+--------------+----------------------+-------------------------------+
| **ADVERSARY  |                      | **ADVERSARY PROCEEDING        |
| PROCEEDING   |                      | NUMBER**                      |
| COVER        |                      |                               |
| SHEET**      |                      |                               |
| (            |                      |                               |
| Instructions |                      |                               |
| next page)   |                      |                               |
+--------------+----------------------+-------------------------------+
| **           |                      | **DEFENDANTS**                |
| PLAINTIFFS** |                      |                               |
| (Name and    |                      |                               |
| Address)     |                      |                               |
+--------------+----------------------+-------------------------------+
| *            |                      | **ATTORNEYS (If Known)**      |
| *ATTORNEYS** |                      |                               |
| (Firm Name,  |                      |                               |
| Address, and |                      |                               |
| Telephone    |                      |                               |
| No.)         |                      |                               |
+--------------+----------------------+-------------------------------+
| **PARTY**    |                      | **PARTY** (Check One Box      |
| (Check One   |                      | Only)                         |
| Box Only)    |                      |                               |
|              |                      | ☐ Debtor ☐ U.S.               |
| ☐ Debtor ☐   |                      | Trustee/Bankruptcy Admin      |
| U.S.         |                      |                               |
| Truste       |                      | ☐ Creditor ☐ Other            |
| e/Bankruptcy |                      |                               |
| Admin        |                      | ☐ Trustee                     |
|              |                      |                               |
| ☐ Creditor ☐ |                      |                               |
| Other        |                      |                               |
|              |                      |                               |
| ☐ Trustee    |                      |                               |
+--------------+----------------------+-------------------------------+
| **CAUSE OF   |                      |                               |
| ACTION**     |                      |                               |
| (WRITE A     |                      |                               |
| BRIEF        |                      |                               |
| STATEMENT OF |                      |                               |
| CAUSE OF     |                      |                               |
| ACTION,      |                      |                               |
| INCLUDING    |                      |                               |
| ALL U. S.    |                      |                               |
| STATUTES     |                      |                               |
| INVOLVED)    |                      |                               |
+--------------+----------------------+-------------------------------+
| **NATURE OF  |                      |                               |
| SUIT**       |                      |                               |
|              |                      |                               |
| (Number up   |                      |                               |
| to five (5)  |                      |                               |
| boxes        |                      |                               |
| starting     |                      |                               |
| with lead    |                      |                               |
| cause of     |                      |                               |
| action as 1, |                      |                               |
| first        |                      |                               |
| alternative  |                      |                               |
| case as 2,   |                      |                               |
| second       |                      |                               |
| alternative  |                      |                               |
| case as 3,   |                      |                               |
| etc.)        |                      |                               |
+--------------+----------------------+-------------------------------+
| **FRBP       |                      |                               |
| 7001(1) -    |                      |                               |
| Recovery of  |                      |                               |
| Mo           |                      |                               |
| ney/Property |                      |                               |
| FREP         |                      |                               |
| 7001(6) -    |                      |                               |
| Disc         |                      |                               |
| hargeability |                      |                               |
| (            |                      |                               |
| continued)** |                      |                               |
|              |                      |                               |
| ☐ 11-        |                      |                               |
| Recovery of  |                      |                               |
| mone         |                      |                               |
| y/property - |                      |                               |
| §542         |                      |                               |
| turnover of  |                      |                               |
| property ☐   |                      |                               |
| 61 -         |                      |                               |
| Discha       |                      |                               |
| rgeability - |                      |                               |
| §523(a)(5)   |                      |                               |
| domestic     |                      |                               |
| support      |                      |                               |
|              |                      |                               |
| ☐ 12 -       |                      |                               |
| Recovery of  |                      |                               |
| mone         |                      |                               |
| y/property - |                      |                               |
| §547         |                      |                               |
| preference ☐ |                      |                               |
| 68 -         |                      |                               |
| Discha       |                      |                               |
| rgeability - |                      |                               |
| §523(a)(6),  |                      |                               |
| willful and  |                      |                               |
| malicious    |                      |                               |
|              |                      |                               |
| injury       |                      |                               |
|              |                      |                               |
| ☐ 13 -       |                      |                               |
| Recovery of  |                      |                               |
| mone         |                      |                               |
| y/property - |                      |                               |
| §548         |                      |                               |
| fraudulent   |                      |                               |
| transfer ☐   |                      |                               |
| 63 -         |                      |                               |
| Discha       |                      |                               |
| rgeability - |                      |                               |
| §523(a)(8),  |                      |                               |
| student loan |                      |                               |
|              |                      |                               |
| ☐ 14 -       |                      |                               |
| Recovery of  |                      |                               |
| mone         |                      |                               |
| y/property - |                      |                               |
| other ☐ 64 - |                      |                               |
| Discha       |                      |                               |
| rgeability - |                      |                               |
| §523(a)(15), |                      |                               |
| divorce or   |                      |                               |
|              |                      |                               |
| separation   |                      |                               |
| obligation   |                      |                               |
| (other than  |                      |                               |
| domestic     |                      |                               |
| support)     |                      |                               |
|              |                      |                               |
| **FRBP       |                      |                               |
| 7001(2) -    |                      |                               |
| Validity,    |                      |                               |
| Priority or  |                      |                               |
| Extent of    |                      |                               |
| Lien** ☐     |                      |                               |
| 65 -         |                      |                               |
| Discha       |                      |                               |
| rgeability - |                      |                               |
| other        |                      |                               |
|              |                      |                               |
| ☐ 21 -       |                      |                               |
| Validity,    |                      |                               |
| priority or  |                      |                               |
| extent of    |                      |                               |
| lien or      |                      |                               |
| other        |                      |                               |
| interest in  |                      |                               |
| property     |                      |                               |
|              |                      |                               |
| **FRBP       |                      |                               |
| 7001(7) -    |                      |                               |
| Injunctive   |                      |                               |
| Relief**     |                      |                               |
|              |                      |                               |
| ☐            |                      |                               |
| 7            |                      |                               |
| 1-Injunctive |                      |                               |
| relief -     |                      |                               |
| r            |                      |                               |
| einstatement |                      |                               |
| of stay      |                      |                               |
|              |                      |                               |
| **FRBP       |                      |                               |
| 7001(3) -    |                      |                               |
| Approval of  |                      |                               |
| Sale of      |                      |                               |
| Property** ☐ |                      |                               |
| 7            |                      |                               |
| 2-Injunctive |                      |                               |
| relief -     |                      |                               |
| other        |                      |                               |
|              |                      |                               |
