United States Bankruptcy Court

Eastern District of Virginia

In re Stephanie Robin Novack Case No. 19-71204

Debtor(s) Chapter 7

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: April 29, 2019

/s/ Genene E. Gardner

Genene E. Gardner 72258

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

State Bar No.: 72258 VA

Mailing Address: The Merna Law Group, PC

3419 Virginia Beach Blvd.

#236

Virginia Beach, VA 23452

Telephone No.: 757-340-4895

[amendcs ver. 12/16]

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 1 of 21
Fill in this information to identify your case:

Debtor 1 Stephanie Robin Novack

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 19-71204

(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.

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

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

Total claim Priority

amount

Nonpriority

amount

2.1 IRS Centralized Insolvency * Last 4 digits of account number $4,073.00 $4,073.00 $0.00

Priority Creditor's Name

PO Box 7346

Philadelphia, PA 19101

When was the debt incurred? 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

 Yes

 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 intoxicated

 Other. Specify

Tax Liability

2.2 Virginia Department of Tax* Last 4 digits of account number $1,685.00 $1,685.00 $0.00

Priority Creditor's Name

PO Box 1115

Richmond, VA 23218

When was the debt incurred? 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

 Yes

 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 intoxicated

 Other. Specify

Tax Liability

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 1 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 27644 Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 2 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

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 Bank of America Last 4 digits of account number 1523 $5,401.00

Nonpriority Creditor's Name

P.O. Box 982238

El Paso, TX 79998

When was the debt incurred? 03/2019

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 Judgment

4.2 Branch B&T Last 4 digits of account number 1368 $2,427.00

Nonpriority Creditor's Name

223 West Nash Street

Wilson, NC 27893

When was the debt incurred? 12/2014

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

Who incurred the debt? Check one.

 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 Consumer Debt

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 3 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.3 Chase Card Last 4 digits of account number 6650 $8,099.00

Nonpriority Creditor's Name

P.O. Box 15298

Wilmington, DE 19850-5298

When was the debt incurred? 03/2016

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 Consumer Debt

4.4 Citicards CBNA Last 4 digits of account number 7504 $3,903.00

Nonpriority Creditor's Name

PO Box 6241

Sioux Falls, SD 57117

When was the debt incurred? 07/2017

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 Consumer Debt

4.5 Citicards CBNA Last 4 digits of account number 7187 $3,509.00

Nonpriority Creditor's Name

PO Box 6241

Sioux Falls, SD 57117

When was the debt incurred? 08/2017

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 Consumer Debt

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 4 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.6 Citicards CBNA Last 4 digits of account number $19,350.00

Nonpriority Creditor's Name

701 E 60th St N

Sioux Falls, SD 57104

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 Consumer Debt

4.7 Comenity Bank/Victorias Secret Last 4 digits of account number 3627 $539.00

Nonpriority Creditor's Name

P.O. Box 182789

Columbus, OH 43218

When was the debt incurred? 09/2015

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 Consumer Debt

4.8 Discover Financial Services Last 4 digits of account number 1309 $15,837.00

Nonpriority Creditor's Name

P.O. Box 15316

Wilmington, DE 19850

When was the debt incurred? 02/2019

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 Judgment

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 5 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.9 Emergency Phys. of Tidewater Last 4 digits of account number $1,700.00

Nonpriority Creditor's Name

PO Box 7549

Portsmouth, VA 23707

When was the debt incurred? 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 Medical Services

4.1

0 EVMS Last 4 digits of account number 1268 $230.00

Nonpriority Creditor's Name

Primary Care Internal Med.

P.O. Box 936

Norfolk, VA 23501

When was the debt incurred? 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 Medical Services

4.1

1 FedLoan Servicing Last 4 digits of account number 1395 $1,750.00

Nonpriority Creditor's Name

P.O. Box 60610

Harrisburg, PA 17106

When was the debt incurred? 07/2018

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

Student Loan

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 6 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.1

2 FedLoan Servicing Last 4 digits of account number 1395 $3,090.00

Nonpriority Creditor's Name

P.O. Box 60610

Harrisburg, PA 17106

When was the debt incurred? 07/2018

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

Student Loan

4.1

3 FedLoan Servicing Last 4 digits of account number 1395 $1,750.00

Nonpriority Creditor's Name

P.O. Box 60610

Harrisburg, PA 17106

When was the debt incurred? 10/2018

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

Student Loan

4.1

4 FedLoan Servicing Last 4 digits of account number 1395 $3,051.00

Nonpriority Creditor's Name

P.O. Box 60610

Harrisburg, PA 17106

When was the debt incurred? 10/2018

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

Student Loan

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 7 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.1

