Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 202

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

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this

form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any

amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document,

and the date. Bankruptcy Rules 1008 and 9011.

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

connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341,

1519, and 3571.

Declaration and signature

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or another

individual serving as a representative of the debtor in this case.

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

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

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

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

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

 Schedule H: Codebtors (Official Form 206H)

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

 Amended Schedule

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

 Other document that requires a declaration

I declare under penalty of perjury that the foregoing is true and correct.

Executed on December 29, 2017 X /s/ Steven Lebischak

Signature of individual signing on behalf of debtor

Steven Lebischak

Printed name

Chief Executive

Position or relationship to debtor

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

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 1 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206Sum

Summary of Assets and Liabilities for Non-Individuals 12/15

Part 1: Summary of Assets

1. Schedule A/B: Assets-Real and Personal Property (Official Form 206A/B)

1a. Real property:

 Copy line 88 from Schedule A/B............................................................................................................................. $ 0.00

1b. Total personal property:

 Copy line 91A from Schedule A/B......................................................................................................................... $ 844,268.44

1c. Total of all property:

 Copy line 92 from Schedule A/B........................................................................................................................... $ 844,268.44

Part 2: Summary of Liabilities

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

Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D.................................... $ 10,000.00

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

3a. Total claim amounts of priority unsecured claims:

 Copy the total claims from Part 1 from line 5a of Schedule E/F.......................................................................... $ 0.00

3b. Total amount of claims of nonpriority amount of unsecured claims:

 Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F................................................ +$ 3,024,301.74

4. Total liabilities .......................................................................................................................................................

Lines 2 + 3a + 3b $ 3,034,301.74

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

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 2 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206A/B

Schedule A/B: Assets - Real and Personal Property 12/15

Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest.

Include all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties

which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts

or unexpired leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).

Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write

the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an

additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.

For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset

schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the

debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.

Part 1: Cash and cash equivalents

1. Does the debtor have any cash or cash equivalents?

 No. Go to Part 2.

 Yes Fill in the information below.

All cash or cash equivalents owned or controlled by the debtor Current value of

debtor's interest

3. Checking, savings, money market, or financial brokerage accounts (Identify all)

Name of institution (bank or brokerage firm) Type of account Last 4 digits of account

number

3.1. EagleBank checking 2389 $11,308.48

3.2. First Bank (closed as of 12/19/2017) checking 1796 $5,127.01

4. Other cash equivalents (Identify all)

4.1.

$13,000 in certified bank checks

$6,000 held for debtor in non-debtor bank account

Note: The above funds were deposited post-petition into Debtor's debtor-in-possession

bank account. $19,000.00

5. Total of Part 1. $35,435.49

Add lines 2 through 4 (including amounts on any additional sheets). Copy the total to line 80.

Part 2: Deposits and Prepayments

6. Does the debtor have any deposits or prepayments?

 No. Go to Part 3.

 Yes Fill in the information below.

Part 3: Accounts receivable

10. Does the debtor have any accounts receivable?

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 1

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 3 of 38
Debtor Aero-X Golf, Inc. Case number (If known) 17-14249

Name

 No. Go to Part 4.

 Yes Fill in the information below.

11. Accounts receivable

11a. 90 days old or less: 10,173.05 - 0.00 = .... $10,173.05

face amount doubtful or uncollectible accounts

11b. Over 90 days old: 5,257.00 - 0.00 =.... $5,257.00

face amount doubtful or uncollectible accounts

12. Total of Part 3. $15,430.05

Current value on lines 11a + 11b = line 12. Copy the total to line 82.

Part 4: Investments

13. Does the debtor own any investments?

 No. Go to Part 5.

 Yes Fill in the information below.

Part 5: Inventory, excluding agriculture assets

18. Does the debtor own any inventory (excluding agriculture assets)?

 No. Go to Part 6.

 Yes Fill in the information below.

General description Date of the last

physical inventory

Net book value of

debtor's interest

(Where available)

Valuation method used

for current value

Current value of

debtor's interest

19. Raw materials

20. Work in progress

21. Finished goods, including goods held for resale

Inventory held in North

Carolina Storage. See

attachment "North

Carolina Storage

Inventory"

Note Re: Physical

Inventory Dates:

Approx. 10/15/17 for

goods in NC, 1/30/17 for

DW Sports (located in

AZ) 10/15/17, 1/30/17 $49,686.40 Cost $49,686.40

Inventory held at Iron

Mountain. See

attachment "Inventory

held at Iron Mountain" Approx. 9/16/17 $79,128.19 Cost $79,128.19

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 2

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 4 of 38
Debtor Aero-X Golf, Inc. Case number (If known) 17-14249

Name

Inventory held by

Whitebox. See

attachment "Inventory

held by Whitebox." $7,376.25 Cost $7,376.25

22. Other inventory or supplies

23. Total of Part 5. $136,190.84

Add lines 19 through 22. Copy the total to line 84.

24. Is any of the property listed in Part 5 perishable?

 No

 Yes

25. Has any of the property listed in Part 5 been purchased within 20 days before the bankruptcy was filed?

 No

 Yes. Book value Valuation method Current Value

26. Has any of the property listed in Part 5 been appraised by a professional within the last year?

 No

 Yes

Part 6: Farming and fishing-related assets (other than titled motor vehicles and land)

27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?

 No. Go to Part 7.

 Yes Fill in the information below.

Part 7: Office furniture, fixtures, and equipment; and collectibles

38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?

 No. Go to Part 8.

 Yes Fill in the information below.

Part 8: Machinery, equipment, and vehicles

46. Does the debtor own or lease any machinery, equipment, or vehicles?

 No. Go to Part 9.

 Yes Fill in the information below.

Part 9: Real property

54. Does the debtor own or lease any real property?

 No. Go to Part 10.

 Yes Fill in the information below.

Part 10: Intangibles and intellectual property

59. Does the debtor have any interests in intangibles or intellectual property?

 No. Go to Part 11.

 Yes Fill in the information below.

