Fill in this information to identify your case:

Debtor 1 Tanya Vanessa Maddox

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 18-71324

(if known)  Check if this is an

amended filing

Official Form 106Sum

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

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

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

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

Part 1: Summarize Your Assets

Your assets

Value of what you own

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

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

1b. Copy line 62, Total personal property, from Schedule A/B..................................................................................... $ 17,961.00

1c. Copy line 63, Total of all property on Schedule A/B............................................................................................... $ 17,961.00

Part 2: Summarize Your Liabilities

Your liabilities

Amount you owe

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

2a. Copy the total you listed in Column A, Amount of claim, at the bottom of the last page of Part 1 of Schedule D... $ 24,912.00

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

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

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F............................ $ 213,820.38

Your total liabilities $ 238,732.38

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................................................................................ $ 4,778.86

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

Copy your monthly expenses from line 22c of Schedule J.......................................................................... $ 4,186.00

Part 4: Answer These Questions for Administrative and Statistical Records

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

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

 Yes

7. What kind of debt do you have?

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

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

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

the court with your other schedules.

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

Software Copyright (c) 1996-2018 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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Debtor 1 Tanya Vanessa Maddox Case number (if known) 18-71324

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. $ 2,973.86

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

Total claim

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

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

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

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

9d. Student loans. (Copy line 6f.) $ 184,268.00

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

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

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

9g. Total. Add lines 9a through 9f. $ 184,268.00

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

Software Copyright (c) 1996-2018 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 18-71324-FJS Doc 14 Filed 04/26/18 Entered 04/26/18 14:51:23 Desc Main

 Document Page 2 of 12
Fill in this information to identify your case:

Debtor 1 Tanya Vanessa Maddox

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 18-71324

(if known)  Check if this is an

amended filing

Official Form 106E/F

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

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

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

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

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

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

name and case number (if known).

Part 1: List All of Your PRIORITY Unsecured Claims

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

 No. Go to Part 2.

 Yes.

Part 2: List All of Your NONPRIORITY Unsecured Claims

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

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

 Yes.

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

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

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

Part 2.

Total claim

4.1 ABNB Last 4 digits of account number 0930 $1,500.00

Nonpriority Creditor's Name

P.O. Box 1192

Chesapeake, VA 23327

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 1 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.2 ADT Last 4 digits of account number 2166 $2,000.00

Nonpriority Creditor's Name

2550 Ellsmere Ave

Norfolk, VA 23513

When was the debt incurred? 2016-2017

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify Security service

4.3 Amanica Real Estate & Property Last 4 digits of account number 2553 $2,000.00

Nonpriority Creditor's Name

12800 Heacock St

Moreno Valley, CA 92553

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify

4.4 Capital One Last 4 digits of account number $958.00

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred? 2015

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.5 Capital One Last 4 digits of account number $2,438.33

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred? 2015-2016

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

4.6 Capital One Last 4 digits of account number $3,977.38

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred? 2015-2016

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

4.7 Capital One Last 4 digits of account number $1,804.59

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.8 Capital One Last 4 digits of account number $553.00

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred? 2015-2016

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

4.9 Capital One Last 4 digits of account number $1,218.00

Nonpriority Creditor's Name

P.O. Box 30281

Salt Lake City, UT 84130-0281

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

4.1

0 Dept of Ed/Nelnet Last 4 digits of account number any/all $184,268.00

Nonpriority Creditor's Name

P.O. Box 740283

Atlanta, GA 30374-0283

When was the debt incurred? any/all

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify

Gov't Guaranteed Student

loans-NON-DISCHARGEABLE currently not

due - still attending school - NOT BEING

PAID THROUGH PLAN

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.1

1 DirecTV Last 4 digits of account number 2166 $2,000.00

Nonpriority Creditor's Name

P. O. Box 78626

Phoenix, AZ 85062-8626

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify Service

4.1

2 Firestone Last 4 digits of account number 1720 $944.00

Nonpriority Creditor's Name

P.O. Box 81307 bk 14

Cleveland, OH 44181

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

4.1

3 So Cailif Edison Last 4 digits of account number $388.00

Nonpriority Creditor's Name

P.O. Box 6109

Covina, CA 91722-5107

When was the debt incurred? 2013

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

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.1

4 State of Maryland Last 4 digits of account number 9209 $3,528.08

Nonpriority Creditor's Name

Central Collections, 5th Fl

300 West Preston Street

Baltimore, MD 21201

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify

4.1

5 University of Redlands Last 4 digits of account number any/all $4,000.00

Nonpriority Creditor's Name

1200 E. Colton

Redlands, CA 92373

When was the debt incurred? any/all

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify tuitioni

4.1

6 Verizon Last 4 digits of account number 4242 $843.00

Nonpriority Creditor's Name

P.O. Box 650584

Dallas, TX 75265

When was the debt incurred? 2015

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify credit card

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

4.1

7 Verizon Last 4 digits of account number $800.00

Nonpriority Creditor's Name

Attn: Bankruptcy Dept.

PO Box 3037

Bloomington, IL 61702

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify

4.1

8 Verizon Wireless Last 4 digits of account number $600.00

Nonpriority Creditor's Name

Attn Bankruptcy Administration

PO Box 3397

Bloomington, IL 61702

When was the debt incurred?

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

Who incurred the debt? Check one.

