Official Form 106A/B

Schedule A/B: Property 12/15 

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

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

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?

 Check if this is an

amended filing

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

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.

What is the property?

Check all that apply.

















Single-family home

Duplex or multi-unit building

Condominium or cooperative

Manufactured or mobile home

Land

Investment property

Timeshare

Other

Do not deduct secured claims or exemptions. Put the

amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

Current value of the

portion you own?

Describe the nature of your ownership

interest (such as fee simple, tenancy by the

entireties, or a life estate), if known.

Who has an interest in the property?

Check one.









Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property

(see instructions)

Other information you wish to add about this item, such as local

property identification number:

1.1.

County

$335,000.00 

Fee Simple

$335,000.00 

Prince William

15047 Holleyside Dr, Dumfries, VA 

22025

15407 Holleyside Dr., Dumfries, VA 

22025

Value per Zillow

Actual value = $335,000.00

Less Liens of $314,210.97

Less cost of sale of $33,500

Leaves value to the estate of $0

2. Add the dollar value of the portion you own for all of your entries from Part 1, including any

entries for pages you have attached for Part 1. Write that number here.............................................................  $335,000.00 

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

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

02/14/2017 12:03:59pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 1 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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





No

Yes

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

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





No

Yes. Describe............

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

See continuation page(s). $3,000.00 

7. Electronics





No

Yes. Describe............

Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners;

music collections; electronic devices including cell phones, cameras, media players, games

Entertainment & Electronics $900.00 

8. Collectibles of value





No

Yes. Describe............

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

9. Equipment for sports and hobbies





No

Yes. Describe............

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

canoes and kayaks; carpentry tools; musical instruments

10. Firearms





No

Yes. Describe............

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

11. Clothes





No

Yes. Describe............

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

See continuation page(s). $2,700.00 

12. Jewelry





No

Yes. Describe............

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

gold, silver

See continuation page(s). $3,500.00 

13. Non-farm animals





No

Yes. Describe............

Examples: Dogs, cats, birds, horses

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

02/14/2017 12:03:59pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 2 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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





No

Yes. Give specific

did not list

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 the number here.............................................................................................................. .........

$10,100.00 

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





No

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

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

petition

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





No

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

institution, list each.

Institution name:

17.1. Checking account: LGE Community Credit Union Checking account ending in 6751 $25.00 

17.2. Checking account: NFCU Checking account ending in 3072 $25.00 

17.3. Checking account: USAA Checking account ending in 3191 $10.00 

17.4. Checking account: Paypal Business Checking Account $0.00 

17.5. Savings account: LGE Community Credit Union Savings account ending in 6210 $5.00 

17.6. Savings account: NFCU Savings account ending in 9407 $5.00 

17.7. Savings account: USAA Savings account ending in 4432 $5.00 

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:

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

Name of entity: % of ownership:

information about

them...............................................

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

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





No

Issuer name:

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

Yes. Give specific

information about

them...............................................

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

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 3 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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

Type of account: Institution name:

Yes. List each

account separately.

IRA: Ameriprise IRA $1,956.68 

Retirement account: Divorce QDRO retirement from ex $29,000.00 

22. Security deposits and prepayments

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

companies, or others





No

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

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

23. Annuities (A contract for a specific 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.





No

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

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

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





No

Yes. Give specific

powers exercisable for your benefit

information about them

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





No

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

Yes. Give specific

information about them

27. Licenses, franchises, and other general intangibles





No

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

Yes. Give specific

information about them

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.....................................

Federal:

State:

Local:

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

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 4 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

29. Family support





No

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

Yes. Give specific information Alimony:

Maintenance:

Support:

Divorce settlement:

Property settlement:

$0.00 

$0.00 

$360.00 

$0.00 

$0.00 

Support: Receiving monthly back child support through Chapter 13 Trustee 

in Alabama. Amt: $360.00

30. Other amounts someone owes you





No

Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers'

Yes. Give specific information

compensation, Social Security benefits; unpaid loans you made to someone else

31. Interests in insurance policies





No

Yes. Name the insurance

Company name: Beneficiary:

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

Surrender or refund value: 

company of each policy

and list its value................

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





No

If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently

Yes. Give specific information

entitled to receive property because someone has died

Inchoate Inheritance $1.00 

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





No

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

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

34. Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and





No

rights to set off claims

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............................................................................................................. ..........

$31,492.68 

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.

38. Accounts receivable or commissions you already earned





No

Yes. Describe................

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

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

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 5 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

39. Office equipment, furnishings, and supplies





No

Yes. Describe................

Examples: Business-related computers, software, modems, printers, copiers, fax machines, rugs, telephones,

desks, chairs, electronic devices

40. Machinery, fixtures, equipment, supplies you use in business, and tools of your trade





No

Yes. Describe................ Tools & Materials used as a freelance artist $2,500.00 

41. Inventory





No

Yes. Describe................

42. Interests in partnerships or joint ventures





No

Yes. Describe................ Name of entity: % of ownership:

43. Customer lists, mailing lists, or other compilations





No

Yes. Do your lists include personally identifiable information (as defined in 11 U.S.C. § 101(41A))?





No

Yes. Describe..............

44. Any business-related property you did not already list





No

Yes. Give specific information.

45. Add the dollar value of all of your entries from Part 5, including any entries for pages you have

attached for Part 5. Write that number here............................................................................................................. ..........

$2,500.00 

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

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.

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

47. Farm animals





No

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

Examples: Livestock, poultry, farm-raised fish

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

48. Crops--either growing or harvested





No

Yes. Give specific

information..........................

49. Farm and fishing equipment, implements, machinery, fixtures, and tools of trade





No

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

Official Form 106A/B Schedule A/B: Property page 6 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 6 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

50. Farm and fishing supplies, chemicals, and feed





No

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

51. Any farm- and commercial fishing-related property you did not already list

No

 Yes. Give specific

information..........................

52. Add the dollar value of all of your entries from Part 6, including any entries for pages you have

attached for Part 6. Write that number here............................................................................................................. ..........

$0.00 

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?





No

Yes. Give specific information.

Examples: Season tickets, country club membership

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.............................................................................................................................................. 

56. Part 2: Total vehicles, line 5

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

58. Part 4: Total financial assets, line 36

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

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

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

62. Total personal property.

63. Total of all property on Schedule A/B.

Add lines 56 through 61.................................