General description Net book value of

debtor's interest

(Where available)

Valuation method used

for current value

Current value of

debtor's interest

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 3

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 5 of 38
Debtor Aero-X Golf, Inc. Case number (If known) 17-14249

Name

60. Patents, copyrights, trademarks, and trade secrets

Patents and Patent Applications. See

attachment "Patents and Patent Applications"

Note: The value listed herein for all of the

intellectual property is based upon the fees

and costs incurred for all conforming and

non-conforming intellectual property,

including attorneys fees and maintenance

fees. $0.00 See Note $647,212.06

61. Internet domain names and websites

www.polaragolf.com

[The brand name Polara Golf is used by

Aero-X but is owned by another company:

Golfer First Technology (GFT). GFT licenses

Polara to Aero-X.] Unknown Unknown

62. Licenses, franchises, and royalties

63. Customer lists, mailing lists, or other compilations

Email registry consisting of approximately

20,000 names/email addresses $0.00 Estimated Cost $10,000.00

64. Other intangibles, or intellectual property

65. Goodwill

66. Total of Part 10. $657,212.06

Add lines 60 through 65. Copy the total to line 89.

67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C.§§ 101(41A) and 107?

 No

 Yes

68. Is there an amortization or other similar schedule available for any of the property listed in Part 10?

 No

 Yes

69. Has any of the property listed in Part 10 been appraised by a professional within the last year?

 No

 Yes

Part 11: All other assets

70. Does the debtor own any other assets that have not yet been reported on this form?

Include all interests in executory contracts and unexpired leases not previously reported on this form.

 No. Go to Part 12.

 Yes Fill in the information below.

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 4

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 6 of 38
Debtor Aero-X Golf, Inc. Case number (If known) 17-14249

Name

Part 12: Summary

In Part 12 copy all of the totals from the earlier parts of the form

Type of property Current value of

personal property

Current value of real

property

80. Cash, cash equivalents, and financial assets.

Copy line 5, Part 1 $35,435.49

81. Deposits and prepayments. Copy line 9, Part 2. $0.00

82. Accounts receivable. Copy line 12, Part 3. $15,430.05

83. Investments. Copy line 17, Part 4. $0.00

84. Inventory. Copy line 23, Part 5. $136,190.84

85. Farming and fishing-related assets. Copy line 33, Part 6. $0.00

86. Office furniture, fixtures, and equipment; and collectibles.

Copy line 43, Part 7. $0.00

87. Machinery, equipment, and vehicles. Copy line 51, Part 8. $0.00

88. Real property. Copy line 56, Part 9.........................................................................................> $0.00

89. Intangibles and intellectual property. Copy line 66, Part 10. $657,212.06

90. All other assets. Copy line 78, Part 11. + $0.00

91. Total. Add lines 80 through 90 for each column $844,268.44 + 91b. $0.00

92. Total of all property on Schedule A/B. Add lines 91a+91b=92 $844,268.44

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 5

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 7 of 38
Inventory Code Inventory Description Availability Total Shipments Total Returns In Stock Cost

$85

D105AMRH45 45' 10.5 A MRH 9 1 8

D105AMRH46 46' 10.5 A MRH 45 45

D105AMRH47 47' 10.5 A MRH 5 5

D105RMRH45 45' 10.5 R MRH 10 2 1 9

D105RMRH46 46' 10.5 R MRH 23 23

D105RMRH47 47' 10.5 R MRH 5 1 4

D105SMRH45 45' 10.5 S MRH 2 1 1

D105SMRH46 46' 10.5 S MRH 2 2

D105SMRH47 47' 10.5 S MRH 1 1

D12AMRH45 45' 12 A MRH 8 1 7

D12AMRH46 46' 12 A MRH 30 30

D12AMRH47 47' 12 A MRH 5 5

D12RMRH45 45' 12 R MRH 2 2 0

D12RMRH46 46' 12 R MRH 23 23

D12RMRH47 47' 12 R MRH 5 5

D12SMRH45 45' 12 S MRH 1 1

D12SMRH46 46' 12 S MRH 0 0

D12SMRH47 47' 12 S MRH 2 2

DHL1AMRH45 45' HL1 A MRH 4 4

DHL1AMRH46 46' HL1 A MRH 8 8

DHL1AMRH47 47' HL1 A MRH 0 0

DHL1RMRH45 45' HL1 R MRH 9 9

DHL1RMRH46 46' HL1 R MRH 32 32

DHL1RMRH47 47' HL1 R MRH 8 8

DHL1SMRH46 46' HL1 S MRH 0 0

DHL1SMRH47 47' HL1 S MRH 0 0

DHL3AMRH45 45' HL3 A MRH 16 16

DHL3AMRH46 46' HL3 A MRH 9 9

DHL3AMRH47 47' HL3 A MRH 12 12

DHL3RMRH45 45' HL3 R MRH 7 7

DHL3RMRH46 46' HL3 R MRH 6 6

DHL3RMRH47 47' HL3 R MRH 6 6

Womens

D105WRH435 43.5' 10.5 WRH 3 3

D105WRH445 44.5' 10.5 WRH 3 3

D12WRH435 43.5' 12 L 2 2

D12WRH445 44.5' 12 WRH WOMEN 5 5

DHL1WRH435 43.5' HL1 WRH WOMEN 5 5

DHL1WRH445 44.5' HL1 WRH WOMEN 14 14

DHL3WRH435 43.5' HL3 WRH WOMEN 2 2

DHL3WRH445 44.5' HL3 WRH WOMEN 41 41

370 8 1 363 $30,855

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 8 of 38
Inventory Code Inventory Description Availability Total Shipments Total Returns In Stock Cost

