Fill in this information to identify your case:

United States Bankruptcy Court for the:

EASTERN DISTRICT OF VIRGINIA

Case number (if known) Chapter you are filing under:

 Chapter 7

 Chapter 11

 Chapter 12

 Chapter 13  Check if this an

amended filing

B 101 

Voluntary Petition for Individuals Filing for Bankruptcy 12/15

The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a joint

case—and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,” the answer

would be yes if either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 1 and Debtor 2 to

distinguish between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The same person must be

Debtor 1 in all of the forms.

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If

more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer

every question.

Part 1: Identify Yourself

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

1. Your full name

Write the name that is on

your government-issued

picture identification (for

example, your driver's

license or passport).

Bring your picture

identification to your

meeting with the trustee.

Tiara William

First name First name

Alberta Monai Samuel

Middle name Middle name

Street, Jr. Street

Last name and Suffix (Sr., Jr., II, III) Last name and Suffix (Sr., Jr., II, III)

2. All other names you have

used in the last 8 years

Include your married or

maiden names.

Tiara Alberta Monai Mears

3. Only the last 4 digits of

your Social Security

number or federal

Individual Taxpayer

Identification number

(ITIN)

xxx-xx-8584 xxx-xx-8726

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 1

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

4. Any business names and

Employer Identification

Numbers (EIN) you have

used in the last 8 years

 I have not used any business name or EINs.  I have not used any business name or EINs.

Include trade names and

doing business as names

Business name(s) Business name(s)

EINs EINs

5. Where you live If Debtor 2 lives at a different address:

204 Peakside Way Apt G

Petersburg, VA 23805

Number, Street, City, State & ZIP Code Number, Street, City, State & ZIP Code

Petersburg City

County County

If your mailing address is different from the one

above, fill it in here. Note that the court will send any

notices to you at this mailing address.

If Debtor 2's mailing address is different from yours, fill it

in here. Note that the court will send any notices to this

mailing address.

Number, P.O. Box, Street, City, State & ZIP Code Number, P.O. Box, Street, City, State & ZIP Code

6. Why you are choosing

this district to file for

bankruptcy

Check one:

 Over the last 180 days before filing this

petition, I have lived in this district longer than

in any other district.

 I have another reason.

Explain. (See 28 U.S.C. § 1408.)

Check one:

 Over the last 180 days before filing this petition, I

have lived in this district longer than in any other

district.

 I have another reason.

Explain. (See 28 U.S.C. § 1408.)

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 2

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Part 2: Tell the Court About Your Bankruptcy Case

7. The chapter of the

Bankruptcy Code you are

choosing to file under

Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy

(Form 2010)). Also, go to the top of page 1 and check the appropriate box.

 Chapter 7

 Chapter 11

 Chapter 12

 Chapter 13

8. How you will pay the fee  I will pay the entire fee when I file my petition. Please check with the clerk’s office in your local court for more details

about how you may pay. Typically, if you are paying the fee yourself, you may pay with cash, cashier’s check, or money

order. If your attorney is submitting your payment on your behalf, your attorney may pay with a credit card or check with

a pre-printed address.

 I need to pay the fee in installments. If you choose this option, sign and attach the Application for Individuals to Pay

The Filing Fee in Installments (Official Form 103A).

 I request that my fee be waived (You may request this option only if you are filing for Chapter 7. By law, a judge may,

but is not required to, waive your fee, and may do so only if your income is less than 150% of the official poverty line

that applies to your family size and you are unable to pay the fee in installments). If you choose this option, you must fill

out the Application to Have the Chapter 7 Filing Fee Waived (Official Form 103B) and file it with your petition.

9. Have you filed for

bankruptcy within the

last 8 years?

 No.

 Yes.

District When Case number

District When Case number

District When Case number

10. Are any bankruptcy

cases pending or being

filed by a spouse who is

not filing this case with

you, or by a business

partner, or by an

affiliate?

 No

 Yes.

Debtor Relationship to you

District When Case number, if known

Debtor Relationship to you

District When Case number, if known

11. Do you rent your

residence?

 No. Go to line 12.

 Yes. Has your landlord obtained an eviction judgment against you and do you want to stay in your residence?

 No. Go to line 12.

 Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) and file it with this

bankruptcy petition.

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 3

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Part 3: Report About Any Businesses You Own as a Sole Proprietor

12. Are you a sole proprietor

of any full- or part-time

business?

 No. Go to Part 4.

 Yes. Name and location of business

A sole proprietorship is a

business you operate as

an individual, and is not a

separate legal entity such

as a corporation,

partnership, or LLC.

Name of business, if any

If you have more than one

sole proprietorship, use a

separate sheet and attach

it to this petition.

Number, Street, City, State & ZIP Code

Check the appropriate box to describe your business:

 Health Care Business (as defined in 11 U.S.C. § 101(27A))

 Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))

 Stockbroker (as defined in 11 U.S.C. § 101(53A))

 Commodity Broker (as defined in 11 U.S.C. § 101(6))

 None of the above

13. Are you filing under

Chapter 11 of the

Bankruptcy Code and are

you a small business

debtor?

If you are filing under Chapter 11, the court must know whether you are a small business debtor so that it can set appropriate

deadlines. If you indicate that you are a small business debtor, you must attach your most recent balance sheet, statement of

operations, cash-flow statement, and federal income tax return or if any of these documents do not exist, follow the procedure

in 11 U.S.C. 1116(1)(B).

For a definition of small

business debtor, see 11

U.S.C. § 101(51D).

 No. I am not filing under Chapter 11.

 No. I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in the Bankruptcy

Code.

 Yes. I am filing under Chapter 11 and I am a small business debtor according to the definition in the Bankruptcy Code.

Part 4: Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention

14. Do you own or have any

property that poses or is

alleged to pose a threat

of imminent and

identifiable hazard to

public health or safety?

Or do you own any

property that needs

immediate attention?

 No.

 Yes.

What is the hazard?

If immediate attention is

needed, why is it needed?

For example, do you own

perishable goods, or

livestock that must be fed,

or a building that needs

urgent repairs?

Where is the property?

Number, Street, City, State & Zip Code

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 4

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Part 5: Explain Your Efforts to Receive a Briefing About Credit Counseling

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

15. Tell the court whether

you have received a

briefing about credit

counseling.

The law requires that you

receive a briefing about

credit counseling before

you file for bankruptcy.

You must truthfully check

one of the following

choices. If you cannot do

so, you are not eligible to

file.

If you file anyway, the court

can dismiss your case, you

will lose whatever filing fee

you paid, and your

creditors can begin

collection activities again.

You must check one: You must check one:

 I received a briefing from an approved credit

counseling agency within the 180 days before I

filed this bankruptcy petition, and I received a

certificate of completion.

Attach a copy of the certificate and the payment

plan, if any, that you developed with the agency.

 I received a briefing from an approved credit

counseling agency within the 180 days before I filed

this bankruptcy petition, and I received a certificate of

completion.

Attach a copy of the certificate and the payment plan, if

any, that you developed with the agency.

 I received a briefing from an approved credit

counseling agency within the 180 days before I

filed this bankruptcy petition, but I do not have

a certificate of completion.

Within 14 days after you file this bankruptcy

petition, you MUST file a copy of the certificate and

payment plan, if any.

 I received a briefing from an approved credit

counseling agency within the 180 days before I filed

this bankruptcy petition, but I do not have a

certificate of completion.

Within 14 days after you file this bankruptcy petition, you

MUST file a copy of the certificate and payment plan, if

any.

 I certify that I asked for credit counseling

services from an approved agency, but was

unable to obtain those services during the 7

days after I made my request, and exigent

circumstances merit a 30-day temporary waiver

of the requirement.

To ask for a 30-day temporary waiver of the

requirement, attach a separate sheet explaining

what efforts you made to obtain the briefing, why

you were unable to obtain it before you filed for

bankruptcy, and what exigent circumstances

required you to file this case.

Your case may be dismissed if the court is

dissatisfied with your reasons for not receiving a

briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must

still receive a briefing within 30 days after you file.

You must file a certificate from the approved

agency, along with a copy of the payment plan you

developed, if any. If you do not do so, your case

may be dismissed.

Any extension of the 30-day deadline is granted

only for cause and is limited to a maximum of 15

days.

 I certify that I asked for credit counseling services

from an approved agency, but was unable to obtain

those services during the 7 days after I made my

request, and exigent circumstances merit a 30-day

temporary waiver of the requirement.

To ask for a 30-day temporary waiver of the requirement,

attach a separate sheet explaining what efforts you made

to obtain the briefing, why you were unable to obtain it

before you filed for bankruptcy, and what exigent

circumstances required you to file this case.

Your case may be dismissed if the court is dissatisfied

with your reasons for not receiving a briefing before you

filed for bankruptcy.

If the court is satisfied with your reasons, you must still

receive a briefing within 30 days after you file. You must

file a certificate from the approved agency, along with a

copy of the payment plan you developed, if any. If you do

not do so, your case may be dismissed.

Any extension of the 30-day deadline is granted only for

cause and is limited to a maximum of 15 days.

 I am not required to receive a briefing about

credit counseling because of:

 I am not required to receive a briefing about credit

counseling because of:

 Incapacity. I have a mental illness or a

mental deficiency that makes

me incapable of realizing or

making rational decisions

about finances.

 Incapacity. I have a mental illness or a mental

deficiency that makes me incapable

of realizing or making rational

decisions about finances.

 Disability. My physical disability causes

me to be unable to participate

in a briefing in person, by

phone, or through the

internet, even after I

reasonably tried to do so.

 Disability. My physical disability causes me to

be unable to participate in a briefing

in person, by phone, or through the

internet, even after I reasonably tried

to do so.

 Active duty. I am currently on active

military duty in a military

combat zone.

 Active duty. I am currently on active military duty

in a military combat zone.

If you believe you are not required to receive a

briefing about credit counseling, you must file a

motion for waiver of credit counseling with the

court.

If you believe you are not required to receive a briefing

about credit counseling, you must file a motion for waiver

of credit counseling with the court.

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 5

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Part 6: Answer These Questions for Reporting Purposes

16. What kind of debts do

you have?

16a. Are your debts primarily consumer debts? Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by an

individual primarily for a personal, family, or household purpose.”

 No. Go to line 16b.

 Yes. Go to line 17.

16b. Are your debts primarily business debts? Business debts are debts that you incurred to obtain

money for a business or investment or through the operation of the business or investment.

 No. Go to line 16c.

 Yes. Go to line 17.

16c. State the type of debts you owe that are not consumer debts or business debts

17. Are you filing under

Chapter 7?

 No. I am not filing under Chapter 7. Go to line 18.

Do you estimate that

after any exempt

property is excluded and

administrative expenses

are paid that funds will

be available for

distribution to unsecured

creditors?

 Yes. I am filing under Chapter 7. Do you estimate that after any exempt property is excluded and administrative

expenses are paid that funds will be available to distribute to unsecured creditors?

 No

 Yes

18. How many Creditors do

you estimate that you

owe?

 1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than100,000

19. How much do you

estimate your assets to

be worth?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

20. How much do you

estimate your liabilities

to be?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

Part 7: Sign Below

For you I have examined this petition, and I declare under penalty of perjury that the information provided is true and correct.

If I have chosen to file under Chapter 7, I am aware that I may proceed, if eligible, under Chapter 7, 11,12, or 13 of title 11,

United States Code. I understand the relief available under each chapter, and I choose to proceed under Chapter 7.

If no attorney represents me and I did not pay or agree to pay someone who is not an attorney to help me fill out this

document, 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 this petition.

I understand making a false statement, concealing property, or obtaining money or property by fraud in connection with a

bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341,

1519, and 3571.

/s/ Tiara Alberta Monai Street, Jr. /s/ William Samuel Street

Tiara Alberta Monai Street, Jr. William Samuel Street

Signature of Debtor 1 Signature of Debtor 2

Executed on December 2, 2015 Executed on December 2, 2015

MM / DD / YYYY MM / DD / YYYY

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 6

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

For your attorney, if you are

represented by one

If you are not represented by

an attorney, you do not need

to file this page.

I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility to proceed

under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each chapter

for which the person is eligible. I also certify that I have delivered to the debtor(s) the notice required by 11 U.S.C. §

342(b) and, in a case in which § 707(b)(4)(D) applies, certify that I have no knowledge after an inquiry that the information

in the schedules filed with the petition is incorrect.

/s/ Richard J. Oulton for America Law Group Date December 2, 2015

Signature of Attorney for Debtor MM / DD / YYYY

Richard J. Oulton for America Law Group

Printed name

America Law Group, Inc. dba Debt Law Group

Firm name

America Law Group, Inc. dba Debt Law Group

8501 Mayland Dr., Ste 106

Henrico, VA 23294

Number, Street, City, State & ZIP Code

Contact phone 804-308-0051 Email address

scgattorney@gmail.com,

2debtlawgroup@gmail.com

29640

Bar number & State

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 7

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Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106Sum

Summary of Your Assets and Liabilities and Certain Statistical Information 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct

information. Fill out all of your schedules first; then complete the information on this form. If you are filing amended schedules after you file

your original forms, you must fill out a new Summary and check the box at the top of this page.

Part 1: Summarize Your Assets

Your assets

Value of what you own

1. Schedule A/B: Property (Official Form 106A/B)

1a. Copy line 55, Total real estate, from Schedule A/B................................................................................................ $ 0.00

1b. Copy line 62, Total personal property, from Schedule A/B..................................................................................... $ 3,872.86

1c. Copy line 63, Total of all property on Schedule A/B............................................................................................... $ 3,872.86

Part 2: Summarize Your Liabilities

Your liabilities

Amount you owe

2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D)

2a. Copy the total you listed in Column A, Amount of claim, at the bottom of the last page of Part 1 of Schedule D... $ 0.00

3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F)

3a. Copy the total claims from Part 1 (priority unsecured claims) from line 6e of Schedule E/F................................. $ 0.00

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F............................ $ 149,547.09

Your total liabilities $ 149,547.09

Part 3: Summarize Your Income and Expenses

4. Schedule I: Your Income (Official Form 106I)

Copy your combined monthly income from line 12 of Schedule I................................................................................ $ 2,374.00

5. Schedule J: Your Expenses (Official Form 106J)

Copy your monthly expenses from line 22c of Schedule J.......................................................................... $ 2,159.00

Part 4: Answer These Questions for Administrative and Statistical Records

6. Are you filing for bankruptcy under Chapters 7, 11, or 13?

 No. You have nothing to report on this part of the form. Check this box and submit this form to the court with your other schedules.