Copy personal

property total 

+

+

Add line 55 + line 62.......................................................................................................

$335,000.00 

$0.00 

$10,100.00 

$31,492.68 

$2,500.00 

$0.00 

$0.00 

$44,092.68 $44,092.68 

$379,092.68 

Official Form 106A/B Schedule A/B: Property page 7 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 7 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

6. Household goods and furnishings (details):

Art $1,500.00 

Kitchen & Dining Items $1,100.00 

Bedroom Items $400.00 

11. Clothes (details):

Clothing $1,200.00 

Shoes/Handbags $1,500.00 

12. Jewelry (details):

Wedding & Engagement Jewelry $1,500.00 

Costume Jewelry $1,000.00 

Valuable Jewelry $1,000.00 

Official Form 106A/B Schedule A/B: Property page 8 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 8 of 54
Official Form 106C

Schedule C: The Property You Claim as Exempt 04/16 

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

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).

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)

 Check if this is an

amended filing

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.

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

Copy the value from

Schedule A/B

Amount of the 

exemption you claim

Check only one box for 

each exemption

Current value of Specific laws that allow exemption

the portion you 

own

Brief description:

Line from Schedule A/B:





6

$1,500.00 $1,500.00

Art

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





6

$1,100.00 $1,100.00

Kitchen & Dining Items

Va. Code Ann. § 34-26(4a)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





6

$400.00 $400.00

Bedroom Items

Va. Code Ann. § 34-26(4a)

100% of fair market 

value, up to any 

applicable statutory 

limit

3. Are you claiming a homestead exemption of more than $160,375?

(Subject to adjustment on 4/01/19 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 1 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 9 of 54
Case number (if known)

Part 2: Additional Page

Brief description of the property and line on

Schedule A/B that lists this property

Copy the value from

Schedule A/B

17-10098-BFK

Amount of the 

exemption you claim

Check only one box for 

each exemption

Current value of Specific laws that allow exemption

the portion you 

own

Debtor 1 Trina A. Lloyd

Brief description:

Line from Schedule A/B:





7

$900.00 $900.00

Entertainment & Electronics

Va. Code Ann. § 34-26(4a)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





11

$1,200.00 $1,000.00

Clothing

Va. Code Ann. § 34-26(4)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





11

$1,500.00 $0.00

Shoes/Handbags

Va. Code Ann. § 34-26(4)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





12

$1,500.00 $1,500.00

Wedding & Engagement Jewelry

Va. Code Ann. § 34-26(1a)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





12

$1,000.00 $1,000.00

Costume Jewelry

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





12

$1,000.00 $1,000.00

Valuable Jewelry

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





16

$100.00 $100.00

Cash on hand

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.1

$25.00 $25.00

LGE Community Credit Union Checking 

account ending in 6751

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.2

$25.00 $25.00

NFCU Checking account ending in 3072

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 2 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 10 of 54
Case number (if known)

Part 2: Additional Page

Brief description of the property and line on

Schedule A/B that lists this property

Copy the value from

Schedule A/B

17-10098-BFK

Amount of the 

exemption you claim

Check only one box for 

each exemption

Current value of Specific laws that allow exemption

the portion you 

own

Debtor 1 Trina A. Lloyd

Brief description:

Line from Schedule A/B:





17.3

$10.00 $10.00

USAA Checking account ending in 3191

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.4

$0.00 $0.00

Paypal Business Checking Account

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.5

$5.00 $5.00

LGE Community Credit Union Savings 

account ending in 6210

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.6

$5.00 $5.00

NFCU Savings account ending in 9407

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





17.7

$5.00 $5.00

USAA Savings account ending in 4432

Va. Code Ann. § 34-4

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





21

$1,956.68 $1,956.68

Ameriprise IRA

Va. Code Ann. § 34-34

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





21

$29,000.00 $29,000.00

Divorce QDRO retirement from ex

Va. Code Ann. § 34-34

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





29

$360.00 $360.00

Receiving monthly back child support 

through Chapter 13 Trustee in Alabama

Va. Code Ann. § 20-108.1(G)

100% of fair market 

value, up to any 

applicable statutory 

limit

Brief description:

Line from Schedule A/B:





32

$1.00 $1.00

Inchoate Inheritance

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 3 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 11 of 54
Case number (if known)

Part 2: Additional Page

Brief description of the property and line on

Schedule A/B that lists this property

Copy the value from

Schedule A/B

17-10098-BFK

Amount of the 

exemption you claim

Check only one box for 

each exemption

Current value of Specific laws that allow exemption

the portion you 

own

Debtor 1 Trina A. Lloyd

Brief description:

Line from Schedule A/B:





40

$2,500.00 $2,500.00

Tools & Materials used as a freelance 

artist

Va. Code Ann. § 34-26(7)

100% of fair market 

value, up to any 

applicable statutory 

limit

Official Form 106C Schedule C: The Property You Claim as Exempt page 4 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 12 of 54
Official Form 106D

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

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

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.

 Check if this is an

amended filing

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).

Part 1: List All Secured Claims

2. List all secured claims. If a creditor has more than one secured

Column A Column B Column C

Amount of claim Value of collateral Unsecured

portion

If any

that supports this

claim

Do not deduct the

value of collateral

claim, list the creditor separately for each claim. If more than one 

creditor has a particular claim, list the other creditors in Part 2. As 

much as possible, list the claims in alphabetical order according to the 

creditor's name.

2.1 Describe the property that

secures the claim:

Creditor's name

Number Street

City State ZIP Code

Who owes the debt? Check one.









Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this claim relates 

to a community debt

Date debt was incurred

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Nature of lien. Check all that apply.









An agreement you made (such as mortgage or secured car loan)

Statutory lien (such as tax lien, mechanic's lien)

Judgment lien from a lawsuit

Other (including a right to offset)

Last 4 digits of account number

Montclair POA

3561 Waterway Dr

Dumfries VA 22025

$1,990.00 $335,000.00 

 

15407 Holleyside Dr., 

Dumfries, VA 22025

HOA

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

$1,990.00 

Add the dollar value of your entries in Column A on this page. Write 

that number here:

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 13 of 54
Part 1:

Additional Page Column A Column B Column C

Amount of claim Value of collateral Unsecured

portion

If any

that supports this

claim

Do not deduct the

value of collateral

Case number (if known) 17-10098-BFK

After listing any entries on this page, number them

sequentially from the previous page.