 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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

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

 Yes  Other. Specify

Part 3: List Others to Be Notified About a Debt That You Already Listed

5. Use this page only if you have others to be notified about your bankruptcy, for a debt that you already listed in Parts 1 or 2. For example, if a collection agency

is trying to collect from you for a debt you owe to someone else, list the original creditor in Parts 1 or 2, then list the collection agency here. Similarly, if you

have more than one creditor for any of the debts that you listed in Parts 1 or 2, list the additional creditors here. If you do not have additional persons to be

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

Part 4: Add the Amounts for Each Type of Unsecured Claim

6. Total the amounts of certain types of unsecured claims. This information is for statistical reporting purposes only. 28 U.S.C. §159. Add the amounts for each

type of unsecured claim.

Total Claim

6a. Domestic support obligations 6a. $ 0.00

Total

claims

from Part 1 6b. Taxes and certain other debts you owe the government 6b. $ 0.00

6c. Claims for death or personal injury while you were intoxicated 6c. $ 0.00

6d. Other. Add all other priority unsecured claims. Write that amount here. 6d. $ 0.00

6e. Total Priority. Add lines 6a through 6d. 6e. $ 0.00

Total Claim

6f. Student loans 6f. $ 184,268.00

Total

claims

from Part 2 6g. Obligations arising out of a separation agreement or divorce that 6g. $ 0.00

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 8

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Debtor 1 Tanya Vanessa Maddox Case number (if know) 18-71324

you did not report as priority claims

6h. Debts to pension or profit-sharing plans, and other similar debts 6h. $ 0.00

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

here.

6i.

$ 29,552.38

6j. Total Nonpriority. Add lines 6f through 6i. 6j. $ 213,820.38

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

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 Document Page 10 of 12
Fill in this information to identify your case:

Debtor 1 Tanya Vanessa Maddox

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 18-71324

(if known)  Check if this is an

amended filing

Official Form 106Dec

Declaration About an Individual Debtor's Schedules 12/15

If two married people are filing together, both are equally responsible for supplying correct information.

You must file this form whenever you file bankruptcy schedules or amended schedules. Making a false statement, concealing property, or

obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20

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

Sign Below

Did you pay or agree to pay someone who is NOT an attorney to help you fill out bankruptcy forms?

 No

 Yes. Name of person Attach Bankruptcy Petition Preparer’s Notice,

Declaration, and Signature (Official Form 119)

Under penalty of perjury, I declare that I have read the summary and schedules filed with this declaration and

that they are true and correct.

X /s/ Tanya Vanessa Maddox X

Tanya Vanessa Maddox Signature of Debtor 2

Signature of Debtor 1

Date April 26, 2018 Date

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

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United States Bankruptcy Court

Eastern District of Virginia

In re Tanya Vanessa Maddox Case No. 18-71324

Debtor(s) Chapter 13

 AMENDMENT COVER SHEET

Amendment(s) to the following petition, list(s), schedule(s) or statement(s) are transmitted herewith:

Involuntary/Voluntary Petition [Specify reason for amendment: ]

Check if applicable: Soc. Sec. No. amended. [If applicable: An original, signed Official Form 121 was

mailed/hand-delivered to the Clerk's office on .*]

Summary of Your Assets and Liabilities (and Certain Statistical Information - Individuals Only)

Declaration (Individuals - Form 106Dec) (Non-Individuals - Form 202)

Schedule A/B – Property

Schedule C – The Property You Claim as Exempt

Schedule D – Creditors Who Hold Claims Secured by Property (See LBR 1009-1)

Schedule E/F – Creditors Who Have Unsecured Claims (See LBR 1009-1)

Schedule E/F Creditors Who Have Unsecured Claims (See LBR 1009-1)

($31.00 fee required if adding or deleting pre-petition creditors, changing amounts owed or classification of

debt.) Check applicable statement(s):

Creditor(s) added Creditor(s) deleted

Change in amounts owed or classification of debt

No pre-petition creditors added/deleted, or amounts owed or classification of debt changed. [Docket:

Amended Schedule(s) and/or Statement(s), List(s)-NO FEE)

Post-petition creditors added (Schedule of Unpaid Debts)

REMINDER: Conversion of Chapter 13 to Chapter 7 - only file Schedule of Unpaid Debts.

Schedule G – Executory Contracts and Unexpired Leases

Schedule H – Codebtors

Schedule I – Your Income

Schedule J – Your Expenses

[NOTE: The form “NOTICE TO CREDITOR(S) (RE AMENDMENT)” is still required when adding or deleting creditors.

*Amendment of debtor(s) Social Security Number requires that this cover sheet together with a completed Official Form 121 –

Statement About Your Social Security Numbers be electronically filed or submitted to the Clerk’s Office for “restricted”

entry of the amended Social Security Number into the case record.]

Statement of Financial Affairs

Statement of Intention for Individuals Filing Under Chapter 7

Chapter 11 List of Equity Security Holders

Chapter 11: The List of Creditors Who Have the 20 Largest Unsecured Claims Against You Who Are Not Insiders

Attorney’s Disclosure of Compensation

Other:

NOTICE OF AMENDMENT(S) TO AFFECTED PARTIES

Pursuant to Federal Rule of Bankruptcy Procedure 1009(a) and Local Rule 1009-1, I certify that notice of the filing of the

amendment(s) checked above has been given this date to the United States Trustee, the trustee in this case, and to any and all entities

affected by the amendment as follows: .

Date: 4/26/18

/s/ Kenneth E. Goolsby

Kenneth E. Goolsby 86347

Attorney for Debtor(s) [or Pro Se Debtor(s)]

State Bar No.: 86347 VA

Mailing Address: The Alliance Legal Group

133 Mt. Pleasant Road

Chesapeake, VA 23322

Telephone No.: (757) 482-5705

[amendcs ver. 12/16]

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Case 18-71324-FJS Doc 14 Filed 04/26/18 Entered 04/26/18 14:51:23 Desc Main

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