVERY, FACSIMILE TRANSMISSION OR EMAIL (indicate method for each person or entityserved): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on _______________________ I served the following person(s)and/or entity(ies) by personal delivery, or (for those who consented in writing to such service method) by facsimile transmissionand/or email as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no laterthan 24 hours after the document is filed. Service information continued on attached pageI declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct._________________________________________________________ _____________________________________ Date Type Name SignatureStatement of Related Cases Information Required byF 1015-2.1Local Bankruptcy Rule 1015-2 - Page 3 of 3In reDebtor.CASE NUMBER:This form is mandatory by Order of the United States Bankruptcy Court for the Central District of California.January 2009F 1015-2.1ADDITIONAL SERVICE INFORMATION (if needed):B 201 - Notice of Available Chapters (Rev. 12/08)USBC, Central District of CaliforniaName: Address: Telephone: Fax: GAttorney for DebtorGDebtor in Pro PerUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAList all names including trade names, used byDebtor(s) within last 8 years:Case No.:NOTICE OF AVAILABLECHAPTERS(Notice to Individual Consumer Debtor Under § 342(b) of the Bankruptcy Code)In accordance with § 342(b) of the Bankruptcy Code, this notice to individuals with primarily consumer debts: (1) Describesbriefly the services available from credit counseling services; (2) Describes briefly the purposes, benefits and costs of the fourtypes of bankruptcy proceedings you may commence; and (3) Informs you about bankruptcy crimes and notifies you that theAttorney General may examine all information you supply in connection with a bankruptcy case. You are cautioned that bankruptcy law is complicated and not easily described. Thus, you may wish to seek the advice of anattorney to learn of your rights and responsibilities should you decide to file a petition. Court employees cannot give you legaladvice. Notices from the bankruptcy court are sent to the mailing address you list on your bankruptcy petition. In order to ensure thatyou receive information about events concerning your case, Bankruptcy Rule 4002 requires that you notify the court of anychanges in your address. If you are filing a joint case (a single bankruptcy case for two individuals married to each other),and each spouse lists the same mailing address on the bankruptcy petition, you and your spouse will generally receive a singlecopy of each notice mailed from the bankruptcy court in a jointly-addressed envelope, unless you file a statement with the courtrequesting that each spouse receive a separate copy of all notices. 1.Services Available from Credit Counseling AgenciesWith limited exceptions, § 109(h) of the Bankruptcy Code requires that all individual debtors who file forbankruptcy relief on or after October 17, 2005, receive a briefing that outlines the available opportunities forcredit counseling and provides assistance in performing a budget analysis. The briefing must be given within 180days before the bankruptcy filing. The briefing may be provided individually or in a group (including briefings conductedby telephone or on the Internet) and must be provided by a nonprofit budget and credit counseling agency approved bythe United States trustee or bankruptcy administrator. The clerk of the bankruptcy court has a list that you may consultof the approved budget and credit counseling agencies. Each debtor in a joint case must complete the briefing.In addition, after filing a bankruptcy case, an individual debtor generally must complete a financial managementinstructional course before he or she can receive a discharge. The clerk also has a list of approved financialmanagement instructional courses. Each debtor in a joint case must complete the course.B 201 - Notice of Available Chapters (Rev. 12/08)USBC, Central District of California2.The Four Chapters of the Bankruptcy Code Available to Individual Consumer DebtorsChapter 7: Liquidation ($245 filing fee, $39 administrative fee, $15 trustee surcharge: Total fee $299)1.Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. Debtorswhose debts are primarily consumer debts are subject to a “means test” designed to determine whether the caseshould be permitted to proceed under chapter 7. If your income is greater than the median income for your state ofresidence and family size, in some cases, creditors have the right to file a motion requesting that the court dismissyour case under § 707(b) of the Code. It is up to the court to decide whether the case should be dismissed.2.Under chapter 7, you may claim certain of your property as exempt under governing law. A trustee may have theright to take possession of and sell the remaining property that is not exempt and use the sale proceeds to pay yourcreditors.3The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found tohave committed certain kinds of improper conduct described in the Bankruptcy Code, the court may deny yourdischarge and, if it does, the purpose for which you filed the bankruptcy petition will be defeated.4.Even if you receive a general discharge, some particular debts are not discharged under the law. Therefore, you maystill be responsible for most taxes and student loans; debts incurred to pay nondischargeable taxes; domestic supportand property settlement obligations; most fines, penalties, forfeitures, and criminal restitution obligations; certaindebts which are not properly listed in your bankruptcy papers; and debts for death or personal injury caused byoperating a motor vehicle, vessel, or aircraft while intoxicated from alcohol or drugs. Also, if a creditor can prove thata debt arose from fraud, breach of fiduciary duty, or theft, or from a willful and malicious injury, the bankruptcy courtmay determine that the debt is not discharged. Chapter 13: Repayment of All or Part of the Debts of an Individual with Regular Income ($235 filing fee, $39administrative fee: Total fee $274)1.Chapter 13 is designed for individuals with regular income who would like to pay all or part of their debts ininstallments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollaramounts set forth in the Bankruptcy Code.2.Under chapter 13, you must file with the court a plan to repay your creditors all or part of the money that you owethem, using your future earnings. The period allowed by the court to repay your debts may be three years or fiveyears, depending upon your income and other factors. The court must approve your plan before it can take effect.3.After completing the payments under your plan, your debts are generally discharged except for domestic supportobligations; most student loans; certain taxes; most criminal fines and restitution obligations; certain debts which arenot properly listed in your bankruptcy papers; certain debts for acts that caused death or personal injury; and certainlong term secured obligations.Chapter 11: Reorganization ($1000 filing fee, $39 administrative fee: Total fee $1039)Chapter 11 is designed for the reorganization of a business but is also available to consumer debtors. Its provisions arequite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney.Chapter 12: Family Farmer or Fisherman ($200 filing fee, $39 administrative fee: Total fee $239)Chapter 12 is designed to permit family farmers and fishermen to repay their debts over a period of time from futureearnings and is similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose incomearises primarily from a family-owned farm or commercial fishing operation.3.Bankruptcy Crimes and Availability of Bankruptcy Papers to Law Enforcement OfficialsA person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of perjury,either orally or in writing, in connection with a bankruptcy case is subject to a fine, imprisonment, or both. All informationsupplied by a debtor in connection with a bankruptcy case is subject to examination by the Attorney General acting throughthe Office of the United States Trustee, the Office of the United States Attorney, and other components and employeesof the Department of Justice.WARNING: Section 521(a)(1) of the Bankruptcy Code requires that you promptly file detailed information regarding yourcreditors, assets, liabilities, income, expenses and general financial condition. Your bankruptcy case may be dismissed if thisinformation is not filed with the court within the time deadlines set by the Bankruptcy Code, the Bankruptcy Rules, and the localrules of the court.B 201 - Notice of Available Chapters (Rev. 12/08)USBC, Central District of CaliforniaCertificate of [Non-Attorney] Bankruptcy Petition PreparerI, the [non-attorney] bankruptcy petition preparer signing the debtor’s petition, hereby certify that I delivered to the debtorthis notice required by § 342(b) of the Bankruptcy Code. Printed name and title, if any, of Bankruptcy Petition PreparerSocial Security number (If the bankruptcy petitionAddress: preparer is not an individual, state theSocial Security number of the officer, principal, responsible person, or partner of the bankruptcypetition preparer.) (Required by 11 U.S.C. § 110.)X Signature of Bankruptcy Petition Preparer or officer,principal, responsible person, or partner whose SocialSecurity number is provided above.Certificate of the DebtorI (We), the debtor(s), affirm that I (we) have received and read this notice. Printed Name(s) of Debtor(s)Signature of DebtorDateCase No. (if known) X Signature of Joint Debtor (if any)DateForm B6 - Summary (12/07)2007 USBC, Central District of CaliforniaFORM 6. SCHEDULESSummary of SchedulesSummary of SchedulesStatistical Summary of Certain Liabilities and Related Data (28 U.S.C. § 159)Schedule A- Real PropertySchedule B- Personal PropertySchedule C- Property Claimed as ExemptSchedule D-Creditors Holding Secured ClaimsSchedule E-Creditors Holding Unsecured Priority ClaimsSchedule F-Creditors Holding Unsecured Nonpriority ClaimsSchedule G-Executory Contracts and Unexpired LeasesSchedule H-CodebtorsSchedule I-Current Income of Individual Debtor(s)Schedule J -Current Expenditures of Individual Debtor(s)Unsworn Declaration under Penalty of PerjuryGENERAL INSTRUCTIONS: The first page of the debtor’s schedules and the first page of any amendmentsthereto must contain a caption as in Form 16B. Subsequent pages should be identified with the debtor’s nameand case number. If the schedules are filed with the petition, the case number should be left blank.Schedules D, E, and F have been designed for the listing of each claim only once. Even when a claim issecured only in part or entitled to priority only in part, it still should be listed only once. A claim which is securedin whole or in part should be listed on Schedule D only, and a claim which is entitled to priority in whole or inpart should be listed on Schedule E only. Do not list the same claim twice. If a creditor has more than oneclaim, such as claims arising from separate transactions, each claim should be scheduled separately.Review the specific instructions for each schedule before completing the schedule.Form B6 - Summary (12/07)2007 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCentral District of CaliforniaIn reCase No.:Debtor.(If known)SUMMARY OF SCHEDULESIndicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from SchedulesA, B, D, E, F, I, and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor’s assets.Add the amounts of all claims from Schedules D, E, and F to determine the total amount of the debtor’s liabilities. Individual debtors alsomust complete the “Statistical Summary of Certain Liabilities and Related Data” if they file a case under chapter 7, 11, or 13.NAME OF SCHEDULEATTACHED(YES/NO)NO. OFSHEETSASSETSLIABILITIESOTHERA -Real Property$B-Personal Property$C-Property Claimed as ExemptD-Creditors Holding Secured Claims$E-Creditors Holding Unsecured PriorityClaims(Total of Claims on Schedule E)$F-Creditors Holding Unsecured NonpriorityClaims$G-Executory Contracts and UnexpiredLeasesH-CodebtorsI-Current Income of Individual Debtor(s)$J-Current Expenditures of IndividualDebtors(s)$TOTAL$$Official Form B6 - Statistical Summary (12/07) 2007 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn reDebtor(s).CHAPTER:CASE NO.:STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C. §101(8)), filing a case under chapter 7, 11 or 13, you must report all information requested below.QCheck this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to report anyinformation here.This information is for statistical purposes only under 28 U.S.C. § 159.Summarize the following types of liabilities, as reported in the Schedules, and total them.Type of Liability AmountDomestic Support Obligations (from Schedule E)$Taxes and Certain Other Debts Owed to Governmental Units(from Schedule E)$Claims for Death or Personal Injury While Debtor WasIntoxicated (from Schedule E) (whether disputed or undisputed)$Student Loan Obligations (from Schedule F)$Domestic Support, Separation Agreement, and Divorce DecreeObligations Not Reported on Schedule E$Obligations to Pension or Profit-Sharing, and Other SimilarObligations (from Schedule F)$TOTAL$State the following:Average Income (from Schedule I, Line 16)$Average Expenses (from Schedule J, Line 18)$Current Monthly Income (from Form 22A Line 12; OR, Form22B Line 11; OR, Form 22C Line 20 )$State the following:1.Total from Schedule D, “UNSECURED PORTION, IFANY” column$2.Total from Schedule E, “AMOUNT ENTITLED TOPRIORITY” column.