Debtor 1 Trina A. Lloyd

2.2 Describe the property that

secures the claim:

Creditor's name

Number Street

City State ZIP Code

Who owes the debt? Check one.









Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this claim relates 

to a community debt

Date debt was incurred

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Nature of lien. Check all that apply.









An agreement you made (such as mortgage or secured car loan)

Statutory lien (such as tax lien, mechanic's lien)

Judgment lien from a lawsuit

Other (including a right to offset)

Last 4 digits of account number

Selene Finance

120 GIBRALTAR RD STE 300

HORSHAM PA 19044

$312,960.97 $335,000.00 

 

15407 Holleyside Dr., 

Dumfries, VA 22025

1st Mortgage

Official Form 106D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page 2 

$312,960.97 

$314,950.97 

Add the dollar value of your entries in Column A on this page. Write 

that number here:

If this is the last page of your form, add the dollar value totals from 

all pages. Write that number here:

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 14 of 54
Part 2: List Others to Be Notified for a Debt That You Already Listed

Case number (if known) 17-10098-BFK

Use this page only if you have others to be notified about your bankruptcy for a debt that you already listed in Part 1. For 

example, if a collection agency is trying to collect from you for a debt you owe to someone else, list the creditor in Part 1, and 

then list the collection agency here. Similarly, if you have more than one creditor for any of the debts that you listed in Part 1, 

list the additional creditors here. If you do not have additional persons to be notified for any debts in Part 1, do not fill out or 

submit this page.

Debtor 1 Trina A. Lloyd

On which line in Part 1 did you enter the creditor?

Last 4 digits of account number

Name

Number Street

City State ZIP Code

BWW Law Group, LLC/Selene Fin

6003 Executive Blvd Ste 101

Rockville MD 20852

1

8 4 4 4

On which line in Part 1 did you enter the creditor?

Last 4 digits of account number

Name

Number Street

City State ZIP Code

Segan Mason & Mason PC/Montclair POA

7010 Little River Turnpike #270

Annandale VA 22003

2

 

Official Form 106D Part 2 of Schedule D: Creditors Who Have Claims Secured by Property page 3 

02/14/2017 12:04:00pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 15 of 54
Official Form 106E/F

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

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

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





No. Go to Part 2.

Yes.

 Check if this is an

amended filing

on Schedule A/B: Property (Official Form 106A/B) and on Schedule G: Executory Contracts and Unexpired Leases

Do not include any creditors with partially secured claims that are listed in Schedule D: Creditors Who Hold 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. On the top of any additional pages, write your name and case number (if known).

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

Part 1: List All of Your PRIORITY Unsecured Claims

(Official Form 106G).

2. List all of your priority unsecured claims. If a creditor has more than one priority unsecured claim, list the creditor separately for each

Total claim Priority

amount

Nonpriority

amount

(For an explanation of each type of claim, see the instructions for this form in the instruction booklet.

claim. For each claim listed, identify what type of claim it is. If a claim has both priority and nonpriority amounts, list that claim here and 

show both priority and nonpriority amounts. As much as possible, list the claims in alphabetical order according to the creditor's name. If 

more space is needed for priority unsecured claims, fill out the Continuation Page of Part 1. If more than one creditor holds a particular 

claim, list the other creditors in Part 3.

2.1

Last 4 digits of account number Priority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of PRIORITY unsecured claim:









Domestic support obligations

Taxes and certain other debts you owe the government

Claims for death or personal injury while you were

Other. Specify

intoxicated

IRS - Centralized Insolvency Op

PO Box 7346

Philadelphia PA 19101

$1,400.00 $1,400.00 $0.00 

 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 16 of 54
Case number (if known)

Part 1: Your PRIORITY Unsecured Claims -- Continuation Page

Total claim Priority

amount

Nonpriority

amount

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

2.2

Last 4 digits of account number Priority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of PRIORITY unsecured claim:









Domestic support obligations

Taxes and certain other debts you owe the government

Claims for death or personal injury while you were

Other. Specify

intoxicated

IRS- Centralized Insolvency Op.

PO Box 7346

Philadelphia PA 19101-7346

$997.00 $997.00 $0.00 

 

2012

2.3

Last 4 digits of account number Priority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of PRIORITY unsecured claim:









Domestic support obligations

Taxes and certain other debts you owe the government

Claims for death or personal injury while you were

Other. Specify

intoxicated

IRS- Centralized Insolvency Op.

PO Box 7346

Philadelphia PA 19101-7346

$6,839.00 $6,839.00 $0.00 

 

2010

2.4

Last 4 digits of account number Priority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of PRIORITY unsecured claim:









Domestic support obligations

Taxes and certain other debts you owe the government

Claims for death or personal injury while you were

Other. Specify

intoxicated

IRS- Centralized Insolvency Op.

PO Box 7346

Philadelphia PA 19101-7346

$4,085.00 $4,085.00 $0.00 

 

2009

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 2 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 17 of 54
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

Part 2: List All of Your NONPRIORITY Unsecured Claims

Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

4. List all of your nonpriority unsecured claims in the alphabetical order of the creditor who holds each claim.

Total 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 more space is needed for nonpriority unsecured claims, fill out the Continuation Page of Part 2.

