Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 page 1

Official Form 108 

Statement of Intention for Individuals Filing Under Chapter 7 12/15

If you are an individual filing under chapter 7, you must fill out this form if: 

 creditors have claims secured by your property, or

 you have leased personal property and the lease has not expired.

You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors, 

whichever is earlier, unless the court extends the time for cause. You must also send copies to the creditors and lessors you list on the form. 

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

Both debtors must sign and date the form. 

Be as complete and accurate as possible. 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). 

Part 1: List Your Creditors Who Have Secured Claims 

1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the

information below.

Identify the creditor and the property that is collateral What do you intend to do with the property that 

secures a debt?

Did you claim the property 

as exempt on Schedule C?

Creditor’s 

name:  Surrender the property.

 Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement.

 Retain the property and [explain]: __________

______________________________________

 No

 Yes

Description of 

property 

securing debt: 

Creditor’s 

name:  Surrender the property.

 Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement.

 Retain the property and [explain]: __________

______________________________________

 No

 Yes

Description of 

property 

securing debt: 

Creditor’s 

name:  Surrender the property.

 Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement.

 Retain the property and [explain]: __________

______________________________________

 No

 Yes

Description of 

property 

securing debt: 

Creditor’s 

name:  Surrender the property.

 Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement.

 Retain the property and [explain]: __________

______________________________________

 No

 Yes

Description of 

property 

securing debt: 

Debtor 1 __________________________________________________________________ First Name Middle Name Last Name

Debtor 2 ________________________________________________________________ 

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

United States Bankruptcy Court for the: __________ District of __________ 

Case number ___________________________________________ 

 (If known) 

Fill in this information to identify your case: 

 Check if this is an

amended filing

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Debtor 1 ______________________________________________________ Case number (If known)_____________________________________ First Name Middle Name Last Name

Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 page 2

Part 2: List Your Unexpired Personal Property Leases 

For any unexpired personal property lease that you listed in Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G), 

fill in the information below. Do not list real estate leases. Unexpired leases are leases that are still in effect; the lease period has not yet 

ended. You may assume an unexpired personal property lease if the trustee does not assume it. 11 U.S.C. § 365(p)(2).

Describe your unexpired personal property leases Will the lease be assumed? 

Lessor’s name:  No

 Yes Description of leased 

property: 

Lessor’s name:  No

 Yes Description of leased 

property: 

Lessor’s name:  No

Description of leased  Yes

property: 

Lessor’s name:  No

 Yes

Description of leased 

property: 

Lessor’s name:  No

 Yes

Description of leased 

property: 

Lessor’s name:  No

 Yes

Description of leased 

property: 

Lessor’s name:  No

 Yes

Description of leased 

property: 

Part 3: Sign Below

Under penalty of perjury, I declare that I have indicated my intention about any property of my estate that secures a debt and any 

personal property that is subject to an unexpired lease. 

___________________________________________ ___________________________________________ 

Signature of Debtor 1 Signature of Debtor 2 

Date _________________ Date _________________ MM / DD / YYYY MM / DD / YYYY

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