5 Sentara Collections Last 4 digits of account number $22,000.00

Nonpriority Creditor's Name

535 Independence Parkway

Chesapeake, VA 23320

When was the debt incurred? 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 Medical Services

4.1

6 Suffolk Fire and Rescue Last 4 digits of account number $900.00

Nonpriority Creditor's Name

PO BOX 863

Lewisville, NC 27023

When was the debt incurred? 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 Medical Services

4.1

7 Tuition Options Last 4 digits of account number Unknown

Nonpriority Creditor's Name

15483 Collections Center Dr

Chicago, IL 60693

When was the debt incurred? June 2018

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 Student Loans

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 8 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

4.1

8 Wells Fargo Card Services Last 4 digits of account number 5752 $2,573.00

Nonpriority Creditor's Name

PO Box 14517

Des Moines, IA 50306

When was the debt incurred? 08/2017

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 Consumer Debt

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

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

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

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

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

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

Attorney General

Tax Division, USDOJ

PO Box 227

Washington, DC 20044

Line 2.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

Attorney General Office *

U.S. Department of Justice

950 Pennsylvania Ave. N.W

Washington, DC 20503

Line 2.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

Internal Revenue Service

400 North Eighth Street Box 76

M/S Room 898

Richmond, VA 23219

Line 2.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

Suffolk General Dist. Court

150 North Main Street

Suffolk, VA 23434

Line 4.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

Suffolk General Dist. Court

150 North Main Street

Suffolk, VA 23434

Line 4.8 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

Tenaglia & Hunt

12 S Summit Ave Ste 322

Gaithersburg, MD 20877

Line 4.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

U.S. Attorney

World Trade Center, Ste 8000

101 West Main Street

Line 2.1 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 9

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 9 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

Norfolk, VA 23510

Last 4 digits of account number

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

Zwicker & Associates

80 Minuteman Road

Andover, MA 01810

Line 4.8 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

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

type of unsecured claim.

Total Claim

6a. Domestic support obligations 6a. $ 0.00

Total

claims

from Part 1 6b. Taxes and certain other debts you owe the government 6b. $ 5,758.00

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. $ 5,758.00

Total Claim

6f. Student loans 6f. $ 9,641.00

Total

claims

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

you did not report as priority claims 6g. $ 0.00

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

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

here.

6i.

$ 86,468.00

6j. Total Nonpriority. Add lines 6f through 6i. 6j. $ 96,109.00

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 10 of 21
Fill in this information to identify your case:

Debtor 1 Stephanie Robin Novack

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 19-71204

(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/ Stephanie Robin Novack X

Stephanie Robin Novack Signature of Debtor 2

Signature of Debtor 1

Date April 29, 2019 Date

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 11 of 21
UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF VIRGINIA

In re Stephanie Robin Novack Case No. 19-71204

Debtor(s) Chapter 7

TO:

Emergency Phys. of Tidewater

PO Box 7549

Portsmouth, VA 23707

EVMS Primary Care Internal Med.

P.O. Box 936

Norfolk, VA 23501

Sentara Collections

535 Independence Parkway

Chesapeake, VA 23320

Suffolk Fire and Rescue

PO BOX 863

Lewisville, NC 27023

 NOTICE TO

CREDITOR(S) (RE AMENDMENT)

NOTICE IS HEREBY GIVEN that an amendment to the above-captioned debtor's schedules has been filed

 adding you as a creditor,

 deleting you as a creditor,

 correcting your address

A copy of the amendment is forwarded to you together with this notice.

[If amendment is adding creditor(s)] NOTICE IS FURTHER GIVEN that also forwarded to you together with this notice is

a copy of the notice of the meeting of creditors called by the United States Trustee pursuant to Federal Rule of Bankruptcy Procedure

2003, giving the particulars of the case and stating the last date for the filing of claims (if any was given), for filing complaints

objecting to the discharge and complaints to determine the dischargeability of certain debts; a copy of the discharge of the debtor, if

one has been entered, a subsequent notice to file claims, if one has been issued, and any other filed document affecting the rights of

the added creditor(s).