 Yes

7. What kind of debt do you have?

 Your debts are primarily consumer debts. Consumer debts are those “incurred by an individual primarily for a personal, family, or

household purpose.” 11 U.S.C. § 101(8). Fill out lines 8-9g for statistical purposes. 28 U.S.C. § 159.

 Your debts are not primarily consumer debts. You have nothing to report on this part of the form. Check this box and submit this form to

the court with your other schedules.

Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 1 of 2

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

8. From the Statement of Your Current Monthly Income: Copy your total current monthly income from Official Form

122A-1 Line 11; OR, Form 122B Line 11; OR, Form 122C-1 Line 14. $ 3,065.61

9. Copy the following special categories of claims from Part 4, line 6 of Schedule E/F:

Total claim

From Part 4 on Schedule E/F, copy the following:

9a. Domestic support obligations (Copy line 6a.) $ 0.00

9b. Taxes and certain other debts you owe the government. (Copy line 6b.) $ 0.00

9c. Claims for death or personal injury while you were intoxicated. (Copy line 6c.) $ 0.00

9d. Student loans. (Copy line 6f.) $ 35,652.00

9e. Obligations arising out of a separation agreement or divorce that you did not report as

priority claims. (Copy line 6g.) $ 0.00

9f. Debts to pension or profit-sharing plans, and other similar debts. (Copy line 6h.) +$ 0.00

9g. Total. Add lines 9a through 9f. $ 35,652.00

Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 2 of 2

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse, if filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number  Check if this is an

amended filing

Official Form 106A/B

Schedule A/B: Property 12/15

In each category, separately list and describe items. List an asset only once. If an asset fits in more than one category, list the asset in the category where you think

it fits best. Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If

more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.

Part 1: Describe Each Residence, Building, Land, or Other Real Estate You Own or Have an Interest In

1. Do you own or have any legal or equitable interest in any residence, building, land, or similar property?

 No. Go to Part 2.

 Yes. Where is the property?

Part 2: Describe Your Vehicles

Do you own, lease, or have legal or equitable interest in any vehicles, whether they are registered or not? Include any vehicles you own that

someone else drives. If you lease a vehicle, also report it on Schedule G: Executory Contracts and Unexpired Leases.

3. Cars, vans, trucks, tractors, sport utility vehicles, motorcycles

 No

 Yes

4. Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories

Examples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle accessories

 No

 Yes

5

.

Add the dollar value of the portion you own for all of your entries from Part 2, including any entries for

pages you have attached for Part 2. Write that number here.............................................................................=> $0.00

Part 3: Describe Your Personal and Household Items

Do you own or have any legal or equitable interest in any of the following items? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

6. Household goods and furnishings

Examples: Major appliances, furniture, linens, china, kitchenware

 No

 Yes. Describe.....

Bedroom set, TV -- all other furniture belongs to relatives with

whom Debtors live $500.00

7. Electronics

Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners; music collections; electronic devices

including cell phones, cameras, media players, games

 No

 Yes. Describe.....

Official Form 106A/B Schedule A/B: Property page 1

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

8. Collectibles of value

Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects; stamp, coin, or baseball card collections;

other collections, memorabilia, collectibles

 No

 Yes. Describe.....

9. Equipment for sports and hobbies

Examples: Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; canoes and kayaks; carpentry tools;

musical instruments

 No

 Yes. Describe.....

Xbox One, games, controllers $300.00

10. Firearms

Examples: Pistols, rifles, shotguns, ammunition, and related equipment

 No

 Yes. Describe.....

11. Clothes

Examples: Everyday clothes, furs, leather coats, designer wear, shoes, accessories

 No

 Yes. Describe.....

Man's & Woman's personal wardrobes $550.00

12. Jewelry

Examples: Everyday jewelry, costume jewelry, engagement rings, wedding rings, heirloom jewelry, watches, gems, gold, silver

 No

 Yes. Describe.....

Wedding bands and engagement rings $230.00

13. Non-farm animals

Examples: Dogs, cats, birds, horses

 No

 Yes. Describe.....

14. Any other personal and household items you did not already list, including any health aids you did not list

 No

 Yes. Give specific information.....

15. Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached

for Part 3. Write that number here .............................................................................. $1,580.00

Part 4: Describe Your Financial Assets

Do you own or have any legal or equitable interest in any of the following? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

16. Cash

Examples: Money you have in your wallet, in your home, in a safe deposit box, and on hand when you file your petition

 No

 Yes................................................................................................................

Cash $100.00

17. Deposits of money

Examples: Checking, savings, or other financial accounts; certificates of deposit; shares in credit unions, brokerage houses, and other similar

institutions. If you have multiple accounts with the same institution, list each.

 No

Official Form 106A/B Schedule A/B: Property page 2

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

 Yes........................ Institution name:

17.1.

Checking &

Savings

Checking and Savings Accounts with Wells

Fargo Bank $3.10

18. Bonds, mutual funds, or publicly traded stocks

Examples: Bond funds, investment accounts with brokerage firms, money market accounts

 No

 Yes.................. Institution or issuer name:

Fidelity Investment Stock Plan $923.00

19. Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in an LLC, partnership,

and joint venture

 No

 Yes. Give specific information about them...................

Name of entity: % of ownership:

20. Government and corporate bonds and other negotiable and non-negotiable instruments

Negotiable instruments include personal checks, cashiers’ checks, promissory notes, and money orders.

Non-negotiable instruments are those you cannot transfer to someone by signing or delivering them.

 No

 Yes. Give specific information about them

Issuer name:

21. Retirement or pension accounts

Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sharing plans

 No

 Yes. List each account separately.

Type of account: Institution name:

Profit-sharing plan Retirement Savings Plan with Verizon

(invested stocks) $258.29

22. Security deposits and prepayments

Your share of all unused deposits you have made so that you may continue service or use from a company

Examples: Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommunications companies, or others

 No

 Yes. ..................... Institution name or individual:

23. Annuities (A contract for a periodic payment of money to you, either for life or for a number of years)

 No

 Yes............. Issuer name and description.

24. Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tuition program.

26 U.S.C. §§ 530(b)(1), 529A(b), and 529(b)(1).

 No

 Yes............. Institution name and description. Separately file the records of any interests.11 U.S.C. § 521(c):

25. Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers exercisable for your benefit

 No

 Yes. Give specific information about them...

26. Patents, copyrights, trademarks, trade secrets, and other intellectual property

Examples: Internet domain names, websites, proceeds from royalties and licensing agreements

 No

 Yes. Give specific information about them...

27. Licenses, franchises, and other general intangibles

Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses, professional licenses

 No

 Yes. Give specific information about them...

Official Form 106A/B Schedule A/B: Property page 3

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Money or property owed to you? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

28. Tax refunds owed to you

 No

 Yes. Give specific information about them, including whether you already filed the returns and the tax years.......

29. Family support

Examples: Past due or lump sum alimony, spousal support, child support, maintenance, divorce settlement, property settlement

 No

 Yes. Give specific information......

30. Other amounts someone owes you

Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers’ compensation, Social Security

benefits; unpaid loans you made to someone else

 No

 Yes. Give specific information..

Garnishment refund $1,008.47

31. Interests in insurance policies

Examples: Health, disability, or life insurance; health savings account (HSA); credit, homeowner’s, or renter’s insurance

 No

 Yes. Name the insurance company of each policy and list its value.

Company name: Beneficiary: Surrender or refund

value:

32. Any interest in property that is due you from someone who has died

If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receive property because

someone has died.

 No

 Yes. Give specific information..

33. Claims against third parties, whether or not you have filed a lawsuit or made a demand for payment

Examples: Accidents, employment disputes, insurance claims, or rights to sue

 No

 Yes. Describe each claim.........

34. Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights to set off claims

 No

 Yes. Describe each claim.........

35. Any financial assets you did not already list

 No

 Yes. Give specific information..

36. Add the dollar value of all of your entries from Part 4, including any entries for pages you have attached

for Part 4. Write that number here..................................................................................................................... $2,292.86

Part 5: Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1.

37. Do you own or have any legal or equitable interest in any business-related property?

 No. Go to Part 6.

 Yes. Go to line 38.

Part 6: Describe Any Farm- and Commercial Fishing-Related Property You Own or Have an Interest In.

If you own or have an interest in farmland, list it in Part 1.

Official Form 106A/B Schedule A/B: Property page 4

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

46. Do you own or have any legal or equitable interest in any farm- or commercial fishing-related property?

 No. Go to Part 7.

 Yes. Go to line 47.

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

Part 7: Describe All Property You Own or Have an Interest in That You Did Not List Above

53. Do you have other property of any kind you did not already list?

Examples: Season tickets, country club membership

 No

 Yes. Give specific information.........

54. Add the dollar value of all of your entries from Part 7. Write that number here .................................... $0.00

Part 8: List the Totals of Each Part of this Form

55. Part 1: Total real estate, line 2 ...................................................................................................................... $0.00

56. Part 2: Total vehicles, line 5 $0.00

57. Part 3: Total personal and household items, line 15 $1,580.00

58. Part 4: Total financial assets, line 36 $2,292.86

59. Part 5: Total business-related property, line 45

$0.00

60. Part 6: Total farm- and fishing-related property, line 52 $0.00

61. Part 7: Total other property not listed, line 54 + $0.00

62. Total personal property. Add lines 56 through 61... $3,872.86 Copy personal property total $3,872.86

63. Total of all property on Schedule A/B. Add line 55 + line 62 $3,872.86

Official Form 106A/B Schedule A/B: Property page 5

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 Document Page 14 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106C

Schedule C: The Property You Claim as Exempt 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. Using

the property you listed on Schedule A/B: Property (Official Form 106A/B) as your source, list the property that you claim as exempt. If more space is

needed, fill out and attach to this page as many copies of Part 2: Additional Page as necessary. On the top of any additional pages, write your name

and case number (if known).

For each item of property you claim as exempt, you must specify the amount of the exemption you claim. One way of doing so is to state a

specific dollar amount as exempt. Alternatively, you may claim the full fair market value of the property being exempted up to the amount of

any applicable statutory limit. Some exemptions—such as those for health aids, rights to receive certain benefits, and tax-exempt retirement

funds—may be unlimited in dollar amount. However, if you claim an exemption of 100% of fair market value under a law that limits the

exemption to a particular dollar amount and the value of the property is determined to exceed that amount, your exemption would be limited

to the applicable statutory amount.

Part 1: Identify the Property You Claim as Exempt

1. Which set of exemptions are you claiming? Check one only, even if your spouse is filing with you.

 You are claiming state and federal nonbankruptcy exemptions. 11 U.S.C. § 522(b)(3)

 You are claiming federal exemptions. 11 U.S.C. § 522(b)(2)

2. For any property you list on Schedule A/B that you claim as exempt, fill in the information below.

Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Bedroom set, TV -- all other furniture

belongs to relatives with whom

Debtors live

Line from Schedule A/B: 6.1

$500.00  $500.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

Xbox One, games, controllers

Line from Schedule A/B: 9.1

$300.00  $300.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Man's & Woman's personal

wardrobes

Line from Schedule A/B: 11.1

$550.00  $550.00 Va. Code Ann. § 34-26(4)

 100% of fair market value, up to

any applicable statutory limit

Wedding bands and engagement

rings

Line from Schedule A/B: 12.1

$230.00  $230.00 Va. Code Ann. § 34-26(1a)

 100% of fair market value, up to

any applicable statutory limit

Cash

Line from Schedule A/B: 16.1

$100.00  $100.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Official Form 106C Schedule C: The Property You Claim as Exempt page 1 of 2

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Checking & Savings: Checking and

Savings Accounts with Wells Fargo

Bank

Line from Schedule A/B: 17.1

$3.10  $3.10 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Fidelity Investment Stock Plan

Line from Schedule A/B: 18.1

$923.00  $923.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Profit-sharing plan: Retirement

Savings Plan with Verizon (invested

stocks)

Line from Schedule A/B: 21.1

$258.29  $258.29 Va. Code Ann. § 34-34

 100% of fair market value, up to

any applicable statutory limit

Garnishment refund

Line from Schedule A/B: 30.1

$1,008.47  $1,008.47 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

3. Are you claiming a homestead exemption of more than $155,675?

(Subject to adjustment on 4/01/16 and every 3 years after that for cases filed on or after the date of adjustment.)

 No

 Yes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case?

 No

 Yes

Official Form 106C Schedule C: The Property You Claim as Exempt page 2 of 2

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 Document Page 16 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106D

Schedule D: Creditors Who Have Claims Secured by Property 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If more space is

needed, copy the Additional Page, fill it out, number the entries, and attach it to this form. On the top of any additional pages, write your name and case number (if

known).

1. Do any creditors have claims secured by your property?

 No. Check this box and submit this form to the court with your other schedules. You have nothing else to report on this form.

 Yes. Fill in all of the information below.

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 1

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 Document Page 17 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106E/F

Schedule E/F: Creditors Who Have Unsecured Claims 12/15

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY claims and Part 2 for creditors with NONPRIORITY claims. List the other party to

any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Property (Official Form 106A/B) and on

Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G). Do not include any creditors with partially secured claims that are listed in Schedule

D: Creditors Who Have Claims Secured by Property. If more space is needed, copy the Part you need, fill it out, number the entries in the boxes on the left. Attach

the Continuation Page to this page. If you have no information to report in a Part, do not file that Part. On the top of any additional pages, write your name and case

number (if known).

Part 1: List All of Your PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims against you?

 No. Go to Part 2.

 Yes.

Part 2: List All of Your NONPRIORITY Unsecured Claims

3. Do any creditors have nonpriority unsecured claims against you?

 No. You have nothing to report in this part. Submit this form to the court with your other schedules.

 Yes.

4. List all of your nonpriority unsecured claims in the alphabetical order of the creditor who holds each claim. If a creditor has more than one nonpriority

unsecured claim, list the creditor separately for each claim. For each claim listed, identify what type of claim it is. Do not list claims already included in Part 1. If more

than one creditor holds a particular claim, list the other creditors in Part 3.If you have more than three nonpriority unsecured claims fill out the Continuation Page of

Part 2.

Total claim

4.1 Acs/jp Morgan Chase Ba Last 4 digits of account number 7261 $ 0.00

Nonpriority Creditor's Name

501 Bleecker St

Utica, NY 13501

When was the debt incurred?