4.1

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Bloomingdales/DSNB

POB 8218

Mason OH 45040

$1,571.00 

 

Credit Card

4.2

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Capital One

POB 30285

Salt Lake City UT 84130

$1,732.00 

 

Credit Card

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 3 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 18 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.3

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Cavalry Portfolio Service

500 Summit Lake Dr Ste 4A

Valhalla NY 10595

$1,034.00 

 

Collection

4.4

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Chase

POB 15298

Wilmington DE 19850

$2,809.00 

 

Credit Card

4.5

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Comcast

POB 3006

Southeastern PA 19398

$985.00 

 

Utility

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 4 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 19 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.6

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Federal Loan Svcing Credit

POB 60610

Harrisburg PA 17106

$16,891.00 

 

4.7

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Kohls/Cap 1

PO BOX 3115

Milwaukee WI 53201

$1,079.00 

 

Credit Card

4.8

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Labcorp

POB 2240

Burlington NC 27216

$713.00 

 

Medical

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 5 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 20 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.9

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Macys

9111 Duke Blvd

Mason OH 45040

$1,170.00 

 

Credit Card

4.10

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Medical Revenue Svc/Emory Univ Hosp

POB 1149

Sebring FL 33871

$943.00 

 

Medical

4.11

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Nordstrom

POB 6555

Englewood CO 80155

$813.00 

 

Credit Card

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 6 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 21 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.12

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

NOVEC

POB 34795

Alexandria VA 22334

$489.00 

 

Utility

4.13

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Patients Acct Bur/Piedmont Hosp/Hollis C

POB 279

Norcross GA 30091

$2,374.00 

 

Medical

4.14

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

Sychrony Bank/Old Navy

POB 965005

Orlando FL 32896

$1,000.00 

 

Credit Card

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 7 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 22 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.15

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

SYNCB/Gap

POB 965005

Orlando FL 32896

$900.00 

 

Credit Card

4.16

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

SYNCB/Lowes

POB 965005

Orlando FL 32896

$1,000.00 

 

Credit Card

4.17

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

SYNCB/Sam's Club

POB 965005

Orlando FL 32896

$600.00 

 

Credit Card

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 8 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 23 of 54
Case number (if known)

Part 2: Your NONPRIORITY Unsecured Claims -- Continuation Page

Total claim

After listing any entries on this page, number them sequentially from the

previous page.

Debtor 1 Trina A. Lloyd 17-10098-BFK

4.18

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

TD Bank/Target

POB 673

Minneapolis MN 55440

$5,837.00 

 

Credit Card

4.19

Last 4 digits of account number

Nonpriority Creditor's Name

Number Street

City State ZIP Code

Who incurred the debt? Check one.











Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

Check if this claim is for a community debt

Is the claim subject to offset?

No

 Yes

When was the debt incurred?

As of the date you file, the claim is: Check all that apply.







Contingent

Unliquidated

Disputed

Type of NONPRIORITY unsecured claim:









Student loans

Obligations arising out of a separation agreement or divorce

Debts to pension or profit-sharing plans, and other similar debts

Other. Specify

that you did not report as priority claims

US Dept of Education

POB 4222

Iowa City IA 52244

$25,191.00 

 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 9 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 24 of 54
Part 3: List Others to Be Notified About a Debt That You Already Listed

5.

Case number (if known) 17-10098-BFK

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 parties to be notified for 

any debts in Parts 1 or 2, do not fill out or submit this page.

Debtor 1 Trina A. Lloyd

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

American Medical Coll/Lab Corp

4 Westchester Plz

Elmsford NY 10523

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Cavalry Portfolio Service/HSBC

500 Summit Lake Dr Ste 4A

Valhalla NY 10595

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Cavalry Portfolio Service/HSBC

500 Summit Lake Dr Ste 4A

Valhalla NY 10595

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Central Credit Svcs LLC/Lab Corp

20 Corporate Hills Dr

St. Charles MO 63301

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Chantel C. Espaillat/Lowes/Cavalry

POB 1538

Kennesaw GA 30156

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Fulton County Superior Ct/Cavalry/Lowes

185 Central Ave SW Ste TG100

Atlanta GA 30303

 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 10 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 25 of 54
Part 3: List Others to Be Notified About a Debt That You Already Listed -- Continuation Page

Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

IRS C/O US Attorney

2100 Jamieson Avenue

Alexandria VA 22314

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

IRS Honorable Loretta E. Lynch

10th St & Constitution Ave NW Rm 6313

Washington DC 20530

 

Taxes

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Midland Funding/GE CAP RETAIL/SYNC

8875 Aero Dr Ste 200

San Diego CA 92123

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Northland Group/Bllomingdales

PO BOX 390846

Minneapolis MN 55439

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Northstar Location Svcs/TD Bank

4285 Genesee St

Cheektowaga NY 14225

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Portfolio Recovery/.GECRB/SYNC

120 Corporate Blvd, Ste 100

Norfolk VA 23502

 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 11 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 26 of 54
Part 3: List Others to Be Notified About a Debt That You Already Listed -- Continuation Page

Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Portfolio Recovery/WFNNB

120 Corporate Blvd, Ste 100

Norfolk VA 23502

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Prince William GDC/Montclair POA

9311 Lee Ave

Manassas VA 20110

1 3 0 0

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Southwest Credit/COMCAST

4120 International Pkwy Ste 1100

Carrollton TX 75007

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

The Bureaus Inc/CAP 1

1717 Central St

Evanston IL 60201

 

Name

Number Street

City State ZIP Code

On which entry in Part 1 or Part 2 did you list the original creditor?

Line of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Total Card/Cavalry/HSBC

5109 S Broadband Ln

Sioux Falls SD 57108

 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 12 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 27 of 54
Part 4: Add the Amounts for Each Type of Unsecured Claim

6.

6a. Domestic support obligations

6b. Taxes and certain other debts you owe the government

6c. Claims for death or personal injury while you were intoxicated

6d. Other. Add all other priority unsecured claims. Write that amount here.

6e. Total. Add lines 6a through 6d.

6a.

Total claim

6b.

6c.

6d.

6d.

+ 

6f. Student loans

6g. Obligations arising out of a separation agreement or divorce

6h. Debts to pension or profit-sharing plans, and other similar

6i. Other. Add all other nonpriority unsecured claims. Write that amount here.

6j. Total. Add lines 6f through 6i.

6f.

Total claim

6g.

6h.

6i.

6j.

+ 

that you did not report as priority claims

debts

Case number (if known) 17-10098-BFK

$0.00 

$13,321.00 

$0.00 

$0.00 

$13,321.00 

$42,082.00 

$0.00 

$0.00 

$25,049.00 

$67,131.00 

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 claims 

from Part 1

Total claims 

from Part 2

Debtor 1 Trina A. Lloyd

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 13 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 28 of 54
Official Form 106G

Schedule G: Executory Contracts and Unexpired Leases 12/15 

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

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 contracts or leases are listed on

 Check if this is an

amended filing

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

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).