Date: April 29, 2019 By

Stephanie Robin Novack

/s/ Genene E. Gardner

Attorney for Debtor [or Pro Se Debtor]

State Bar No.: 72258 VA

Address: The Merna Law Group, PC

3419 Virginia Beach Blvd.

#236

Virginia Beach, VA 23452

Telephone No.: 757-340-4895

CERTIFICATION

I certify that on April 29, 2019 , I served a copy of the foregoing notice on the United States Trustee, any appointed

trustee, and any and all entities affected by the amendment pursuant to Local Bankruptcy Rule 1009-1(A).

/s/ Genene E. Gardner

Genene E. Gardner 72258

Attorney for Debtor [or Pro Se Debtor]

[ ntctoaddcreds ver. R. 11/01]

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 12 of 21
Fill in this information to identify your case:

Debtor 1 Stephanie Robin Novack

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 19-71204

(if known)  Check if this is an

amended filing

Official Form 107

Statement of Financial Affairs for Individuals Filing for Bankruptcy 4/19

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

information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case

number (if known). Answer every question.

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

1. What is your current marital status?

 Married

 Not married

2. During the last 3 years, have you lived anywhere other than where you live now?

 No

 Yes. List all of the places you lived in the last 3 years. Do not include where you live now.

Debtor 1 Prior Address: Dates Debtor 1

lived there

Debtor 2 Prior Address: Dates Debtor 2

lived there

3709 Nottaway Street

Norfolk, VA 23519

From-To:

01/2016 - 06/2017

 Same as Debtor 1  Same as Debtor 1

From-To:

4224 Summerset Drive

Portsmouth, VA 23703

From-To:

12/2015 to

01/2016

 Same as Debtor 1  Same as Debtor 1

From-To:

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

states and territories include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington and Wisconsin.)

 No

 Yes. Make sure you fill out Schedule H: Your Codebtors (Official Form 106H).

Part 2 Explain the Sources of Your Income

4. Did you have any income from employment or from operating a business during this year or the two previous calendar years?

Fill in the total amount of income you received from all jobs and all businesses, including part-time activities.

If you are filing a joint case and you have income that you receive together, list it only once under Debtor 1.

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Check all that apply.

Gross income

(before deductions and

exclusions)

Sources of income

Check all that apply.

Gross income

(before deductions

and exclusions)

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 13 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

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)

 Wages, commissions,

bonuses, tips

 Operating a business

$0.00  Wages, commissions,

bonuses, tips

 Operating a business

 Wages, commissions,

bonuses, tips

 Operating a business

$0.00  Wages, commissions,

bonuses, tips

 Operating a business

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

Include income regardless of whether that income is taxable. Examples of other income are alimony; child support; Social Security, unemployment,

and other public benefit payments; pensions; rental income; interest; dividends; money collected from lawsuits; royalties; and gambling and lottery

winnings. If you are filing a joint case and you have income that you received together, list it only once under Debtor 1.

List each source and the gross income from each source separately. Do not include income that you listed in line 4.

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Describe below.

Gross income from

each source

(before deductions and

exclusions)

Sources of income

Describe below.

Gross income

(before deductions

and exclusions)

From January 1 of current year until

the date you filed for bankruptcy:

Alimony $12,501.00

For last calendar year:

(January 1 to December 31, 2018 )

Alimony $50,004.00

Retirement

Distribution

$8,350.00

For the calendar year before that:

(January 1 to December 31, 2017 )

Alimony $50,004.00

Distribution from

Equity

$90,000.00

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 $6,825* or more?

 No. Go to line 7.

 Yes List below each creditor to whom you paid a total of $6,825* or more in one or more payments and the total amount you

paid that creditor. Do not include payments for domestic support obligations, such as child support and alimony. Also, do

not include payments to an attorney for this bankruptcy case.

* Subject to adjustment on 4/01/22 and every 3 years after that for cases filed on or after the date of adjustment.

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 14 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

 Yes. Debtor 1 or Debtor 2 or both have primarily consumer debts.

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $600 or more?

 No. Go to line 7.

 Yes List below each creditor to whom you paid a total of $600 or more and the total amount you paid that creditor. Do not

include payments for domestic support obligations, such as child support and alimony. Also, do not include payments to an

attorney for this bankruptcy case.

Creditor's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Was this payment for ...

Pacific Union Financial*

C T CORPORATION SYSTEM

4701 COX ROAD, SUITE 285

Glen Allen, VA 23060

last 90 days $1,697.00 $234,413.00  Mortgage

 Car

 Credit Card

 Loan Repayment

 Suppliers or vendors

 Other

7. Within 1 year before you filed for bankruptcy, did you make a payment on a debt you owed anyone who was an insider?

Insiders include your relatives; any general partners; relatives of any general partners; partnerships of which you are a general partner; corporations

of which you are an officer, director, person in control, or owner of 20% or more of their voting securities; and any managing agent, including one for

a business you operate as a sole proprietor. 11 U.S.C. § 101. Include payments for domestic support obligations, such as child support and

alimony.