$3.Total from Schedule E, “AMOUNT NOT ENTITLED TOPRIORITY, IF ANY” column$4.Total from Schedule F$5.Total of non-priority unsecured debt (sum of 1, 3, and 4)$Form B6A (12/07)2007 USBC, Central District of California In reCase No.:Debtor.(If known)SCHEDULE A - REAL PROPERTYExcept as directed below, list all real property in which the debtor has any legal, equitable, or future interest, including all property ownedas a co-tenant, community property, or in which the debtor has a life estate. Include any property in which the debtor holds rights and powersexercisable for the debtor’s own benefit. If the debtor is married, state whether the husband, wife, both, or the marital community own theproperty by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.” If the debtor holds no interest inreal property, write “None” under “Description and Location of Property.”Do not include interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - ExecutoryContracts and Unexpired Leases.If an entity claims to have a lien or hold a secured interest in any property, state the amount of the secured claim. See Schedule D.If no entity claims to hold a secured interest in the property, write “None” in the column labeled “Amount of Secured Claim.”If the debtor is an individual or if a joint petition is filed, state the amount of any exemption claimed in the property only in Schedule C -Property Claimed as Exempt.DESCRIPTION ANDLOCATION OFPROPERTYNATURE OF DEBTOR’SINTEREST IN PROPERTYHUSBAND, WIFE, JOINT, OR COMMUNITYCURRENT VALUEOF DEBTOR’SINTEREST INPROPERTY, WITHOUTDEDUCTING ANYSECURED CLAIMOR EXEMPTIONAMOUNT OFSECUREDCLAIMTotal (Report also on Summary of Schedules.)Form B6B - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE B - PERSONAL PROPERTYExcept as directed below, list all personal property of the debtor of whatever kind. If the debtor has no property in one or more ofthe categories, place an “x” in the appropriate position in the column labeled “None.” If additional space is needed in any category, attacha separate sheet properly identified with the case name, case number, and the number of the category. If the debtor is married, statewhether the husband, wife, both, or the marital community own the property by placing an “H,” “W,” “J,” or “C” in the column labeled“Husband, Wife, Joint, or Community.” If the debtor is an individual or a joint petition is filed, state the amount of any exemptions claimedonly in Schedule C - Property Claimed as Exempt.Do not list interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - ExecutoryContracts and Unexpired Leases.If the property is being held for the debtor by someone else, state that person’s name and address under “Description and Locationof Property.” If the property is being held for a minor child, simply state the child's initials and the name and address of the child's parentor guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr.P. 1007(m).TYPE OF PROPERTYNONEDESCRIPTION AND LOCATIONOF PROPERTYHUSBAND,WIFE, JOINTORCOMMUNITYCURRENT VALUE OFDEBTOR’S INTEREST IN PROPERTY, WITH-OUT DEDUCTING ANYSECURED CLAIMOR EXEMPTION1.2.3.4.5.6.7.8.9.10.11.Cash on hand.Checking, savings or other financialaccounts, certificates of deposit, orshares in banks, savings and loan,thrift, building and loan, and homestead associations, or credit unions,brokerage houses, or cooperatives.Security deposits with public utilities,telephone companies, landlords, andothers.Household goods and furnishings,including audio, video, and computerequipment.Books; pictures and other art objects;antiques; stamp, coin, record, tape,compact disc, and other collectionsor collectibles.Wearing apparel.Furs and jewelry.Firearms and sports, photo-graphic,and other hobby equipment.Interests in insurance policies.Name insurance company of eachpolicy and itemize surrender orrefund value of each.Annuities. Itemize and name eachissuer.Interests in an education IRA asdefined in 26 U.S.C. § 530(b)(1) orunder a qualified State tuition plan asdefined in 26 U.S.C. § 529(b)(1).Give particulars. (File separately therecord(s) of any such interest(s). 11U.S.C. § 521(c); Rule 1007(b)). Form B6B - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE B - PERSONAL PROPERTY(Continuation Sheet)TYPE OF PROPERTYNONEDESCRIPTION AND LOCATIONOF PROPERTYHUSBAND,WIFE, JOINTORCOMMUNITYCURRENT VALUE OFDEBTOR’S INTEREST IN PROPERTY, WITH-OUT DEDUCTING ANYSECURED CLAIMOR EXEMPTION12.13.14.15.16.17.18.19.20.21.22. 23.Interests in IRA, ERISA, Keogh, orother pension or profit sharingplans. Give particulars.Stock and interests in incorporatedand unincorporated businesses.Itemize. Interests in partnerships or jointventures. Itemize. Government and corporate bondsand other negotiable and non-negotiable instruments.Accounts receivable.Alimony, maintenance, support,and property settlements to whichthe debtor is or may be entitled.Give particulars.Other liquidated debts owed todebtor including tax refunds. Giveparticulars.Equitable or future interests, lifeestates, and rights or powersexercisable for the benefit of thedebtor other than those listed inSchedule A – Real Property.Contingent and non-contingentinterests in estate of a decedent,death benefit plan, life insurancepolicy, or trust.Other contingent and unliquidatedclaims of every nature, includingtax refunds, counterclaims of thedebtor, and rights to setoff claims.Give estimated value of each.Patents, copyrights, and otherintellectual property. Giveparticulars.Licenses, franchises, and othergeneral intangibles. Giveparticulars.Form B6B - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE B -PERSONAL PROPERTY(Continuation Sheet)TYPE OF PROPERTYNONEDESCRIPTION AND LOCATIONOF PROPERTYHUSBAND,WIFE, JOINTORCOMMUNITYCURRENT VALUE OFDEBTOR’S INTEREST IN PROPERTY, WITH-OUT DEDUCTING ANYSECURED CLAIMOR EXEMPTION24.25.26.27. 28. 29.30.31.32.33.34. 35.Customer lists or othercompilations containingpersonally identifiableinformation (as defined in 11U.S.C. § 101(41A)) provided tothe debtor by individuals inconnection with obtaining aproduct or service from thedebtor primarily for personal,family, or household purposes.Automobiles, trucks, trailers,and other vehicles andaccessories.Boats, motors, andaccessories.Aircraft and accessories.Office equipment, furnishings,and supplies.Machinery, fixtures, equipment,and supplies used in business.Inventory.Animals.Crops - growing or harvested.Give particulars.Farming equipment andimplements.Farm supplies, chemicals, andfeed.Other personal property of anykind not already listed. Itemize.__________continuation sheets attachedTotal $(Include amounts from any continuationsheets attached. Report total also onSummary of Schedules.)Form B6C - (04/10) 2010 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE C - PROPERTY CLAIMED AS EXEMPTDebtor claims the exemptions to which debtor is entitledunder: (Check one box)v 11 U.S.C. § 522(b)(2)v 11 U.S.C. § 522(b)(3)vCheck if debtor claims a homestead exemption that exceeds $146.450*.DESCRIPTION OF PROPERTYSPECIFY LAWPROVIDING EACHEXEMPTIONVALUE OFCLAIMEDEXEMPTIONCURRENT VALUE OF PROPERTYWITHOUT DEDUCTING EXEMPTION*Amount subject to adjustment on 4/1/13, and every three years there after with respect to cases commenced on or after the date ofadjustmentForm B6D - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE D – CREDITORS HOLDING SECURED CLAIMSState the name, mailing address, including zip code, and last four digits of any account number of all entities holding claimssecured by property of the debtor as of the date of filing of the petition. The complete account number of any account the debtor haswith the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. List creditors holding alltypes of secured interests such as judgment liens, garnishments, statutory liens, mortgages, deeds of trust, and other security interests.List creditors in alphabetical order to the extent practicable. If a minor child is the creditor, state the child's initials and the nameand address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name.See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). If all secured creditors will not fit on this page, use the continuation sheetprovided.If any entity other than a spouse in a joint case may be jointly liable on a claim, place an “X” in the column labeled “Codebtor,”include the entity on the appropriate schedule of creditors, and complete Schedule H – Codebtors. If a joint petition is filed, statewhether the husband, wife, both of them, or the marital community may be liable on each claim by placing an “H,” “W,” “J,” or “C” in thecolumn labeled “Husband, Wife, Joint, or Community.”If the claim is contingent, place an “X” in the column labeled “Contingent.” If the claim is unliquidated, place an “X” in the columnlabeled “Unliquidated.” If the claim is disputed, place an “X” in the column labeled “Disputed.” (You may need to place an “X” in morethan one of these three columns.)Total the columns labeled “Amount of Claim Without Deducting Value of Collateral” and “Unsecured Portion, if Any” in the boxeslabeled “Total(s)” on the last sheet of the completed schedule. Report the total from the column labeled “Amount of Claim WithoutDeducting Value of Collateral” also on the Summary of Schedules and, if the debtor is an individual with primarily consumer debts,report the total from the column labeled “Unsecured Portion, if Any” on the Statistical Summary of Certain Liabilities and Related Data.GCheck this box if debtor has no creditors holding secured claims to report on this Schedule D.CREDITOR’S NAME ANDMAILING ADDRESSINCLUDING ZIP CODE AND AACCOUNT NUMBER(See Instructions Above)CODEBTORHUSBAND, WIFE, JOINT, OR COMMUNITYDATE CLAIM WAS INCURRED,NATURE OF LIEN, ANDDESCRIPTION AND VALUE OF PROPERTYSUBJECT TO LIENCONTINGENTUNLIQUIDATEDDISPUTEDAMOUNT OF CLAIMWITHOUTDEDUCTING VALUEOF COLLATERALUNSECUREDPORTION,IF ANYLast four digits ofACCOUNT NO.Value $Last four digits of ACCOUNT NO.Value $Last four digits ofACCOUNT NO.Value $ Continuation Sheets attachedSubtotal(Total of this page) $Total(Use only last page) $(Report total alsoon Summary ofSchedules)(If applicable, reportalso on StatisticalSummary of CertainLiabilities andRelated Data.)Form B6D - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE D – CREDITORS HOLDING SECURED CLAIMS(Continuation Sheet)CREDITOR’S NAME ANDMAILING ADDRESSINCLUDING ZIP CODEAND AN ACCOUNTNUMBER(See Instructions Above)CODEBTORHUSBAND, WIFE, JOINT, OR COMMUNITYDATE CLAIM WAS INCURRED,NATURE OF LIEN, ANDDESCRIPTION AND VALUE OF PROPERTYSUBJECT TO LIENCONTINGENTUNLIQUIDATEDDISPUTEDAMOUNT OFCLAIMWITHOUTDEDUCTINGVALUE OFCOLLATERALUNSECUREDPORTION,IF ANYLast four digits ofACCOUNT NO.Value $Last four digits ofACCOUNT NO.Value $Last four digits ofACCOUNT NO.Value $Last four digits ofACCOUNT NO.Value $Last four digits ofACCOUNT NO.Value $Sheet no. of continuation sheetsattached to Schedule of Creditors Holding SecuredClaimsSubtotal(s)(Total(s) of this page) $Total(s)(Use only last page) $(Report also onSummary ofSchedules)(If applicable, reportalso on StatisticalSummary of CertainLiabilities andRelated Data.)Form B6E - (Rev. 04/10)2010 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)*Amount subject to adjustment on 04/01/13, and every three years there after with respect to cases commenced on or after the date ofadjustment.SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMSA complete list of claims entitled to priority, listed separately by type of priority, is to be set forth on the sheets provided. Only holdersof unsecured claims entitled to priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name,mailing address, including zip code, and last four digits of the account number, if any, of all entities holding priority claims against the debtoror the property of the debtor, as of the date of the filing of the petition. Use a separate continuation sheet for each type of priority and labeleach with the type of priority.The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be providedif the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian,such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," includethe entity on the appropriate schedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband,wife, both of them, or the marital community may be liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband,Wife, Joint, or Community." If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, placean "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to placean "X" in more than one of these three columns.)Report the total of claims listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all claims listed on thisSchedule E in the box labeled “Total” on the last sheet of the completed schedule. Report this total also on the Summary of Schedules.Report the total of amounts entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of allamounts entitled to priority listed on this Schedule E in the box labeled “Totals” on the last sheet of the completed schedule. Individualdebtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.Report the total of amounts not entitled to priority listed on each sheet in the box labeled “Subtotals” on each sheet. Report the totalof all amounts not entitled to priority listed on this Schedule E in the box labeled “Totals” on the last sheet of the completed schedule.Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.G Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets)GDomestic Support Obligations: Claims for domestic support that are owed to or recoverable by a spouse, former spouse, or childof the debtor, or the parent, legal guardian, or responsible relative of such a child, or a governmental unit to whom such a domesticsupport claim has been assigned to the extent provided in 11 U.S.C. § 507(a)(1).GExtensions of credit in an involuntary case: Claims arising in the ordinary course of the debtor's business or financial affairs afterthe commencement of the case but before the earlier of the appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(3).GWages, salaries, and commissions: Wages, salaries, and commissions, including vacation, severance, and sick leave pay owingto employees and commissions owing to qualifying independent sales representatives up to $11,725* per person earned within 180days immediately preceding the filing of the original petition, or the cessation of business, whichever occurred first, to the extent providedin 11 U.S.C. § 507(a)(4).GContributions to employee benefit plans: Money owed to employee benefit plans for services rendered within 180 days immediatelypreceding the filing of the original petition, or the cessation of business, whichever occurred first, to the extent provided in 11 U.S.C.§ 507(a)(5).GCertain farmers and fishermen: Claims of certain farmers and fishermen, up to $5,775* per farmer or fisherman, against the debtor,as provided in 11 U.S.C. § 507(a)(6).GDeposits by individuals: Claims of individuals up to $2,600* for deposits for the purchase, lease, or rental of property or services forpersonal, family, or household use, that were not delivered or provided. 11 U.S.C. § 507(a)(7).Form B6E - (Rev. 04/10)2010 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)GTaxes and Certain Other Debts Owed to Governmental Units: Taxes, customs duties, and penalties owing to federal, state, andlocal governmental units as set forth in 11 U.S.C. § 507(a)(8).GCommitments to Maintain the Capital of an Insured Depository Institution: Claims based on commitments to the FDIC, RTC,Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors of the Federal Reserve System, or theirpredecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C. § 507 (a)(9).GClaims for Death or Personal Injury While Debtor Was Intoxicated: Claims for death or personal injury resulting from the operationof a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug, or another substance. 11 U.S.C. § 507(a)(10). *Amounts are subject to adjustment on April 1, 2013, and every three years thereafter with respect to cases commenced on or after thedate of adjustment. Continuation Sheets attachedForm B6E - (Rev. 04/10)2010 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS(Continuation Sheet) Type of Priority for Claims Listed on This Sheet CREDITOR’S NAME, MAILING ADDRESSINCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions.)CODEBTORHUSBAND, WIFE, JOINT,OR COMMUNITYDATE CLAIM WASINCURRED ANDCONSIDERATION FORCLAIMCONTINGENTUNLIQUIDATED DISPUTEDAMOUNT OF CLAIMAMOUNTENTITLED TOPRIORITYAMOUNT NOTENTITLED TOPRIORITY, IFANYLast four digits ofAccount No.Last four digits ofAccount No.Last four digits ofAccount No.Last four digits ofAccount No.Last four digits ofAccount No.Sheet no. ___ of ___ continuation sheetsattached to Schedule of Creditors HoldingPriority ClaimsSubtotals(Totals of this page) $$Total(Use only on last page of the completed Schedule E.Report also on the Summary of Schedules.) $Totals(Use only on last page of the completed Schedule E.If applicable, report also on the Statistical Summary of Certain Liabilities and Related Data.) $$Form B6F (Official Form 6F) - (Rev. 12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMSState the name, mailing address, including zip code, and last four digits of any account number, of all entities holding unsecured claims withoutpriority against the debtor or the property of the debtor, as of the date of filing of the petition. The complete account number of any account thedebtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor,state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do notdisclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Do not include claims listed in Schedules D and E. If all creditorswill not fit on this page, use the continuation sheet provided.If any entity other than a spouse in a joint case may be jointly liable on a claim, place an “X” in the column labeled “Codebtor,” include the entityon the appropriate schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, bothof them, or the marital community may be liable on each claim by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, orCommunity.”If the claim is contingent, place an “X” in the column labeled “Contingent.” If the claim is unliquidated, place an “X” in the column labeled“Unliquidated.” If the claim is disputed, place an “X” in the column labeled “Disputed.” (You may need to place an “X” in more than one of thesethree columns.)Report the total of all claims listed on this schedule in the box labeled “Total” on the last sheet of the completed schedule. Report this total alsoon the Summary of Schedules and, if the debtor is an individual with primarily consumer debts filing a case under chapter 7, report this total alsoon the Statistical Summary of Certain Liabilities and Related Data..GCheck this box if debtor has no creditors holding unsecured claims to report on this Schedule F.CREDITOR’S NAME, MAILING ADDRESS INCLUDING ZIP CODE, AND ACCOUNT NUMBER(See instructions above.)CODEBTORHUSBAND, WIFE,JOINT, ORCOMMUNITYDATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM IS SUBJECT TO SETOFF, SO STATE.CONTINGENTUNLIQUIDATEDDISPUTEDAMOUNT OF CLAIMLast four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Subtotal $ Continuation Sheets attachedTotal(Use only on last page of the completed Schedule F.) (Report also on Summary of Schedules and, if applicable, onthe Statistical Summary of Certain Liabilities and Related Data.) $Form B6F (Official Form 6F) - (Rev. 12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)CREDITOR’S NAME, MAILING ADDRESS INCLUDING ZIP CODE, AND ACCOUNT NUMBER(See instructions above.)CODEBTORHUSBAND, WIFE,JOINT, ORCOMMUNITYDATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM IS SUBJECT TO SETOFF,SO STATE.CONTINGENTUNLIQUIDATEDDISPUTEDAMOUNT OF CLAIMLast four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Last four digits ofACCOUNT NO.Subtotal $Sheet no. of sheets attached toSchedule of Creditors Holding UnsecuredNonpriority ClaimsTotal(Use only on last page of the completed Schedule F.) (Report also on Summary of Schedules and, if applicable on theStatistical Summary of Certain Liabilities and Related Data.) $Form B6G - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASESDescribe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests.State nature of debtor’s interest in contract, i.e., “Purchaser,” “Agent,” etc. State whether debtor is the lessor or lessee of a lease. Providethe names and complete mailing addresses of all other parties to each lease or contract described. If a minor child is a party to one of theleases or contracts, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by JohnDoe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).G Check this box if debtor has no executory contracts or unexpired leases.NAME AND MAILING ADDRESS,INCLUDING ZIP CODE,OF OTHER PARTIES TO LEASE OR CONTRACT.DESCRIPTION OF CONTRACT OR LEASE ANDNATURE OF DEBTOR’S INTEREST. STATEWHETHER LEASE IS FOR NONRESIDENTIALREAL PROPERTY. STATE CONTRACTNUMBER OF ANY GOVERNMENT CONTRACT.Form B6H - (12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE H - CODEBTORSProvide the information requested concerning any person or entity, other than a spouse in a joint case, that is also liable on anydebts listed by the debtor in the schedules of creditors. Include all guarantors and co-signers. If the debtor resides or resided in acommunity property state, commonwealth, or territory (including Alaska, Arizona, California, Idaho, Louisiana, Nevada, New Mexico, PuertoRico, Texas, Washington, or Wisconsin) within the eight-year period immediately preceding the commencement of the case, identify thename of the debtor’s spouse and of any former spouse who resides or resided with the debtor in the community property state,commonwealth, or territory. Include all names used by the nondebtor spouse during the eight years immediately preceding thecommencement of this case. If a minor child is a codebtor or a creditor, state the child's initials and the name and address of the child'sparent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed.R. Bankr. P. 1007(m).G Check this box if debtor has no codebtors.NAME AND ADDRESS OF CODEBTORNAME AND ADDRESS OF CREDITORForm B6I - (Rev. 12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)The column labeled “Spouse” must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petitionis filed, unless the spouses are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthlyincome calculated on this form may differ from the current monthly income calculated on Form 22A, 22B, or 22C.Debtor’s MaritalStatus:DEPENDENTS OF DEBTOR AND SPOUSERELATIONSHIP(S)AGE(S)Employment:DEBTORSPOUSEOccupationName of EmployerHow Long EmployedAddress of EmployerINCOME: (Estimate of average or projected monthly income at time case filed)1.Monthly gross wages, salary, and commissions (Prorate if not paid monthly)2.Estimate monthly overtime3.SUBTOTAL4.LESS PAYROLL DEDUCTIONSa.Payroll taxes and social securityb.Insurancec.Union duesd.Other (specify) 5.SUBTOTAL OF PAYROLL DEDUCTIONS6.TOTAL NET MONTHLY TAKE HOME PAY7.Regular income from operation of business or profession or farm (attach detailedstatement)8.Income from real property9.Interest and dividends10.Alimony, maintenance or support payments payable to the debtor for the debtor’s use orthat of dependents listed above.11.Social security or other government assistance (Specify) 12.Pension or retirement income13.Other monthly income(Specify) 14.SUBTOTAL OF LINES 7 THROUGH 1315.AVERAGE MONTHLY INCOME: (Add amounts shown on lines 6 and 14)16.COMBINED AVERAGE MONTHLY INCOME (Combine column totals from line 15)DEBTORSPOUSE$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ (Report also on Summary of Schedules and, if applicable, onStatistical Summary of Certain Liabilities and RelatedData) 17. Describe any increase or decrease in income reasonably anticipated to occur within the year following the filing of this document:Form B6J - (Rev. 12/07) 2007 USBC, Central District of California..In reCase No.:Debtor.(If known)$ SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor’s family at time case filed.Prorate any payments made bi-weekly, quarterly, semi-annually, or annually to show monthly rate. The average monthly expenses calculatedon this form may differ from the deductions from income allowed on Form22A or 22C.GCheck this box if a joint petition is filed and debtor’s spouse maintains a separate household. Complete a separate schedule ofexpenditures labeled “Spouse.”1.Rent or home mortgage payment (include lot rented for mobile home)$ a.Are real estate taxes included?Yes ________No ________b.Is property insurance included?Yes ________No ________2.Utilities:a.Electricity and heating fuel$ b.Water and sewer$ c.Telephone$ d.Other ___________________________________________________________________$ 3.Home maintenance (repairs and upkeep)$ 4.Food$ 5.Clothing$ 6.Laundry and dry cleaning$ 7.Medical and dental expenses$ 8.Transportation (not including car payments)$ 9.Recreation, clubs and entertainment, newspapers, magazines, etc.$ 10.Charitable contributions$ 11.Insurance (not deducted from wages or included in home mortgage payments)a.Homeowner’s or renter’s$ b.Life$ c.Health$ d.Auto$ e.Other ______________________________________________________________________$ 12.Taxes (not deducted from wages or included in home mortgage payments)(Specify) ___________________________________________________________________________$ 13.Installment payments: (In chapter 11, 12, and 13 cases, do not list payments to be included in the plan)a.Auto$ b.Other _____________________________________________________________________$ c.Other _____________________________________________________________________$ 14.Alimony, maintenance, and support paid to others$ 15.Payments for support of additional dependents not living at your home$ 16.Regular expenses from operation of business, profession, or farm (attach detailed statement)$ 17.Other $ 18.AVERAGE MONTHLY EXPENSES (Total lines 1-17, Report also on Summary of Schedules and,If applicable, on the Statistical Summary of Certain Liabilities and Related Data.)19.Describe any increase or decrease in expenditures reasonably anticipated to occur within the year following thefiling of this document: 20.STATEMENT OF MONTHLY NET INCOMEa.Total monthly income from Line 15 of Schedule I $ b.Total monthly expenses from Line 18 above$ c.Monthly net income (a. minus b.) $ Form B6 - Declaration (Rev. 12/07)2007 USBC, Central District of CaliforniaPenalty for making a false statement or concealing property: Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.C. §§ 152 and 3571. In reCase No.:Debtor.(If known)DECLARATION CONCERNING DEBTOR'S SCHEDULESDECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTORI declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of __________________________sheets, and that they are true and correct to the best of my knowledge, information, and belief.Date Signature: DebtorDate Signature: (Joint Debtor, if any)[If joint case, both spouses must sign.]DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110)I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this documentfor compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C.