| ☐ 31 -       |                      |                               |
| Approval of  |                      |                               |
| sale of      |                      |                               |
| property of  |                      |                               |
| estate and   |                      |                               |
| of a         |                      |                               |
| co-owner -   |                      |                               |
| §363(h)      |                      |                               |
|              |                      |                               |
| **FRBP       |                      |                               |
| 7001(4) -    |                      |                               |
| Objectio     |                      |                               |
| n/Revocation |                      |                               |
| of Discharge |                      |                               |
| FRBP         |                      |                               |
| 7001(8) -    |                      |                               |
| S            |                      |                               |
| ubordination |                      |                               |
| of Claim or  |                      |                               |
| Interest**   |                      |                               |
|              |                      |                               |
| ☐            |                      |                               |
| 41-Objection |                      |                               |
| / revocation |                      |                               |
| of           |                      |                               |
| discharge -  |                      |                               |
| §72          |                      |                               |
| 7(c),(d),(e) |                      |                               |
| ☐            |                      |                               |
| 81-S         |                      |                               |
| ubordination |                      |                               |
| of claim or  |                      |                               |
| interest     |                      |                               |
|              |                      |                               |
| **FRBP       |                      |                               |
| 7001(5) -    |                      |                               |
| Revocation   |                      |                               |
| of           |                      |                               |
| Confirmation |                      |                               |
| FRBP 7001(9) |                      |                               |
| Declaratory  |                      |                               |
| Judgment**   |                      |                               |
|              |                      |                               |
| ☐ 51 -       |                      |                               |
| Revocation   |                      |                               |
| of           |                      |                               |
| confirmation |                      |                               |
| ☐ 91 -       |                      |                               |
| Declaratory  |                      |                               |
| judgment     |                      |                               |
|              |                      |                               |
| **F          |                      |                               |
| RBP7001(6) - |                      |                               |
| Disc         |                      |                               |
| hargeability |                      |                               |
| FRBP         |                      |                               |
| 7001(10)     |                      |                               |
| D            |                      |                               |
| etermination |                      |                               |
| of Removed   |                      |                               |
| Action**     |                      |                               |
|              |                      |                               |
| ☐            |                      |                               |
| 66-Discha    |                      |                               |
| rgeability - |                      |                               |
| §523(a)(1    |                      |                               |
| ),(14),(14A) |                      |                               |
| priority tax |                      |                               |
| claims ☐     |                      |                               |
| 01-D         |                      |                               |
| etermination |                      |                               |
| of removed   |                      |                               |
| claim or     |                      |                               |
| cause        |                      |                               |
|              |                      |                               |
| ☐            |                      |                               |
| 62-Discha    |                      |                               |
| rgeability - |                      |                               |
| §523(a)(2),  |                      |                               |
| false        |                      |                               |
| pretenses,   |                      |                               |
| false        |                      |                               |
| rep          |                      |                               |
| resentation, |                      |                               |
|              |                      |                               |
| actual fraud |                      |                               |
| **Other**    |                      |                               |
|              |                      |                               |
| ☐            |                      |                               |
| 67-Discha    |                      |                               |
| rgeability - |                      |                               |
| §523(a)(4),  |                      |                               |
| fraud as     |                      |                               |
| fiduciary,   |                      |                               |
| e            |                      |                               |
| mbezzlement, |                      |                               |
| ☐ SS-SIPA    |                      |                               |
| Case - 15    |                      |                               |
| U.S.C.       |                      |                               |
| §§78aaa      |                      |                               |
| *et.seq*     |                      |                               |
|              |                      |                               |
| larceny ☐    |                      |                               |
| 02-Other     |                      |                               |
| (e.g. other  |                      |                               |
| actions that |                      |                               |
| would have   |                      |                               |
| been in      |                      |                               |
|              |                      |                               |
| state court  |                      |                               |
| if unrelated |                      |                               |
| to           |                      |                               |
| bankruptcy   |                      |                               |
| case)        |                      |                               |
|              |                      |                               |
| **(continued |                      |                               |
| next         |                      |                               |
| column)**    |                      |                               |
+--------------+----------------------+-------------------------------+
| ☐ Check if   |                      | ☐ Check if this is asserted   |
| this case    |                      | to be a class action under    |
| involves a   |                      | FRCP 23                       |
| substantive  |                      |                               |
| issue of     |                      |                               |
| state law    |                      |                               |
+--------------+----------------------+-------------------------------+
| ![]          |                      | Demand \$                     |
| (media/image |                      |                               |
| 1.wmf){width |                      |                               |
| ="0.15069444 |                      |                               |
| 444444444in" |                      |                               |
| height=      |                      |                               |
| "0.150694444 |                      |                               |
| 44444444in"} |                      |                               |
|              |                      |                               |
| Check if a   |                      |                               |
| jury trial   |                      |                               |
| is demanded  |                      |                               |
| in complaint |                      |                               |
+--------------+----------------------+-------------------------------+
| Other Relief |                      |                               |
| Sought       |                      |                               |
+--------------+----------------------+-------------------------------+
| **BANKRUPTCY |                      |                               |
| CASE IN      |                      |                               |
| WHICH THIS   |                      |                               |
| ADVERSARY    |                      |                               |
| PROCEEDING   |                      |                               |
| ARISES**     |                      |                               |
+--------------+----------------------+-------------------------------+
| NAME OF      |                      | BANKRUPTCY CASE NO.           |
| DEBTOR       |                      |                               |
+--------------+----------------------+-------------------------------+
| DISTRICT IN  | DIVISIONAL OFFICE    | NAME OF JUDGE                 |
| WHICH        |                      |                               |
|              |                      |                               |
| CASE IS      |                      |                               |
| PENDING      |                      |                               |
+--------------+----------------------+-------------------------------+
| **RELATED    |                      |                               |
| ADVERSARY    |                      |                               |
| PROCEEDING   |                      |                               |
| (IF ANY)**   |                      |                               |
+--------------+----------------------+-------------------------------+
| PLAINTIFF    | DEFENDANT            | ADVERSARY PROCEEDING NO.      |
+--------------+----------------------+-------------------------------+
| DISTRICT IN  | DIVISIONAL OFFICE    | NAME OF JUDGE                 |
| WHICH        |                      |                               |
| ADVERSARY IS |                      |                               |
| PENDING      |                      |                               |
+--------------+----------------------+-------------------------------+
| SIGNATURE OF |                      |                               |
| ATTORNEY (OR |                      |                               |
| PLAINTIFF)   |                      |                               |
+--------------+----------------------+-------------------------------+
| DATE         | PRINT NAME OF        |                               |
|              | ATTORNEY (OR         |                               |
|              | PLAINTIFF)           |                               |
+--------------+----------------------+-------------------------------+