 No

 Yes. List all payments to an insider.

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

8. Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account of a debt that benefited an

insider?

Include payments on debts guaranteed or cosigned by an insider.

 No

 Yes. List all payments to an insider

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

Include creditor's name

Kevin Paul Summer 2018 $160.00 $0.00 Debtor paid friend's phone

bill.

Part 4: Identify Legal Actions, Repossessions, and Foreclosures

9. Within 1 year before you filed for bankruptcy, were you a party in any lawsuit, court action, or administrative proceeding?

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

modifications, and contract disputes.

 No

 Yes. Fill in the details.

Case title

Case number

Nature of the case Court or agency Status of the case

Bank of America

v.

Stephanie Robin Novack

GV19001523

Warrant in Debt Suffolk General Dist. Court

150 North Main Street

Suffolk, VA 23434

 Pending

 On appeal

 Concluded

Discover Financial Services

v.

Stephanie Robin Novack

GV19001309

Warrant in Debt Suffolk General Dist. Court

150 North Main Street

Suffolk, VA 23434

 Pending

 On appeal

 Concluded

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 15 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

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

Check all that apply and fill in the details below.

 No. Go to line 11.

 Yes. Fill in the information below.

Creditor Name and Address Describe the Property

Explain what happened

Date Value of the

property

11. Within 90 days before you filed for bankruptcy, did any creditor, including a bank or financial institution, set off any amounts from your

accounts or refuse to make a payment because you owed a debt?

 No

 Yes. Fill in the details.

Creditor Name and Address Describe the action the creditor took Date action was

taken

Amount

12. Within 1 year before you filed for bankruptcy, was any of your property in the possession of an assignee for the benefit of creditors, a

court-appointed receiver, a custodian, or another official?

 No

 Yes

Part 5: List Certain Gifts and Contributions

13. Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person?

 No

 Yes. Fill in the details for each gift.

Gifts with a total value of more than $600

per person

Person to Whom You Gave the Gift and

Address:

Describe the gifts Dates you gave

the gifts

Value

14. Within 2 years before you filed for bankruptcy, did you give any gifts or contributions with a total value of more than $600 to any charity?

 No

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

Gifts or contributions to charities that total

more than $600

Charity's Name

Address (Number, Street, City, State and ZIP Code)

Describe what you contributed Dates you

contributed

Value

Part 6: List Certain Losses

15. Within 1 year before you filed for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, fire, other disaster,

or gambling?

 No

 Yes. Fill in the details.

Describe the property you lost and

how the loss occurred

Describe any insurance coverage for the loss

Include the amount that insurance has paid. List pending

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

Date of your

loss

Value of property

lost

The debtor had 3 watches,

purse and wallet, Nikon digital

camra and 3 lenses stolen from

her home.

N/A September

2018

$1,475.00

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 16 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

Part 7: List Certain Payments or Transfers

16. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you

consulted about seeking bankruptcy or preparing a bankruptcy petition?

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

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Email or website address

Person Who Made the Payment, if Not You

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

The Merna Law Group, P.C.

3419 Virginia Beach Blvd., #236

Virginia Beach, VA 23452

$1523.00 attorney fees (includes $73.00

for homestead deed preparation) and

$362.00 filing fee and costs (includes

$27.00 homestead deed filing fee)

December

2018 - March

2019

$1,885.00

Urgent Credit Counseling $20 for credit counseling March 2019 $20.00

17. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone who

promised to help you deal with your creditors or to make payments to your creditors?

Do not include any payment or transfer that you listed on line 16.

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

18. Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property

transferred in the ordinary course of your business or financial affairs?

Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property). Do not

include gifts and transfers that you have already listed on this statement.

 No

 Yes. Fill in the details.

Person Who Received Transfer

Address

Person's relationship to you

Description and value of

property transferred

Describe any property or

payments received or debts

paid in exchange

Date transfer was

made

Unknown Buyers

N/A

The debtor sold various

pieces of clothing and

purses and received

approximately $1,000.

The debtor sold various

pieces of clothing and

purses and received

approximately $1,000.

Past 24 months

Jewelry store The debtor sold a wedding

band, engagement ring, and

2 bracelets to a jewelry store

for $2,000 to cover her dog's

surgery.