Opened 3/16/10 Last

Active 6/24/10

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.2 Afni Inc Last 4 digits of account number 9046 $ 337.54

Nonpriority Creditor's Name

1310 Martin Luther King Dr.

PO Box 3517

Bloomington, IL 61702-3517

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 1 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: DirectTV

4.3 Allied Cash Advance Last 4 digits of account number 8584 $ 763.95

Nonpriority Creditor's Name

200 SE 1st St

Ste 800

Miami, FL 33131

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Payday Loan

4.4 Barry L Katchinoff MD & Assoc. Last 4 digits of account number 6391 $ 360.59

Nonpriority Creditor's Name

7305 Boulders View Lane

Richmond, VA 23225

When was the debt incurred?

multiple: 5/8/2014 -

5/30/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.5 Broadwater Associates Last 4 digits of account number 1200 $ 909.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

168 Business Park Dr. Ste 200

Virginia Beach, VA 23462

When was the debt incurred? 12/10/2013

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment

4.6 Broadwater Associates Last 4 digits of account number 8584 $ 3,000.00

Nonpriority Creditor's Name

168 Business Park Dr. Ste 200

Virginia Beach, VA 23462

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Unpaid rent

4.7 Capio Partners LLC Last 4 digits of account number 6338 $ 468.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.8 Capio Partners LLC Last 4 digits of account number 9497 $ 398.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.9 Capio Partners Llc Last 4 digits of account number 1874 $ 370.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 150

Sherman, TX 75090

When was the debt incurred? Opened 11/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Coweta Emergency Group Llc

4.10 Capio Partners LLC Last 4 digits of account number 6770 $ 100.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.11 Capio Partners LLC Last 4 digits of account number 5791 $ 100.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.12 Capio Partners LLC Last 4 digits of account number 9330 $ 100.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.13 Capio Partners LLC Last 4 digits of account number 4279 $ 3,025.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

re: Florida Hospital

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.14 Capio Partners LLC Last 4 digits of account number 9970 $ 80.00

Nonpriority Creditor's Name

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Florida Hospital

4.15 Cbe Group Last 4 digits of account number 7902 $ 479.00

Nonpriority Creditor's Name

Attn: Bankruptcy

Po Box 900

Waterloo, IA 50704

When was the debt incurred? Opened 6/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 23 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Dominion Electric Ii

4.16 Cbe Group Last 4 digits of account number 6270 $ 569.00

Nonpriority Creditor's Name

Attn: Bankruptcy

Po Box 900

Waterloo, IA 50704

When was the debt incurred? Opened 10/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Dominion Electric Ii

4.17 Central Credit/Penn Cr Last 4 digits of account number 0433 $ 479.00

Nonpriority Creditor's Name

Attn: Bankruptcy

PO Box 988

Harrisburg, PA 17108

When was the debt incurred?

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Dominion Power

4.18 Check City Last 4 digits of account number 9700 $ 326.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 46

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 24 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

re: Bankruptcy

6001 West Broad Street

Richmond, VA 23230

When was the debt incurred? 5/21/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment in Richmond City GDC

4.19 Check City Last 4 digits of account number 6700 $ 784.00

Nonpriority Creditor's Name

PO Box 970183

Orem, UT 84097

When was the debt incurred? pending 12/16/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Payday Loan

4.20 Check City Last 4 digits of account number 8584 $ 448.50

Nonpriority Creditor's Name

re: Bankruptcy

6001 West Broad Street

Richmond, VA 23230

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Payday Loan

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 25 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.21 CJW Medical Center Last 4 digits of account number 0815 $ 0.00

Nonpriority Creditor's Name

PO Box 13620

Richmond, VA 23225

When was the debt incurred? 12/11/2013

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.22 CJW Medical Center Last 4 digits of account number 0815 $ 511.29

Nonpriority Creditor's Name

PO Box 13620

Richmond, VA 23225

When was the debt incurred? 12/11/2013

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.23 Comcast Last 4 digits of account number 1087 $ 466.15

Nonpriority Creditor's Name

8029 Corporate Dr

Nottingham, MD 21236-4977

When was the debt incurred? 2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 9 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 26 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Utility

4.24 Credit Control Corporation Last 4 digits of account number 3982 $ 2,085.02

Nonpriority Creditor's Name

PO Box 120568

Newport News, VA 23612

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: MCV / VCU

4.25 Durham & Durham Last 4 digits of account number 4780 $ 726.00

Nonpriority Creditor's Name

5665 New Northside Dr.

Suite 510

Atlanta, GA 30328

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Group

4.26 ERC/Enhanced Recovery Corp Last 4 digits of account number 8531 $ 647.31

Nonpriority Creditor's Name

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 6/01/13

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 10 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 27 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Sprint

4.27 ERC/Enhanced Recovery Corp Last 4 digits of account number 6605 $ 547.00

Nonpriority Creditor's Name

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred?

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Tmobile

4.28 ERC/Enhanced Recovery Corp Last 4 digits of account number 1356 $ 438.00

Nonpriority Creditor's Name

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 5/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Tmobile

4.29 ERC/Enhanced Recovery Corp Last 4 digits of account number 0166 $ 433.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 11 of 46

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 28 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 8/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Comcast Cable Communications

4.30 ERC/Enhanced Recovery Corp Last 4 digits of account number 6046 $ 338.00

Nonpriority Creditor's Name

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 6/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Erc/Directv Inc.

4.31 ERC/Enhanced Recovery Corp Last 4 digits of account number 9330 $ 201.00

Nonpriority Creditor's Name

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 12/01/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Tmobile

4.32 Fall Line Emergency Phys Last 4 digits of account number 6149 $ 438.00

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 12 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 29 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Nonpriority Creditor's Name

18167 US Highway 19N

Suite 650

Clearwater, FL 33764

When was the debt incurred? 3/2/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.33 Fed Loan Servicing Last 4 digits of account number 0001 $ 0.00

Nonpriority Creditor's Name

PO Box 69184

Harrisburg, PA 17106

When was the debt incurred?

Opened 6/15/11 Last

Active 5/01/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.34 First Virginia Last 4 digits of account number 8584 $ 1,763.89

Nonpriority Creditor's Name

6785 Bobcat Way, Suite 200

Dublin, OH 43016

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 13 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 30 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Payday Loan

4.35 First Virginia Financial Svcs Last 4 digits of account number 1762 $ 497.78

Nonpriority Creditor's Name

4503 W Broad Street

Richmond, VA 23230

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Payday Loan

4.36 First Virginia, VA134 Last 4 digits of account number 6054 $ 138.49

Nonpriority Creditor's Name

7001 Post Road, Suite 300

Dublin, OH 43016-8755

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.37 Focus Recovery Solutions Last 4 digits of account number 3606 $ 317.00

Nonpriority Creditor's Name

Attn: Bankruptcy

9701 Metropolitan Court Ste B

Richmond, VA 23236

When was the debt incurred?

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 14 of 46

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 31 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: John Randolph Medical Center

4.38 Focus Recovery Solutions Last 4 digits of account number 3638 $ 203.31

Nonpriority Creditor's Name

Attn: Bankruptcy

9701 Metropolitan Court Ste B

Richmond, VA 23236

When was the debt incurred? Opened 6/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Henrico Drs Hospital

4.39 Focused Recovery Solutions Last 4 digits of account number 0815 $ 511.29

Nonpriority Creditor's Name

9701 Metropolitan Court, Ste B

Richmond, VA 23236-3690

When was the debt incurred? 12/11/2013

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: CJW Medical

4.40 Freedom Respiratory Last 4 digits of account number 6711 $ 134.38

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 15 of 46

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 Document Page 32 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

2233 E Main St.

Montrose, CO 81401

When was the debt incurred? 7/21/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.41 Full Sail University Last 4 digits of account number 4783 $ 8,726.21

Nonpriority Creditor's Name

3300 University Blvd

Winter Park, FL 32792

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Unpaid tuition

4.42 Full Sail University Last 4 digits of account number 9239 $ 1,448.00

Nonpriority Creditor's Name

3300 University Blvd

Winter Park, FL 32792

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Unpaid tuition

4.43 Genesis Properties Inc Last 4 digits of account number 2900 $ 919.00

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 16 of 46

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 33 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Nonpriority Creditor's Name

101 W Commerce Rd

Richmond, VA 23224

When was the debt incurred? 4/15/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment

4.44 Genesis Properties Inc Last 4 digits of account number 5300 $ 898.00

Nonpriority Creditor's Name

101 W Commerce Rd

Richmond, VA 23224

When was the debt incurred? 2/27/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment

4.45 Great Lakes Educational Loan Last 4 digits of account number 8581 $ 16,385.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 11/01/11 Last

Active 9/25/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 17 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 34 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.46 Great Lakes Educational Loan Last 4 digits of account number 8581 $ 0.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 7/01/10 Last

Active 1/01/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.47 Great Lakes Educational Loan Last 4 digits of account number 9577 $ 0.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 5/01/09 Last

Active 8/01/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.48 Great Lakes Educational Loan Last 4 digits of account number 7577 $ 0.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 3/01/10 Last

Active 8/01/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 18 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 35 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.49 Great Lakes Educational Loan Last 4 digits of account number 8581 $ 0.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 7/12/10 Last

Active 2/28/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.50 Great Lakes Educational Loan Last 4 digits of account number 7577 $ 0.00

Nonpriority Creditor's Name

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 3/16/10 Last

Active 9/30/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.51 Great Lakes Educational Loan Last 4 digits of account number 9577 $ 0.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 19 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 36 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

2401 International

Madison, WI 53704

When was the debt incurred?

Opened 5/21/09 Last

Active 9/30/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.52 Henrico Doctor's Hospital Last 4 digits of account number 3392 $ 735.26

Nonpriority Creditor's Name

PO Box 13620

Richmond, VA 23225-8620

When was the debt incurred? 1/22/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.53 Henrico Doctor's Hospital-Fore Last 4 digits of account number 3614 $ 1,122.10

Nonpriority Creditor's Name

PO Box 99400

Louisville, KY 40269

When was the debt incurred? 3/2/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 20 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 37 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.54 Henrico Doctor's Hospital-Fore Last 4 digits of account number 3392 $ 888.00

Nonpriority Creditor's Name

PO Box 99400

Louisville, KY 40269

When was the debt incurred? 1/22/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.55 Hercules Real Estate Services Last 4 digits of account number 8584 $ 0.00

Nonpriority Creditor's Name

dba England Run II

168 Business Park Dr. 103

Virginia Beach, VA 23462

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify unpaid rent

4.56 Internal Revenue Service Last 4 digits of account number 8584 $ 1,847.00

Nonpriority Creditor's Name

Insolvency Unit

PO Box 7346

Philadelphia, PA 19101-7346

When was the debt incurred? 2013

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 21 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 38 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Federal Income Tax

4.57 Jefferson Capital Systems, LLC Last 4 digits of account number 3003 $ 2,432.00

Nonpriority Creditor's Name

16 Mcleland Rd

Saint Cloud, MN 56303

When was the debt incurred? Opened 4/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Verizon Wireless

4.58 Jefferson Capital Systems, LLC Last 4 digits of account number 2003 $ 1,306.00

Nonpriority Creditor's Name

16 Mcleland Rd

Saint Cloud, MN 56303

When was the debt incurred? Opened 4/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Verizon Wireless

4.59 JP Morgan Chase Bank Last 4 digits of account number 2602 $ 0.00

Nonpriority Creditor's Name

Attn: Bankruptcy

PO Box 15298

Wilmington, DE 19850

When was the debt incurred?

Opened 5/21/09 Last

Active 10/15/09

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 22 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 39 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.60 JP Morgan Chase Bank Last 4 digits of account number 2601 $ 0.00

Nonpriority Creditor's Name

Attn: Bankruptcy

PO Box 15298

Wilmington, DE 19850

When was the debt incurred?

Opened 5/21/09 Last

Active 10/15/09

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.61 MCV Associated Physicians Last 4 digits of account number 4600 $ 1,313.27

Nonpriority Creditor's Name

830 E Main St

Suite 1900

Richmond, VA 23219

When was the debt incurred? 9/6/2012

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment

4.62 MCV Physicians Last 4 digits of account number 7159 $ 194.14

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 23 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 40 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

830 E Main St

Suite 1900

Richmond, VA 23219

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.63 Medical Data Systems I Last 4 digits of account number 2948 $ 2,273.00

Nonpriority Creditor's Name

2001 9th Ave

Suite 312

Vero beach, FL 32960

When was the debt incurred? Opened 11/01/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Cen

4.64 Medical Data Systems I Last 4 digits of account number 3249 $ 2,186.00

Nonpriority Creditor's Name

2001 9th Ave

Suite 312

Vero beach, FL 32960

When was the debt incurred? Opened 1/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 24 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 41 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Cen

4.65 Medical Data Systems I Last 4 digits of account number 9266 $ 1,204.00

Nonpriority Creditor's Name

2001 9th Ave

Suite 312

Vero beach, FL 32960

When was the debt incurred? Opened 2/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Cen

4.66 Medical Data Systems I Last 4 digits of account number 8554 $ 810.00

Nonpriority Creditor's Name

2001 9th Ave

Suite 312

Vero beach, FL 32960

When was the debt incurred? Opened 2/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Cen

4.67 Medical Data Systems I Last 4 digits of account number 2389 $ 3,168.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 25 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 42 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

2001 9th Ave

Suite 312

Vero beach, FL 32960

When was the debt incurred? Opened 5/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Cen

4.68 Medical Revenue Services Last 4 digits of account number 7243 $ 8,250.47

Nonpriority Creditor's Name

645 Walnut St

Ste 5

Gadsden, AL 35902

When was the debt incurred? multiple

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Southside Regional Medical Center

4.69 Online Collections Last 4 digits of account number 2869 $ 188.00

Nonpriority Creditor's Name

PO Box 1489

Winterville, NC 28590

When was the debt incurred? Opened 7/01/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Progress Energy Florida

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 26 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 43 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.70 Online Collections Last 4 digits of account number 2912 $ 125.00

Nonpriority Creditor's Name

PO Box 1489

Winterville, NC 28590

When was the debt incurred? Opened 11/01/10

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Pwc Of Fayetteville

4.71 PaymentsMD.Com Last 4 digits of account number 6022 $ 196.02

Nonpriority Creditor's Name

5665 New Northside Dr.

Suite 330

Atlanta, GA 30328

When was the debt incurred? 7/24/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.72 PaymentsMD.Com Last 4 digits of account number 4056 $ 177.63

Nonpriority Creditor's Name

5665 New Northside Dr.

Suite 330

Atlanta, GA 30328

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 27 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 44 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Group

4.73 Phoenix Financial Serv Last 4 digits of account number 4521 $ 438.00

Nonpriority Creditor's Name

8902 Otis Ave Ste 103a

Indianapolis, IN 46216

When was the debt incurred? Opened 7/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Fall Line Emerg Phys Llc

4.74 Progressive Direct Ins Last 4 digits of account number 3300 $ 2,331.00

Nonpriority Creditor's Name

6300 Wilson Mills Rd

Cleveland, OH 44143

When was the debt incurred? 10/6/2009

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment

4.75 Public Storage Last 4 digits of account number 8584 $ 267.70

Nonpriority Creditor's Name

5440 Midlothian Tnpk

Richmond, VA 23225

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 28 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 45 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collections

4.76 Regional Acceptance Co Last 4 digits of account number 7801 $ 9,313.00

Nonpriority Creditor's Name

1200 E Fire Tower Rd

Greenville, NC 27858

When was the debt incurred?

