Fill in this information to identify your case:

United States Bankruptcy Court for the:

EASTERN DISTRICT OF VIRGINIA

Case number (if known) Chapter you are filing under:

 Chapter 7

 Chapter 11

 Chapter 12

 Chapter 13  Check if this an

amended filing

Official Form 101

Voluntary Petition for Individuals Filing for Bankruptcy 12/17

The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a joint

case—and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,” the answer

would be yes if either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 1 and Debtor 2 to distinguish

between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The same person must be Debtor 1 in

all of the forms.

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: Identify Yourself

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

1. Your full name

Write the name that is on

your government-issued

picture identification (for

example, your driver's

license or passport).

Bring your picture

identification to your

meeting with the trustee.

John Jennifer

First name First name

A. M.

Middle name Middle name

Lundeen Lundeen

Last name and Suffix (Sr., Jr., II, III) Last name and Suffix (Sr., Jr., II, III)

2. All other names you have

used in the last 8 years

Include your married or

maiden names.

Jennifer M. Kraus

3. Only the last 4 digits of

your Social Security

number or federal

Individual Taxpayer

Identification number

(ITIN)

xxx-xx-6321 xxx-xx-5528

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 1

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

4. Any business names and

Employer Identification

Numbers (EIN) you have

used in the last 8 years

 I have not used any business name or EINs.  I have not used any business name or EINs.

Include trade names and

doing business as names

Business name(s) Business name(s)

EINs EINs

5. Where you live If Debtor 2 lives at a different address:

13337 Diamond Ridge Drive

Midlothian, VA 23112

Number, Street, City, State & ZIP Code Number, Street, City, State & ZIP Code

Chesterfield

County County

If your mailing address is different from the one

above, fill it in here. Note that the court will send any

notices to you at this mailing address.

If Debtor 2's mailing address is different from yours, fill it

in here. Note that the court will send any notices to this

mailing address.

Number, P.O. Box, Street, City, State & ZIP Code Number, P.O. Box, Street, City, State & ZIP Code

6. Why you are choosing

this district to file for

bankruptcy

Check one:

 Over the last 180 days before filing this petition,

I have lived in this district longer than in any

other district.

 I have another reason.

Explain. (See 28 U.S.C. § 1408.)

Check one:

 Over the last 180 days before filing this petition, I

have lived in this district longer than in any other

district.

 I have another reason.

Explain. (See 28 U.S.C. § 1408.)

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 2

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Part 2: Tell the Court About Your Bankruptcy Case

7. The chapter of the

Bankruptcy Code you are

choosing to file under

Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy

(Form 2010)). Also, go to the top of page 1 and check the appropriate box.

 Chapter 7

 Chapter 11

 Chapter 12

 Chapter 13

8. How you will pay the fee  I will pay the entire fee when I file my petition. Please check with the clerk’s office in your local court for more details

about how you may pay. Typically, if you are paying the fee yourself, you may pay with cash, cashier’s check, or money

order. If your attorney is submitting your payment on your behalf, your attorney may pay with a credit card or check with

a pre-printed address.

 I need to pay the fee in installments. If you choose this option, sign and attach the Application for Individuals to Pay

The Filing Fee in Installments (Official Form 103A).

 I request that my fee be waived (You may request this option only if you are filing for Chapter 7. By law, a judge may,

but is not required to, waive your fee, and may do so only if your income is less than 150% of the official poverty line that

applies to your family size and you are unable to pay the fee in installments). If you choose this option, you must fill out

the Application to Have the Chapter 7 Filing Fee Waived (Official Form 103B) and file it with your petition.

9. Have you filed for

bankruptcy within the

last 8 years?

 No.

 Yes.

District

Joint - VA Chapter 13

Dismissed 1/17/19 When 10/06/17 Case number 17-35028

District

Wife - VA Chapter 7

Discharged 3/1/2002 When 11/16/01 Case number 01-14406

District When Case number

10. Are any bankruptcy

cases pending or being

filed by a spouse who is

not filing this case with

you, or by a business

partner, or by an

affiliate?

 No

 Yes.