AAD105AR45 Used A Adv 10.5 Men A RH 45' 4 4

AAD105AR46 Used A Adv 10.5 Men A RH 46' 5 5

AAD105AR47 Used A Adv 10.5 Men A RH 47' 1 1

AAD105RR45 Used A Adv 10.5 Men R RH 45' 0

AAD105RR46 Used A Adv 10.5 Men R RH 46' 0

AAD105RR47 Used A Adv 10.5 Men R RH 47' 0

AAD105SR46 Used A Adv 10.5 Men S RH 46' 0

AAD105SR45 Used A Adv 10.5 Men S RH 45' 0

AAD105SR47 Used A Adv 10.5 Men S RH 47' 0

AAD12AR45 Used A Adv 12 Men A RH 45' 0

AAD12AR46 Used A Adv 12 Men A RH 46' 4 4

AAD12AR47 Used A Adv 12 Men A RH 47' 0

AAD12RR45 Used A Adv 12 Men R RH 45' 0

AAD12RR46 Used A Adv 12 Men R RH 46' 0

AAD12RR47 Used A Adv 12 Men R RH 47' 0

AAD12SR45 Used A Adv 12 Men S RH 45' 0

AAD12SR46 Used A Adv 12 Men S RH 46' 0

AAD12SR47 Used A Adv 12 Men S RH 47' 0

AADH1AR45 Used A Adv HL1 Men A RH 45' 1 1

AADH1AR46 Used A Adv HL1 Men A RH 46' 25 25

AADH1AR47 Used A Adv HL1 Men A RH 47' 4 4

AADH1RR45 Used A Adv HL1 Men R RH 45' 3 3

AADH1RR46 Used A Adv HL1 Men R RH 46' 4 4

AADH3AR45 Used A Adv HL3 Men A RH 45' 1 1

AADH3AR46 Used A Adv HL3 Men A RH 46' 0

Womens

AAD10WR435 Used A Adv 10.5 Women L RH 435 2 2

AAD10WR445 Used A Adv 10.5 Women L RH 445 1 1

AAD12WR435 Used A Adv 12 Women L RH 435 1 1

AAD12WR445 Used A Adv 12 Women L RH 445 1 1

AADH1WR435 Used A Adv HL1 Women L RH 435 2 2

AADH1WR445 Used A Adv HL1 Women L RH 445 8 8

AADH3WR435 Used A Adv HL3 Women L RH 435 2 2

AADH3WR445 Used A Adv HL3 Women L RH 445 4 4

73 0 0 73 $6,205 

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 9 of 38
In Stock Unit 24 Sold Total

10.5 A 45 1 1

10.5 R 45 1 1

10.5 R 46 1 2 3

10.5 S 45 1 1 0

10.5 S 46 2 2 0

12 A 45 3 3

12 A 46 2 2

12 A 47 1 1

12 L 44.5 1 1

12 R 45 1 1 2

12 R 46 1 1 0

HL1 A 42 1 1

HL1 A 43.5 2 2

HL1 A 45 5 1 4

HL1 A 45 2 2

HL1 A 46 1 2 3

HL1 L 43.5 5 5

HL1 L 44.5 1 1 2

HL1 R 45 2 2

HL1 R 46 1 1 2

HL3 A 45 1 1 2

HL3 L 43.5 1 1

HL3 L 44.5 4 1 5

HL3 R 45 1 1

HL3 R 46 1 1

Total 47

Cost 3,995.00

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 10 of 38
In Stock Sold Available Cost Total

US 8 8 5.25 42

XS 114 114 8.25 940.5

XD 24 24 5.25 126

Total Cost 1108.5

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 11 of 38
Loose Heads (New) In Stock Unit 24 Sold Total in stock Cost/unit Total Cost

10.5 25 3 1 27 50.00 1,350.00

12 1 1 50.00

HL1 24 4 28 1,400.00

Hl3 2 15 17 850.00

Used Heads

10.5 1 1 50.00

Headcovers

Ladies 1 box

Mens 1 box

Shafts 200 Mostly ladies 10.00 2,000.00

Ladies 4 boxes

R 11 11

Golf Balls

US 64 12 58 5.25 304.50

XS 56 57 31 8.25 255.75

XD 82 102 0 5.25 -

XD 2 ball sleeves 120 30 90 0.80 72.00

XDS 2 ball sleeves 16 12 4 1.10 4.40

XD Dz. No Top 68 60 8

US/XD combo 21 21 5.25 110.25

XS No Top 36 36 8.25 297.00

Miscellaneous

Hard Drives 4

Monitors 5

Hat Tool 40 3 37 7.00 259.00

Sport Tool 40 40 7.00 280.00

Gloves 30 30 8.00 240.00

Total Cost 7,522.90

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 12 of 38
Stock Number Description Qty Available # of Dz Cost/unit Total Ordered Notes

960014093B 3 Red Balls Tria (case=12) 38 456 8.25 $ 3,762.00 XS no top full dozen

96001409XS 1 dz XS (case=20) 358 7160 8.25 $59,070.00

CUSTOMER RETURNS Customer Returns (mixed pallet) 2 0 $ -

P2SUS2SXD 2 sleeves each of the US and XD (case=20) 16 320 5.25 $ 1,680.00

P2SUS2SXD-B 2 sleeves each of the US and XD (box=12) 10 10 5.25 $ 52.50

P2SUSXD US-XD Trial Pack (case=90) 5 112.5 5.25 $ 590.63 18-Dec XD sleeves

P2SUSXD-S US-XD Trial Pack (Sleeve = 3) 20 5 5.25 $ 26.25 18-Dec XD sleeves

PBCXD12DZ 12 dz XD (case=20) 4 80 5.25 $ 420.00

PBXS20DZ 20 dz XS (case=20) 59 1180 8.25 $ 9,735.00

PLASTICBINS Plastic Bins (case=3) 32 0 $ -

PLASTICBINS-E Plastic Bins (each) 2 0 $ -

PSUS3B 3 green ball Trial Sleeve (case=90) 19 427.5 5.25 $ 2,244.38

PSUS3B-S 3 green ball Trial Sleeve (sleeve=3) 59 14.75 5.25 $ 77.44

XDSEMPTY XDS empty boxes (case=20) 7 0 $ -

XDSEMPTY-E XDS empty boxes (each) 14 0 $ -

XS2BALSLV 1 Two ball sleeve XD (case= 120) 14 280 5.25 $ 1,470.00

XSEMPTY XS empty boxes ( Case=20 ) 19 0 $ -

$79,128.19

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 13 of 38
SKU Client SKU Product Amazon PriceeBay Price ASIN Sales VelocityQty Requested Inbound To Whitebox Processing at Whitebox Ready To Ship From Whitebox In Storage at Whitebox Inbound To Amazon Reserved For Transfer In Stock Total Stock Cost/unit Total Cost

POL-001 POL-001 Polara Golf Master Trial Pack (12 Balls), Ultimate Straight, Ultimate Strait XS, XD, XDS, Pack of 12 34.95 34.95 B01N69L8NX 0 0

POL-002 POL-002 Polara Golf XD Extra Distance Balls, Reduces Hooks And Slices By Up To 50%, Pack of 12 34.95 34.95 B0074APHK2 0 0 0 106 106 5.25 $556.50

POL-003 POL-003 Polara Golf XS Ultimate Straight 3-piece Balls, Reduces Hooks And Slices By Up To 75%, Pack of 12 34.95 34.95 B004CMZHFA 0 0 0 580 580 8.25 $4,785.00

POL-004 POL-004 Polara Golf Ultimate Straight 2-piece Balls, Reduces Hooks And Slices By Up To 75%, Pack of 12 29.95 29.95 B004CMRPQO 0 0 0 330 330 5.25 $1,732.50