§§ 110(b), 110(h) and 342(b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum feefor services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing anydocument for filing for a debtor or accepting any fee from the debtor, as required by that section. Printed or Typed Name and Title, if any, of Bankruptcy Petition PreparerSocial Security No.(Required by 11 U.S.C. § 110.)If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social security number of the officer,principal, responsible person, or partner who signs this document.___________________________________________________________________________________________________AddressX ___________________________________________________ Signature of Bankruptcy Petition PreparerDateNames and Social Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not anindividual:If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person.A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C.§ 110; 18 U.S.C. § 156.DECLARATION UNDER PENALTY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIPI, the __________________________________ [the president or other officer or an authorized agent of the corporation or a member or an authorized agentof the partnership ] of the ___________________________________ [corporation or partnership] named as debtor in this case, declare under penalty ofperjury that I have read the foregoing summary and schedules, consisting of _______________________________________________ sheets, and thatthey are true and correct to the best of my knowledge, information, and belief. (Total shown on summary page plus 1.)Date Signature: [Print or type name of individual signing on behalf of debtor.][An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.]Statement of Financial Affairs (Form 7) - Page 1 - (Rev. 04/10)2010 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCentral District of CaliforniaIn reCase No.:Debtor.(If known)STATEMENT OF FINANCIAL AFFAIRSThis statement is to be completed by every debtor. Spouses filing a joint petition may file a single statement on which theinformation for both spouses is combined. If the case is filed under chapter 12 or chapter 13, a married debtor must furnishinformation for both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is notfiled. An individual debtor engaged in business as a sole proprietor, partner, family farmer, or self-employed professional,should provide the information requested on this statement concerning all such activities as well as the individual's personalaffairs. To indicate payments, transfers and the like to minor children, state the child's initials and the name and address ofthe child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See,11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).Questions 1 - 18 are to be completed by all debtors. Debtors that are or have been in business, as defined below, also mustcomplete Questions 19 - 25. If the answer to an applicable question is "None," mark the box labeled "None." Ifadditional space is needed for the answer to any question, use and attach a separate sheet properly identified with the casename, case number (if known), and the number of the question.Definitions"In business." A debtor is "in business" for the purpose of this form if the debtor is a corporation or partnership. An individualdebtor is "in business" for the purpose of this form if the debtor is or has been, within six years immediately preceding the filingof this bankruptcy case, any of the following: an officer, director, managing executive, or owner of 5 percent or more of thevoting or equity securities of a corporation; a partner, other than a limited partner, of a partnership; a sole proprietor or self-employed full-time or part-time. An individual debtor also may be “in business” for the purpose of this form if the debtorengages in a trade, business, or other activity, other than as an employee, to supplement income from the debtor’s primaryemployment."Insider." The term "insider" includes but is not limited to: relatives of the debtor; general partners of the debtor and theirrelatives; corporations of which the debtor is an officer, director, or person in control; officers, directors, and any owner of 5percent or more of the voting or equity securities of a corporate debtor and their relatives; affiliates of the debtor and insidersof such affiliates; any managing agent of the debtor. 11 U.S.C. § 101.1.Income from Employment or Operation of BusinessNoneState the gross amount of income the debtor has received from employment, trade, or profession, or from operationof the debtor's business, including part-time activities either as an employee or in independent trade or business, fromthe beginning of this calendar year to the date this case was commenced. State also the gross amounts receivedduring the two years immediately preceding this calendar year. (A debtor that maintains, or has maintained, financialrecords on the basis of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning andending dates of the debtor's fiscal year.) If a joint petition is filed, state income for each spouse separately. (Marrieddebtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.)AMOUNTSOURCE Statement of Financial Affairs (Form 7) - Page 2 - (Rev. 04/10)2010 USBC, Central District of California2.Income Other than from Employment or Operation of BusinessNoneState the amount of income received by the debtor other than from employment, trade, profession, operation of thedebtor's business during the two years immediately preceding the commencement of this case. Give particulars. Ifa joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or chapter13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated anda joint petition is not filed.)AMOUNTSOURCE3.Payments to CreditorsComplete a. or b., as appropriate, and c.Nonea. Individual or joint debtor(s) with primarily consumer debts: List all payments on loans, installment purchases ofgoods or services, and other debts to any creditor made within 90 days immediately preceding the commencementof this case unless the aggregate value of all property that constitutes or is affected by such transfer is less than$600. Indicate with an asterisk (*) any payments that were made to a creditor on account of a domestic supportobligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting andcreditor counseling agency. (Married debtors filing under chapter 12 or chapter 13 must include payments byeither or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petitionis not filed.) DATES OFAMOUNT AMOUNTNAME AND ADDRESS OF CREDITOR PAYMENTS PAIDSTILL OWINGNoneb.Debtor whose debts are not primarily consumer debts: List each payment or other transfer to any creditor madewithin 90 days immediately preceding the commencement of the case unless the aggregate value of all propertythat constitutes or is affected by such transfer is less than $5,850. If the debtor is an individual, indicate with anasterisk (*) any payments that were made to a creditor on account of a domestic support obligation or as part ofan alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency.(Married debtors filing under chapter 12 or chapter 13 must include payments and other transfers by either or bothspouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF CREDITORDATES OFPAYMENTS/TRANSFERSAMOUNT PAIDOR VALUE OFTRANSFERSAMOUNTSTILL OWINGStatement of Financial Affairs (Form 7) - Page 3 - (Rev. 04/10)2010 USBC, Central District of CaliforniaNonec.All debtors: List all payments made within one year immediately preceding the commencement of this case to orfor the benefit of creditors who are or were insiders. (Married debtors filing under chapter 12 or chapter 13 mustinclude payments by either or both spouses whether or not a joint petition is filed, unless the spouses areseparated and a joint petition is not filed.)NAME AND ADDRESS OF CREDITORAND RELATIONSHIP TO DEBTORDATE OFPAYMENTAMOUNT PAIDAMOUNTSTILL OWING4.Suits and Administrative Proceedings, Executions, Garnishments and AttachmentsNonea.List all suits and administrative proceedings to which the debtor is or was a party within one year immediatelypreceding the filing of this bankruptcy case. (Married debtors filing under chapter 12 or chapter 13 must includeinformation concerning either or both spouses whether or not a joint petition is filed, unless the spouses areseparated and a joint petition is not filed.) CAPTION OF SUITAND CASE NUMBERNATURE OF PROCEEDINGCOURT OR AGENCYAND LOCATION STATUS ORDISPOSITION Noneb.Describe all property that has been attached, garnished or seized under any legal or equitable process within oneyear immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter13 must include information concerning property of either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF PERSON FOR WHOSE BENEFIT PROPERTY WAS SEIZEDDATE OFSEIZUREDESCRIPTION AND VALUE OF PROPERTY Statement of Financial Affairs (Form 7) - Page 4 - (Rev. 04/10)2010 USBC, Central District of California5.Repossessions, Foreclosures and ReturnsNoneList all property that has been repossessed by a creditor, sold at a foreclosure sale, transferred through a deed in lieuof foreclosure or returned to the seller, within one year immediately preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or bothspouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF CREDITOR OR SELLERDATE OF REPOSSESSION,FORECLOSURE SALE, TRANSFER OR RETURNDESCRIPTION AND VALUE OF PROPERTY 6.Assignments and ReceivershipsNonea.Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding thecommencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include any assignmentby either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)NAME AND ADDRESS OF ASSIGNEEDATE OFASSIGNMENTTERMS OF ASSIGNMENT OR SETTLEMENT Noneb.List all property which has been in the hands of a custodian, receiver, or court-appointed official within one yearimmediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13must include information concerning property of either or both spouses whether or not a joint petition is filed, unlessthe spouses are separated and a joint petition is not filed.)NAME AND ADDRESSOF CUSTODIANNAME AND LOCATION OF COURT CASE TITLE AND NUMBERDATE OFORDERDESCRIPTION AND VALUE OF PROPERTY Statement of Financial Affairs (Form 7) - Page 5 - (Rev. 04/10)2010 USBC, Central District of California7.Gifts NoneList all gifts or charitable contributions made within one year immediately preceding the commencement of this caseexcept ordinary and usual gifts to family members aggregating less than $200 in value per individual family memberand charitable contributions aggregating less than $100 per recipient. (Married debtors filing under chapter 12 orchapter 13 must include gifts or contributions by either or both spouses whether or not a joint petition is filed, unlessthe spouses are separated and a joint petition is not filed.)NAME AND ADDRESSOF PERSONOR ORGANIZATIONRELATIONSHIPTO DEBTOR,IF ANYDATE OFGIFTDESCRIPTION AND VALUE OF GIFT 8.LossesNoneList all losses from fire, theft, other casualty or gambling within one year immediately preceding the commencementof this case or since the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 mustinclude losses by either or both spouses whether or not a joint petition is filed, unless the spouses are separated anda joint petition is not filed.)DESCRIPTIONAND VALUE OF PROPERTY DESCRIPTION OF CIRCUMSTANCES AND, IF LOSS WAS COVERED IN WHOLE OR IN PART BY INSURANCE, GIVE PARTICULARSDATE OF LOSS 9.Payments Related to Debt Counseling or BankruptcyNoneList all payments made or property transferred by or on behalf of the debtor to any persons, including attorneys, forconsultation concerning debt consolidation, relief under the bankruptcy law or preparation of a petition in bankruptcywithin one year immediately preceding the commencement of this case.NAME AND ADDRESSOF PAYEEDATE OF PAYMENT,NAME OF PAYER IFOTHER THAN DEBTORAMOUNT OF MONEY ORDESCRIPTION AND VALUEOF PROPERTY Statement of Financial Affairs (Form 7) - Page 6 - (Rev. 04/10)2010 USBC, Central District of California10.Other TransfersNonea.List all other property, other than property transferred in the ordinary course of the business or financial affairs ofthe debtor, transferred either absolutely or as security within two years immediately preceding the commencementof this case. (Married debtors filing under chapter 12 or chapter 13 must include transfers by either or bothspouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF TRANSFEREE,RELATIONSHIP TO DEBTORDATEDESCRIBE PROPERTYTRANSFERRED AND VALUE RECEIVEDNoneb.List all property transferred by the debtor within ten years immediately preceding the commencement of this caseto a self-settled trust or similar device of which the debtor is a beneficiary.NAME OF TRUST OR OTHER DEVICEDATE(S) OFTRANSFER(S)AMOUNT OF MONEY ORDESCRIPTION AND VALUE OFPROPERTY OR DEBTOR’S INTEREST IN PROPERTY11.Closed Financial Accounts NoneList all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which wereclosed, sold, or otherwise transferred within one year immediately preceding the commencement of this case. Includechecking, savings, or other financial accounts, certificates of deposit, or