Debtor Relationship to you

District When Case number, if known

Debtor Relationship to you

District When Case number, if known

11. Do you rent your

residence?

 No. Go to line 12.

 Yes. Has your landlord obtained an eviction judgment against you?

 No. Go to line 12.

 Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) and file it with this

bankruptcy petition.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 3

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Part 3: Report About Any Businesses You Own as a Sole Proprietor

12. Are you a sole proprietor

of any full- or part-time

business?

 No. Go to Part 4.

 Yes. Name and location of business

A sole proprietorship is a

business you operate as

an individual, and is not a

separate legal entity such

as a corporation,

partnership, or LLC.

Name of business, if any

If you have more than one

sole proprietorship, use a

separate sheet and attach

it to this petition.

Number, Street, City, State & ZIP Code

Check the appropriate box to describe your business:

 Health Care Business (as defined in 11 U.S.C. § 101(27A))

 Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))

 Stockbroker (as defined in 11 U.S.C. § 101(53A))

 Commodity Broker (as defined in 11 U.S.C. § 101(6))

 None of the above

13. Are you filing under

Chapter 11 of the

Bankruptcy Code and are

you a small business

debtor?

If you are filing under Chapter 11, the court must know whether you are a small business debtor so that it can set appropriate

deadlines. If you indicate that you are a small business debtor, you must attach your most recent balance sheet, statement of

operations, cash-flow statement, and federal income tax return or if any of these documents do not exist, follow the procedure

in 11 U.S.C. 1116(1)(B).

For a definition of small

business debtor, see 11

U.S.C. § 101(51D).

 No. I am not filing under Chapter 11.

 No. I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in the Bankruptcy

Code.

 Yes. I am filing under Chapter 11 and I am a small business debtor according to the definition in the Bankruptcy Code.

Part 4: Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention

14. Do you own or have any

property that poses or is

alleged to pose a threat

of imminent and

identifiable hazard to

public health or safety?

Or do you own any

property that needs

immediate attention?

 No.

 Yes.

What is the hazard?

If immediate attention is

needed, why is it needed?

For example, do you own

perishable goods, or

livestock that must be fed,

or a building that needs

urgent repairs?

Where is the property?

Number, Street, City, State & Zip Code

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 4

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Part 5: Explain Your Efforts to Receive a Briefing About Credit Counseling

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

15. Tell the court whether

you have received a

briefing about credit

counseling.

The law requires that you

receive a briefing about

credit counseling before

you file for bankruptcy.

You must truthfully check

one of the following

choices. If you cannot do

so, you are not eligible to

file.

If you file anyway, the court

can dismiss your case, you

will lose whatever filing fee

you paid, and your

creditors can begin

collection activities again.

You must check one: You must check one:

 I received a briefing from an approved credit

counseling agency within the 180 days before I

filed this bankruptcy petition, and I received a

certificate of completion.

Attach a copy of the certificate and the payment

plan, if any, that you developed with the agency.

 I received a briefing from an approved credit

counseling agency within the 180 days before I filed

this bankruptcy petition, and I received a certificate of

completion.

Attach a copy of the certificate and the payment plan, if

any, that you developed with the agency.

 I received a briefing from an approved credit

counseling agency within the 180 days before I

filed this bankruptcy petition, but I do not have

a certificate of completion.

Within 14 days after you file this bankruptcy

petition, you MUST file a copy of the certificate and

payment plan, if any.

 I received a briefing from an approved credit

counseling agency within the 180 days before I filed

this bankruptcy petition, but I do not have a certificate

of completion.

Within 14 days after you file this bankruptcy petition, you

MUST file a copy of the certificate and payment plan, if

any.

 I certify that I asked for credit counseling

services from an approved agency, but was

unable to obtain those services during the 7

days after I made my request, and exigent

circumstances merit a 30-day temporary waiver

of the requirement.

To ask for a 30-day temporary waiver of the

requirement, attach a separate sheet explaining

what efforts you made to obtain the briefing, why

you were unable to obtain it before you filed for

bankruptcy, and what exigent circumstances

required you to file this case.

Your case may be dismissed if the court is

dissatisfied with your reasons for not receiving a

briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must

still receive a briefing within 30 days after you file.