POL-005 POL-005 Polara Golf Ultimate Straight & XD Combo Pack, 2 Sleeves Of Each, Pack of 12 32.95 32.95 B01N0JLSHQ 0 0 0 9 9 5.25 $47.25

POL-006 POL-006 Polara Golf XS (Extra Straight) & XDS (Extra Distance & Spin) Combo Pack, 2 Sleeves Of Each, Pack of 12 37.95 37.95 B01N9ADH4A 0 0

POL-007 DHL3WRH445Polara Golf HL3 Advantage Driver, Women's RH 44.5" 299 299 B00FCCOC7I 0 0 0

POL-008 DHL3RMRH46Polara Golf HL3 Advantage Driver, Men's RH 46" 299 299 B00FCCOCJ6 0 0 0

POL-009 DHL3AMRH46Polara Golf HL3 Advantage Driver, Men's RH Senior Flex 46" 299 299 B00FCCO6VA 0 0 0 1 1 85 $85.00

POL-010 DHL1WRH445Polara Golf HL1 Advantage Driver, Women's RH 44.5" 299 299 B00FCCOCWI 0 0 0

POL-011 DHL1RMRH46Polara Golf HL1 Advantage Driver, Men's RH 46" 299 299 B01N9ADKES 0 0 0

POL-012 DHL1AMRH46Polara Golf HL1 Advantage Driver, Men's RH Senior Flex 46" 299 299 B00FCCOCOQ 0 0 0

POL-013 D12WRH445Polara Golf 12 Degree Advantage Driver, Women's RH 44.5" 299 299 B00FCCOJTO 0 0 0

POL-014 D12RMRH46Polara Golf 12 Degree Advantage Driver, Men's RH 46" 299 299 B01NBCKOMW 0 0

POL-015 D12AMRH46Polara Golf 12 Degree Advantage Driver, Men's RH Senior Flex 46" 299 299 B01MQOTYQK 0 0

POL-016 D12SMRH46Polara Golf 12 Degree Advantage Driver, Men's RH Stiff Flex 46" 299 299 B01MTTCQ5C 0 0 0

POL-017 D105WRH445Polara Golf 10.5 Degree Advantage Driver, Women's RH 44.5" 299 299 B01NBC8JOY 0 0 0 1 1 85 $85.00

POL-018 D105RMRH46Polara Golf 10.5 Degree Advantage Driver, Men's RH 46" 299 299 B01MTTCQ13 0 0

POL-019 D105AMRH46Polara Golf 10.5 Degree Advantage Driver, Men's RH Senior Flex 46" 299 299 B01MXR0I4K 0 0 0 1 1 85 $85.00

POL-020 D105SMRH46Polara Golf 10.5 Degree Advantage Driver, Men's RH Stiff Flex 46" 299 299 B01MRQ6OVC 0 0 0

POL-007A POL-007A Polara Golf HL3 Advantage Driver 299 299 0 0 0

POL-010A POL-010A Polara Golf HL1 Advantage Driver 299 299 0 0 0

GO-XGJC-YJKCGO-XGJC-YJKCPolara Golf 12 Degree Advantage Driver 299 299 0 0 0

DH-Q0GF-B6Q0 DH-Q0GF-B6Q0 Polara Golf 10.5 Degree Advantage Driver 299 299 0 0 0

POL-021 XDS2BALX3Polara Golf XDS Extra Distance & Spin 3-Piece Golf Balls (6 Balls) 19.99 19.99 0 0

POL-022 XDS2BALX6Polara Golf XDS Extra Distance & Spin 3-Piece Golf Balls (12 Balls) 39.99 39.99 B0074ASVVO 0 0

POL-023C POL-023C Polara Golf XDS Extra Distance & Spin 3-Piece Golf Balls, CASE OF 1 CARTON (240 balls) 39.99 39.99 0 0 0

$7,376.25

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 14 of 38
Attachment to Schedule B | Part 5: Question No. 60

Patents and Patent Applications

Patent No. Description Patent No. Description

9,211,442 Anti-slice golf ball 

construction 20140349782 Low lift golf ball

8,795,103 Low lift golf ball 20130090189

Kit for a driver and golf ball that 

provides optimum performance

8,708,840 Low lift golf ball 20120238378 Anti-Slice Golf Ball Construction

8,708,839 Low lift golf ball 20120108362 Nonconforming Anti-Slice Ball

8,657,706 Low lift golf ball 20110294605 Nonconforming Anti-Slice Ball

8,622,852 Low lift golf ball 20110294604 Nonconforming Anti-Slice Ball

8,602,916 Low lift golf ball 20110294603 Nonconforming Anti-Slice Ball

8,579,730 Low lift golf ball 20110294602 Nonconforming Anti-Slice Ball

8,574,098 Low lift golf ball 20110294601 Nonconforming Anti-Slice Ball

8,550,938 Low lift golf ball 20110293765 Nonconforming Anti-Slice Ball

8,550,937 Low lift golf ball 20110269578 Nonconforming Anti-Slice Ball

8,512,167 Low lift golf ball 20110269577 Nonconforming Anti-Slice Ball

8,491,420 Low lift golf ball 20110269576 Nonconforming Anti-Slice Ball

8,491,419 Low lift golf ball 20110269575 Nonconforming Anti-Slice Ball

8,475,299 Low lift golf ball 20110268833 Nonconforming Anti-Slice Ball

8,454,456 Low lift golf ball

8,388,468 Low lift golf ball

8,388,467 Low lift golf ball

8,382,613 Low lift golf ball

8,371,961 Low lift golf ball

8,366,569 Low lift golf ball

8,323,124 Low lift golf ball

8,267,810 Low lift golf ball

8,262,513 Low lift golf ball

8,251,840 Low lift golf ball

8,246,490 Low lift golf ball

8,226,502 Low lift golf ball

8,202,179 Low lift golf ball

8,202,178 Low lift golf ball

8,197,361 Low lift golf ball

8,192,307 Low lift golf ball

8,192,306 Low lift golf ball

8,038,548 Low lift golf ball

Patents 

(Non-Conforming Golf Balls)

Patent Applications

 (Non-Conforming Golf Balls)

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 15 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206D

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

Be as complete and accurate as possible.

1. Do any creditors have claims secured by debtor's property?

 No. Check this box and submit page 1 of this form to the court with debtor's other schedules. Debtor has nothing else to report on this form.