other instruments; shares and share accountsheld in banks, credit unions, pension funds, cooperatives, associations, brokerage houses and other financialinstitutions. (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts orinstruments held by or for either or both spouses whether or not a joint petition is filed, unless the spouses areseparated and a joint petition is not filed.)NAME AND ADDRESS OF INSTITUTIONTYPE OF ACCOUNT, LAST FOURDIGITS OF ACCOUNT NUMBER, ANDAMOUNT OF FINAL BALANCEAMOUNT ANDDATE OF SALEOR CLOSING Statement of Financial Affairs (Form 7) - Page 7 - (Rev. 04/10)2010 USBC, Central District of California12.Safe Deposit BoxesNoneList each safe deposit or other box or depository in which the debtor has or had securities, cash, or other valuableswithin one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 orchapter 13 must include boxes or depositories of either or both spouses whether or not a joint petition is filed, unlessthe spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF BANK OROTHER DEPOSITORYNAMES AND ADDRESSESOF THOSE WITH ACCESSTO BOX OR DEPOSITORYDESCRIPTIONOFCONTENTSDATE OF TRANSFEROR SURRENDER, IF ANY13.SetoffsNoneList all setoffs made by any creditor, including a bank, against a debt or deposit of the debtor within 90 days precedingthe commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include informationconcerning either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)NAME AND ADDRESS OF CREDITORDATE OFSETOFFAMOUNT OFSETOFF 14.Property Held for Another PersonNoneList all property owned by another person that the debtor holds or controls.NAME AND ADDRESS OF OWNERDESCRIPTION AND VALUEOF PROPERTYLOCATION OF PROPERTYStatement of Financial Affairs (Form 7) - Page 8 - (Rev. 04/10)2010 USBC, Central District of California15.Prior Address of DebtorNoneIf debtor has moved within three years immediately preceding the commencement of this case, list all premises whichthe debtor occupied during that period and vacated prior to the commencement of this case. If a joint petition is filed,report also any separate address of either spouse.ADDRESSNAME USEDDATES OF OCCUPANCY 16. Spouses and Former SpousesNoneIf the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona,California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight yearsimmediately preceding the commencement of the case, identify the name of the debtor’s spouse and of any formerspouse who resides or resided with the debtor in the community property state. NAME17. Environmental Information For the purpose of this question, the following definitions apply: "Environmental Law" means any federal, state, or local statute or regulation regulating pollution, contamination,releases of hazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, orother medium, including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes,or material. "Site" means any location, facility, or property as defined under any Environmental Law, whether or not presently orformerly owned or operated by the debtor, including, but not limited to, disposal sites. "Hazardous Material" means anything defined as a hazardous waste, hazardous substance, toxic substance,hazardous material, pollutant, or contaminant or similar term under an Environmental Law.Nonea.List the name and address of every site for which the debtor has received notice in writing by a governmental unitthat it may be liable or potentially liable under or in violation of an Environmental Law. Indicate the governmentalunit, the date of the notice, and, if known, the Environmental Law:SITE NAMEAND ADDRESSNAME AND ADDRESS OF GOVERNMENTAL UNITDATE OFNOTICE ENVIRONMENTALLAWStatement of Financial Affairs (Form 7) - Page 9 - (Rev. 04/10)2010 USBC, Central District of CaliforniaNoneb.List the name and address of every site for which the debtor provided notice to a governmental unit of a releaseof Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice.SITE NAMEAND ADDRESSNAME AND ADDRESS OF GOVERNMENTAL UNITDATE OFNOTICE ENVIRONMENTALLAWNonec.List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law withrespect to which the debtor is or was a party. Indicate the name and address of the governmental unit that is orwas a party to the proceeding, and the docket number.NAME AND ADDRESS OF GOVERNMENTAL UNITDOCKETNUMBERSTATUS ORDISPOSITION 18.Nature, Location and Name of Business Nonea.If the debtor is an individual, list the names, addresses, taxpayer identification numbers, nature of the businesses,and beginning and ending dates of all businesses in which the debtor was an officer, director, partner, or managingexecutive of a corporation, partner in a partnership, sole proprietor, or was self-employed in a trade, profession,or other activity either full- or part-time within six years immediately preceding the commencement of this case,or in which the debtor owned 5 percent or more of the voting or equity securities within six years immediatelypreceding the commencement of this case. If the debtor is a partnership, list the names, addresses, taxpayer identification numbers, nature of the businesses,and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or moreof the voting or equity securities, within six years immediately preceding the commencement of this case.If the debtor is a corporation, list the names, addresses, taxpayer identification numbers, nature of the businesses,and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or moreof the voting or equity securities within six years immediately preceding the commencement of this case. NAMELAST FOUR DIGITS OF SOC.SEC. NO./ COMPLETE EIN¹ OROTHER TAXPAYER I.D. NO.ADDRESSNATURE OFBUSINESS BEGINNING ANDENDING DATESStatement of Financial Affairs (Form 7) - Page 10 - (Rev. 04/10)2010 USBC, Central District of CaliforniaNoneb.Identify any business listed in response to subdivision a., above, that is "single asset real estate" as definedin 11 U.S.C. § 101.NAMEADDRESSThe following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtorwho is or has been, within six years immediately preceding the commencement of this case, any of the following: an officer,director, managing executive, or owner of more than 5 percent of the voting or equity securities of a corporation; a partner,other than a limited partner, of a partnership, a sole proprietor, or self-employed in a trade, profession, or other activity, eitherfull- or part-time.(An individual or joint debtor should complete this portion of the statement only if the debtor is or has been in business, asdefined above, within six years immediately preceding the commencement of this case. A debtor who has not been in businesswithin those six years should go directly to the signature page.)19.Books, Records and Financial StatementsNonea.List all bookkeepers and accountants who within two years immediately preceding the filing of this bankruptcycase kept or supervised the keeping of books of account and records of the debtor.NAME AND ADDRESSDATES SERVICES RENDEREDNoneb.List all firms or individuals who within two years immediately preceding the filing of this bankruptcy case haveaudited the books of account and records, or prepared a financial statement of the debtor.NAMEADDRESSDATES SERVICES RENDEREDNonec.List all firms or individuals who at the time of the commencement of this case were in possession of the books ofaccount and records of the debtor. If any of the books of account and records are not available, explain.NAMEADDRESSStatement of Financial Affairs (Form 7) - Page 11 - (Rev. 04/10)2010 USBC, Central District of CaliforniaNoned.List all financial institutions, creditors and other parties, including mercantile and trade agencies, to whom afinancial statement was issued by the debtor within two years immediately preceding the commencement of thiscase.NAME AND ADDRESSDATE ISSUED20.InventoriesNonea.List the dates of the last two inventories taken of your property, the name of the person who supervised the takingof each inventory, and the dollar amount and basis of each inventory.DATE OF INVENTORYINVENTORY SUPERVISOR DOLLAR AMOUNTOF INVENTORY(Specify cost, market, or other basis)Noneb.List the name and address of the person having possession of the records of each of the inventories reportedin a., above. DATE OF INVENTORYNAME AND ADDRESS OF CUSTODIANOF INVENTORY RECORDS21.Current Partners, Officers, Directors and ShareholdersNonea.If the debtor is a partnership, list the nature and percentage of partnership interest of each member of thepartnership.NAME AND ADDRESSNATURE OF INTERESTPERCENTAGE OF INTERESTStatement of Financial Affairs (Form 7) - Page 12 - (Rev. 04/10)2010 USBC, Central District of CaliforniaNoneb.If the debtor is a corporation, list all officers and directors of the corporation, and each stockholder who directly orindirectly owns, controls, or holds 5 percent or more of the voting or equity securities of the corporation.NAME AND ADDRESS TITLENATURE AND PERCENTAGE OF STOCK OWNERSHIP 22.Former Partners, Officers, Directors and ShareholdersNonea.If the debtor is a partnership, list each member who withdrew from the partnership within one year immediatelypreceding the commencement of this case.NAMEADDRESSDATE OF WITHDRAWALNoneb.If the debtor is a corporation, list all officers, or directors whose relationship with the corporation terminated withinone year immediately preceding the commencement of this case.NAME AND ADDRESSTITLEDATE OF TERMINATION23.Withdrawals from a Partnership or Distributions by a CorporationNoneIf the debtor is a partnership or corporation, list all withdrawals or distributions credited or given to an insider,including compensation in any form, bonuses, loans, stock redemptions, options exercised and any other perquisiteduring one year immediately preceding the commencement of this case.NAME AND ADDRESS OF RECIPIENT,RELATIONSHIP TO DEBTORDATE AND PURPOSEOF WITHDRAWALAMOUNT OF MONEYOR DESCRIPTIONAND VALUE OF PROPERTY Statement of Financial Affairs (Form 7) - Page 13 - (Rev. 04/10)2010 USBC, Central District of California24. Tax Consolidation Group. None If the debtor is a corporation, list the name and federal taxpayer identification number of the parent corporation of anyconsolidated group for tax purposes of which the debtor has been a member at any time within six years immediatelypreceding the commencement of the case. NAME OF PARENT CORPORATIONTAXPAYER IDENTIFICATION NUMBER (EIN)25. Pension Funds. NoneIf the debtor is not an individual, list the name and federal taxpayer identification number of any pension fund to whichthe debtor, as an employer, has been responsible for contributing at any time within six years immediately precedingthe commencement of the case.NAME OF PENSION FUNDTAXPAYER IDENTIFICATION NUMBER (EIN)M M M M M M M M M Statement of Financial Affairs (Form 7) - Page 14 - (Rev. 04/10)2010 USBC, Central District of California[If completed by an individual or individual and spouse]I declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs andany attachments thereto and that they are true and correct.Date Signature DebtorDate Signature Joint Debtor (if any)[If completed on behalf of a partnership or corporation]I, declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs andany attachments thereto and that they are true and correct to the best of my knowledge, information and belief.Date Signature Print Name and Title [An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.] continuation sheets added Penalty for making a false statement: Fine of up to $500,000 or imprisonment for up to 5 years, or both. 18 U.S.C. §§ 152 and 3571DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110)I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this documentfor compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§110(b), 110(h), and 342(b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum feefor services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing anydocument for filing for a debtor or accepting any fee from the debtor, as required by that section. Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Complete Social Security No. (Required by 11 U.S.C. § 110.)If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social-security number of the officer,principal, responsible person, or partner who signs this document. Address Signature of Bankruptcy Petition Preparer DateNames and Social Security numbers of all other individuals who prepared or assisted in preparing this document if the bankruptcypetition preparer is not an individual:If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for eachperson.A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Proceduremay result in fines or imprisonment or both. 18 U.S.C. § 156.Form B8 (Official Form 8) - (Rev. 12/08) - Page 12008 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCentral District of CaliforniaIn reDebtorCase No.:Chapter:CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTIONPART A – Debts secured by property of the estate. (Part A must be fully completed for EACH debt which is secured byproperty of the estate. Attach additional pages if necessary.)Property No. 1Creditor's Name:Describe Property Securing Debt:Property will be (check one): Surrendered RetainedIf retaining the property, I intend to (check at least one): Redeem the property Reaffirm the debt Other. Explain (for example, avoid lien using11 U.S.C. § 522(f)).Property is (check one): Claimed as exempt Not claimed as exemptProperty No. 2 (if necessary) Creditor's Name:Describe Property Securing Debt:Property will be (check one): Surrendered RetainedIf retaining the property, I intend to (check at least one): Redeem the property Reaffirm the debt Other. Explain (for example, avoid lien using11 U.S.C. § 522(f)).Property is (check one): Claimed as exempt Not claimed as exemptForm B8 (Official Form 8) - (Rev. 12/08) - Page 22008 USBC, Central District of CaliforniaPART B – Personal property subject to unexpired leases. (All three columns of Part B must be completed for eachunexpired lease. Attach additional pages if necessary.)Property No. 1Lessor’s Name:Describe Leased Property:Lease will be Assumed pursuant to11 U.S.C. § 365(p)(2): YES NO Property No. 2 (if necessary)Lessor’s Name:Describe Leased Property:Lease will be Assumed pursuant to11 U.S.C. § 365(p)(2): YES NO Property No. 3 (if necessary)Lessor’s Name:Describe Leased Property:Lease will be Assumed pursuant to11 U.S.C. § 365(p)(2): YES NO continuation sheets attached (if any)I declare under penalty of perjury that the above indicates my intention as to any property of my estate securing a debtand/or personal property subject to an unexpired lease.Date: Signature of Debtor Signature of Joint DebtorForm B8 (Official Form 8) - (Rev. 12/08) - Page 32008 USBC, Central District of CaliforniaCHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION(Continuation Sheet)PART A - ContinuationProperty No. Creditor's Name:Describe Property Securing Debt:Property will be (check one): Surrendered RetainedIf retaining the property, I intend to (check at least one): Redeem the property Reaffirm the debt Other. Explain (for example, avoid lien using11U.S.C. § 522(f)).Property is (check one): Claimed as exempt Not claimed as exemptPART B - ContinuationProperty No. Lessor’s Name:Describe Leased Property:Lease will be Assumed pursuant to11 U.S.C. § 365(p)(2): YES NO Property No. Lessor’s Name:Describe Leased Property:Lease will be Assumed pursuant to11 U.S.C. § 365(p)(2): YES NO Statement Regarding Assistance of Non-Attorney - Local Bankruptcy Rule 1002-1 (Rev. 12/03)2003 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn reCase No.:Chapter:STATEMENT REGARDING ASSISTANCE OFNON-ATTORNEY WITH RESPECT TOTHE FILING OF BANKRUPTCY CASETHE DEBTOR/JOINT DEBTOR DOES HEREBY STATE AND REPRESENT:GI received assistance from a non-attorney in connection with the filing of my bankruptcy case.1.I paid the sum of $ 2.I still owe the sum of $ 3.I agreed to turn over or give a security interest in the following property:4.The name of the person or the name of the firm that assisted me was:Name:Address:Telephone:GI did not receive assistance from a non-attorney in connection with the filing of my bankruptcy case.I declare under penalty of perjury that the foregoing is true and correct.Executed at , California.Executed on: Date Debtor Joint DebtorDisclosure of Compensation - (Rev. 12/03)2003 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAAttorney or Party Name, Address, and Telephone NumberFOR COURT USE ONLYIn reCASE NO.:CHAPTER:Debtor.Debtor Address:DISCLOSURE OF COMPENSATION OF BANKRUPTCY PETITION PREPARER1.Under 11 U.S.C. § 110(h), I declare under penalty of perjury that I am not an attorney or employee of an attorney, that Iprepared or caused to be prepared one or more documents for filing by the above-named debtor(s) in connection with thisbankruptcy case, and that compensation paid to me within one year before the filing of the bankruptcy petition, or agreedto be paid to me, for services rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcycase is as follows:For document preparations services, I have agreed to accept...................$ Prior to the filing of this statement I have received............................$ Balance Due.........................................................$ 2.I have prepared or caused to be prepared the following documents (itemize):and provided the following services (itemize):3.The source of the compensation paid to me was:GdebtorGOther (specify):4.The source of compensation to be paid to me is:GdebtorGOther (specify):5.The foregoing is a complete statement of any agreement or arrangement for payment to me for preparation of the petitionfiled by the debtor(s) in this bankruptcy case.6.To my knowledge no other person has prepared for compensation a document for filing in connection with this bankruptcycase except as listed below: NameComplete Social Security NumberDisclosure of Compensation - Page 2 - (Rev. 12/03)2003 USBC, Central District of CaliforniaIn reDebtor.Case No.:(If known)DECLARATION OF BANKRUPTCY PETITION PREPARERI declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge, information, and belief. Signature Complete Social Security NumberDateName (Print): Address: A bankruptcy petition preparer’s failure to comply with the provisions of title 11 and the Federal Rules of BankruptcyProcedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.Form 19 - Page 1 (Rev. 12/07)2007 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCentral District of CaliforniaIn reCase No.:Debtor.(If known)DECLARATION AND SIGNATURE OF NON-ATTORNEYBANKRUPTCY PETITION PREPARER (11 U.S.C. § 110)I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared the accompanying document(s) listed below for compensation and have provided the debtor with a copyof the document(s) and the attached notice as required by 11 U.S.C. §§ 110(b), 110(h), and 342(b); and (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for serviceschargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing anydocument for filing for a debtor or accepting any fee from the debtor, as required by that section.Accompanying documents: Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social Security No. of Bankruptcy Petition Preparer(Required by 11 U.S.C. § 110)If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social security number of theofficer, principal, responsible person or partner who signs this document. AddressX Signature of Bankruptcy Petition PreparerDateNames and social-security numbers of all other individuals who prepared or assisted in preparing this document, unless thebankruptcy petition preparer is not an individual:If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Formfor each person.A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of BankruptcyProcedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.Form 19 - Page 2 (Rev. 12/07)2007 USBC, Central District of CaliforniaIn reCase No.:Debtor.(If known)NOTICE TO DEBTOR BY NON-ATTORNEY BANKRUPTCY PETITION PREPARER[Must be filed with any document(s) prepared by a bankruptcy petition preparer.]I am a bankruptcy petition preparer. I am not an attorney and may not practice law or give legal advice. Beforepreparing any document for filing as defined in § 110(a)(2) of the Bankruptcy Code or accepting any fees, I am required bylaw to provide you with this notice concerning bankruptcy petition preparers. Under the law, § 110 of the Bankruptcy Code(11 U.S.C. § 110), I am forbidden to offer you any legal advice, including advice about any of the following:•whether to file a petition under the Bankruptcy Code (11 U.S.C. § 101 et seq.);•whether commencing a case under chapter 7, 11, 12, or 13 is appropriate;•whether your debts will be eliminated or discharged in a case under the Bankruptcy Code;•whether you will be able to retain your home, car, or other property after commencing a case under the BankruptcyCode;•the tax consequences of a case brought under the Bankruptcy Code;•the dischargeability of tax claims;•whether you may or should promise to repay debts to a creditor or enter into a reaffirmation agreement with a creditorto reaffirm a debt;•how to characterize the nature of your interests in property or your debts; or•bankruptcy procedures and rights.[The notice may provide additional examples of legal advice that a bankruptcy petition preparer is not authorized to give.]In addition, under 11 U.S.C. § 110(h), the Supreme Court or the Judicial Conference of the United States may promulgaterules or guidelines setting a maximum allowable fee chargeable by a bankruptcy petition preparer. As required by law, I havenotified you of this maximum allowable fee, if any, before preparing any document for filing or accepting any fee from you. Signature of DebtorDateJoint Debtor (if any)Date[In a joint case, both spouses must sign.]Form B203 - Disclosure of Compensation of Attorney for Debtor - (1/88)1998 USBC, Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn reCase No.:Debtor.DISCLOSURE OF COMPENSATIONOF ATTORNEY FOR DEBTOR1.Pursuant to 11 U.S.C. § 329(a) and Bankruptcy Rule 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 bankruptcycase is as follow: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:q Debtorq Other (specify)3.The source of compensation to be paid to me is:q Debtorq Other (specify)4.qI have not agreed to share the above-disclosed compensation with any other person unless they are members andassociates of my law firm.qI have agreed to share the above-disclosed compensation with a person or persons who are not members or associatesof 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 petitionin 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;d.Representation of the debtor in adversary proceedings and other contested bankruptcy matters;e.[Other provisions as needed].Form B203 Page Two - Disclosure of Compensation of Attorney for Debtor (1/88)1998 USBC, Central District of California6.By agreement with the debtor(s), the above-disclosed fee does not include the following servicesCERTIFICATION I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me forrepresentation of the debtor(s) in this bankruptcy proceeding. ____________________________________________________________________________DateSignature of Attorney__________________________________________Name of Law FirmRev. 1/01 This form is optional. It has been approved for use by the United States Bankruptcy Court for the Central District of California.F 2090-1.1Attorney or Party Name, Address, Telephone & FAX Numbers, and California State Bar NumberFOR COURT USE ONLYAttorney forUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn re:CHAPTER _______CASE NUMBERDebtor.(No Hearing Required)DECLARATION RE: LIMITED SCOPE OF APPEARANCEPURSUANT TO LOCAL BANKRUPTCY RULE 2090-1TO THE COURT, THE DEBTOR, THE TRUSTEE (if any), AND THE UNITED STATES TRUSTEE:1.I am the attorney for the Debtor in the above-captioned bankruptcy case.2.On (specify date) ____________________________, I agreed with the Debtor that for a fee of $___________, I wouldprovide only the following services:a.qPrepare and file the Petition and Schedulesb.qRepresent the Debtor at the 341(a) Meetingc.qRepresent the Debtor in any relief from stay actionsd.qRepresent the Debtor in any proceeding involving an objection to Debtor’s discharge pursuant to11 U.S.C. § 727e.qRepresent the Debtor in any proceeding to determine whether a specific debt is nondischargeable under 11 U.S.C. § 523f.qOther (specify):3.I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct andthat this declaration was executed on the following date at the city set forth in the upper left-hand corner of this page.Dated:_________________________________________Law Firm NameI HEREBY APPROVE THE ABOVE:By: ___________________________________________________________________________Name: ___________________________________Signature of Debtor Attorney for DebtorFebruary 20062006 USBC Central District of CaliforniaUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAIn reDebtor(s).CHAPTER:CASE NO.:DEBTOR’S CERTIFICATION OF EMPLOYMENT INCOMEPURSUANT TO 11 U.S.C. § 521(a)(1)(B)(iv)Please fill out the following blank(s) and check the box next to one of the following statements:I, , the debtor in this case, declare under penalty (Print Name of Debtor) of perjury under the laws of the United States of America that: GI have attached to this certificate copies of my pay stubs, pay advices and/or other proof of employment income for the60-day period prior to the date of the filing of my bankruptcy petition. (NOTE: the filer is responsible for blacking out the Social Security number on pay stubs prior to filing them.)GI was self-employed for the entire 60-day period prior to the date of the filing of my bankruptcy petition, and receivedno payment from any other employer.GI was unemployed for the entire 60-day period prior to the date of the filing of my bankruptcy petition.I, , the debtor in this case, declare under penalty of (Print Name of Joint Debtor, if any)perjury under the laws of the United States of America that: GI have attached to this certificate copies of my pay stubs, pay advices and/or other proof of employment income for the 60-day period prior to the date of the filing of my bankruptcy petition.(NOTE: the filer is responsible for blacking out the Social Security number on pay stubs prior to filing them.)GI was self-employed for the entire 60-day period prior to the date of the filing of my bankruptcy petition, and receivedno payment from any other employer.GI was unemployed for the entire 60-day period prior to the date of the filing of my bankruptcy petition.Date Signature DebtorDate Signature Joint Debtor (if any)Form B22A (Chapter 7) (04/10) 2010 USBC, Central District of CaliforniaIn re:Case No.:Debtor.