You must file a certificate from the approved

agency, along with a copy of the payment plan you

developed, if any. If you do not do so, your case

may be dismissed.

Any extension of the 30-day deadline is granted

only for cause and is limited to a maximum of 15

days.

 I certify that I asked for credit counseling services

from an approved agency, but was unable to obtain

those services during the 7 days after I made my

request, and exigent circumstances merit a 30-day

temporary waiver of the requirement.

To ask for a 30-day temporary waiver of the requirement,

attach a separate sheet explaining what efforts you made

to obtain the briefing, why you were unable to obtain it

before you filed for bankruptcy, and what exigent

circumstances required you to file this case.

Your case may be dismissed if the court is dissatisfied

with your reasons for not receiving a briefing before you

filed for bankruptcy.

If the court is satisfied with your reasons, you must still

receive a briefing within 30 days after you file. You must

file a certificate from the approved agency, along with a

copy of the payment plan you developed, if any. If you do

not do so, your case may be dismissed.

Any extension of the 30-day deadline is granted only for

cause and is limited to a maximum of 15 days.

 I am not required to receive a briefing about

credit counseling because of:

 I am not required to receive a briefing about credit

counseling because of:

 Incapacity.

I have a mental illness or a mental deficiency

that makes me incapable of realizing or

making rational decisions about finances.

 Incapacity.

I have a mental illness or a mental deficiency that

makes me incapable of realizing or making rational

decisions about finances.

 Disability.

My physical disability causes me to be

unable to participate in a briefing in person,

by phone, or through the internet, even after I

reasonably tried to do so.

 Disability.

My physical disability causes me to be unable to

participate in a briefing in person, by phone, or

through the internet, even after I reasonably tried to

do so.

 Active duty.

I am currently on active military duty in a

military combat zone.

 Active duty.

I am currently on active military duty in a military

combat zone.

If you believe you are not required to receive a

briefing about credit counseling, you must file a

motion for waiver credit counseling with the court.

If you believe you are not required to receive a briefing

about credit counseling, you must file a motion for waiver

of credit counseling with the court.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 5

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Part 6: Answer These Questions for Reporting Purposes

16. What kind of debts do

you have?

16a. Are your debts 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.”

 No. Go to line 16b.

 Yes. Go to line 17.

16b. Are your debts primarily business debts? Business debts are debts that you incurred to obtain

money for a business or investment or through the operation of the business or investment.

 No. Go to line 16c.

 Yes. Go to line 17.

16c. State the type of debts you owe that are not consumer debts or business debts

17. Are you filing under

Chapter 7?

 No. I am not filing under Chapter 7. Go to line 18.

Do you estimate that

after any exempt

property is excluded and

administrative expenses

are paid that funds will

be available for

distribution to unsecured

creditors?

 Yes. I am filing under Chapter 7. Do you estimate that after any exempt property is excluded and administrative expenses

are paid that funds will be available to distribute to unsecured creditors?

 No

 Yes

18. How many Creditors do

you estimate that you

owe?

 1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than100,000

19. How much do you

estimate your assets to

be worth?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

20. How much do you

estimate your liabilities

to be?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

Part 7: Sign Below

For you I have examined this petition, and I declare under penalty of perjury that the information provided is true and correct.

If I have chosen to file under Chapter 7, I am aware that I may proceed, if eligible, under Chapter 7, 11,12, or 13 of title 11,

United States Code. I understand the relief available under each chapter, and I choose to proceed under Chapter 7.

If no attorney represents me and I did not pay or agree to pay someone who is not an attorney to help me fill out this

document, I have obtained and read the notice required by 11 U.S.C. § 342(b).

I request relief in accordance with the chapter of title 11, United States Code, specified in this petition.

I understand 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/ John A. Lundeen /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Executed on May 13, 2019 Executed on May 13, 2019

MM / DD / YYYY MM / DD / YYYY

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 6

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 Document Page 6 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

For your attorney, if you are

represented by one

If you are not represented by

an attorney, you do not need

to file this page.