 Yes. Fill in all of the information below.

Part 1: List Creditors Who Have Secured Claims

2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one secured

claim, list the creditor separately for each claim.

Column A

Amount of claim

Do not deduct the value

of collateral.

Column B

Value of collateral

that supports this

claim

2.1 Dr. Rocky Lee Describe debtor's property that is subject to a lien $7,500.00 Unknown

Creditor's Name Polara Golf Ball Inventory - 2000 dozen

26A Luna Gardens, US Patent 8038548 and 9211442

Rockwell Ctr

Makati, Metro Manila

1229 Philippines

Creditor's mailing address Describe the lien

Is the creditor an insider or related party?

 No

Creditor's email address, if known  Yes

Is anyone else liable on this claim?

Date debt was incurred  No

 Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of account number

Do multiple creditors have an

interest in the same property?

As of the petition filing date, the claim is:

Check all that apply

 No  Contingent

 Unliquidated

 Disputed

 Yes. Specify each creditor,

including this creditor and its relative

priority.

2.2

Foremost Golf

Manufacturing Describe debtor's property that is subject to a lien $2,500.00 Unknown

Creditor's Name Polara Golf Ball Inventory - 2000 dozen

2Fl, No. 16, Lane 35, Ji-Hu US Patent 8038548 and 9211442

Rd

Taipei 11492

Taiwan, R.O.C.

Creditor's mailing address Describe the lien

Is the creditor an insider or related party?

 No

Creditor's email address, if known  Yes

Is anyone else liable on this claim?

Date debt was incurred  No

 Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of account number

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 2

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 16 of 38
Debtor Aero-X Golf, Inc. Case number (if know) 17-14249

Name

Do multiple creditors have an

interest in the same property?

As of the petition filing date, the claim is:

Check all that apply

 No  Contingent

 Unliquidated

 Disputed

 Yes. Specify each creditor,

including this creditor and its relative

priority.

3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional Page, if any. $10,000.00

Part 2: List Others to Be Notified for a Debt Already Listed in Part 1

List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection agencies,

assignees of claims listed above, and attorneys for secured creditors.

If no others need to notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page.

Name and address On which line in Part 1 did

you enter the related creditor?

Last 4 digits of

account number for

this entity

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

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 17 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206E/F

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

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured claims.

List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Assets - Real and

Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and

2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1: List All Creditors with PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507).

 No. Go to Part 2.

 Yes. Go to line 2.

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill

out and attach the Additional Page of Part 2.

Amount of claim

3.1 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $9,000.00

Action Media Inc

4665 Red Deer Trail

Broomfield, CO 80020

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.2 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $528.00

AFCO Insurance Premium Finance

5600 N. River Road Ste 400

Des Plaines, IL 60018-5187

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.3 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,269.00

Antonelli, Terry, Stout

1300 North Seventeenth Street

Suite 1800

Arlington, VA 22209

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.4 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $18,279.66

Bellatrix PC

5405 Morehouse Dr., Suite 110

San Diego, CA 92121

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of 8

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com 47850 Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 18 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.5 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $5,000.00

Bruce Pettibone Consulting

2633 Ocean St #2

Carlsbad, CA 92008

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.6 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,700.00

Commonwealth of Virginia

State Corp Comm

PO Box 7607

Merrifield, VA 22116-7607

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.7 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,282,348.97

David Felker

20844 Wild Willow Hollow

Escondido, CA 92029

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: judgment 

Is the claim subject to offset?  No  Yes

3.8 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,000.00

deBary Partners

1012 Brentwood Lane

Brentwood, TN 37027

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.9 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $419.25

DW Sports Group

310 South Nina Drive, Ste 1

Mesa, AZ 85210

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.10 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $529.55

Executive Financial Enterprise

1626 N Wilcox AVE, Box 680

Los Angeles, CA 90028

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.11 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,000,000.00

Foremost Golf Manufacturing

No. 5 Kegong 8th Rd

Touliu City, Yunlin County 640

Taiwan (R.O.C)

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 8

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 19 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.12 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $800.00

Franchise Tax Board

PO Box 942857

Sacramento, CA 94257-0531

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.13 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $597.00

Golf Talk Radio

900 Salida Del Sol Drive

Paso Robles, CA 93446

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.14 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $7,027.28

Golfer's First Technologies

3444 Silverlake Ct.

Jamestown, NC 27282

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.15 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,785.20

Hammacher Schlemmer INC

9307 N Milwaukee Ave

Saint Charles, IL 60174

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.16 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $3,031.78

Hye Precision Products

745 Carroll Street

Perry, GA 31069

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.17 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,329.00

IP Data

704 W Park Ave Suite C

Edgewater, FL 32132-1409

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.18 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $7,208.34

Just Add Technology Solutions

PO Box 2092

Merrifield, VA 22116

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 8

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 20 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.19 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $455.75

Liberty Mutual Insurance

P. O. Box 85834

San Diego, CA 92186-5834

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.20 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $800.00

Life After 50

50 S. De Lacey Ave. Suite 200

Pasadena, CA 91105-3806

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.21 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,500.00

Madavor Media LLC

25 Braintree Hill Office Park

Suite 404

Braintree, MA 02184

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.22 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $5,762.77

McCarthy, Burgess, Wolff

26000 Cannon Road

Bedford, OH 44146

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.23 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $665.02

Minuteman Press of Carlsbad

6353 El Camino Real #H

Carlsbad, CA 92009

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.24 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,345.00

Miranda & Associates

1595 South Mission Road

Fallbrook, CA 92028

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.25 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $101,162.50

Miranda CFO Services, Inc.

1595 South Mission Rd

Fallbrook, CA 92028

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 8

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 21 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.26 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $21,061.62

MLG Automotive Law

2801 W. Coast Hiighway

Suite 370

Newport Beach, CA 92663

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.27 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $822.95

Montana Department of Revenue

PO Box 6309

Helena, MT 59604-6309

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.28 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown

Mr. Cole Burr

Burrtec

9820 Cherry Avenue

Fontana, CA 92335

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.29 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $528.00

New Jersey Commercial

Collection (AFCO)

PO Box 2212

Cherry Hill, NJ 08034

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.30 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $96,043.52

Novus Media Inc.