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 State what the contract or lease is for

Official Form 106G Schedule G: Executory Contracts and Unexpired Leases page 1 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 29 of 54
Official Form 106H

Schedule H: Your Codebtors 12/15 

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

1. Do you have any codebtors?





No

Yes

 Check if this is an

amended filing

(If you are filing a joint case, do not list either spouse as a codebtor.)

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.

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?





No

Yes

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 Column 2: The creditor to whom you owe the debt

Check all schedules that apply:

Official Form 106H Schedule H: Your Codebtors page 1 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 30 of 54
Official Form 106I

Schedule I: Your Income 12/15 

Part 1: Describe Employment

1.

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

 An amended filing

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

Fill in your employment

Check if this is:

 A supplement showing postpetition

chapter 13 income as of the following date:

MM / DD / YYYY

information.

Employment status

Occupation

Employer's name

Employer's address

How long employed there?

Debtor 1 Debtor 2 or non-filing spouse

Employed

 Not employed

 Employed

 Not employed

Number Street Number Street

City State Zip Code City State Zip Code

Self Employed & Landlord

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.

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.

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.

2. List monthly gross wages, salary, and commissions

For Debtor 1 For Debtor 2 or

non-filing spouse

(before all

payroll deductions). If not paid monthly, calculate what the monthly wage

2. $0.00 

would be.

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.

3. Estimate and list monthly overtime pay. 3. + $0.00 

4. Calculate gross income. Add line 2 + line 3. 4. $0.00 

Official Form 106I Schedule I: Your Income page 1 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 31 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Copy line 4 here ...................................................................................................................

For Debtor 1 For Debtor 2 or

non-filing spouse

 4. $0.00 

5. List all payroll deductions:

5a. Tax, Medicare, and Social Security deductions 5a.

5b. Mandatory contributions for retirement plans 5b.

5c. Voluntary contributions for retirement plans 5c.

5d. Required repayments of retirement fund loans 5d.

5e. Insurance 5e.

5f. Domestic support obligations 5f.

5g. Union dues 5g.

5h.

5h. Other deductions.

Specify: +

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

6. Add the payroll deductions. Add lines 5a + 5b + 5c + 5d + 5e + 5f + 6. $0.00 

5g + 5h.

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. $0.00 

8. List all other income regularly received:

8a. 8a.

8b. Interest and dividends 8b.

8c. 8c.

8d. Unemployment compensation 8d.

8f.

8f.

8e. Social Security 8e.

Other government assistance that you regularly receive

Specify:

8h.

8h.

8g. Pension or retirement income 8g.

Other monthly income.

Specify: +

$4,445.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

$0.00 

C13 Pymt for Child Support Arrears $248.00 

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.

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.

Include cash assistance and the value (if known) or any noncash assistance that you receive, such as food stamps 

(benefits under the Supplemental Nutrition Assistance Program) 

or housing subsidies.

9. Add all other income. Add lines 8a + 8b + 8c + 8d + 8e + 8f + 8g + 8h. 9. $4,693.00 

10. Calculate monthly income. Add line 7 + line 9. 10.

Add the entries in line 10 for Debtor 1 and Debtor 2 or non-filing spouse.

$4,693.00 + = $4,693.00 

11. State all other regular contributions to the expenses that you list in Schedule J.

Specify: 11. + $0.00 

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.

12. Add the amount in the last column of line 10 to the amount in line 11. The result is the combined monthly 12.

income. Write that amount on the Summary of Your Assets and Liabilities and Certain Statistical Information,

Combined

monthly income

$4,693.00 

if it applies.

13. Do you expect an increase or decrease within the year after you file this form?

No.

Yes. Explain:





None.

Official Form 106I Schedule I: Your Income page 2 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 32 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Expense Category Amount 

Business

8a. Attached Statement (Debtor 1)

Gross Monthly Income: $2,650.00 

Total Monthly Expenses $0.00 

Net Monthly Income: $2,650.00 

Official Form 106I Schedule I: Your Income page 3 

02/14/2017 12:04:01pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 33 of 54
Official Form 106J

Schedule J: Your Expenses 12/15 

Part 1: Describe Your Household

1.

 An amended filing

Is this a joint case?

Check if this is:

 A supplement showing postpetition

chapter 13 expenses as of the

following date:

MM / DD / YYYY

No. Go to line 2.

 Yes.

 No

 Yes. Debtor 2 must file Official Form 106J-2, Expenses for Separate Household of Debtor 2.

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

Does Debtor 2 live in a separate household?

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.

2. Do you have dependents? 



No

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?





No

Yes





No

Yes





No

Yes





No

Yes





No

Yes

Do not list Debtor 1 and 

Debtor 2.

Do not state the dependents' 

names.

3. 



No

Yes

Do your expenses include 

expenses of people other than 

yourself and your dependents?

Part 2: Estimate Your Ongoing Monthly Expenses

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.

If not included in line 4:

4a. Real estate taxes

4b. Property, homeowner's, or renter's insurance

4c. Home maintenance, repair, and upkeep expenses

4d. Homeowner's association or condominium dues

4a.

4b.

4c.

4d. $53.00 

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.)

Official Form 106J Schedule J: Your Expenses page 1 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 34 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Your expenses

5. Additional mortgage payments for your residence, such as home equity loans 5.

6. Utilities:

6a. Electricity, heat, natural gas

6b. Water, sewer, garbage collection

6c. Telephone, cell phone, Internet, satellite, and 

6d. Other. Specify:

6a.

6b.

6c.

Cell Phone 6d. $175.00 

cable services

7. Food and housekeeping supplies 7. $375.00 

8. Childcare and children's education costs 8.

9. Clothing, laundry, and dry cleaning 9. $100.00 

10. Personal care products and services 10. $120.00 

11. Medical and dental expenses 11. $210.00 

12. Transportation. Include gas, maintenance, bus or train 12.

fare. Do not include car payments.

$300.00 

13. Entertainment, clubs, recreation, newspapers, 13. $100.00 

magazines, and books

14. Charitable contributions and religious donations 14. $100.00 

15. Insurance.

15a. Life insurance

15b. Health insurance

15c. Vehicle insurance

15d. Other insurance. Specify:

15a.

15b.

15c.

15d.

Do not include insurance deducted from your pay or included in lines 4 or 20.

$100.00 

$170.00 

$70.00 

16. Taxes.

Specify: 16.