Opened 9/01/12 Last

Active 2/10/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Deficiency Balance

4.77 Reliacare Home Medical Last 4 digits of account number 6711 $ 206.84

Nonpriority Creditor's Name

2233 E Main St

Montrose, CO 81401

When was the debt incurred? 8/21/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.78 Sleep Diagnostics Last 4 digits of account number 6391 $ 367.79

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 29 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 46 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

7305 Boulders View Lane

Richmond, VA 23225

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.79 Southside Regional Hospital Last 4 digits of account number 4063 $ 8,377.46

Nonpriority Creditor's Name

200 Medical Parks Boulevard

Petersburg, VA 23805

When was the debt incurred? 1/16/2015-1/17/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.80 Southside Regional Medical Last 4 digits of account number 6022 $ 793.70

Nonpriority Creditor's Name

200 Medical Park Blvd

Petersburg, VA 23805

When was the debt incurred? 4/22/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.81 Southside Regional Medical Last 4 digits of account number 3866 $ 12.60

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 30 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 47 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Nonpriority Creditor's Name

200 Medical Park Blvd

Petersburg, VA 23805

When was the debt incurred? 11/1/2014 - 11/30/2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.82 Southside Regional Medical Last 4 digits of account number 4056 $ 1,663.34

Nonpriority Creditor's Name

200 Medical Park Blvd

Petersburg, VA 23805

When was the debt incurred? 3/19/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.83 Southwest Credit Syste Last 4 digits of account number 8524 $ 578.00

Nonpriority Creditor's Name

4120 International Pkwy

Suite 1100

Carrollton, TX 75007

When was the debt incurred? Opened 9/01/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Comcast

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 31 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 48 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.84 Sprint Last 4 digits of account number 8584 $ 773.64

Nonpriority Creditor's Name

Attn: Bankruptcy Dept

4900 W. 95th Street

Oak Lawn, IL 60453

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Utility

4.85 Sternrecsvcs Last 4 digits of account number 5841 $ 223.00

Nonpriority Creditor's Name

415 N Edgeworth St

Greensboro, NC 27401

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Carilion Labs

4.86 Sternrecsvcs Last 4 digits of account number 5840 $ 140.00

Nonpriority Creditor's Name

415 N Edgeworth St

Greensboro, NC 27401

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 32 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 49 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Carilion Labs

4.87 Surgical Associates of Rchmnd Last 4 digits of account number 6900 $ 163.00

Nonpriority Creditor's Name

PO Box 11023

Richmond, VA 23230

When was the debt incurred? 2/10/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Judgment in Chesterfield Co GDC

4.88 T-Mobile Bankruptcy Team Last 4 digits of account number 8584 $ 437.99

Nonpriority Creditor's Name

PO Box 53410

Bellevue, WA 98015-5341

When was the debt incurred? unknown

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Utility

4.89 Transworld Sys Inc/38 Last 4 digits of account number 4338 $ 789.00

Nonpriority Creditor's Name

507 Prudential Rd

Horsham, PA 19044

When was the debt incurred? Opened 8/01/13

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 33 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 50 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Physicians

4.90 Transworld Sys Inc/38 Last 4 digits of account number 9661 $ 789.00

Nonpriority Creditor's Name

507 Prudential Rd

Horsham, PA 19044

When was the debt incurred? Opened 2/01/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Physicians

4.91 Transworld Sys Inc/38 Last 4 digits of account number 1504 $ 636.00

Nonpriority Creditor's Name

507 Prudential Rd

Horsham, PA 19044

When was the debt incurred? Opened 12/01/12

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Physicians

4.92 Transworld Sys Inc/38 Last 4 digits of account number 9220 $ 867.00

Nonpriority Creditor's Name

507 Prudential Rd

Horsham, PA 19044

When was the debt incurred? Opened 6/01/12

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 34 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 51 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: Virginia Emergency Physicians

4.93 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7590 $ 1,299.00

Nonpriority Creditor's Name

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 3/01/11 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.94 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7925 $ 2,574.00

Nonpriority Creditor's Name

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 7/01/10 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.95 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7953 $ 4,139.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 35 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 52 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 5/01/09 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.96 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7919 $ 1,642.00

Nonpriority Creditor's Name

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 3/01/11 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.97 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7957 $ 5,668.00

Nonpriority Creditor's Name

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 5/01/09 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 36 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 53 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

4.98 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7961 $ 2,636.00

Nonpriority Creditor's Name

PO Box 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 2/01/10 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.99 U S Dept Of Ed/Gsl/Atl Last 4 digits of account number 7964 $ 1,309.00

Nonpriority Creditor's Name

POBox 4222

Iowa City, IA 52244

When was the debt incurred?

Opened 2/01/10 Last

Active 11/06/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Student Loan

4.10

0 United Consumers Inc Last 4 digits of account number 1868 $ 110.16

Nonpriority Creditor's Name

PO Box 4466

Woodbridge, VA 22194

When was the debt incurred? multiple dates, 2014

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 37 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 54 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: MCV Physicians

4.10

1 United Consumers Inc Last 4 digits of account number 1462 $ 579.51

Nonpriority Creditor's Name

PO Box 4466

Woodbridge, VA 22194

When was the debt incurred? multiple dates, 2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify re: MCV Physicians

4.10

2 VCU Health System -- MCV Hosp. Last 4 digits of account number 3982 $ 201.00

Nonpriority Creditor's Name

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

When was the debt incurred? 1/26/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.10

3 VCU Health System -- MCV Hosp. Last 4 digits of account number 2538 $ 1,428.75

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 38 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 55 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

When was the debt incurred? 2/23/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.10

4 VCU Health System -- MCV Hosp. Last 4 digits of account number 3982 $ 2,085.02

Nonpriority Creditor's Name

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

When was the debt incurred? 1/26/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.10

5 VCU Health System -- MCV Hosp. Last 4 digits of account number 2538 $ 1,905.00

Nonpriority Creditor's Name

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

When was the debt incurred? 2/23/2015

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 39 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 56 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.10

6 Verizon Last 4 digits of account number 0001 $ 1,090.00

Nonpriority Creditor's Name

500 Technology Dr

Suite 500

Weldon Spring, MO 63304

When was the debt incurred?

Opened 7/01/14 Last

Active 4/30/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Utility

4.10

7 Verizon Last 4 digits of account number 5072 $ 213.00

Nonpriority Creditor's Name

500 Technology Dr

Suite 500

Weldon Spring, MO 63304

When was the debt incurred?

Opened 11/01/13 Last

Active 2/24/14

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Utility

4.10

8 Virginia Medical Group Last 4 digits of account number 5581 $ 21.00

Nonpriority Creditor's Name

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 40 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

2905 Boulevard

Colonial Heights, VA 23834

When was the debt incurred? 9/30/2011

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.10

9 Westlake Financial Svc Last 4 digits of account number 9057 $ 13,192.00

Nonpriority Creditor's Name

4751 Wilshire Blvd Suite 100

Los Angeles, CA 90010

When was the debt incurred?

Opened 10/01/13 Last

Active 9/02/15

Number Street City State ZIp Code As of the date you file, the claim is: Check all that apply

Who incurred the debt? Check one.  Contingent

 Debtor 1 only

 Debtor 2 only  Unliquidated

 Debtor 1 and Debtor 2 only  Disputed

 At least one of the debtors and another Type of NONPRIORITY unsecured claim:

 Check if this claim is for a community

debt

 Student loans

Is the claim subject to offset?  Obligations arising out of a separation agreement or divorce that you did

not report as priority claims

 No  Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Deficiency Balance

Part 3: List Others to Be Notified About a Debt That You Already Listed

5. Use this page only if you have others to be notified about your bankruptcy, for a debt that you already listed in Parts 1 or 2. For example, if a collection agency is

trying to collect from you for a debt you owe to someone else, list the original creditor in Parts 1 or 2, then list the collection agency here. Similarly, if you have

more than one creditor for any of the debts that you listed in Parts 1 or 2, list the additional creditors here. If you do not have additional persons to be notified for

any debts in Parts 1 or 2, do not fill out or submit this page.

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Bay Area Credit Service LLC

1000 Abernathy Rd NE

Suite 195

Atlanta, GA 30328

Line 4.32 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Carillion Labs

213 S Jefferson St, Ste 1202

Roanoke, VA 24011

Line 4.85 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

CBE Group

1309 Technology Pkwy

Cedar Falls, IA 50613

Line 4.57 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 41 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Last 4 digits of account number 0001

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Check City

2729 West Broad St.

Henrico, VA 23228

Line 4.18 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

CJW Medical Center

PO Box 13620

Richmond, VA 23225

Line 4.39 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Comcast

5401 Staples Mill Road

Henrico, VA 23228-5421

Line 4.29 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Comcast Chesterfield

6510 Iron Bridge Rd

Richmond, VA 23234

Line 4.83 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Coweta Emergency Group

200 Corporate Blvd

Suite 201

Lafayette, LA 70508

Line 4.10 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

D. Kent Gilliam

7821 Ironbridge Road

Richmond, VA 23237

Line 4.87 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

DirectTV

attn: Bankruptcy Claims

PO Box 6550

Englewood, CO 80155-6550

Line 4.30 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

DirectTV

attn: Bankruptcy Claims

PO Box 6550

Englewood, CO 80155-6550

Line 4.2 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Diversified Consultants

PO Box 551268

Jacksonville, FL 32255

Line 4.107 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Dominion Virginia Power

PO Box 26543

Richmond, VA 23290-0001

Line 4.15 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number 7927

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 42 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Eastern Account System of Conn

PO Box 837

Newtown, CT 06470

Line 4.29 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Enterprise Recovery Systems

PO Box 5288

Hinsdale, IL 60522

Line 4.33 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Fall Line Emergency Phys

18167 US Highway 19N

Suite 650

Clearwater, FL 33764

Line 4.73 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Florida Hospital

601 E Rollins St

Orlando, FL 32803

Line 4.11 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

FMS Investment Corp

PO Box 1423

Elk Grove Village, IL 60009

Line 4.94 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Focused Recovery Solutions

9701 Metropolitan Court, Ste B

Richmond, VA 23236-3690

Line 4.54 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Henrico Doctor's Hospital

PO Box 13620

Richmond, VA 23225-8620

Line 4.38 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Henrico Doctor's Hospital

PO Box 13620

Richmond, VA 23225

Line 4.53 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Henrico Doctor's Hospital

PO Box 13620

Richmond, VA 23225

Line 4.54 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

John Randolph Medical Center

411 W Randolph Rd

Hopewell, VA 23860

Line 4.37 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

John Randolph Medical Center

PO Box 13620

Line 4.37 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 43 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Richmond, VA 23225  Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

MCV Associated Physicians

830 E Main St

Suite 1900

Richmond, VA 23219

Line 4.24 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

MCV Physicians

1601 Willow Lawn Dr, Ste 275

Richmond, VA 23230

Line 4.61 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

MCV Physicians

1601 Willow Lawn Dr, Ste 275

Richmond, VA 23230

Line 4.24 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

MCV Physicians

830 E Main St

Suite 1900

Richmond, VA 23219

Line 4.100 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Parrish and LeBar, LLP

5 E Franklin St.

Richmond, VA 23219

Line 4.61 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Parrish and LeBar, LLP

5 E Franklin St.

Richmond, VA 23219

Line 4.101 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number 7159

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Penn Credit Corporation

916 S 14th St

Harrisburg, PA 17108

Line 4.15 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Penn Credit Corporation

PO Box 988

Harrisburg, PA 17108-0988

Line 4.16 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Progress Energy Florida

Duke Energy

PO Box 14042

Saint Petersburg, FL 33733

Line 4.69 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

PWC of Fayetteville

955 Old Wilmington Rd

Fayetteville, NC 28301

Line 4.70 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 44 of 46

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Shenandoah Legal

310 Jefferson Street S.E.

Roanoke, VA 24011

Line 4.109 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Southside Regional Medical

200 Medical Park Blvd

Petersburg, VA 23805

Line 4.63 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Southside Regional Medical

200 Medical Park Blvd

Petersburg, VA 23805

Line 4.68 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Sprint

Attn: Bankruptcy Dept

4900 W. 95th Street

Oak Lawn, IL 60453

Line 4.26 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Sykes, Bourdon, Ahern & Levy

281 Independence Blvd

Pembroke 1 Building, 5th Floor

Virginia Beach, VA 23462

Line 4.5 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

T-Mobile Bankruptcy Team

PO Box 53410

Bellevue, WA 98015-5341

Line 4.27 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

T-Mobile Bankruptcy Team

PO Box 53410

Bellevue, WA 98015-5341

Line 4.31 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

VCU Health System -- MCV Hosp.

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

Line 4.24 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Verizon Wireless

PO Box 25505

Lehigh Valley, PA 18002-5505

Line 4.57 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Verizon Wireless

PO Box 25505

Lehigh Valley, PA 18002-5505

Line 4.58 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 45 of 46

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if know)

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Virginia Emergency Group

5665 New Northside Dr.

Suite 320

Atlanta, GA 30328

Line 4.71 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Virginia Emergency Group

5665 New Northside Dr.

Suite 320

Atlanta, GA 30328

Line 4.25 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Name and Address On which entry in Part 1 or Part2 did you list the original creditor?

Virginia Emergency Physicians

1602 Skipwith Rd

Henrico, VA 23229

Line 4.89 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Part 4: Add the Amounts for Each Type of Unsecured Claim

6. Total the amounts of certain types of unsecured claims. This information is for statistical reporting purposes only. 28 U.S.C. §159. Add the amounts for each type

of unsecured claim.