I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility to proceed

under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each chapter

for which the person is eligible. I also certify that I have delivered to the debtor(s) the notice required by 11 U.S.C. § 342(b)

and, in a case in which § 707(b)(4)(D) applies, certify that I have no knowledge after an inquiry that the information in the

schedules filed with the petition is incorrect.

/s/ Pia J. North Date May 13, 2019

Signature of Attorney for Debtor MM / DD / YYYY

Pia J. North 29672

Printed name

North Law Bar# 29672

Firm name

5913 Harbour Park Drive

Midlothian, VA 23112

Number, Street, City, State & ZIP Code

Contact phone (804) 739-3700 Email address Help@PiaNorth.com

29672 VA

Bar number & State

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 7

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 7 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(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..................................................................................... $ 22,571.83

1c. Copy line 63, Total of all property on Schedule A/B............................................................................................... $ 22,571.83

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... $ 14,264.84

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................................. $ 19,291.37

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F............................ $ 69,694.60

Your total liabilities $ 103,250.81

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................................................................................ $ 6,163.90

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

Copy your monthly expenses from line 22c of Schedule J.......................................................................... $ 6,262.66

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) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

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 Document Page 8 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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. $ 9,461.24

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.) $ 19,291.37

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

9d. Student loans. (Copy line 6f.) $ 9,625.00

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. $ 28,916.37

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

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

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 Document Page 9 of 94
Fill in this information to identify your case and this filing:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number  Check if this is an

amended filing

Official Form 106A/B

Schedule A/B: Property 12/15

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.

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

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?

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

3.1 Make: Kia Who has an interest in the property? Check one Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Model: Soul  Debtor 1 only Creditors Who Have Claims Secured by Property.

Year: 2015  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 82,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

Value KBB REAFIRM

Payoff - In client docs

DMV ok

 Check if this is community property $8,800.00 $8,800.00

 (see instructions)

3.2 Make: Dodge Who has an interest in the property? Check one Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Model: Ram  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2001  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 200,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

Value KBB Retain and keep

current

DMV ok

 Check if this is community property $1,854.00 $1,854.00

 (see instructions)

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

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

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

3.3 Make: Scion Who has an interest in the property? Check one Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Model: xB  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2009  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 200,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

Value KBB NO LIENS

 Check if this is community property $3,121.00 $3,121.00

 (see instructions)

3.4 Make: Toyota Who has an interest in the property? Check one Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Model: T-100  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 1995  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 300,000+  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

Valu KBB NO LIENS

 Check if this is community property $344.00 $344.00

 (see instructions)

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

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

 No

 Yes

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.............................................................................=> $14,119.00

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

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

 No

 Yes. Describe.....

Household Goods $3,000.00

7. Electronics

Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners; music collections; electronic devices

including cell phones, cameras, media players, games

 No

 Yes. Describe.....

TVs, desktop, laptop, dvd player, cell phone, tablet $1,000.00

8. Collectibles of value

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

 No

 Yes. Describe.....

Books, Pictures $200.00

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

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 Document Page 11 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

9. Equipment for sports and hobbies

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

musical instruments

 No

 Yes. Describe.....

Fishing poles, rods, tackle boxes & lures $800.00

10. Firearms

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

 No

 Yes. Describe.....

11. Clothes

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

 No

 Yes. Describe.....

Clothes $600.00

12. Jewelry

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

 No

 Yes. Describe.....

Wedding and Engagement Rings $1,200.00

Misc. Costume Jewelry $100.00

13. Non-farm animals

Examples: Dogs, cats, birds, horses

 No

 Yes. Describe.....

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

 No

 Yes. Give specific 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 that number here .............................................................................. $6,900.00

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

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

 No

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

Cash -

Approx. $7.00

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

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 Document Page 12 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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 institution, list each.

 No

 Yes........................ Institution name:

17.1. Bank Account

Navy FCU Checking Account ending 3113 .07

cents

Navy FCU Savings Account ending 7060 - $0 $1.00

17.2. Bank Account C&F Account ending 2873 - $2.83 $2.83

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 information about them...................

Name of entity: % of ownership:

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

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

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

 No

 Yes. Give specific information about them

Issuer name:

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

 Yes. List each account separately.