PO Box 86

Minneapolis, MN 55486-0664

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.31 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $6,173.75

Pijush Dewanjee

3746 Saddle Dr.

Carlsbad, CA 92010

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.32 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,179.36

POP TV LLC

5069 Maureen Lane, Unit A

Moorpark, CA 93021

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 8

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 22 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.33 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $400,000.00

Procopio, Cory, Hargreaves

& Savitch LLP

12544 High Bluff Drive, #300

San Diego, CA 92130

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.34 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $14,000.00

QSControl Corp

No.39, Jing 3 Rd, C.E.P.Z

Wuchi, 04

Taichung City, Taiwan 435

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.35 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $758.33

RBC Capital Markets

FBO David Felker

500 La Terraza Blvd, #102

Escondido, CA 92025

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.36 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $250.00

State of California

Franschise Tax Board

PO Box 942857

Sacramento, CA 94257-0511

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.37 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $6,519.11

Steven Lebischak

PO Box 2092

Merrifield, VA 22116

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.38 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $3,083.35

The Golf Shop - James Love

2768 Loker Avenue

Suite 100

Carlsbad, CA 92010

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.39 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $6,625.00

The McLean Group

7918 Jones Branch Dr #750

Mc Lean, VA 22102

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 8

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 23 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

3.40 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $7,500.00

The Media Group

848 West Bartlett Road, #10E

Bartlett, IL 60103

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.41 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,624.73

Travelers Insurance

PO Box 660317

Dallas, TX 75266-0317

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.42 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $425.00

Turnstile Media Group

PO Box 951276

Dallas, TX 75395-1323

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.43 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $766.95

Word's Court Reporting Service

Gidgette Nieves, CSR, Principa

1265 Carlsbad Village Dr. #210

Carlsbad, CA 92008

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.44 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $396.00

Yellow Pages United

 PO Box 50038

Jacksonville Beach, FL 32240-0038

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Part 3: List Others to Be Notified About Unsecured Claims

4. List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies,

assignees of claims listed above, and attorneys for unsecured creditors.

If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page.

Name and mailing address On which line in Part1 or Part 2 is the

related creditor (if any) listed?

Last 4 digits of

account number, if

any

4.1 James P. Koch, Esq.

Law Offices of James P. Koch

1101 St. Paul Street

Baltimore, MD 21202

Line 3.7 

 Not listed. Explain 

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

5. Add the amounts of priority and nonpriority unsecured claims.

Total of claim amounts

5a. Total claims from Part 1 5a. $ 0.00

5b. Total claims from Part 2 5b. + $ 3,024,301.74

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 8

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 24 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name

5c. Total of Parts 1 and 2

Lines 5a + 5b = 5c. 5c. $ 3,024,301.74

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 8

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

Document Page 25 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206G

Schedule G: Executory Contracts and Unexpired Leases 12/15

Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, number the entries consecutively.

1. Does the debtor have any executory contracts or unexpired leases?

 No. Check this box and file this form with the debtor's other schedules. There is nothing else to report on this form.

 Yes. Fill in all of the information below even if the contacts of leases are listed on Schedule A/B: Assets - Real and Personal Property

(Official Form 206A/B).

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

2.1. State what the contract or

lease is for and the nature of

the debtor's interest

Storage Unit

$220/month

Storage of drivers and

some golf balls

AAA Self Storage

2553 Willard Dairy Rd

High Point, NC 27265

State the term remaining Monthly

List the contract number of any

government contract

2.2. State what the contract or

lease is for and the nature of

the debtor's interest

Storage Unit in Falls

Church, VA

$150/month

Storage of Company

files and documents

Extra Space Storage

2795 East Cottonwood Pkwy

Suite 400

Salt Lake City, UT 84121

State the term remaining

List the contract number of any

government contract

2.3. State what the contract or

lease is for and the nature of

the debtor's interest

License Agreement

dated 8/12/10 for use of

trademarks, service

marks and trade names

POLARA, POLARA

GOLF, and similar

names.

Golfer First Technologies LLC

3444 Silverlake Ct.

Jamestown, NC 27282

State the term remaining Effective until licensee

decides to terminate

List the contract number of any

government contract

2.4. State what the contract or

lease is for and the nature of

the debtor's interest

Fulfillment

Storage of inventory for

shipping to retailers

Iron Mountain

1 Federal Street

Boston, MA 02110

State the term remaining Monthly

List the contract number of any

government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 1 of 2

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Document Page 26 of 38
Debtor 1 Aero-X Golf, Inc. Case number (if known) 17-14249

First Name Middle Name Last Name

Additional Page if You Have More Contracts or Leases

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

2.5. State what the contract or

lease is for and the nature of

the debtor's interest

Insurance

Piedmont Triad Insurance

7 Battleground Court

Greensboro, NC 27408

State the term remaining December 2018

List the contract number of any

government contract

2.6. State what the contract or

lease is for and the nature of

the debtor's interest

Fulfillment of online

orders on Amazon.com

Whitebox

702 S Port St

Baltimore, MD 21224

State the term remaining

List the contract number of any

government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 2 of 2

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Document Page 27 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 206H

Schedule H: Your Codebtors 12/15

Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach the

Additional Page to this page.

1. Do you have any codebtors?

 No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form.

 Yes

2. In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of

creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule

on which the creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.

Column 1: Codebtor Column 2: Creditor

Name Mailing Address Name Check all schedules

that apply:

2.1 Chris Holiday 12624 Carmel Country Road, #82

San Diego, CA 92130

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

2.2 David Felker 20844 Wild Willow Hollow

Escondido, CA 92029

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

2.3 Doug Winfield 1 Carriage Hill

Madison, AL 35758

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

2.4 John Chu 3444 Silverlake Ct.

Jamestown, NC 27282

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

2.5 John McGinnis 4333 E. Hashknife Rd.

Phoenix, AZ 85050

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

Official Form 206H Schedule H: Your Codebtors Page 1 of 2

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Document Page 28 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Additional Page to List More Codebtors

Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page.

Column 1: Codebtor Column 2: Creditor

2.6 Karen Weseloh 6250 Mimulus

Rancho Santa Fe, CA 92067

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

2.7 Steven

Lebischak

PO Box 2092

Merrifield, VA 22116

Guarantor

Foremost Golf

Manufacturing

 D 

 E/F 3.11 

 G 

Official Form 206H Schedule H: Your Codebtors Page 2 of 2

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Document Page 29 of 38
Fill in this information to identify the case:

Debtor name Aero-X Golf, Inc.

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 17-14249

 Check if this is an

amended filing

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy 04/16

The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,

write the debtor’s name and case number (if known).

Part 1: Income

1. Gross revenue from business

 None.