Total claim

6a. Domestic support obligations 6a. $ 0.00

Total claims

from Part 1 6b. Taxes and certain other debts you owe the government 6b. $ 0.00

6c. Claims for death or personal injury while you were intoxicated 6c. $ 0.00

6d. Other. Add all other priority unsecured claims. Write that amount here. 6d. $ 0.00

6e. Total. Add lines 6a through 6d. 6e. $ 0.00

Total Claim

6f. Student loans 6f. $ 35,652.00

Total claims

from Part 2 6g. Obligations arising out of a separation agreement or divorce that you

did not report as priority claims 6g. $ 0.00

6h. Debts to pension or profit-sharing plans, and other similar debts 6h. $ 0.00

6i. Other. Add all other nonpriority unsecured claims. Write that amount here. 6i. $ 113,895.09

6j. Total. Add lines 6f through 6i. 6j. $ 149,547.09

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 46 of 46

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Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106G

Schedule G: Executory Contracts and Unexpired Leases 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct

information. If more space is needed, copy the additional page, fill it out, number the entries, and attach it to this page. On the top of any

additional pages, write your name and case number (if known).

1. Do you have any executory contracts or unexpired leases?

 No. Check this box and file this form with the court with your other schedules. You have nothing else to report on this form.

 Yes. Fill in all of the information below even if the contacts of leases are listed on Schedule A/B:Property (Official Form 106 A/B).

2. List separately each person or company with whom you have the contract or lease. Then state what each contract or lease is for (for

example, rent, vehicle lease, cell phone). See the instructions for this form in the instruction booklet for more examples of executory contracts

and unexpired leases.

Person or company with whom you have the contract or lease

Name, Number, Street, City, State and ZIP Code

State what the contract or lease is for

2.1 T-Mobile Bankruptcy Team

PO Box 53410

Bellevue, WA 98015-5341

Cell. Debtors intend to honor current contract.

Official Form 106G Schedule G: Executory Contracts and Unexpired Leases Page 1 of 1

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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 Document Page 64 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106H

Schedule H: Your Codebtors 12/15

Codebtors are people or entities who are also liable for any debts you may have. Be as complete and accurate as possible. If two married

people are filing together, both are equally responsible for supplying correct information. If more space is needed, copy the Additional Page,

fill it out, and number the entries in the boxes on the left. Attach the Additional Page to this page. On the top of any Additional Pages, write

your name and case number (if known). Answer every question.

1. Do you have any codebtors? (If you are filing a joint case, do not list either spouse as a codebtor.

 No

 Yes

2. Within the last 8 years, have you lived in a community property state or territory? (Community property states and territories include

Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, and Wisconsin.)

 No. Go to line 3.

 Yes. Did your spouse, former spouse, or legal equivalent live with you at the time?

3. In Column 1, list all of your codebtors. Do not include your spouse as a codebtor if your spouse is filing with you. List the person shown

in line 2 again as a codebtor only if that person is a guarantor or cosigner. Make sure you have listed the creditor on Schedule D (Official

Form 106D), Schedule E/F (Official Form 106E/F), or Schedule G (Official Form 106G). Use Schedule D, Schedule E/F, or Schedule G to

fill out Column 2.

Column 1: Your codebtor

Name, Number, Street, City, State and ZIP Code

Column 2: The creditor to whom you owe the debt

Check all schedules that apply:

3.1  Schedule D, line

Name  Schedule E/F, line

 Schedule G, line

Number Street

City State ZIP Code

3.2  Schedule D, line

Name  Schedule E/F, line

 Schedule G, line

Number Street

City State ZIP Code

Official Form 106H Schedule H: Your Codebtors Page 1 of 1

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 Document Page 65 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

Debtor 2 William Samuel Street

(Spouse, if filing)

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number Check if this is:

(If known)  An amended filing

 A supplement showing postpetition chapter

13 income as of the following date:

Official Form 106I MM / DD/ YYYY

Schedule I: Your Income 12/15

Be as complete and accurate as possible. If two married people are filing together (Debtor 1 and Debtor 2), both are equally responsible for

supplying correct information. If you are married and not filing jointly, and your spouse is living with you, include information about your

spouse. If you are separated and your spouse is not filing with you, do not include information about your spouse. If more space is needed,

attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.

Part 1: Describe Employment

1. Fill in your employment

information. Debtor 1 Debtor 2 or non-filing spouse

If you have more than one job,

attach a separate page with

information about additional

employers.

Include part-time, seasonal, or

self-employed work.

Occupation may include student

or homemaker, if it applies.

Employment status

 Employed

 Not employed

 Employed

 Not employed

Occupation Customer Service

Employer's name T-Mobile

Employer's address 100 Westgate Pkwy

Richmond, VA

How long employed there? 10 months

Part 2: Give Details About Monthly Income

Estimate monthly income as of the date you file this form. If you have nothing to report for any line, write $0 in the space. Include your non-filing

spouse unless you are separated.

If you or your non-filing spouse have more than one employer, combine the information for all employers for that person on the lines below. If you need

more space, attach a separate sheet to this form.

For Debtor 1 For Debtor 2 or

non-filing spouse

2.

List monthly gross wages, salary, and commissions (before all payroll

deductions). If not paid monthly, calculate what the monthly wage would be. 2. $ 0.00 $ 3,168.00

3. Estimate and list monthly overtime pay. 3. +$ 0.00 +$ 0.00

4. Calculate gross Income. Add line 2 + line 3. 4. $ 0.00 $ 3,168.00

Official Form 106I Schedule I: Your Income page 1

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 66 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

For Debtor 1 For Debtor 2 or

non-filing spouse

Copy line 4 here 4. $ 0.00 $ 3,168.00

5. List all payroll deductions:

5a. Tax, Medicare, and Social Security deductions 5a. $ 0.00 $ 798.00

5b. Mandatory contributions for retirement plans 5b. $ 0.00 $ 0.00

5c. Voluntary contributions for retirement plans 5c. $ 0.00 $ 0.00

5d. Required repayments of retirement fund loans 5d. $ 0.00 $ 0.00

5e. Insurance 5e. $ 0.00 $ 139.00

5f. Domestic support obligations 5f. $ 0.00 $ 0.00

5g. Union dues 5g. $ 0.00 $ 0.00

5h. Other deductions. Specify: LTD 5h.+ $ 0.00 + $ 7.00

6. Add the payroll deductions. Add lines 5a+5b+5c+5d+5e+5f+5g+5h. 6. $ 0.00 $ 944.00

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. $ 0.00 $ 2,224.00

8. List all other income regularly received:

8a. Net income from rental property and from operating a business,

profession, or farm

Attach a statement for each property and business showing gross

receipts, ordinary and necessary business expenses, and the total

monthly net income. 8a. $ 0.00 $ 0.00

8b. Interest and dividends 8b. $ 0.00 $ 0.00

8c. Family support payments that you, a non-filing spouse, or a dependent

regularly receive

Include alimony, spousal support, child support, maintenance, divorce

settlement, and property settlement. 8c. $ 0.00 $ 0.00

8d. Unemployment compensation 8d. $ 0.00 $ 0.00

8e. Social Security 8e. $ 0.00 $ 0.00

8f. Other government assistance that you regularly receive

Include cash assistance and the value (if known) of any non-cash assistance

that you receive, such as food stamps (benefits under the Supplemental

Nutrition Assistance Program) or housing subsidies.

Specify: 8f. $ 0.00 $ 0.00

8g. Pension or retirement income 8g. $ 0.00 $ 0.00

8h. Other monthly income. Specify: Prorated tax refund 8h.+ $ 150.00 + $ 0.00

9. Add all other income. Add lines 8a+8b+8c+8d+8e+8f+8g+8h. 9. $ 150.00 $ 0.00

10. Calculate monthly income. Add line 7 + line 9. 10. $ 150.00 + $ 2,224.00 = $ 2,374.00

Add the entries in line 10 for Debtor 1 and Debtor 2 or non-filing spouse.

11. State all other regular contributions to the expenses that you list in Schedule J.

Include contributions from an unmarried partner, members of your household, your dependents, your roommates, and

other friends or relatives.

Do not include any amounts already included in lines 2-10 or amounts that are not available to pay expenses listed in Schedule J.

Specify: 11. +$ 0.00

12. Add the amount in the last column of line 10 to the amount in line 11. The result is the combined monthly income.

12. $ 2,374.00

Write that amount on the Summary of Schedules and Statistical Summary of Certain Liabilities and Related Data, if it

applies

Combined

monthly income

13. Do you expect an increase or decrease within the year after you file this form?

 No.

 Yes. Explain: Debtor 1's employment is seasonal and will end in February/March

Official Form 106I Schedule I: Your Income page 2

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 67 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr. Check if this is:

 An amended filing

Debtor 2 William Samuel Street  A supplement showing postpetition chapter

(Spouse, if filing) 13 expenses as of the following date:

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA MM / DD / YYYY

Case number

(If known)

Official Form 106J

Schedule J: Your Expenses 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct

information. If more space is needed, attach another sheet to this form. On the top of any additional pages, write your name and case

number (if known). Answer every question.

Part 1: Describe Your Household

1. Is this a joint case?

 No. Go to line 2.

 Yes. Does Debtor 2 live in a separate household?

 No

 Yes. Debtor 2 must file Official Form 106J-2, Expenses for Separate Household of Debtor 2.

2. Do you have dependents?  No

Do not list Debtor 1

and Debtor 2.

 Yes. Fill out this information for

each dependent..............

Dependent’s relationship to

Debtor 1 or Debtor 2

Dependent’s

age

Does dependent

live with you?

Do not state the

dependents names.

 No

 Yes

 No

 Yes

 No

 Yes

 No

 Yes

3. Do your expenses include

expenses of people other than

yourself and your dependents?

 No

 Yes

Part 2: Estimate Your Ongoing Monthly Expenses

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

expenses as of a date after the bankruptcy is filed. If this is a supplemental Schedule J, check the box at the top of the form and fill in the

applicable date.

Include expenses paid for with non-cash government assistance if you know

the value of such assistance and have included it on Schedule I: Your Income

(Official Form 106I.) Your expenses

4. The rental or home ownership expenses for your residence. Include first mortgage

payments and any rent for the ground or lot. 4. $ 400.00

If not included in line 4:

4a. Real estate taxes 4a. $ 0.00

4b. Property, homeowner’s, or renter’s insurance 4b. $ 0.00

4c. Home maintenance, repair, and upkeep expenses 4c. $ 40.00

4d. Homeowner’s association or condominium dues 4d. $ 0.00

5. Additional mortgage payments for your residence, such as home equity loans 5. $ 0.00

Official Form 106J Schedule J: Your Expenses page 1

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 Document Page 68 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

6. Utilities:

6a. Electricity, heat, natural gas 6a. $ 0.00

6b. Water, sewer, garbage collection 6b. $ 0.00

6c. Telephone, cell phone, Internet, satellite, and cable services 6c. $ 350.00

6d. Other. Specify: 6d. $ 0.00

7. Food and housekeeping supplies 7. $ 654.00

8. Childcare and children’s education costs 8. $ 0.00

9. Clothing, laundry, and dry cleaning 9. $ 75.00

10. Personal care products and services 10. $ 60.00

11. Medical and dental expenses 11. $ 120.00

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

Do not include car payments. 12. $ 350.00

13. Entertainment, clubs, recreation, newspapers, magazines, and books 13. $ 60.00

14. Charitable contributions and religious donations 14. $ 0.00

15. Insurance.

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

15a. Life insurance 15a. $ 0.00

15b. Health insurance 15b. $ 0.00

15c. Vehicle insurance 15c. $ 0.00

15d. Other insurance. Specify: 15d. $ 0.00

16. Taxes. Do not include taxes deducted from your pay or included in lines 4 or 20.

Specify: 16. $ 0.00

17. Installment or lease payments:

17a. Car payments for Vehicle 1 17a. $ 0.00

17b. Car payments for Vehicle 2 17b. $ 0.00

17c. Other. Specify: 17c. $ 0.00

17d. Other. Specify: 17d. $ 0.00

18. Your payments of alimony, maintenance, and support that you did not report as

deducted from your pay on line 5, Schedule I, Your Income (Official Form 106I). 18. $ 0.00

19. Other payments you make to support others who do not live with you. $ 0.00

Specify: 19.

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

20a. Mortgages on other property 20a. $ 0.00

20b. Real estate taxes 20b. $ 0.00

20c. Property, homeowner’s, or renter’s insurance 20c. $ 0.00

20d. Maintenance, repair, and upkeep expenses 20d. $ 0.00

20e. Homeowner’s association or condominium dues 20e. $ 0.00

21. Other: Specify: Emergency funds 21. +$ 50.00

22. Calculate your monthly expenses

22a. Add lines 4 through 21. $ 2,159.00

22b. Copy line 22 (monthly expenses for Debtor 2), if any, from Official Form 106J-2 $

22c. Add line 22a and 22b. The result is your monthly expenses. $ 2,159.00

23. Calculate your monthly net income.

23a. Copy line 12 (your combined monthly income) from Schedule I. 23a. $ 2,374.00

23b. Copy your monthly expenses from line 22c above. 23b. -$ 2,159.00

23c. Subtract your monthly expenses from your monthly income.

The result is your monthly net income. 23c. $ 215.00

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

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

modification to the terms of your mortgage?

 No.

 Yes. Explain here:

Official Form 106J Schedule J: Your Expenses page 2

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 69 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106Dec

Declaration About an Individual Debtor's Schedules 12/15

If two married people are filing together, both are equally responsible for supplying correct information.

You must file this form whenever you file bankruptcy schedules or amended schedules. Making a false statement, concealing property, or

obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20

years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

Sign Below

Did you pay or agree to pay someone who is NOT an attorney to help you fill out bankruptcy forms?

 No

 Yes. Name of person . Attach Bankruptcy Petition Preparer’s Notice, Declaration,

and Signature (Official Form 119).

Under penalty of perjury, I declare that I have read the summary and schedules filed with this declaration and

that they are true and correct.

X /s/ Tiara Alberta Monai Street, Jr. X /s/ William Samuel Street

Tiara Alberta Monai Street, Jr. William Samuel Street

Signature of Debtor 1 Signature of Debtor 2

Date December 2, 2015 Date December 2, 2015

Official Form 106Dec Declaration About an Individual Debtor's Schedules

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 70 of 91
Fill in this information to identify your case:

Debtor 1 Tiara Alberta Monai Street, Jr.

First Name Middle Name Last Name

Debtor 2 William Samuel Street

(Spouse if, filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 107

Statement of Financial Affairs for Individuals Filing for Bankruptcy 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct

information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case

number (if known). Answer every question.