Type of account: Institution name:

22. Security deposits and prepayments

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

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

 No

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

Rental deposit Security Deposit $1,645 Unknown

23. Annuities (A contract for a 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.

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

 No

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

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

 No

 Yes. Give specific information about them...

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

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

 No

 Yes. Give specific information about them...

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

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 Document Page 13 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

27. Licenses, franchises, and other general intangibles

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

 No

 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.......

ALL Federal and State Tax refunds:

Including Tax year 2018 and all prior

years

2018 Federal Tax refund: OWED $496

2018 Comm VA Tax refund: OWED

$115 Federal & State Unknown

29. Family support

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

 No

 Yes. Give specific information......

30. Other amounts someone owes you

Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers’ compensation, Social Security

benefits; unpaid loans you made to someone else

 No

 Yes. Give specific information..

31. Interests in insurance policies

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

 No

 Yes. Name the insurance company of each policy and list its value.

Company name: Beneficiary: Surrender or refund

value:

Any and all life insurance policies that

the debtor is listed as a beneficiary. Unknown

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

If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receive property because

someone has died.

 No

 Yes. Give specific information..

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

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

 No

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

NO Potential claims or lawsuits Unknown

34. Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights to set off claims

 No

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

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 Document Page 14 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

35. Any financial assets you did not already list

 No

 Yes. Give specific information..

Garnished Funds: $542 withheld pursuant to garnishment

summons. $542.00

Negotiable Instruments or Uncashed checks

Michael & Son's final paycheck. Debtor is unsure of the

actual amount owed to him. $1,000.00

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..................................................................................................................... $1,552.83

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.

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

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

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.

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?

Examples: Season tickets, country club membership

 No

 Yes. Give specific information.........

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 ...................................................................................................................... $0.00

56. Part 2: Total vehicles, line 5 $14,119.00

57. Part 3: Total personal and household items, line 15 $6,900.00

58. Part 4: Total financial assets, line 36 $1,552.83

59. Part 5: Total business-related property, line 45 $0.00

60. Part 6: Total farm- and fishing-related property, line 52 $0.00

61. Part 7: Total other property not listed, line 54 + $0.00

62. Total personal property. Add lines 56 through 61... $22,571.83 Copy personal property total $22,571.83

63. Total of all property on Schedule A/B. Add line 55 + line 62 $22,571.83

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

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 Document Page 15 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

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

(if known)  Check if this is an

amended filing

Official Form 106C

Schedule C: The Property You Claim as Exempt 4/19

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).

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.

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)

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

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Debtor 1 Exemptions

2001 Dodge Ram 200,000 miles

Value KBB Retain and keep current

DMV ok

Line from Schedule A/B: 3.2

$1,854.00  $854.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

2009 Scion xB 200,000 miles

Value KBB NO LIENS

Line from Schedule A/B: 3.3

$3,121.00  $3,121.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

1995 Toyota T-100 300,000+ miles

Valu KBB NO LIENS

Line from Schedule A/B: 3.4

$344.00  $344.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

Household Goods

Line from Schedule A/B: 6.1

$3,000.00  $1,500.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

TVs, desktop, laptop, dvd player, cell

phone, tablet

Line from Schedule A/B: 7.1

$1,000.00  $500.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

Official Form 106C Schedule C: The Property You Claim as Exempt page 1 of 5

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Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Fishing poles, rods, tackle boxes &

lures

Line from Schedule A/B: 9.1

$800.00  $1.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Clothes

Line from Schedule A/B: 11.1

$600.00  $300.00 Va. Code Ann. § 34-26(4)

 100% of fair market value, up to

any applicable statutory limit

Wedding and Engagement Rings

Line from Schedule A/B: 12.1

$1,200.00  $200.00 Va. Code Ann. § 34-26(1a)

 100% of fair market value, up to

any applicable statutory limit

Cash - Approx.