(If known) According to the calculations required by this statement: G The presumption arises.G The presumption does not arise.G The presumption is temporarily inapplicable. (Check the box as directed in Part I, III, and VI of this statement) STATEMENT OF CURRENT MONTHLY INCOME AND MEANS TEST CALCULATIONFOR USE IN CHAPTER 7In addition to Schedules I and J, this statement must be completed by every individual chapter 7 debtor, whether or not filing jointly. Unless the exclusionin Line 1C applies, joint debtors may complete a single statement. If the exclusion in Line 1C applies, each joint filer must complete a separate statement.Joint debtors may complete one statement only.Part I. MILITARY AND NON-CONSUMER DEBTORS1. ADisabled Veterans. If you are a disabled veteran described in the Declaration in this Part IA, (1) check the box at the beginning of theDeclaration, (2) check the box for “The presumption does not arise” at the top of this statement, and (3) complete the verification in Part VIII.Do not complete any of the remaining parts of this statement.GDeclaration of Disabled Veteran. By checking this box, I declare under penalty of perjury that I am a disabled veteran (as definedin 38 U.S.C. § 3741(1)) whose indebtedness occurred primarily during a period in which I was on active duty (as defined in 10U.S.C. § 101(d)(1)) or while I was performing a homeland defense activity (as defined in 32 U.S.C. § 901(1)). 1. BNon-consumer Debtors. If your debts are not primarily consumer debts, check the box below and complete the verification in Part VIII.Do not complete any of the remaining parts of this statement. GDeclaration of non-consumer debts. By checking this box, I declare that my debts are not primarily consumer debts.1.CReservists and National Guard Members; active duty or homeland defense activity. Members of a reserve component of the ArmedForces and members of the National Guard who were called to active duty (as defined in 10 U.S.C. § 101(d)(1)) after September 11, 2001,for a period of at least 90 days, or who have performed homeland defense activity (as defined in 32 U.S.C. § 901(1)) for a period of at least90 days, are excluded from all forms of means testing during the time of active duty or homeland defense activity and for 540 days thereafter(the “exclusion period”). If you qualify for this temporary exclusion, (1) check the appropriate boxes and complete any required informationin the Declaration of Reservists and National Guard Members below, (2) check the box for “The presumption is temporarily inapplicable”at the top of this statement, and (3) complete the verification in Part VIII. During your exclusion period you are not required to completethe balance of this form, but you must complete the form no later than 14 days after the date on which your exclusion period ends,unless the time for filing a motion raising the means test presumption expires in your case before your exclusion period ends.G Declaration of Reservists and National Guard Members. By checking this box and making the appropriate entries below, I declarethat I am eligible for a temporary exclusion from means testing because, as a member of a reserve component of the Armed Forces or theNational Guarda. G I was called to active duty after September 11, 2001, for a period of at least 90 days andG I remain on active duty /or/G I was released from active duty on ________________, which is less than 540 days before this bankruptcy casewas filed; ORb. G I am performing homeland defense activity for a period of at least 90 days /or/ G I performed homeland defense activity for a period of at least 90 days, terminating on _______________, which is less than 540 days before this bankruptcy case was filed. Part II. CALCULATION OF MONTHLY INCOME FOR § 707(b)(7) EXCLUSION2.Marital/filing status. Check the box that applies and complete the balance of this part of this statement as directed.a. GUnmarried. Complete only Column A (“Debtor’s Income”) for Lines 3-11. b. GMarried, not filing jointly, with declaration of separate households. By checking this box, debtor declares under penalty of perjury: “Myspouse and I are legally separated under applicable non-bankruptcy law or my spouse and I are living apart other than for the purposeof evading the requirements of § 707(b)(2)(A) of the Bankruptcy Code.” Complete only Column A (“Debtor’s Income”) for Lines 3-11. c. GMarried, not filing jointly, without the declaration of separate households set out in Line 2.b above. Complete both Column A(“Debtor’s Income”) and Column B (Spouse’s Income) for Lines 3-11.d. GMarried, filing jointly. Complete both Column A (“Debtor’s Income”) and Column B (“Spouse’s Income”) for Lines 3-11.Form B22A (Chapter 7)(04/10)2010 USBC, Central District of CaliforniaAll figures must reflect average monthly income received from all sources, derived during the sixcalendar months prior to filing the bankruptcy case, ending on the last day of the month before the filing.If the amount of monthly income varied during the six months, you must divide the six-month total bysix, and enter the result on the appropriate line.Column ADebtor’sIncomeColumn BSpouse’sIncome3.Gross wages, salary, tips, bonuses, overtime, commissions.$$4.Income from the operation of a business, profession or farm. Subtract Line b from Line a andenter the difference in the appropriate column(s) of Line 4. If you operate more than one business,profession or farm, enter aggregate numbers and provide details on an attachment. Do not enter anumber less than zero. Do not include any part of the business expenses entered on Line b asa deduction in Part V.$$a.Gross receipts$b.Ordinary and necessary operating expenses$c.Business incomeSubtract Line b from Line a5.Rent and other real property income. Subtract Line b from Line a and enter the difference in theappropriate column(s) of Line 5. Do not enter a number less than zero. Do not include any part ofthe operating expenses entered on Line b as a deduction in Part V.$$a.Gross receipts$b.Ordinary and necessary operating expenses$c.Rental incomeSubtract Line b from Line a 6.Interest, dividends and royalties.$$7.Pension and retirement income.$$8.Any amounts paid by another person or entity, on a regular basis, for the household expensesof the debtor or the debtor’s dependents, including child support paid for that purpose. Do notinclude alimony or separate maintenance payments or amounts paid by your spouse if Column B iscompleted.$$9.Unemployment compensation. Enter the amount in the appropriate column(s) of Line 9. However,if you contend that unemployment compensation received by you or your spouse was a benefit underthe Social Security Act, do not list the amount of such compensation in Column A or B, but instead statethe amount in the space below$$Unemployment compensation claimed to bea benefit under the Social Security ActDebtor $ Spouse $ 10.Income from all other sources. Specify source and amount. If necessary, list additional sources ona separate page. Total and enter on Line 9. Do not include alimony or separate maintenancepayments paid by your spouse if Column B is completed, but include all other payments ofalimony or separate maintenance. Do not include any benefits received under the Social SecurityAct or payments received as a victim of a war crime, crime against humanity, or as a victim ofinternational or domestic terrorism.$$a.$b.$Total and enter on Line 1011.Subtotal of Current Monthly Income for § 707(b)(7). Add Lines 3 thru 10 in Column A, and, ifColumn B is completed, add Lines 3 through 10 in Column B. Enter the total(s).$$12.Total Current Monthly Income for § 707(b)(7). If Column B has been completed, add Line 11,Column A to Line 11, Column B, and enter the total. If Column B has not been completed, enter theamount from Line 11, Column A.$Part III. APPLICATION OF § 707(b)(7) EXCLUSION13.Annualized Current Monthly Income for § 707(b)(7). Multiply the amount from Line 12 by the number 12 and enterthe result.$14.Applicable median family income. Enter the median family income for the applicable state and household size. (Thisinformation is available by family size at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)a. Enter debtor’s state of residence: _______________ b. Enter debtor’s household size: __________ $Form B22A (Chapter 7)(04/10)2010 USBC, Central District of California15.Application of Section 707(b)(7). Check the applicable box and proceed as directed.GThe amount on Line 13 is less than or equal to the amount on Line 14. Check the box for “The presumption doesnot arise” at the top of page 1 of this statement, and complete Part VIII; do not complete Parts IV, V, VI or VII.GThe amount on Line 13 is more than the amount on Line 14. Complete the remaining parts of this statement.$ Complete Parts IV, V, VI, and VII of this statement only if required. (See Line 15.)Part IV. CALCULATION OF CURRENT MONTHLY INCOME FOR § 707(b)(2)16.Enter the amount from Line 12.$17.Marital adjustment. If you checked the box at Line 2.c, enter on Line 17 the total of any income listed in Line 11, ColumnB that was NOT paid on a regular basis for the household expenses of the debtor or the debtor’s dependents. Specifyin the lines below the basis for excluding the Column B income (such as payment of the spouse’s tax liability or thespouse’s support of persons other than the debtor or the debtor’s dependents) and the amount of income devoted to eachpurpose. If necessary, list additional adjustments on a separate page. If you did not check box at Line 2.c, enter zero.$a.$b.$c.$Total and enter on Line 17.18.Current monthly income for § 707(b)(2). Subtract Line 17 from Line 16 and enter the result.$Part V. CALCULATION OF DEDUCTIONS FROM INCOMESubpart A: Deductions under Standards of the Internal Revenue Service (IRS)19ANational Standards: food, clothing and other items. Enter in Line 19A the “Total” amount from IRS National Standardsfor Food, Clothing and Other Items for the applicable household size. (This information is available at www.usdoj.gov/ust/or from the clerk of the bankruptcy court.) $19BNational Standards: health care. Enter in Line a1 below the amount from IRS National Standards for Out-of-PocketHealth Care for persons under 65 years of age, and in Line a2 the IRS National Standards for Out-of-Pocket Health Carefor persons 65 years of age or older. (This information is available at www.usdoj.gov/ust/ or from the clerk of thebankruptcy court.) Enter in Line b1 the number of members of your household who are under 65 years of age, and enterin Line b2 the number of members of your household who are 65 years of age or older. (The total number of householdmembers must be the same as the number stated in Line 14b.) Multiply Line a1 by Line b1 to obtain a total amount forhousehold members under 65, and enter the result in Line c1. Multiply Line a2 by Line b2 to obtain a total amount forhousehold members 65 and older, and enter the result in Line c2. Add Lines c1 and c2 to obtain a total health careamount, and enter the result in Line 19B.$Household members under 65 years of ageHousehold members 65 years of age or oldera1.Allowance per membera2.Allowance per memberb1.Number of membersb2.Number of membersc1.Subtotalc2.Subtotal20ALocal Standards: housing and utilities; non-mortgage expenses. Enter the amount of the IRS Housing and UtilitiesStandards; non-mortgage expenses for the applicable county and household size. (This information is available atwww.usdoj.gov/ust/ or from the clerk of the bankruptcy court).$20BLocal Standards: housing and utilities; mortgage/rent expense. Enter, in Line a below, the amount of the IRSHousing and Utilities Standards; mortgage/rent expense for your county and household size (this information is availableat www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter on Line b the total of the Average MonthlyPayments for any debts secured by your home, as stated in Line 42; subtract Line b from Line a and enter the result inLine 20B. Do not enter an amount less than zero.$a.IRS Housing and Utilities Standards; mortgage/rental expense$b.Average Monthly Payment for any debts secured by your home, if any,as stated in Line 42 $c.Net mortgage/rental expenseSubtract Line b from Line a.Form B22A (Chapter 7)(04/10)2010 USBC, Central District of California21.Local Standards: housing and utilities; adjustment. If you contend that the process set out in Lines 20A and 20B doesnot accurately compute the allowance to which you are entitled under the IRS Housing and Utilities Standards, enter anyadditional amount to which you contend you are entitled, and state the basis for your contention in the space below: $22A.Local Standards: transportation; vehicle operation/public transportation expense. You are entitled to an expenseallowance in this category regardless of whether you pay the expenses of operating a vehicle and regardless of whetheryou use public transportation.Check the number of vehicles for which you pay the operating expenses or for which the operating expenses are includedas a contribution to your household expenses in Line 8. G 0 G 1 G 2 or more.If you checked 0, enter on Line 22A the “Public Transportation” amount from IRS Local Standards: Transportation. If youchecked 1 or 2 or more, enter on Line 22A the “Operating Costs” amount from IRS Local Standards: Transportation forthe applicable number of vehicles in the applicable Metropolitan Statistical Area or Census Region. (These amounts areavailable at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)$22B.Local Standards: transportation; additional public transportation expense. If you pay the operating expenses fora vehicle and also use public transportation, and you contend that you are entitled to an additional deduction for yourpublic transportation expenses, enter on Line 22B the “Public Transportation” amount from IRS Local Standards:Transportation. (This amount is available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)$23.Local Standards: transportation ownership/lease expense; Vehicle 1. Check the number of vehicles for which youclaim an ownership/lease expense. (You may not claim an ownership/lease expense for more than two vehicles.)G 1 G 2 or more. Enter, in Line a below, the “Ownership Costs” for “One Car” from the IRS Local Standards: Transportation (available atwww.