Part 1: Give Details About Your Marital Status and Where You Lived Before

1. What is your current marital status?

 Married

 Not married

2. During the last 3 years, have you lived anywhere other than where you live now?

 No

 Yes. List all of the places you lived in the last 3 years. Do not include where you live now.

Debtor 1 Prior Address: Dates Debtor 1

lived there

Debtor 2 Prior Address: Dates Debtor 2

lived there

25512 Simmons Ave

Petersburg, VA 23803

From-To:

March 2014 -

January 2015

 Same as Debtor 1  Same as Debtor 1

From-To:

5 West Marshall St.

Apt 202

Richmond, VA 23220

From-To:

Oct. 2013- March

2014

 Same as Debtor 1  Same as Debtor 1

From-To:

15217 Timsberry Terrace

Chester, VA 23831

From-To:

Oct. 2011 - Oct.

2013

 Same as Debtor 1  Same as Debtor 1

From-To:

3. Within the last 8 years, did you ever live with a spouse or legal equivalent in a community property state or territory? (Community property

states and territories include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington and Wisconsin.)

 No

 Yes. Make sure you fill out Schedule H: Your Codebtors (Official Form 106H).

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

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 71 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Part 2 Explain the Sources of Your Income

4. Did you have any income from employment or from operating a business during this year or the two previous calendar years?

Fill in the total amount of income you received from all jobs and all businesses, including part-time activities.

If you are filing a joint case and you have income that you receive together, list it only once under Debtor 1.

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Check all that apply.

Gross income

(before deductions and

exclusions)

Sources of income

Check all that apply.

Gross income

(before deductions

and exclusions)

From January 1 of current year until

the date you filed for bankruptcy:

 Wages, commissions,

bonuses, tips

 Operating a business

$0.00  Wages, commissions,

bonuses, tips

 Operating a business

$27,211.35

For last calendar year:

(January 1 to December 31, 2014 )

 Wages, commissions,

bonuses, tips

 Operating a business

$0.00  Wages, commissions,

bonuses, tips

 Operating a business

$16,990.00

For the calendar year before that:

(January 1 to December 31, 2013 )

 Wages, commissions,

bonuses, tips

 Operating a business

$9,215.00  Wages, commissions,

bonuses, tips

 Operating a business

$22,010.00

5. Did you receive any other income during this year or the two previous calendar years?

Include income regardless of whether that income is taxable. Examples of other income are alimony; child support; Social Security,

unemployment, and other public benefit payments; pensions; rental income; interest; dividends; money collected from lawsuits; royalties; and

gambling and lottery winnings. If you are filing a joint case and you have income that you received together, list it only once under Debtor 1.

List each source and the gross income from each source separately. Do not include income that you listed in line 4.

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Describe below..

Gross income

(before deductions and

exclusions)

Sources of income

Describe below.

Gross income

(before deductions

and exclusions)

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

6. Are either Debtor 1’s or Debtor 2’s debts primarily consumer debts?

 No. Neither Debtor 1 nor Debtor 2 has primarily consumer debts. Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by an

individual primarily for a personal, family, or household purpose.”

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $6,225* or more?

 No. Go to line 7.

 Yes List below each creditor to whom you paid a total of $6,225* or more in one or more payments and the total amount you

paid that creditor. Do not include payments for domestic support obligations, such as child support and alimony. Also, do

not include payments to an attorney for this bankruptcy case.

* Subject to adjustment on 4/01/16 and every 3 years after that for cases filed on or after the date of adjustment.

 Yes. Debtor 1 or Debtor 2 or both have primarily consumer debts.

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $600 or more?

 No. Go to line 7.

 Yes List below each creditor to whom you paid a total of $600 or more and the total amount you paid that creditor. Do not

include payments for domestic support obligations, such as child support and alimony. Also, do not include payments to

an attorney for this bankruptcy case.

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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 Document Page 72 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Creditor's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Was this payment for ...

7. Within 1 year before you filed for bankruptcy, did you make a payment on a debt you owed anyone who was an insider?

Insiders include your relatives; any general partners; relatives of any general partners; partnerships of which you are a general partner;

corporations of which you are an officer, director, person in control, or owner of 20% or more of their voting securities; and any managing agent,

including one for a business you operate as a sole proprietor. 11 U.S.C. § 101. Include payments for domestic support obligations, such as child

support and alimony.

 No

 Yes. List all payments to an insider

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

8. Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account of a debt that benefited an

insider?

Include payments on debts guaranteed or cosigned by an insider.

 No

 Yes. List all payments to an insider

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

Include creditor's name

Part 4: Identify Legal Actions, Repossessions, and Foreclosures

9. Within 1 year before you filed for bankruptcy, were you a party in any lawsuit, court action, or administrative proceeding?

List all such matters, including personal injury cases, small claims actions, divorces, collection suits, paternity actions, support or custody

modifications, and contract disputes.

 No

 Yes. Fill in the details.

Case title

Case number

Nature of the case Court or agency Status of the case

Surgical Associates of Richmond

v. William Street

GV14022869-00

Warrant in Debt Chesterfield Co. GDC

P. O. Box 144

Chesterfield, VA 23832

 Pending

 On appeal

 Concluded

Hearing held: 2/10/2015

Judgment Principal:

$163.00

Regional Acceptance Corporation

v. William Street

GV15015374-00

Warrant in Debt Norfolk General District

Court

811 East City Hall Avenue

Norfolk, VA 23510-2772

 Pending

 On appeal

 Concluded

Hearing held: 6/25/2015

Judgment granted

Regional Acceptance Corp v.

William Street

GV15015374-01

Garnishment

Summons

City of Norfolk GDC

Civil Div.

150 St Pauls Blvd 2-D

Norfolk, VA 23510

 Pending

 On appeal

 Concluded

Pending: 2/3/2015

US Department of Education v.

William Street

1012023678

 Pending

 On appeal

 Concluded

Started: August 28, 2015

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 3

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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 Document Page 73 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Case title

Case number

Nature of the case Court or agency Status of the case

Genesis Properties v. William

Street

GV14007253-01

Garnishment

Summons

Richmond City GDC

John Marshall Court

Building

400 N 9th St, Rm 203

Richmond, VA 23219

 Pending

 On appeal

 Concluded

Hearing Date: 8/19/2015

Genesis Properties v. William

Street

GV14013018-01

Garnishment

Summons

Richmond City GDC

John Marshall Court

Building

400 N 9th St, Rm 203

Richmond, VA 23219

 Pending

 On appeal

 Concluded

Hearing held: May 20, 2015

Genesis Properties v. William

Street

GV14013018-02

Garnishment

Summons

Richmond City GDC

John Marshall Court

Building

400 N 9th St, Rm 203

Richmond, VA 23219

 Pending

 On appeal

 Concluded

Hearing held: July 16, 2015

10. Within 1 year before you filed for bankruptcy, was any of your property repossessed, foreclosed, garnished, attached, seized, or levied?

Check all that apply and fill in the details below.

 No

 Yes. Fill in the information below.

Creditor Name and Address Describe the Property

Explain what happened

Date Value of the

property

Westlake Financial Svc

4751 Wilshire Blvd Suite 100

Los Angeles, CA 90010

2008 Nissan Altima

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

August 2015 Unknown

Regional Acceptance Co

1200 E Fire Tower Rd

Greenville, NC 27858

2010 Mitsubishi Lancer

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

July 2015 Unknown

Genesis Properties Inc

101 W Commerce Rd

Richmond, VA 23224

Wages Garnished. Garnishment started

2/19/2015

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

per paycheck

through

8/19/2015

$1,258.42

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 4

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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 Document Page 74 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Creditor Name and Address Describe the Property

Explain what happened

Date Value of the

property

Genesis Properties Inc

101 W Commerce Rd

Richmond, VA 23224

Wages Garnished. Garnishment started

6/2/2015

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

per paycheck

through

7/16/2015

$247.88

Genesis Properties Inc

101 W Commerce Rd

Richmond, VA 23224

Wages Garnished. Garnishment started

6/12/2015

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

per paycheck

through

8/19/2015

$658.39

Regional Acceptance Co.

1200 E Fire Tower Rd

Greenville, NC 27858

Wages Garnished. Garnishment started

8/14/2015

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

per paycheck

through

2/3/2016

$1,008.47

U S Dept Of Ed/Gsl/Atl

PO Box 4222

Iowa City, IA 52244

Wages levied. Started 8/28/2015

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

per paycheck,

starting

8/28/2015

$581.66

11. Within 90 days before you filed for bankruptcy, did any creditor, including a bank or financial institution, set off any amounts from your

accounts or refuse to make a payment because you owed a debt?

 No

 Yes. Fill in the details.

Creditor Name and Address Describe the action the creditor took Date action was

taken

Amount

12. Within 1 year before you filed for bankruptcy, was any of your property in the possession of an assignee for the benefit of creditors, a

court-appointed receiver, a custodian, or another official?

 No

 Yes

Part 5: List Certain Gifts and Contributions

13. Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person?

 No

 Yes. Fill in the details for each gift.

Gifts with a total value of more than $600

per person

Person to Whom You Gave the Gift and

Address:

Describe the gifts Dates you gave

the gifts

Value

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 5

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 75 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

14. Within 2 years before you filed for bankruptcy, did you give any gifts or contributions with a total value of more than $600 to any charity

 No

 Yes. Fill in the details for each gift or contribution.

Gifts or contributions to charities that total

more than $600

Charity's Name

Address (Number, Street, City, State and ZIP Code)

Describe what you contributed Dates you

contributed

Value

Part 6: List Certain Losses

15. Within 1 year before you filed for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, fire, other

disaster, or gambling?

 No

 Yes. Fill in the details.

Describe the property you lost and

how the loss occurred

Describe any insurance coverage for the loss

Include the amount that insurance has paid. List

pending insurance claims on line 33 of Schedule A/B:

Property.

Date of your

loss

Value of property

lost

Part 7: List Certain Payments or Transfers

16. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you

consulted about seeking bankruptcy or preparing a bankruptcy petition?

Include any attorneys, bankruptcy petition preparers, or credit counseling agencies for services required in your bankruptcy.

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Email or website address

Person Who Made the Payment, if Not You

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

America Law Group, Inc.

8501 Mayland Dr.

Suite 106

Henrico, VA 23294

$437 paid to pre-filing expenses: $310

filing fee, $127 attorney's fees. $5,050

promised toward overall attorney's

fees.

11/16/2015,

11/23/2015

$437.00

CIN Group

4540 Honeywell Ct.

Dayton, OH 45424

$33 for credit report 11/30/2015 $53.00

Access Counseling

633 W 5th Street

Suite 26001

Los Angeles, CA 90071

www.accessbk.org

$15 for credit counseling 11/16/2015 $15.00

17. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone who

promised to help you deal with your creditors or to make payments to your creditors?

Do not include any payment or transfer that you listed on line 16.

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 6

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Case 15-36204-KLP Doc 1 Filed 12/02/15 Entered 12/02/15 17:40:26 Desc Main

 Document Page 76 of 91
Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

18. Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property

transferred in the ordinary course of your business or financial affairs?

Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property). Do not

include gifts and transfers that you have already listed on this statement.

 No

 Yes. Fill in the details.

Person Who Received Transfer

Address

Person's relationship to you

Description and value of

property transferred

Describe any property or

payments received or debts

paid in exchange

Date transfer was

made

19. Within 10 years before you filed for bankruptcy, did you transfer any property to a self-settled trust or similar device of which you are a

beneficiary? (These are often called asset-protection devices.)

 No

 Yes. Fill in the details.

Name of trust Description and value of the property transferred Date Transfer was

made

Part 8: List of Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units

20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed,

sold, moved, or transferred?

Include checking, savings, money market, or other financial accounts; certificates of deposit; shares in banks, credit unions, brokerage

houses, pension funds, cooperatives, associations, and other financial institutions.

 No

 Yes. Fill in the details.

Name of Financial Institution and

Address (Number, Street, City, State and ZIP

Code)

Last 4 digits of

account number

Type of account or

instrument

Date account was

closed, sold,

moved, or

transferred

Last balance

before closing or

transfer

21. Do you now have, or did you have within 1 year before you filed for bankruptcy, any safe deposit box or other depository for securities,

cash, or other valuables?

 No

 Yes. Fill in the details.

Name of Financial Institution

Address (Number, Street, City, State and ZIP Code)

Who else had access to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

22. Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy

 No

 Yes. Fill in the details.

Name of Storage Facility

Address (Number, Street, City, State and ZIP Code)

Who else has or had access

to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

Part 9: Identify Property You Hold or Control for Someone Else

23. Do you hold or control any property that someone else owns? Include any property you borrowed from, are storing for, or hold in trust

for someone.

 No

 Yes. Fill in the details.

Owner's Name

Address (Number, Street, City, State and ZIP Code)

Where is the property?

(Number, Street, City, State and ZIP

Code)

Describe the property Value

Part 10: Give Details About Environmental Information

For the purpose of Part 10, the following definitions apply:

 Environmental law means any federal, state, or local statute or regulation concerning pollution, contamination, releases of hazardous or

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 7

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

toxic substances, wastes, or material into the air, land, soil, surface water, groundwater, or other medium, including statutes or

regulations controlling the cleanup of these substances, wastes, or material.

 Site means any location, facility, or property as defined under any environmental law, whether you now own, operate, or utilize it or used

to own, operate, or utilize it, including disposal sites.

 Hazardous material means anything an environmental law defines as a hazardous waste, hazardous substance, toxic substance,

hazardous material, pollutant, contaminant, or similar term.

Report all notices, releases, and proceedings that you know about, regardless of when they occurred.

24. Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental law?

 No

 Yes. Fill in the details.

Name of site

Address (Number, Street, City, State and ZIP Code)

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

25. Have you notified any governmental unit of any release of hazardous material?

 No

 Yes. Fill in the details.

Name of site

Address (Number, Street, City, State and ZIP Code)

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

26. Have you been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.

 No

 Yes. Fill in the details.

Case Title

Case Number

Court or agency

Name

Address (Number, Street, City,

State and ZIP Code)

Nature of the case Status of the

case

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

27. Within 4 years before you filed for bankruptcy, did you own a business or have any of the following connections to any business?

 A sole proprietor or self-employed in a trade, profession, or other activity, either full-time or part-time

 A member of a limited liability company (LLC) or limited liability partnership (LLP)

 A partner in a partnership

 An officer, director, or managing executive of a corporation

 An owner of at least 5% of the voting or equity securities of a corporation

 No. None of the above applies. Go to Part 12.