Identify the beginning and ending dates of the debtor’s fiscal year,

which may be a calendar year

Sources of revenue

Check all that apply

Gross revenue

(before deductions and

exclusions)

From the beginning of the fiscal year to filing date:

From 1/01/2017 to Filing Date

 Operating a business $219,835.12

 Other

For prior year:

From 1/01/2016 to 12/31/2016

 Operating a business $272,006.00

 Other

For year before that:

From 1/01/2015 to 12/31/2015

 Operating a business $1,188,436.00

 Other

2. Non-business revenue

Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits,

and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.

 None.

Description of sources of revenue Gross revenue from

each source

(before deductions and

exclusions)

Part 2: List Certain Transfers Made Before Filing for Bankruptcy

3. Certain payments or transfers to creditors within 90 days before filing this case

List payments or transfers--including expense reimbursements--to any creditor, other than regular employee compensation, within 90 days before

filing this case unless the aggregate value of all property transferred to that creditor is less than $6,425. (This amount may be adjusted on 4/01/19

and every 3 years after that with respect to cases filed on or after the date of adjustment.)

 None.

Creditor's Name and Address Dates Total amount of value Reasons for payment or transfer

Check all that apply

4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider

List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or guaranteed

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 1

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Document Page 30 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than $6,425. (This amount

may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) Do not include any payments

listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their relatives; general partners of a partnership

debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and any managing agent of the debtor. 11 U.S.C. § 101(31).

 None.

Insider's name and address

Relationship to debtor

Dates Total amount of value Reasons for payment or transfer

5. Repossessions, foreclosures, and returns

List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor, sold at

a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6.

 None

Creditor's name and address Describe of the Property Date Value of property

See SOFA No. 13 $0.00

6. Setoffs

List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account

of the debtor without permission or refused to make a payment at the debtor’s direction from an account of the debtor because the debtor owed a

debt.

 None

Creditor's name and address Description of the action creditor took Date action was

taken

Amount

Part 3: Legal Actions or Assignments

7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits

List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor was involved

in any capacity—within 1 year before filing this case.

 None.

Case title

Case number

Nature of case Court or agency's name and

address

Status of case

7.1. David Felker v. Aero-X Golf,

Inc.

24C17004566

Foreign Judgment Circuit Court for Baltimore

City

100 N Calvert St

Baltimore, MD 21202

 Pending

 On appeal

 Concluded

7.2. David Felker v. Aero-X Golf,

Inc.

37-2015-00043016-CU-PT-CTL

Judgment

(Confirming

Arbitration Award)

Superior Court of the State

of

California, County of San

Diego

Central Division

 Pending

 On appeal

 Concluded

7.3. David Felker v. Aero-X Golf,

Inc.

01-16-0000-9155

Arbitration American Arbitration

Association

Employment Arbitration

Tribunal

 Pending

 On appeal

 Concluded

7.4. David Felker v. Aero-X Golf,

Inc.

CL-2017-16974

Foreign Judgment Circuit Court for Fairfax

County, VA

4110 Chain Bridge Rd

Fairfax, VA 22030

 Pending

 On appeal

 Concluded

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 2

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Document Page 31 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Case title

Case number

Nature of case Court or agency's name and

address

Status of case

7.5. David Felker v. Aero-X Golf,

Inc.

516077/2017

Foreign Judgment Supreme Court of New York

360 Adams St #4

Brooklyn, NY 11201

 Pending

 On appeal

 Concluded

8. Assignments and receivership

List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the hands of a

receiver, custodian, or other court-appointed officer within 1 year before filing this case.

 None

Part 4: Certain Gifts and Charitable Contributions

9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of

the gifts to that recipient is less than $1,000

 None

Recipient's name and address Description of the gifts or contributions Dates given Value

Part 5: Certain Losses

10. All losses from fire, theft, or other casualty within 1 year before filing this case.

 None

Description of the property lost and

how the loss occurred

Amount of payments received for the loss

If you have received payments to cover the loss, for

example, from insurance, government compensation, or

tort liability, list the total received.

List unpaid claims on Official Form 106A/B (Schedule

A/B: Assets – Real and Personal Property).

Dates of loss Value of property

lost

Part 6: Certain Payments or Transfers

11. Payments related to bankruptcy

List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing

of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy

relief, or filing a bankruptcy case.

 None.

Who was paid or who received

the transfer?

Address

If not money, describe any property transferred Dates Total amount or

value

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 3

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Document Page 32 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Who was paid or who received

the transfer?

Address

If not money, describe any property transferred Dates Total amount or

value

11.1.

Offit Kurman, P.A.

8171 Maple Lawn Blvd. #200

Fulton, MD 20759 Attorney Fees

$25,000

Retainer

Paid 10/9/17

From

Retainer,

the

following

Invoices

were paid:

$7,920 on

11/8/17

$1,848 on

12/6/17

$4,357 on

12/14/17

(includes

filing fee) $12,408.00

Email or website address

smetz@offitkurman.com

Who made the payment, if not debtor?

12. Self-settled trusts of which the debtor is a beneficiary

List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case

to a self-settled trust or similar device.

Do not include transfers already listed on this statement.

 None.

Name of trust or device Describe any property transferred Dates transfers

were made

Total amount or

value

13. Transfers not already listed on this statement

List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within

2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include

both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.

 None.

Who received transfer?

Address

Description of property transferred or

payments received or debts paid in exchange

Date transfer

was made

Total amount or

value

13.1

.

David Felker

20844 Wild Willow Hollow

Escondido, CA 92029

$6,289 (Garnished funds in Debtor's

Account Prior to 90 days before Petition

Date)

$60,000 (Obtained Possession of

Inventory Valued at Approximately

$60,000 Prior to 90 days before Petition

Date) $66,289.00

Relationship to debtor

Former insider

Part 7: Previous Locations

14. Previous addresses

List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 4

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Document Page 33 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

 Does not apply

Address Dates of occupancy

From-To

14.1. C/O Robert Miranda

Miranda & Associates

1595 South Mission Road

Fallbrook, CA 92028

Approx. June 2013-December 2015

Part 8: Health Care Bankruptcies

15. Health Care bankruptcies

Is the debtor primarily engaged in offering services and facilities for:

- diagnosing or treating injury, deformity, or disease, or

- providing any surgical, psychiatric, drug treatment, or obstetric care?

 No. Go to Part 9.

 Yes. Fill in the information below.