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b the total of the Average Monthly Paymentsfor any debts secured by Vehicle 1, as stated in Line 42; subtract Line b from Line a and enter the result in Line 23. Donot enter an amount less than zero.$a.IRS Transportation Standards, Ownership Costs$b.Average Monthly Payment for any debts secured by Vehicle 1, asstated in Line 42$c.Net ownership/lease expense for Vehicle 1Subtract Line b from Line a.24.Local Standards: transportation ownership/lease expense; Vehicle 2. Complete this Line only if you checked the“2 or more” Box in Line 23.Enter, in Line a below, the “Ownership Costs” for “One Car” from the IRS Local Standards: Transportation (available atat www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b the total of the Average Monthly Paymentsfor any debts secured by Vehicle 2, as stated in Line 42; subtract Line b from Line a and enter the result in Line 24. Donot enter an amount less than zero.$a.IRS Transportation Standards, Ownership Costs$b.Average Monthly Payments for debts secured by Vehicle 2, if any,as stated in Line 42$c.Net ownership/lease expense for Vehicle 2Subtract Line b from Line a.25.Other Necessary Expenses: taxes. Enter the total average monthly expense that you actually incur for all federal, stateand local taxes, other than real estate and sales taxes, such as income taxes, self-employment taxes, social-securitytaxes, and Medicare taxes. Do not include real estate or sales taxes.$26.Other Necessary Expenses: involuntary deductions for employment. Enter the total average monthly payrolldeductions that are required for your employment, such as retirement contributions, union dues, and uniform costs. Donot include discretionary amounts, such as voluntary 401(k) contributions.$27Other Necessary Expenses: life insurance. Enter total average monthly premiums that you actually pay for term lifeinsurance for yourself. Do not include premiums for insurance on your dependents, for whole life or for any otherform of insurance.$28.Other Necessary Expenses: court-ordered payments. Enter the total monthly amount that you are required to paypursuant to the order of a court or administrative agency, such as spousal or child support payments. Do not includepayments on past due obligations included in Line 44.$Form B22A (Chapter 7)(04/10)2010 USBC, Central District of California29.Other Necessary Expenses: education for employment or for a physically or mentally challenged child. Enterthe total average monthly amount that you actually expend for education that is a condition of employment and foreducation that is required for a physically or mentally challenged dependent child for whom no public education providingsimilar services is available.$30Other Necessary Expenses: childcare. Enter the total average monthly amount that you actually expend onchildcare—such as baby-sitting, day care, nursery and preschool. Do not include other educational payments.$31.Other Necessary Expenses: health care. Enter the total average monthly amount that you actually expend on healthcare that is required for the health and welfare of yourself or your dependents, that is not reimbursed by insurance or paidby a health savings account, and that is in excess of the amount entered in Line 19B. Do not include payments forhealth insurance or health savings accounts listed in Line 34.$32.Other Necessary Expenses: telecommunication services. Enter the total average monthly amount that you actuallypay for telecommunication services other than your basic home telephone and cell phone service—such as pagers, callwaiting, caller id, special long distance, or internet service—to the extent necessary for your health and welfare or thatof your dependents. Do not include any amount previously deducted.$33.Total Expenses Allowed under IRS Standards. Enter the total of Lines 19 through 32.$Subpart B: Additional Living Expense DeductionsNote: Do not include any expenses that you have listed in Lines 19-3234.Health Insurance, Disability Insurance, and Health Savings Account Expenses. List the monthly expenses in thecategories set out in lines a-c below that are reasonably necessary for yourself, your spouse, or your dependents$a.Health Insurance$b.Disability Insurance$c.Health Savings Account$Total and enter on Line 34 If you do not actually expend this total amount, state your actual total average monthly expenditures in the space below:$ ____________ 35.Continued contributions to the care of household or family members. Enter the total average actual monthlyexpenses that you will continue to pay for the reasonable and necessary care and support of an elderly, chronically ill, ordisabled member of your household or member of your immediate family who is unable to pay for such expenses.$36.Protection against family violence. Enter the total average reasonably necessary monthly expenses that you actuallyincurred to maintain the safety of your family under the Family Violence Prevention and Services Act or other applicablefederal law. The nature of these expenses is required to be kept confidential by the court.$37.Home energy costs. Enter the total average monthly amount, in excess of the allowance specified by IRS LocalStandards for Housing and Utilities, that you actually expend for home energy costs. You must provide your casetrustee with documentation of your actual expenses, and you must demonstrate that the additional amountclaimed is reasonable and necessary.$38.Education expenses for dependent children less than 18. Enter the total average monthly expenses that you actuallyincur, not to exceed $147.92* per child, for attendance at a private or public elementary or secondary school by yourdependent children less than 18 years of age. You must provide your case trustee with documentation of your actualexpenses, and you must explain why the amount claimed is reasonable and necessary and not already accountedfor in the IRS Standards.$39.Additional food and clothing expense. Enter the total average monthly amount by which your food and clothingexpenses exceed the combined allowances for food and clothing (apparel and services) in the IRS National Standards,not to exceed 5% of those combined allowances. (This information is available at www.usdoj.gov/ust/ or from the clerkof the bankruptcy court.) You must demonstrate that the additional amount claimed is reasonable and necessary.$40.Continued charitable contributions. Enter the amount that you will continue to contribute in the form of cash or financialinstruments to a charitable organization as defined in 26 U.S.C. § 170(c)(1)-(2).$41.Total Additional Expense Deductions under § 707(b). Enter the total of Lines 34 through 40$* Amount subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after date of adjustment.Form B22A (Chapter 7)(04/10)2010 USBC, Central District of CaliforniaSubpart C: Deductions for Debt Payment42.Future payments on secured claims. For each of your debts that is secured by an interest in property that you own,list the name of the creditor, identify the property securing the debt, state the Average Monthly Payment, and checkwhether the payment includes taxes or insurance. The Average Monthly Payment is the total of all amounts scheduledas contractually due to each Secured Creditor in the 60 months following the filing of the bankruptcy case, divided by 60.If necessary, list additional entries on a separate page. Enter the total of the Average Monthly Payments on Line 42.$Name of CreditorProperty Securing the DebtAverage MonthlyPaymentDoes paymentinclude taxes orinsurance?a.$… yes … nob.$… yes … noc.$… yes … noTotal: Add Lines a,b and c43.Other payments on secured claims. If any of debts listed in Line 42 are secured by your primary residence, a motorvehicle, or other property necessary for your support or the support of your dependents, you may include in your deduction1/60th of any amount (the “cure amount”) that you must pay the creditor in addition to the payments listed in Line 42, inorder to maintain possession of the property. The cure amount would include any sums in default that must be paid inorder to avoid repossession or foreclosure. List and total any such amounts in the following chart. If necessary, listadditional entries on a separate page.$Name of CreditorProperty Securing the Debt1/60 of the Cure Amounta.$b.$c.$Total: Add Lines a, b and c44.Payments on prepetition priority claims. Enter the total amount, divided by 60, of all priority claims, such as prioritytax, child support and alimony claims, for which you were liable at the time of your bankruptcy filing. Do not includecurrent obligations, such as those set out in Line 28. $45.Chapter 13 administrative expenses. If you are eligible to file a case under chapter 13, complete the following chart,multiply the amount in line a by the amount in line b, and enter the resulting administrative expense.$a.Projected average monthly Chapter 13 plan payment.$b.Current multiplier for your district as determined under schedules issued bythe Executive Office for United States Trustees. (This information isavailable at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)Xc.Average monthly administrative expense of Chapter 13 case Total: Multiply Lines a and b 46.Total Deductions for Debt Payment. Enter the total of Lines 42 through 45.$Subpart D: Total Deductions from Income47.Total of all deductions allowed under § 707(b)(2). Enter the total of Lines 33, 41, and 46.$Part VI. DETERMINATION OF § 707(b)(2) PRESUMPTION48.Enter the amount from Line 18 (Current monthly income for § 707(b)(2)) $49.Enter the amount from Line 47 (Total of all deductions allowed under § 707(b)(2))$50.Monthly disposable income under § 707(b)(2). Subtract Line 49 from Line 48 and enter the result.$51.60-month disposable income under § 707(b)(2). Multiply the amount in Line 50 by the number 60 and enter the result.$Form B22A (Chapter 7)(04/10)2010 USBC, Central District of California52.Initial presumption determination. Check the applicable box and proceed as directed.GThe amount on Line 51 is less than $7,025* Check the box for “The presumption does not arise” at the top of page 1 of this statement,and complete the verification in Part VIII. Do not complete the remainder of Part VI.GThe amount set forth on Line 51 is more than $11,725* Check the box for “The presumption arises” at the top of page 1 of thisstatement, and complete the verification in Part VIII. You may also complete Part VII. Do not complete the remainder of Part VI.GThe amount on Line 51 is at least $7,025*, but not more than $11,725*. Complete the remainder of Part VI (Lines 53 through 55).53.Enter the amount of your total non-priority unsecured debt$54.Threshold debt payment amount. Multiply the amount in Line 53 by the number 0.25 and enter the result.$55.Secondary presumption determination. Check the applicable box and proceed as directed.GThe amount on Line 51 is less than the amount on Line 54. Check the box for “The presumption does not arise” at the top of page 1of this statement, and complete the verification in Part VIII.GThe amount on Line 51 is equal to or greater than the amount on Line 54. Check the box for “The presumption arises” at the topof page 1 of this statement, and complete the verification in Part VIII. You may also complete Part VII.Part VII: ADDITIONAL EXPENSE CLAIMS56.Other Expenses. List and describe any monthly expenses, not otherwise stated in this form, that are required for the health and welfareof you and your family and that you contend should be an additional deduction from your current monthly income under § 707(b)(2)(A)(ii)(I).If necessary, list additional sources on a separate page. All figures should reflect your average monthly expense for each item. Total theexpenses.Expense DescriptionMonthly Amounta.$b.$c.$Total: Add Lines a, b and c$Part VIII: VERIFICATION57.I declare under penalty of perjury that the information provided in this statement is true and correct. (If this is a joint case, both debtorsmust sign.)Date: Signature (Debtor)Date: Signature (Joint Debtor, if any)* Amount subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after date of adjustment.Verification of Creditor Mailing List - (Rev. 10/05)2003 USBC, Central District of CaliforniaMASTER MAILING LISTVerification Pursuant to Local Bankruptcy Rule 1007-2(d)Name Address Telephone GAttorney for Debtor(s)GDebtor in Pro PerUNITED STATES BANKRUPTCY COURTCENTRAL DISTRICT OF CALIFORNIAList all names including trade names used by Debtor(s) within last8 years):Case No.:Chapter:VERIFICATION OF CREDITOR MAILING LISTThe above named debtor(s), or debtor’s attorney if applicable, do hereby certify under penalty of perjury that the attachedMaster Mailing List of creditors, consisting of sheet(s) is complete, correct, and consistent with the debtor’s schedulespursuant to Local Rule 1007-2(d) and I/we assume all responsibility for errors and omissions.Date: Debtor Attorney (if applicable)Joint Debtor