 Yes. Check all that apply above and fill in the details below for each business.

Business Name

Address

(Number, Street, City, State and ZIP Code)

Describe the nature of the business

Name of accountant or bookkeeper

Employer Identification number

Do not include Social Security number or ITIN.

Dates business existed

28. Within 2 years before you filed for bankruptcy, did you give a financial statement to anyone about your business? Include all financial

institutions, creditors, or other parties.

 No

 Yes. Fill in the details below.

Name

Address

(Number, Street, City, State and ZIP Code)

Date Issued

Part 12: Sign Below

I have read the answers on this Statement of Financial Affairs and any attachments, and I declare under penalty of perjury that the answers

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 8

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

are true and correct. I understand that making a false statement, concealing property, or obtaining money or property by fraud in connection

with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20 years, or both.

18 U.S.C. §§ 152, 1341, 1519, and 3571.

/s/ Tiara Alberta Monai Street, Jr. /s/ William Samuel Street

Tiara Alberta Monai Street, Jr. William Samuel Street

Signature of Debtor 1 Signature of Debtor 2

Date December 2, 2015 Date December 2, 2015

Did you attach additional pages to Your Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107)?

 No

 Yes

Did you pay or agree to pay someone who is not an attorney to help you fill out bankruptcy forms?

 No

 Yes. Name of Person . Attach the Bankruptcy Petition Preparer's Notice, Declaration, and Signature (Official Form 119).

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 9

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Form B203 2014 USBC, Eastern District of Virginia

United States Bankruptcy Court

Eastern District of Virginia

In re

Tiara Alberta Monai Street, Jr.

William Samuel Street Case No.

Debtor(s) Chapter 13

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

IN A CHAPTER 13 CASE

(for use in the Richmond Division only)

1. 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, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the

bankruptcy case is as follows:

For legal services, I have agreed to accept $ 5,050.00

Prior to the filing of this statement I have received $ 127.00

Balance Due $ 4,923.00

2. $ 310.00 of the filing fee has been paid.

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

 Debtor  Other (specify)

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

 Debtor  Other (specify)

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

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

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

6. In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, as required by Local

Bankruptcy Rule 2016-1(C)(3).

7. I am electing to request compensation and reimbursement of expenses in this case:

a.  In accordance with the “no-look” fee set forth in Local Bankruptcy Rule 2016-1(C)(1)(a) and (C)(3)(a).

b.  By submitting applications for compensation in the manner set forth in Local Bankruptcy Rule 2016-1(C)(1)(c)(ii).

An attorney for the debtor that fails to make the election to request compensation pursuant to Local Bankruptcy Rule 2016-1(C)(1)(a) and

(C)(3)(a) at the commencement of the case will be deemed to have elected to request compensation in the manner set forth within Local

Bankruptcy Rule 2016-1(C)(1)(c)(ii).

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Form B203 2014 USBC, Eastern District of Virginia

CERTIFICATION

I certify that the foregoing is an accurate statement of any agreement or arrangement for payment to me for representation of the debtor(s) in

this bankruptcy proceeding.

December 2, 2015 /s/ Richard J. Oulton for America Law Group

Date Richard J. Oulton for America Law Group

Signature of Attorney

America Law Group, Inc. dba Debt Law Group

Name of Law Firm

America Law Group, Inc. dba Debt Law Group

8501 Mayland Dr., Ste 106

Henrico, VA 23294

804-308-0051 Fax: 804-308-0053

NOTICE TO DEBTOR(S), STANDING CHAPTER 13 TRUSTEE AND UNITED

STATES TRUSTEE

PURSUANT TO LOCAL BANKRUPTCY RULE 2016-1(C) AND

CLERK’S CM/ECF POLICY 9

Notice is hereby given that pursuant to Local Bankruptcy Rule 2016-1(C), you must file an objection with the court to the fees requested

in this disclosure of compensation opposing said fees in their entirety, or in a specific amount, no later than the last day for filing objections to

confirmation of the chapter 13 plan.

PROOF OF SERVICE

The undersigned hereby certifies that on this date the foregoing Notice was served upon the debtor(s), the standing Chapter 13 trustee,

and U. S. trustee pursuant to Local Bankruptcy Rule 2016-1(C) and the Clerk’s CM/ECF Policy 9, either electronically or in paper form (first class

mail).

December 2, 2015 /s/ Richard J. Oulton for America Law Group

Date Richard J. Oulton for America Law Group

Signature of Attorney

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Fill in this information to identify your case: Check as directed in lines 17 and 21:

According to the calculations required by this

Statement:

 1. Disposable income is not determined under

11 U.S.C. § 1325(b)(3).

 2. Disposable income is determined under 11

U.S.C. § 1325(b)(3).

 3. The commitment period is 3 years.

 4. The commitment period is 5 years.

Debtor 1 Tiara Alberta Monai Street, Jr.

Debtor 2 William Samuel Street

(Spouse, if filing)

United States Bankruptcy Court for the: Eastern District of Virginia

Case number

(if known)

 Check if this is an amended filing

Official Form 122C-1

Chapter 13 Statement of Your Current Monthly Income

and Calculation of Commitment Period 12/15

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for being accurate. If more

space is needed, attach a separate sheet to this form. Include the line number to which the additional information applies. On the top of any

additional pages, write your name and case number (if known).

Part 1: Calculate Your Average Monthly Income

1. What is your marital and filing status? Check one only.

 Not married. Fill out Column A, lines 2-11.

 Married. Fill out both Columns A and B, lines 2-11.

Fill in the average monthly income that you received from all sources, derived during the 6 full months before you file this bankruptcy case. 11 U.S.C. §

101(10A). For example, if you are filing on September 15, the 6-month period would be March 1 through August 31. If the amount of your monthly income varied during the

6 months, add the income for all 6 months and divide the total by 6. Fill in the result. Do not include any income amount more than once. For example, if both spouses own

the same rental property, put the income from that property in one column only. If you have nothing to report for any line, write $0 in the space.

Column A

Debtor 1

Column B

Debtor 2 or

non-filing spouse

2. Your gross wages, salary, tips, bonuses, overtime, and commissions (before

all payroll deductions). $ 0.00 $ 3,065.61

3. Alimony and maintenance payments. Do not include payments from a spouse if

Column B is filled in. $ 0.00 $ 0.00

4. All amounts from any source which are regularly paid for household expenses

of you or your dependents, including child support. Include regular contributions

from an unmarried partner, members of your household, your dependents, parents,

and roommates. Include regular contributions from a spouse only if Column B is not

filled in. Do not include payments you listed on line 3. $ 0.00 $ 0.00

5. Net income from operating a business,

profession, or farm Debtor 1

Gross receipts (before all deductions) $ 0.00

Ordinary and necessary operating expenses -$ 0.00

Net monthly income from a business, profession, or farm $ 0.00 Copy here -> $ 0.00 $ 0.00

6. Net income from rental and other real property Debtor 1

Gross receipts (before all deductions) $ 0.00

Ordinary and necessary operating expenses -$ 0.00

Net monthly income from rental or other real property $ 0.00 Copy here -> $ 0.00 $ 0.00

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 1

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

Column A

Debtor 1

Column B

Debtor 2 or

non-filing spouse

7. Interest, dividends, and royalties $ 0.00 $ 0.00

8. Unemployment compensation $ 0.00 $ 0.00

Do not enter the amount if you contend that the amount received was a benefit

under the Social Security Act. Instead, list it here:

For you $ 0.00

For your spouse $ 0.00

9. Pension or retirement income. Do not include any amount received that was a

benefit under the Social Security Act. $ 0.00 $ 0.00

10. Income from all other sources not listed above. Specify the source and amount.

Do not include any benefits received under the Social Security Act or payments

received as a victim of a war crime, a crime against humanity, or international or

domestic terrorism. If necessary, list other sources on a separate page and put the

total below.

$ 0.00 $ 0.00

$ 0.00 $ 0.00

Total amounts from separate pages, if any. + $ 0.00 $ 0.00

11. Calculate your total average monthly income. Add lines 2 through 10 for

each column. Then add the total for Column A to the total for Column B. $ 0.00 + $ 3,065.61 = $ 3,065.61

Total average

monthly income

Part 2: Determine How to Measure Your Deductions from Income

12. Copy your total average monthly income from line 11. $ 3,065.61

13. Calculate the marital adjustment. Check one:

 You are not married. Fill in 0 below.

 You are married and your spouse is filing with you. Fill in 0 below.

 You are married and your spouse is not filing with you.

Fill in the amount of the income listed in line 11, Column B, that was NOT regularly paid for the household expenses of you or your

dependents, such as payment of the spouse's tax liability or the spouse's support of someone other than you or your dependents.

Below, specify the basis for excluding this income and the amount of income devoted to each purpose. If necessary, list additional

adjustments on a separate page.

If this adjustment does not apply, enter 0 below.

$

$

+$

Total $ 0.00 Copy here=> - 0.00

14. Your current monthly income. Subtract line 13 from line 12. $ 3,065.61

15. Calculate your current monthly income for the year. Follow these steps:

15a. Copy line 14 here=> $

3,065.61

Multiply line 15a by 12 (the number of months in a year). x 12

15b. The result is your current monthly income for the year for this part of the form. ........................................... $ 36,787.32

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 2

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Debtor 1

Debtor 2

Tiara Alberta Monai Street, Jr.

William Samuel Street Case number (if known)

16. Calculate the median family income that applies to you. Follow these steps:

16a. Fill in the state in which you live. VA

16b. Fill in the number of people in your household. 2

16c. Fill in the median family income for your state and size of household. $

69,195.00

To find a list of applicable median income amounts, go online using the link specified in the separate

instructions for this form. This list may also be available at the bankruptcy clerk's office.

17. How do the lines compare?

17a.  Line 15b is less than or equal to line 16c. On the top of page 1 of this form, check box 1, Disposable income is not determined under

11 U.S.C. § 1325(b)(3). Go to Part 3. Do NOT fill out Calculation of Your Disposable Income (Official Form 122C-2).

17b.  Line 15b is more than line 16c. On the top of page 1 of this form, check box 2, Disposable income is determined under 11 U.S.C. §

1325(b)(3). Go to Part 3 and fill out Calculation of Your Disposable Income (Official Form 122C-2). On line 39 of that form,

copy your current monthly income from line 14 above.

Part 3: Calculate Your Commitment Period Under 11 U.S.C. § 1325(b)(4)

18. Copy your total average monthly income from line 11 . $ 3,065.61

19. Deduct the marital adjustment if it applies. If you are married, your spouse is not filing with you, and you

contend that calculating the commitment period under 11 U.S.C. § 1325(b)(4) allows you to deduct part of your

spouse's income, copy the amount from line 13.

19a. If the marital adjustment does not apply, fill in 0 on line 19a. -$ 0.00

19b. Subtract line 19a from line 18. $ 3,065.61

20. Calculate your current monthly income for the year. Follow these steps:

20a. Copy line 19b $

3,065.61

Multiply by 12 (the number of months in a year). x 12

20b. The result is your current monthly income for the year for this part of the form $ 36,787.32

20c. Copy the median family income for your state and size of household from line 16c $ 69,195.00

21. How do the lines compare?

 Line 20b is less than line 20c. Unless otherwise ordered by the court, on the top of page 1 of this form, check box 3, The commitment

period is 3 years. Go to Part 4.

 Line 20b is more than or equal to line 20c. Unless otherwise ordered by the court, on the top of page 1 of this form, check box 4, The

commitment period is 5 years. Go to Part 4.

Part 4: Sign Below

By signing here, under penalty of perjury I declare that the information on this statement and in any attachments is true and correct.

X /s/ Tiara Alberta Monai Street, Jr. X /s/ William Samuel Street

Tiara Alberta Monai Street, Jr. William Samuel Street

Signature of Debtor 1 Signature of Debtor 2

Date December 2, 2015 Date December 2, 2015

MM / DD / YYYY MM / DD / YYYY

If you checked 17a, do NOT fill out or file Form 122C-2.

If you checked 17b, fill out Form 122C-2 and file it with this form. On line 39 of that form, copy your current monthly income from line 14 above.

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 3

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Notice Required by 11 U.S.C. § 342(b) for

Individuals Filing for Bankruptcy (Form 2010)

This notice is for you if:

You are an individual filing for bankruptcy,

and

Your debts are primarily consumer debts.

Consumer debts are defined in 11 U.S.C.

§ 101(8) as “incurred by an individual

primarily for a personal, family, or

household purpose.”

Chapter 7: Liquidation

$245 filing fee

 $75 administrative fee

+ $15 trustee surcharge

$335 total fee

Chapter 7 is for individuals who have financial

difficulty preventing them from paying their debts

and who are willing to allow their nonexempt

property to be used to pay their creditors. The

primary purpose of filing under chapter 7 is to have

your debts discharged. The bankruptcy discharge

relieves you after bankruptcy from having to pay

many of your pre-bankruptcy debts. Exceptions exist

for particular debts, and liens on property may still

be enforced after discharge. For example, a creditor

may have the right to foreclose a home mortgage or

repossess an automobile.

However, if the court finds that you have committed

certain kinds of improper conduct described in the

Bankruptcy Code, the court may deny your

discharge.

You should know that even if you file chapter 7 and

you receive a discharge, some debts are not

discharged under the law. Therefore, you may still

be responsible to pay:

most taxes;

most student loans;

domestic support and property settlement

obligations;

The types of bankruptcy that are available to

individuals

Individuals who meet the qualifications may file under

one of four different chapters of Bankruptcy Code:

Chapter 7 - Liquidation

Chapter 11 - Reorganization

Chapter 12 - Voluntary repayment plan

for family farmers or

fishermen

Chapter 13 - Voluntary repayment plan

for individuals with regular

income

You should have an attorney review your

decision to file for bankruptcy and the choice of

chapter.

Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 1

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most fines, penalties, forfeitures, and criminal

restitution obligations; and

certain debts that are not listed in your bankruptcy

papers.

You may also be required to pay debts arising from:

fraud or theft;

fraud or defalcation while acting in breach of

fiduciary capacity;

intentional injuries that you inflicted; and

death or personal injury caused by operating a

motor vehicle, vessel, or aircraft while intoxicated

from alcohol or drugs.

If your debts are primarily consumer debts, the court

can dismiss your chapter 7 case if it finds that you have

enough income to repay creditors a certain amount.

You must file Chapter 7 Statement of Your Current

Monthly Income (Official Form 122A–1) if you are an

individual filing for bankruptcy under chapter 7. This

form will determine your current monthly income and

compare whether your income is more than the median

income that applies in your state.