Facility name and address Nature of the business operation, including type of services

the debtor provides

If debtor provides meals

and housing, number of

patients in debtor’s care

Part 9: Personally Identifiable Information

16. Does the debtor collect and retain personally identifiable information of customers?

 No.

 Yes. State the nature of the information collected and retained.

17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other pension or

profit-sharing plan made available by the debtor as an employee benefit?

 No. Go to Part 10.

 Yes. Does the debtor serve as plan administrator?

Part 10: Certain Financial Accounts, Safe Deposit Boxes, and Storage Units

18. Closed financial accounts

Within 1 year before filing this case, were any financial accounts or instruments held in the debtor’s name, or for the debtor’s benefit, closed, sold,

moved, or transferred?

Include checking, savings, money market, or other financial accounts; certificates of deposit; and shares in banks, credit unions, brokerage houses,

cooperatives, associations, and other financial institutions.

 None

Financial Institution name and

Address

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

18.1. Wells Fargo Bank XXXX-9058  Checking

 Savings

 Money Market

 Brokerage

 Other

8/21/17 $50.25

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 5

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Document Page 34 of 38
Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Financial Institution name and

Address

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

18.2. First Bank

PO Box 925

Troy, NC 27371

XXXX-1796  Checking

 Savings

 Money Market

 Brokerage

 Other

12/19/2017 $5,127.01

19. Safe deposit boxes

List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this

case.

 None

Depository institution name and address Names of anyone with

access to it

Address

Description of the contents Do you still

have it?

20. Off-premises storage

List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in

which the debtor does business.

 None

Facility name and address Names of anyone with

access to it

Description of the contents Do you still

have it?

AAA Self Storage

2553 Willard Dairy Rd

High Point, NC 27265

John Chu

3444 Silverlake Ct.

Jamestown, NC 27782

Drivers and parts for drivers

Some golf balls

 No

 Yes

Extra Space Storage

2795 East Cottonwood Pkwy

Suite 400

Salt Lake City, UT 84121

Steven Lebischak Company files and

documents

Storage Unit is in Falls

Church, VA

 No

 Yes

Motivational Fulfillment

15820 Euclid Avenue

Chino, CA 91708

Golf balls, Golf clubs and

accessories

 No

 Yes

The Belt's Corporation-BBC

608 Folcroft Street

Baltimore, MD 21224

Golf balls, Golf clubs and

accessories

 No

 Yes

Iron Mountain Fulfillment Services

1242 S. River Road

Cranbury, NJ 08512

Iron Mountain employees Golf balls, Golf clubs and

accessories

 No

 Yes

Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own

21. Property held for another

List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do

not list leased or rented property.

 None

Part 12: Details About Environment Information

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 6

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Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

For the purpose of Part 12, the following definitions apply:

Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the

medium affected (air, land, water, or any other medium).

Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly

owned, operated, or utilized.

Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a

similarly harmful substance.

Report all notices, releases, and proceedings known, regardless of when they occurred.

22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.

 No.

 Yes. Provide details below.

Case title

Case number

Court or agency name and

address

Nature of the case Status of case

23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an

environmental law?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address

Environmental law, if known Date of notice

24. Has the debtor notified any governmental unit of any release of hazardous material?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address

Environmental law, if known Date of notice

Part 13: Details About the Debtor's Business or Connections to Any Business

25. Other businesses in which the debtor has or has had an interest

List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.

Include this information even if already listed in the Schedules.

 None

Business name address Describe the nature of the business Employer Identification number

Do not include Social Security number or ITIN.

Dates business existed

26. Books, records, and financial statements

26a. List all accountants and bookkeepers who maintained the debtor’s books and records within 2 years before filing this case.

 None

Name and address Date of service

From-To

26a.1. Jain & Associates

43448 Katling Sq.

Chantilly, VA 20152

March 2016 -

Present

26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of account and records or prepared a financial statement

within 2 years before filing this case.

 None

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 7

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Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

Name and address Date of service

From-To

26b.1. Jain & Associates

43448 Katling Sq.

Chantilly, VA 20152

March 2016 -

Present

26c. List all firms or individuals who were in possession of the debtor’s books of account and records when this case is filed.

 None

Name and address If any books of account and records are

unavailable, explain why

26c.1. Steve Lebischak

Aero-X Golf

Unit A220

2820 Hollywood Road

Falls Church, VA 22043

26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial

statement within 2 years before filing this case.

 None

Name and address

27. Inventories

Have any inventories of the debtor’s property been taken within 2 years before filing this case?

 No

 Yes. Give the details about the two most recent inventories.

Name of the person who supervised the taking of the

inventory

Date of inventory The dollar amount and basis (cost, market,

or other basis) of each inventory

28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other people

in control of the debtor at the time of the filing of this case.

Name Address Position and nature of any

interest

% of interest, if

any

Steven Lebischak PO Box 2092

Merrifield, VA 22116

Chief Executive

Director

29,178

Common A

2,487

Common B

Name Address Position and nature of any

interest

% of interest, if

any

Louis M. Green 77 Downey St

San Francisco, CA 94117

Chairman of Board

Director

170,702

Common A

29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in

control of the debtor, or shareholders in control of the debtor who no longer hold these positions?

 No

 Yes. Identify below.

Name Address Position and nature of any

interest

Period during which

position or interest

was held

Dr. Rocky Lee 26A Luna Gardens, Rockwell Ctr

Makati, Metro Manila

1229 Philippines

Chairman of Board

Director

November 2015 -

November 2017

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 8

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Debtor Aero-X Golf, Inc. Case number (if known) 17-14249

30. Payments, distributions, or withdrawals credited or given to insiders

Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses,

loans, credits on loans, stock redemptions, and options exercised?

 No

 Yes. Identify below.

Name and address of recipient Amount of money or description and value of

property

Dates Reason for

providing the value

31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?

 No

 Yes. Identify below.

Name of the parent corporation Employer Identification number of the parent

corporation

32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?

 No

 Yes. Identify below.

Name of the parent corporation Employer Identification number of the parent

corporation

Part 14: Signature and Declaration

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

connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both.

18 U.S.C. §§ 152, 1341, 1519, and 3571.

I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information is true

and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on December 29, 2017

/s/ Steven Lebischak Steven Lebischak

Signature of individual signing on behalf of the debtor Printed name

Position or relationship to debtor Chief Executive

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?

 No

 Yes

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 9

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Case 17-14249-BFK Doc 14 Filed 12/29/17 Entered 12/29/17 12:56:48 Desc Main

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