Line from Schedule A/B: 16.1

$7.00  $1.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Rental deposit: Security Deposit

$1,645

Line from Schedule A/B: 22.1

Unknown  $1.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Federal & State: ALL Federal and

State Tax refunds: Including Tax year

2018 and all prior years

2018 Federal Tax refund: OWED $496

2018 Comm VA Tax refund: OWED

$115

Line from Schedule A/B: 28.1

Unknown  Unknown Va. Code Ann. § 34-26(9)

100% of Fair Market Value not

 100% of fair market value, up to to exceed exemption limits

any applicable statutory limit

Federal & State: ALL Federal and

State Tax refunds: Including Tax year

2018 and all prior years

2018 Federal Tax refund: OWED $496

2018 Comm VA Tax refund: OWED

$115

Line from Schedule A/B: 28.1

Unknown  $1.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Any and all life insurance policies

that the debtor is listed as a

beneficiary.

Line from Schedule A/B: 31.1

Unknown  Va. Code Ann. § 38.2-3122

100% of Fair Market Value

 100% of fair market value, up to

any applicable statutory limit

Negotiable Instruments or Uncashed

checks

Michael & Son's final paycheck.

Debtor is unsure of the actual

amount owed to him.

Line from Schedule A/B: 35.2

$1,000.00  $750.00 Va. Code Ann. § 34-29

 100% of fair market value, up to

any applicable statutory limit

Official Form 106C Schedule C: The Property You Claim as Exempt page 2 of 5

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 Document Page 17 of 94
Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Negotiable Instruments or Uncashed

checks

Michael & Son's final paycheck.

Debtor is unsure of the actual

amount owed to him.

Line from Schedule A/B: 35.2

$1,000.00  $250.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

3. Are you claiming a homestead exemption of more than $170,350

(Subject to adjustment on 4/01/22 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 3 of 5

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 Document Page 18 of 94
Fill in this information to identify your case:

Debtor 1

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106C

Schedule C: The Property You Claim as Exempt 4/19

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).

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.

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)

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

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Debtor 2 Exemptions

Household Goods

Line from Schedule A/B: 6.1

$3,000.00  $1,500.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

TVs, desktop, laptop, dvd player, cell

phone, tablet

Line from Schedule A/B: 7.1

$1,000.00  $500.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

Clothes

Line from Schedule A/B: 11.1

$600.00  $300.00 Va. Code Ann. § 34-26(4)

 100% of fair market value, up to

any applicable statutory limit

Wedding and Engagement Rings

Line from Schedule A/B: 12.1

$1,200.00  $1,000.00 Va. Code Ann. § 34-26(1a)

 100% of fair market value, up to

any applicable statutory limit

Misc. Costume Jewelry

Line from Schedule A/B: 12.2

$100.00  $1.00 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 4 of 5

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Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

Cash - Approx.

Line from Schedule A/B: 16.1

$7.00  $6.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Bank Account: C&F Account ending

2873 - $2.83

Line from Schedule A/B: 17.2

$2.83  $2.83 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Rental deposit: Security Deposit

$1,645

Line from Schedule A/B: 22.1

Unknown  $1.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Garnished Funds: $542 withheld

pursuant to garnishment summons.

Line from Schedule A/B: 35.1

$542.00  $542.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

3. Are you claiming a homestead exemption of more than $170,350?

(Subject to adjustment on 4/01/22 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 5 of 5

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 Document Page 20 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106D

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

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).

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.

Part 1: List All Secured Claims

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

Column A

Amount of claim

Do not deduct the

value of collateral.

Column B

Value of collateral

that supports this

claim

Column C

Unsecured

portion

If any

2.1 C&F Finance Company Describe the property that secures the claim: $13,264.84 $8,800.00 $4,464.84

Creditor's Name 2015 Kia Soul 82,000 miles

1313 E Main St Ste 400

Richmond, VA 23219

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

apply.

 Contingent

Number, Street, City, State & Zip Code  Unliquidated

 Disputed

Who owes the debt? Check one. Nature of lien. Check all that apply.

 Debtor 1 only

 Debtor 2 only

 An agreement you made (such as mortgage or secured

car loan)

 Debtor 1 and Debtor 2 only  Statutory lien (such as tax lien, mechanic's lien)

 At least one of the debtors and another  Judgment lien from a lawsuit

 Check if this claim relates to a

community debt

 Other (including a right to offset) Title

Date debt was incurred

Opened

09/16 Last

Active

4/19/19 Last 4 digits of account number 2631

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 2

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Debtor 1 John A. Lundeen Case number (if known)

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

First Name Middle Name Last Name

2.2

Title Max Bankruptcy

Dept Describe the property that secures the claim: $1,000.00 $1,854.00 $0.00

Creditor's Name 2001 Dodge Ram 200,000 miles

TMX Finance LLC

15 Bull St, Ste 200

Savannah, GA 31401

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

apply.