Do not include taxes deducted from your pay or included in lines 4 or 20.

$100.00 

17. Installment or lease payments:

17a. Car payments for Vehicle 1

17b. Car payments for Vehicle 2

17c. Other. Specify:

17d. Other. Specify:

17a.

17b.

17c.

17d.

Travel between VA & GA $295.00 

18. Your payments of alimony, maintenance, and support that you did not report as 18.

deducted from your pay on line 5, Schedule I, Your Income (Official Form 106I).

19. Other payments you make to support others who do not live with you.

Specify: 19.

20. Other real property expenses not included in lines 4 or 5 of this form or on

20a. Mortgages on other property

20b. Real estate taxes

20c. Property, homeowner's, or renter's insurance

20d. Maintenance, repair, and upkeep expenses

20a.

20b.

20c.

20d.

Schedule I: Your Income.

20e. Homeowner's association or condominium dues 20e.

$1,588.00 

Official Form 106J Schedule J: Your Expenses page 2 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 35 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

21. Other. Specify: 21. Storage + $200.00 

22. Calculate your monthly expenses.

22a. Add lines 4 through 21.

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. 22c.

$4,056.00 

$4,056.00 

22a.

22b.

23. Calculate your monthly net income.

23a. Copy line 12 (your combined monthly income) from Schedule I.

23b. Copy your monthly expenses from line 22c above.

23c. Subtract your monthly expenses from your monthly income.

23a.

23b.

The result is your monthly net income. 23c.

–

$4,693.00 

$4,056.00 

$637.00 

24. Do you expect an increase or decrease in your expenses within the year after you file this form?





No.

Yes. Explain here:

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?

Renting out former residence and living with mother or other family. Personal car expenses high because 

she sometimes works as a model. She has car insurance expense because she drives family car.

Official Form 106J Schedule J: Your Expenses page 3 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 36 of 54
Official Form 106Sum

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

Part 1: Summarize Your Assets

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

1a.

1b.

1c.

Copy line 55, Total real estate, from Schedule A/B.....................................................................................................................

Copy line 62, Total personal property, from Schedule A/B...........................................................................................................................................................

Copy line 63, Total of all property on Schedule A/B.....................................................................................................................................................................

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK  Check if this is an

amended filing

$335,000.00 

$44,092.68 

$379,092.68 

Your assets

Value of what you own

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 2: Summarize Your Liabilities

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

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

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

3a.

3b.

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

Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F........................................................ + 

Your total liabilities

2a. $314,950.97 

$13,321.00 

$67,131.00 

$395,402.97 

Your liabilities

Amount you owe

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........................................................................................................................................................

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

Copy your monthly expenses from line 22c of Schedule J.........................................................................................................

$4,693.00 

$4,056.00 

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

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 37 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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.

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. $4,694.96 

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.

9b.

Domestic support obligations. (Copy line 6a.)

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

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

9d. Student loans. (Copy line 6f.)

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

priority claims. (Copy line 6g.)

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

9g. Total. Add lines 9a through 9f.

$0.00 

$13,321.00 

$0.00 

$42,082.00 

$0.00 

$0.00 

$55,403.00 

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

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 38 of 54
Official Form 106Dec

Declaration About an Individual Debtor's Schedules 12/15 

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK  Check if this is an

amended filing

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).

X /s/ Trina A. Lloyd X

Trina A. Lloyd, Debtor 1 Signature of Debtor 2

Date

MM / DD / YYYY

Date

MM / DD / YYYY

02/14/2017

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.

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.

Official Form 106Dec Declaration About an Individual Debtor's Schedules page 1 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 39 of 54
Official Form 107

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

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK

1. What is your current marital status?





Married

Not married

 Check if this is an

amended filing

Part 1: Give Details About Your Marital Status and Where You Lived Before

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.

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.

3. Within the last 8 years, did you ever live with a spouse or legal equivalent in a community property state or territory?





No

Yes. Make sure you fill out

(Community property states and territories include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas,

Washington, and Wisconsin.)

Schedule H: Your Codebtors (Official Form 106H).

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?





No

Yes. Fill in the details.

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.



Operating a business

For the last calendar year:

(January 1 to December 31,

YYYY

)



Operating a business



Operating a business

For the calendar year before that:

(January 1 to December 31,

YYYY

)



 Operating a business



 Operating a business



 Operating a business

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

2016

2015

$0.00 

$24,000.00 

$8,510.00 

Wages, commissions, 

bonuses, tips

From January 1 of the current year until 

the date you filed for bankruptcy:

Wages, commissions, 

bonuses, tips

Wages, commissions, 

bonuses, tips

Wages, commissions, 

bonuses, tips

Wages, commissions, 

bonuses, tips

Wages, commissions, 

bonuses, tips

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

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 40 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

5. Did you receive any other income during this year or the two previous calendar years?





No

Yes. Fill in the details.

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 in 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.

Debtor 1 Debtor 2

Sources of income

Describe below.

Gross income

from each source

Sources of income

Describe below.

Gross income

(before deductions

and exclusions

from each source

(before deductions

and exclusions

Back Child Support $0.00 From January 1 of the current year until 

the date you filed for bankruptcy:

For the last calendar year:

(January 1 to December 31,

YYYY

2016 )

Back Child Support $2,400.00 

For the calendar year before that:

(January 1 to December 31,

YYYY

2015 )

Back Child Support $1,200.00 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 41 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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 $6,425* or more?

 No. Go to line 7.

 Yes.

* Subject to adjustment on 4/01/19 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 $6,425* 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.

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.

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;





No

Yes. List all payments to an insider.

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.

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?





No

Yes. List all payments that benefited an insider.

Include payments on debts guaranteed or cosigned by an insider.

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?





No

Yes. Fill in the details.

List all such matters, including personal injury cases, small claims actions, divorces, collection suits, paternity actions, support or custody 

modifications, and contract disputes.