If your income is not above the median for your state,

you will not have to complete the other chapter 7 form,

the Chapter 7 Means Test Calculation (Official Form

122A–2).

If your income is above the median for your state, you

must file a second form —the Chapter 7 Means Test

Calculation (Official Form 122A–2). The calculations on

the form— sometimes called the Means Test—deduct

from your income living expenses and payments on

certain debts to determine any amount available to pay

unsecured creditors. If

your income is more than the median income for your

state of residence and family size, depending on the

results of the Means Test, the U.S. trustee, bankruptcy

administrator, or creditors can file a motion to dismiss

your case under § 707(b) of the Bankruptcy Code. If a

motion is filed, the court will decide if your case should

be dismissed. To avoid dismissal, you may choose to

proceed under another chapter of the Bankruptcy

Code.

If you are an individual filing for chapter 7 bankruptcy,

the trustee may sell your property to pay your debts,

subject to your right to exempt the property or a portion

of the proceeds from the sale of the property. The

property, and the proceeds from property that your

bankruptcy trustee sells or liquidates that you are

entitled to, is called exempt property. Exemptions may

enable you to keep your home, a car, clothing, and

household items or to receive some of the proceeds if

the property is sold.

Exemptions are not automatic. To exempt property, you

must list it on Schedule C: The Property You Claim as

Exempt (Official Form 106C). If you do not list the

property, the trustee may sell it and pay all of the

proceeds to your creditors.

Chapter 11: Reorganization

$1,167 filing fee

+ $550 administrative fee

$1,717 total fee

Chapter 11 is often used for reorganizing a business,

but is also available to individuals. The provisions of

chapter 11 are too complicated to summarize briefly.

Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 2

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Read These Important Warnings

Because bankruptcy can have serious long-term financial and legal consequences, including loss of

your property, you should hire an attorney and carefully consider all of your options before you file. Only

an attorney can give you legal advice about what can happen as a result of filing for bankruptcy and

what your options are. If you do file for bankruptcy, an attorney can help you fill out the forms properly

and protect you, your family, your home, and your possessions.

Although the law allows you to represent yourself in bankruptcy court, you should understand that many

people find it difficult to represent themselves successfully. The rules are technical, and a mistake or

inaction may harm you. If you file without an attorney, you are still responsible for knowing and

following all of the legal requirements.

You should not file for bankruptcy if you are not eligible to file or if you do not intend to file the

necessary documents.

Bankruptcy fraud is a serious crime; you could be fined and imprisoned if you commit fraud in your

bankruptcy case. Making a false statement, concealing property, or obtaining money or property by

fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to

20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

Chapter 12: Repayment plan for family

farmers or fishermen

Under chapter 13, you must file with the court a plan to

repay your creditors all or part of the money that you

owe them, usually using your future earnings. If the

court approves your plan, the court will allow you to

repay your debts, as adjusted by the plan, within 3

years or 5 years, depending on your income and other

factors.

After you make all the payments under your plan,

many of your debts are discharged. The debts that are

not discharged and that you may still be responsible to

pay include:

domestic support obligations,

most student loans,

certain taxes,

debts for fraud or theft,

debts for fraud or defalcation while acting in a

fiduciary capacity,

most criminal fines and restitution obligations,

certain debts that are not listed in your

bankruptcy papers,

certain debts for acts that caused death or

personal injury, and

certain long-term secured debts.

$200 filing fee

+ $75 administrative fee

$275 total fee

Similar to chapter 13, chapter 12 permits family farmers

and fishermen to repay their debts over a period of time

using future earnings and to discharge some debts that

are not paid.

Chapter 13: Repayment plan for

individuals with regular

income

$235 filing fee

+ $75 administrative fee

$310 total fee

Chapter 13 is for individuals who have regular income

and would like to pay all or part of their debts in

installments over a period of time and to discharge some

debts that are not paid. You are eligible for chapter 13

only if your debts are not more than certain dollar

amounts set forth in 11 U.S.C. § 109.

Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 3

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Warning: File Your Forms on Time

A married couple may file a bankruptcy case

together—called a joint case. If you file a joint case and

each spouse lists the same mailing address on the

bankruptcy petition, the bankruptcy court generally will

mail you and your spouse one copy of each notice,

unless you file a statement with the court asking that

each spouse receive separate copies.

Understand which services you could receive from

credit counseling agencies

The law generally requires that you receive a credit

counseling briefing from an approved credit counseling

agency. 11 U.S.C. § 109(h). If you are filing a joint case,

both spouses must receive the briefing. With limited

exceptions, you must receive it within the 180 days

before you file your bankruptcy petition. This briefing is

usually conducted by telephone or on the Internet.

In addition, after filing a bankruptcy case, you generally

must complete a financial management instructional

course before you can receive a discharge. If you are

filing a joint case, both spouses must complete the

course.

You can obtain the list of agencies approved to provide

both the briefing and the instructional course from:

http://justice.gov/ust/eo/hapcpa/ccde/cc_approved.html.

In Alabama and North Carolina, go to:

http://www.uscourts.gov/FederalCourts/Bankruptcy/

BankruptcyResources/ApprovedCredit

AndDebtCounselors.aspx.

If you do not have access to a computer, the clerk of

the bankruptcy court may be able to help you obtain the

list.

Section 521(a)(1) of the Bankruptcy Code requires that

you promptly file detailed information about your

creditors, assets, liabilities, income, expenses and

general financial condition. The court may dismiss your

bankruptcy case if you do not file this information within

the deadlines set by the Bankruptcy Code, the

Bankruptcy Rules, and the local rules of the court.

For more information about the documents and

their deadlines, go to:

http://www.uscourts.gov/bkforms/bankruptcy_form

s.html#procedure.

Bankruptcy crimes have serious consequences

If you knowingly and fraudulently conceal assets

or make a false oath or statement under penalty of

perjury—either orally or in writing—in connection

with a bankruptcy case, you may be fined,

imprisoned, or both.

All information you supply in connection with a

bankruptcy case is subject to examination by the

Attorney General acting through the Office of the

U.S. Trustee, the Office of the U.S. Attorney, and

other offices and employees of the U.S.

Department of Justice.

Make sure the court has your mailing address

The bankruptcy court sends notices to the mailing

address you list on Voluntary Petition for Individuals

Filing for Bankruptcy (Official Form 101). To ensure

that you receive information about your case,

Bankruptcy Rule 4002 requires that you notify the court

of any changes in your address.

Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 4

Software Copyright (c) 1996-2015 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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}bk1{Credito AresMatix}bk{

Acs/jp Morgan Chase Ba

501 Bleecker St

Utica, NY 13501

Afni Inc

1310 Martin Luther King Dr.

PO Box 3517

Bloomington, IL 61702-3517

Allied Cash Advance

200 SE 1st St

Ste 800

Miami, FL 33131

Barry L Katchinoff MD & Assoc.

7305 Boulders View Lane

Richmond, VA 23225

Bay Area Credit Service LLC

1000 Abernathy Rd NE

Suite 195

Atlanta, GA 30328

Broadwater Associates

168 Business Park Dr. Ste 200

Virginia Beach, VA 23462

Capio Partners LLC

re: Florida Hospital

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

Capio Partners LLC

Attn: Bankruptcy

2222 Texoma Pkwy Ste 160

Sherman, TX 75090

Capio Partners Llc

Attn: Bankruptcy

2222 Texoma Pkwy Ste 150

Sherman, TX 75090

Carillion Labs

213 S Jefferson St, Ste 1202

Roanoke, VA 24011

Cbe Group

Attn: Bankruptcy

Po Box 900

Waterloo, IA 50704

CBE Group

1309 Technology Pkwy

Cedar Falls, IA 50613

Central Credit/Penn Cr

Attn: Bankruptcy

PO Box 988

Harrisburg, PA 17108

Check City

re: Bankruptcy

6001 West Broad Street

Richmond, VA 23230

Check City

PO Box 970183

Orem, UT 84097

Check City

2729 West Broad St.

Henrico, VA 23228

CJW Medical Center

PO Box 13620

Richmond, VA 23225

Comcast

8029 Corporate Dr

Nottingham, MD 21236-4977

Comcast

5401 Staples Mill Road

Henrico, VA 23228-5421

Comcast Chesterfield

6510 Iron Bridge Rd

Richmond, VA 23234

Coweta Emergency Group

200 Corporate Blvd

Suite 201

Lafayette, LA 70508

Credit Control Corporation

PO Box 120568

Newport News, VA 23612

D. Kent Gilliam

7821 Ironbridge Road

Richmond, VA 23237

DirectTV

attn: Bankruptcy Claims

PO Box 6550

Englewood, CO 80155-6550

Diversified Consultants

PO Box 551268

Jacksonville, FL 32255

Dominion Virginia Power

PO Box 26543

Richmond, VA 23290-0001

Durham & Durham

5665 New Northside Dr.

Suite 510

Atlanta, GA 30328

Eastern Account System of Conn

PO Box 837

Newtown, CT 06470

Enterprise Recovery Systems

PO Box 5288

Hinsdale, IL 60522

ERC/Enhanced Recovery Corp

8014 Bayberry Rd

Jacksonville, FL 32256

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Fall Line Emergency Phys

18167 US Highway 19N

Suite 650

Clearwater, FL 33764

Fed Loan Servicing

PO Box 69184

Harrisburg, PA 17106

First Virginia

6785 Bobcat Way, Suite 200

Dublin, OH 43016

First Virginia Financial Svcs

4503 W Broad Street

Richmond, VA 23230

First Virginia, VA134

7001 Post Road, Suite 300

Dublin, OH 43016-8755

Florida Hospital

601 E Rollins St

Orlando, FL 32803

FMS Investment Corp

PO Box 1423

Elk Grove Village, IL 60009

Focus Recovery Solutions

Attn: Bankruptcy

9701 Metropolitan Court Ste B

Richmond, VA 23236

Focused Recovery Solutions

9701 Metropolitan Court, Ste B

Richmond, VA 23236-3690

Freedom Respiratory

2233 E Main St.

Montrose, CO 81401

Full Sail University

3300 University Blvd

Winter Park, FL 32792

Genesis Properties Inc

101 W Commerce Rd

Richmond, VA 23224

Great Lakes Educational Loan

2401 International

Madison, WI 53704

Henrico Doctor's Hospital

PO Box 13620

Richmond, VA 23225-8620

Henrico Doctor's Hospital

PO Box 13620

Richmond, VA 23225

Henrico Doctor's Hospital-Fore

PO Box 99400

Louisville, KY 40269

Hercules Real Estate Services

dba England Run II

168 Business Park Dr. 103

Virginia Beach, VA 23462

Internal Revenue Service

Insolvency Unit

PO Box 7346

Philadelphia, PA 19101-7346

Jefferson Capital Systems, LLC

16 Mcleland Rd

Saint Cloud, MN 56303

John Randolph Medical Center

411 W Randolph Rd

Hopewell, VA 23860

John Randolph Medical Center

PO Box 13620

Richmond, VA 23225

JP Morgan Chase Bank

Attn: Bankruptcy

PO Box 15298

Wilmington, DE 19850

MCV Associated Physicians

830 E Main St

Suite 1900

Richmond, VA 23219

MCV Physicians

830 E Main St

Suite 1900

Richmond, VA 23219

MCV Physicians

1601 Willow Lawn Dr, Ste 275

Richmond, VA 23230

Medical Data Systems I

2001 9th Ave

Suite 312

Vero beach, FL 32960

Medical Revenue Services

645 Walnut St

Ste 5

Gadsden, AL 35902

Online Collections

PO Box 1489

Winterville, NC 28590

Parrish and LeBar, LLP

5 E Franklin St.

Richmond, VA 23219

PaymentsMD.Com

5665 New Northside Dr.

Suite 330

Atlanta, GA 30328

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Penn Credit Corporation

916 S 14th St

Harrisburg, PA 17108

Penn Credit Corporation

PO Box 988

Harrisburg, PA 17108-0988

Phoenix Financial Serv

8902 Otis Ave Ste 103a

Indianapolis, IN 46216

Progress Energy Florida

Duke Energy

PO Box 14042

Saint Petersburg, FL 33733

Progressive Direct Ins

6300 Wilson Mills Rd

Cleveland, OH 44143

Public Storage

5440 Midlothian Tnpk

Richmond, VA 23225

PWC of Fayetteville

955 Old Wilmington Rd

Fayetteville, NC 28301

Regional Acceptance Co

1200 E Fire Tower Rd

Greenville, NC 27858

Reliacare Home Medical

2233 E Main St

Montrose, CO 81401

Shenandoah Legal

310 Jefferson Street S.E.

Roanoke, VA 24011

Sleep Diagnostics

7305 Boulders View Lane

Richmond, VA 23225

Southside Regional Hospital

200 Medical Parks Boulevard

Petersburg, VA 23805

Southside Regional Medical

200 Medical Park Blvd

Petersburg, VA 23805

Southwest Credit Syste

4120 International Pkwy

Suite 1100

Carrollton, TX 75007

Sprint

Attn: Bankruptcy Dept

4900 W. 95th Street

Oak Lawn, IL 60453

Sternrecsvcs

415 N Edgeworth St

Greensboro, NC 27401

Surgical Associates of Rchmnd

PO Box 11023

Richmond, VA 23230

Sykes, Bourdon, Ahern & Levy

281 Independence Blvd

Pembroke 1 Building, 5th Floor

Virginia Beach, VA 23462

T-Mobile Bankruptcy Team

PO Box 53410

Bellevue, WA 98015-5341

Transworld Sys Inc/38

507 Prudential Rd

Horsham, PA 19044

U S Dept Of Ed/Gsl/Atl

PO Box 4222

Iowa City, IA 52244

U S Dept Of Ed/Gsl/Atl

POBox 4222

Iowa City, IA 52244

United Consumers Inc

PO Box 4466

Woodbridge, VA 22194

VCU Health System -- MCV Hosp

Set-off Debt Section

PO Box 980462

Richmond, VA 23298-0462

Verizon

500 Technology Dr

Suite 500

Weldon Spring, MO 63304

Verizon Wireless

PO Box 25505

Lehigh Valley, PA 18002-5505

Virginia Emergency Group

5665 New Northside Dr.

Suite 320

Atlanta, GA 30328

Virginia Emergency Physicians

1602 Skipwith Rd

Henrico, VA 23229

Virginia Medical Group

2905 Boulevard

Colonial Heights, VA 23834

Westlake Financial Svc

4751 Wilshire Blvd Suite 100

Los Angeles, CA 90010

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