The debtor sold a

wedding band,

engagement ring, and 2

bracelets to a jewelry

store for $2,000 to cover

her dog's surgery.

February 2018

19. Within 10 years before you filed for bankruptcy, did you transfer any property to a self-settled trust or similar device of which you are a

beneficiary? (These are often called asset-protection devices.)

 No

 Yes. Fill in the details.

Name of trust Description and value of the property transferred Date Transfer was

made

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 17 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

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

20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed,

sold, moved, or transferred?

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

houses, pension funds, cooperatives, associations, and other financial institutions.

 No

 Yes. Fill in the details.

Name of Financial Institution and

Address (Number, Street, City, State and ZIP

Code)

Last 4 digits of

account number

Type of account or

instrument

Date account was

closed, sold,

moved, or

transferred

Last balance

before closing or

transfer

BB&T

238 S. Battlefield Blvd, #200

Chesapeake, VA 23322

XXXX-6219  Checking

 Savings

 Money Market

 Brokerage

 Other

March 20, 2019 $100.00

BB&T

238 S. Battlefield Blvd, #200

Chesapeake, VA 23322

XXXX-1421  Checking

 Savings

 Money Market

 Brokerage

 Other

March 20, 2019 $0.25

21. Do you now have, or did you have within 1 year before you filed for bankruptcy, any safe deposit box or other depository for securities,

cash, or other valuables?

 No

 Yes. Fill in the details.

Name of Financial Institution

Address (Number, Street, City, State and ZIP Code)

Who else had access to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

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

 No

 Yes. Fill in the details.

Name of Storage Facility

Address (Number, Street, City, State and ZIP Code)

Who else has or had access

to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

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

23. Do you hold or control any property that someone else owns? Include any property you borrowed from, are storing for, or hold in trust

for someone.

 No

 Yes. Fill in the details.

Owner's Name

Address (Number, Street, City, State and ZIP Code)

Where is the property?

(Number, Street, City, State and ZIP

Code)

Describe the property Value

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 18 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

Part 10: Give Details About Environmental Information

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

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

toxic substances, wastes, or material into the air, land, soil, surface water, groundwater, or other medium, including statutes or

regulations controlling the cleanup of these substances, wastes, or material.

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

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

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

hazardous material, pollutant, contaminant, or similar term.

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

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

 No

 Yes. Fill in the details.

Name of site

Address (Number, Street, City, State and ZIP Code)

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

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

 No

 Yes. Fill in the details.

Name of site

Address (Number, Street, City, State and ZIP Code)

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

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

 No

 Yes. Fill in the details.

Case Title

Case Number

Court or agency

Name

Address (Number, Street, City,

State and ZIP Code)

Nature of the case Status of the

case

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

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

 A sole proprietor or self-employed in a trade, profession, or other activity, either full-time or part-time

 A member of a limited liability company (LLC) or limited liability partnership (LLP)

 A partner in a partnership

 An officer, director, or managing executive of a corporation

 An owner of at least 5% of the voting or equity securities of a corporation

 No. None of the above applies. Go to Part 12.

 Yes. Check all that apply above and fill in the details below for each business.

Business Name

Address

(Number, Street, City, State and ZIP Code)

Describe the nature of the business

Name of accountant or bookkeeper

Employer Identification number

Do not include Social Security number or ITIN.

Dates business existed

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 19 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

28. Within 2 years before you filed for bankruptcy, did you give a financial statement to anyone about your business? Include all financial

institutions, creditors, or other parties.

 No

 Yes. Fill in the details below.

Name

Address

(Number, Street, City, State and ZIP Code)

Date Issued

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 20 of 21
Debtor 1 Stephanie Robin Novack Case number (if known) 19-71204

Part 12: Sign Below

I have read the answers on this Statement of Financial Affairs and any attachments, and I declare under penalty of perjury that the answers

are true and correct. I understand that making a false statement, concealing property, or obtaining money or property by fraud in connection

with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20 years, or both.

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

/s/ Stephanie Robin Novack

Stephanie Robin Novack Signature of Debtor 2

Signature of Debtor 1

Date April 29, 2019 Date

Did you attach additional pages to Your Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107)?

 No

 Yes

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

 No

 Yes. Name of Person . Attach the Bankruptcy Petition Preparer's Notice, Declaration, and Signature (Official Form 119).

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

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 19-71204-SCS Doc 13 Filed 04/29/19 Entered 04/29/19 14:07:51 Desc Main

 Document Page 21 of 21