 Contingent

Number, Street, City, State & Zip Code  Unliquidated

 Disputed

Who owes the debt? Check one. Nature of lien. Check all that apply.

 Debtor 1 only

 Debtor 2 only

 An agreement you made (such as mortgage or secured

car loan)

 Debtor 1 and Debtor 2 only  Statutory lien (such as tax lien, mechanic's lien)

 At least one of the debtors and another  Judgment lien from a lawsuit

 Check if this claim relates to a

community debt

 Other (including a right to offset) Title

Date debt was incurred 2017 Last 4 digits of account number 6321

Add the dollar value of your entries in Column A on this page. Write that number here: $14,264.84

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

Write that number here: $14,264.84

Part 2: List Others to Be Notified for a Debt That You Already Listed

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.

Name, Number, Street, City, State & Zip Code

C&f Finance Company

Attn: Bankruptcy Department

1313 E. Main St., Ste 400

Richmond, VA 23219

On which line in Part 1 did you enter the creditor? 2.1 

Last 4 digits of account number 

Name, Number, Street, City, State & Zip Code

TitleMax of Virginia

6221 Hull Street Road

Richmond, VA 23224

On which line in Part 1 did you enter the creditor? 2.2 

Last 4 digits of account number 

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

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 Document Page 22 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(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 Commonwealth of VA-Tax Last 4 digits of account number $149.77 $149.77 $0.00

Priority Creditor's Name

P.O. Box 2156

Richmond, VA 23218-2156

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

 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 year 2013, 2014 & 2016

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 1 of 36

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 26367 Best Case Bankruptcy

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

2.2 Internal Revenue Service Last 4 digits of account number 6321 $19,141.60 $5,080.58 $14,061.02

Priority Creditor's Name

Centralized Insolvency Unit

P O Box 7346

Philadelphia, PA 19101-7346

When was the debt incurred? 2014-2019

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

 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

2006, 2014-2018 Income Tax Return

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 Acceptance Now Last 4 digits of account number 1480 Unknown

Nonpriority Creditor's Name

5501 Headquarters Dr

Plano, TX 75024

When was the debt incurred?

Opened 12/16 Last Active

09/17

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 Rental Agreement

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 36

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.2 American Disposal Services Last 4 digits of account number $96.00

Nonpriority Creditor's Name

PO Box 28150

Miami, FL 33102

When was the debt incurred? 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 Service

4.3 Applied Bank Last 4 digits of account number $1,057.00

Nonpriority Creditor's Name

P.O. Box 11170

Wilmington, DE 19850

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 Account balance

4.4 Auto Credit Of Charl Last 4 digits of account number 1179 Unknown

Nonpriority Creditor's Name

952 Houston Northcutt Blvd.

Mount Pleasant, SC 29464

When was the debt incurred?

Opened 06/09 Last Active

08/11

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 Automobile

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 36

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.5 Banfield Pet Hospital Last 4 digits of account number 8124 $252.00

Nonpriority Creditor's Name

Attn: Billing & Collections

PO Box 13998

Portland, OR 97213

When was the debt incurred?

Opened 12/15 Last Active

07/15

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 Account Balance

4.6 Barry Ekdom PHD Last 4 digits of account number $2,345.00

Nonpriority Creditor's Name

3040 Williams Dr #402

Fairfax, VA 22031

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 Medical

4.7 BetterMed Urgent Care Last 4 digits of account number $60.00

Nonpriority Creditor's Name

PO Box 14099

Belfast, ME 04915

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 36

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.8 Bon Secours Last 4 digits of account number $8,081.00