Case title

Pending

 On appeal

Case number  Concluded

Court Name

Number Street

City State ZIP Code

GV17000345-00

9311 Lee Avenue 

Manassas VA 20110

Nature of the case Court or agency Status of the case

Warrant in Debt

Return Date: 2/15/2017

Montclair POA v. Trina Lloyd Prince William County GDC

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 3 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 42 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Case title

 Pending

 On appeal

Case number Concluded

Court Name

Number Street

City State ZIP Code

GV16001213-00

9311 Lee Avenue

Manassas VA 20110

Nature of the case Court or agency Status of the case

Warrant in Debt

Judgment 4/20/2016

Montclair POA v. Trina Lloyd Prince William County GDC

Case title

 Pending

 On appeal

Case number Concluded

Court Name

Number Street

City State ZIP Code

14MS016652

185 Central Ave SW Ste TG100

Atlanta GA 30303

Nature of the case Court or agency Status of the case

Warrant in Debt

Judgment August 18, 2016

Cavalry SPV I, LLC vs. Trina 

Lloyd

Fulton County Superior Ct

10. Within 1 year before you filed for bankruptcy, was any of your property repossessed, foreclosed, garnished, attached,





No. Go to line 11.

Yes. Fill in the information below.

seized, or levied?

Check all that apply and fill in the details below.

11.





No

Yes. Fill in the details.

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?

12.





No

Yes

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?

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.

14.





No

Yes. Fill in the details for each gift or contribution.

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?

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 4 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 43 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Part 6: List Certain Losses

15.





No

Yes. Fill in the details.

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?

Describe the property you lost and how

the loss occurred

Describe any insurance coverage for the loss Date of your

lost

Value of property

Include the amount that insurance has paid. List pending

insurance claims on line 33 of Schedule A/B: Property.

loss

January 2016

Car Fire

Part 7: List Certain Payments or Transfers

16.





No

Yes. Fill in the details.

Include any attorneys, bankruptcy petition preparers, or credit counseling agencies for services required for your bankruptcy.

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?

Description and value of any property transferred Date payment

or transfer was

Amount of

Person Who Was Paid

Number Street

City State ZIP Code

Email or website address

Person Who Made the Payment, if Not You

payment Law Offices of Robert R. Weed

300 Garrisonville Rd., Suite #201

Stafford VA 22554

01/09/2017 $1,780.00

made

Description and value of any property transferred Date payment

or transfer was

Amount of

Person Who Was Paid

Number Street

City State ZIP Code

Email or website address

Person Who Made the Payment, if Not You

payment Moneysharp.org

$20.00

made

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 5 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 44 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

17.





No

Yes. Fill in the details.

Do not include any payment or transfer that you listed on line 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 who promised to help you deal with your creditors or to make payments to your creditors?

18.





No

Yes. Fill in the details.

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 granting of a security interest or mortgage on your property).

Do not include gifts and transfers that you have already listed on this statement.

19.





No

Yes. Fill in the details.

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.)

Part 8: List Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units

20.





No

Yes. Fill in the details.

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.











Checking

Savings

Money market

Brokerage

Other

XXXXName of Financial Institution

Number Street

City State ZIP Code

NFCU

 March 2016 $0.00

Type of account or 

instrument

Last 4 digits of account 

number

Date account 

was closed, 

sold, moved, 

or transferred

Last balance 

before closing 

or transfer

21.





No

Yes. Fill in the details.

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?

22.





No

Yes. Fill in the details.

Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy?

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 6 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 45 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Part 9: Identify Property You Hold or Control for Someone Else

23.





No

Yes. Fill in the details.

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.

Part 10: Give Details About Environmental Information





For the purpose of Part 10, the following definitions apply:

means any federal, state, or local statute or regulation concerning pollution, contamination, releases of

means any location, facility, or property as defined under any environmental law, whether you now own, operate, or 

 means anything an environmental law defines as a hazardous waste, hazardous substance, toxic

Environmental law

Site

Hazardous material

hazardous or toxic substance, 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.

utilize it or used to own, operate, or utilize it, including disposal sites.

substance, hazardous material, pollutant, contaminant, or similar item.

Report all notices, releases, and proceedings that you know about, regardless of when they occurred.

24.





No

Yes. Fill in the details.

Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental 

law?

25.





No

Yes. Fill in the details.

Have you notified any governmental unit of any release of hazardous material?

26.





No

Yes. Fill in the details.

Have you been a party in any judicial or administrative proceeding under any environmental law? Include settlements and 

orders.

27.

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)

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

 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.

Within 4 years before you filed for bankruptcy, did you own a business or have any of the following connections to any 

business?

Business Name

Number Street

City State ZIP Code

Describe the nature of the business Employer Identification number

Name of accountant or bookkeeper

Do not include Social Security number or ITIN.

EIN: –

Dates business existed

From To

Trina Lloyd Residential Rental of 15047 Holleyside 

Drive

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 7 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 46 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Business Name

Number Street

City State ZIP Code

Describe the nature of the business Employer Identification number

Name of accountant or bookkeeper

Do not include Social Security number or ITIN.

EIN: –

Dates business existed

From To

Trina Lloyd Modeling, business admin, consulting

28.





No

Yes. Fill in the details below.

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.

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 8 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 47 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

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

X /s/ Trina A. Lloyd X

Trina A. Lloyd, Debtor 1 Signature of Debtor 2

Date Date

Did you attach additional pages toYour 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).

02/14/2017

that answers 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.

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 9 

02/14/2017 12:04:02pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 48 of 54
UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF VIRGINIA

ALEXANDRIA DIVISION

In re Case No. 17-10098-BFK

Chapter 13

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

B2030 (Form 2030) (12/15)

Trina A. Lloyd

1.

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

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

Balance Due..............................................................................................................................................................

$5,480.00 

$3,700.00 

$1,780.00 

Pursuant to 11 U.S.C. § 329(a) and Fed. Bankr. P. 2016(b), I certify that I am the attorney for the above named debtor(s) and 

that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for 

services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case 

is as follows:

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

 Debtor Other (specify) 

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

 Debtor Other (specify) 

4. 



I have not agreed to share the above-disclosed compensation with any other person unless they are members and 

associates of my law firm.

I have agreed to share the above-disclosed compensation with another person or persons who are not members or 

associates of my law firm. A copy of the agreement, together with a list of the names of the people sharing in the 

compensation, is attached.

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

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

bankruptcy;

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

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

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 49 of 54
B2030 (Form 2030) (12/15)

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

CERTIFICATION

Date

02/14/2017 /s/ Robert R. Weed

Robert R. Weed

/s/ Trina A. Lloyd

Trina A. Lloyd

Bar No. 24646

Law Office of Robert Weed

300 Garrisonville Rd #200

Stafford, VA 22554

Phone: (703) 335-7793

 I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for 

representation of the debtor(s) in this bankruptcy proceeding.