**INSTRUCTIONS**

The filing of a bankruptcy case creates an "estate" under the
jurisdiction of the bankruptcy court which consists of all of the
property of the debtor, wherever that property is located. Because the
bankruptcy estate is so extensive and the jurisdiction of the court so
broad, there may be lawsuits over the property or property rights of the
estate. There also may be lawsuits concerning the debtor's discharge. If
such a lawsuit is filed in a bankruptcy court, it is called an adversary
proceeding.

A party filing an adversary proceeding must also complete and file Form
104, the Adversary Proceeding Cover Sheet, if it is required by the
court. In some courts, the cover sheet is not required when the
adversary proceeding is filed electronically through the court's Case
Management/Electronic Case Files (CM/ECF) system. (CM/ECF captures the
information on Form 104 as part of the filing process.) When completed,
the cover sheet summarizes basic information on the adversary
proceeding. The clerk of court needs the information to process the
adversary proceeding and prepare required statistical reports on court
activity.

The cover sheet and the information contained on it do not replace or
supplement the filing and service of pleadings or other papers as
required by law, the Bankruptcy Rules, or the local rules of court. The
cover sheet, which is largely self-explanatory, must be completed by the
plaintiff's attorney (or by the plaintiff if the plaintiff is not
represented by an attorney). A separate cover sheet must be submitted to
the clerk for each complaint filed.

**Plaintiffs** and **Defendants.** Give the names of the plaintiffs and
the defendants exactly as they appear on the complaint.

**Attorneys.** Give the names and addresses of the attorneys, if known.

**Party.** Check the most appropriate box in the first column for the
plaintiffs and in the second column for the defendants.

**Demand.** Enter the dollar amount being demanded in the complaint.

**Signature.** This cover sheet must be signed by the attorney of record
in the box on the second page of the form. If the plaintiff is
represented by a law firm, a member of the firm must sign. If the
plaintiff is pro se, that is, not represented by an attorney, the
plaintiff must sign.