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 50 of 54
Official Form 122C-1

Chapter 13 Statement of Your Current Monthly Income

12/15 

Part 1: Calculate Your Average Monthly Income

1.

 Check if this is an amended filing

What is your marital and filing status? Check one only.

Fill in this information to identify your case:

Debtor 1

Debtor 2

(Spouse, if filing)

First Name Middle Name Last Name

First Name Middle Name Last Name

United States Bankruptcy Court for the:

Case number

(if known)

Trina A. Lloyd

EASTERN DISTRICT OF VIRGINIA

17-10098-BFK





Not married.

Married.

Fill out Column A, lines 2-11.

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

Check as directed in lines 17 and 21:







1.

2.

3.

and Calculation of Commitment Period

 4.

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).

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.

Disposable income is not determined 

under 11 U.S.C. § 1325(b)(3).

Disposable income is determined 

under 11 U.S.C. § 1325(b)(3).

The commitment period is 3 years.

According to the calculations required by this 

Statement:

The commitment period is 5 years.

Column B

Debtor 2 or

Column A

Debtor 1

non-filing spouse

2. Your gross wages, salary, tips, bonuses, overtime, and commissions

(before all payroll deductions).

$0.00 

3. Alimony and maintenance payments. Do not include payments from a spouse. $0.00 

4. All amounts from any source which are regularly paid for household

expenses of you or your dependents, including child support. Include

$247.90 

regular contributions from an unmarried partner, members of your household, 

your dependents, parents, and roommates. Do not include payments from a 

spouse. Do not include payments you listed on line 3.

5. Net income from operating a business, profession, or farm

Gross receipts (before all

Ordinary and necessary operating

Net monthly income from a business,

Copy

here  $2,652.06 

See continuation page(s) for details

– 

Debtor 1 Debtor 2

$2,652.06 

– 

$2,652.06 

$0.00 

expenses

profession, or farm

deductions)

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 1 

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 51 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

Column B

Debtor 2 or

Column A

Debtor 1

non-filing spouse

6. Net income from rental and other real property

Gross receipts (before all

Ordinary and necessary operating

Net monthly income from rental or

Copy

here  $1,795.00 

– 

Debtor 1 Debtor 2

$1,795.00 

$0.00 

$1,795.00 

– 

expenses

other real property

deductions)

7. Interest, dividends, and royalties $0.00 

8. Unemployment compensation

For you............................................................................................................................

For your spouse..............................................................................................................

$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: .......................................  ........

9. Pension or retirement income. Do not include any amount received that

was a benefit under the Social Security Act.

$0.00 

10. Income from all other sources not listed above. Specify the source and

Total amounts from separate pages, if any. + + 

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.

11. Calculate your total average monthly income.

+ =

Total average

monthly income

Add lines 2 through 10 for each column. $4,694.96 $4,694.96 

Then add the total for Column A to the total for Column B.

Part 2: Determine How to Measure Your Deductions from Income

12. Copy your total average monthly income from line 11. .............................................................................................................................................. $4,694.96 

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.

Total...................................................................................................................... Copy here  $0.00 

+ 

$0.00 – 

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.

14. Your current monthly income. Subtract the total in line 13 from line 12. $4,694.96 

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 2 

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 52 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

15. Calculate your current monthly income for the year. Follow these steps:

15a. Copy line 14 here  $4,694.96 

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. ....................................................................... $56,339.52 ................

...................................................................................................................................................................................

16. Calculate the median family income that applies to you. Follow these steps:

Fill in the state in which you live.

Fill in the number of people in your household.

Fill in the median family income for your state and size of household....................................................................................$70,976.00 ..................................

Virginia

2

16a.

16b.

16c.

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,

Go to Part 3.

Disposable income is not determined

17b.  Line 15b is more than line 16c. On the top of page 1 of this form, check box 2,

Go to Part 3 and fill out Calculation of Your Disposable Income (Official Form 122C-2).

Disposable income is determined under

under 11 U.S.C. § 1325(b)(3). Do NOT fill out Calculation of Your Disposable Income (Official Form 122C-2).

11 U.S.C. § 1325(b)(3).

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. .............................................................................................................................................. $4,694.96 

19. Deduct the marital adjustment if it applies. If you are married, your spouse is not filing with you, and you contend

If the marital adjustment does not apply, fill in 0 on line 19a. ....................................................................................................................... – $0.00 

Subtract line 19a from line 18. $4,694.96 

19a.

19b.

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.

20. Calculate your current monthly income for the year. Follow these steps:

20a. Copy line 19b $4,694.96 

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. $56,339.52 

...................................................................................................................................................................................

20c. Copy the median family income for your state and size of household from line 16c. ....................................................... $70,976.00 

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,

The commitment period is 3 years.

 Line 20b is more than or equal to line 20c. Unless otherwise ordered by the court, on the top of page 1

The commitment period is 5 years.

Go to Part 4.

of this form, check box 4,

check box 3,

Go to Part 4.

By signing here, under penalty of perjury I declare that the information on this statement and in any attachments is true and correct.

Date Date

X X

Trina A. Lloyd, Debtor 1 Signature of Debtor 2

2/14/2017

/s/ Trina A. Lloyd

Part 4: Sign Below

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 

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 53 of 54
Debtor 1 Trina A. Lloyd Case number (if known) 17-10098-BFK

5. Net income from operating a business, profession, or farm (details):

Debtor 1 / Debtor 2 Description (if available) Average Monthly Amount

Debtor 1 Misc Checks

Gross receipts (before all deductions) $809.17 

Ordinary and necessary operating expenses

Net monthly income from a business, profession, or farm

$0.00 

$809.17 

Debtor 1 Paypal

Gross receipts (before all deductions) $1,842.89 

Ordinary and necessary operating expenses

Net monthly income from a business, profession, or farm

$0.00 

$1,842.89 

Official Form 122C-1 Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period page 4 

02/14/2017 12:04:03pm Case 17-10098-BFK Doc 14 Filed 02/14/17 Entered 02/14/17 12:32:58 Desc Main

Document Page 54 of 54