Nonpriority Creditor's Name

P.O. Box 28538

Richmond, VA 23228

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 Medical bills

4.9 Capital Spine & Pain Center Last 4 digits of account number $115.00

Nonpriority Creditor's Name

3031 Javier Rd Ste 210

Fairfax, VA 22031

When was the debt incurred? 1/24/2011

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

4.1

0 Centreville Childrens Dentist Last 4 digits of account number $81.00

Nonpriority Creditor's Name

14245 Centreville Square

Centreville, VA 20121

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 36

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.1

1 Chesterfield Fire & EMS Last 4 digits of account number $593.00

Nonpriority Creditor's Name

Post Office Box 70

Chesterfield, VA 23832

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 Medical services

4.1

2 Chesterfield Imaging Center Last 4 digits of account number $876.00

Nonpriority Creditor's Name

P.O. Box 13342

Richmond, VA 23225

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 Medical

4.1

3 Children's Book of the Month C Last 4 digits of account number $88.00

Nonpriority Creditor's Name

Customer Service Center

Post Office Box 6404

Camp Hill, PA 17012-6404

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 Account balance

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 36

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

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.1

4 CJW Medical Center Last 4 digits of account number 7388 $9,190.00

Nonpriority Creditor's Name

P.O. Box 13620

Richmond, VA 23225

When was the debt incurred?

Opened 06/17 Last Active

10/16

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

4.1

5 CJW Medical Center Last 4 digits of account number $3,026.13

Nonpriority Creditor's Name

P.O. Box 13620

Richmond, VA 23225

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 Medical

4.1

6 Commonwealth Radiology Last 4 digits of account number $1,140.00

Nonpriority Creditor's Name

1508 William Lawn Drive

Suite 117

Richmond, VA 23230

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 36

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

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.1

7 County Waste Last 4 digits of account number $97.00

Nonpriority Creditor's Name

12230 Deergrove Rd

Midlothian, VA 23112

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 Account balance

4.1

8 Cox Communications Last 4 digits of account number $437.00

Nonpriority Creditor's Name

PO Box 62549

Virginia Beach, VA 23466

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

9 Dermatology Assoc. of NOVA Last 4 digits of account number $22.00

Nonpriority Creditor's Name

13880 Braddock Rd Ste 301

Centreville, VA 20121

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 36

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.2

0 Dish Network Last 4 digits of account number 9256 $335.00

Nonpriority Creditor's Name

PO Box 94063

Palatine, IL 60094

When was the debt incurred?

Opened 02/17 Last Active

03/14

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

4.2

1 Duck's Disposal Last 4 digits of account number $50.00

Nonpriority Creditor's Name

P.O. Box 5657

Midlothian, VA 23112

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

4.2

2 EMA Novant Health Last 4 digits of account number 3342 $770.00

Nonpriority Creditor's Name

20010 Century Blvd Ste 200

Germantown, MD 20874

When was the debt incurred?

Opened 04/15 Last Active

11/13

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

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 9 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 31 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.2

3 Fair Oaks Anesthesia Last 4 digits of account number 2019 $40.00

Nonpriority Creditor's Name

3998 Fair Ridge Dr

Fairfax, VA 22033

When was the debt incurred?

Opened 01/12 Last Active

09/11

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

4.2

4 Fair Oaks ER Physicians Last 4 digits of account number $795.00

Nonpriority Creditor's Name

3600 Joseph Siewick Dr

Fairfax, VA 22033

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 Medical

4.2

5 Fair Oaks Orthopaedic Assoc. Last 4 digits of account number $15.00

Nonpriority Creditor's Name

3620 Joseph Siewick Dr Ste 201

Fairfax, VA 22033

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 10 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 32 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.2

6 Fairfax Radiological Consult Last 4 digits of account number $40.00

Nonpriority Creditor's Name

2722 Merritee Dr Ste 230

Fairfax, VA 22031

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 Medical

4.2

7 Family Medicine of Clifton/Cen Last 4 digits of account number $80.00

Nonpriority Creditor's Name

6201 Centreville Rd #100

Centreville, VA 20121

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 Medical

4.2

8 FedLoan Servicing Last 4 digits of account number 0002 $1,957.00

Nonpriority Creditor's Name

Po Box 60610

Harrisburg, PA 17106

When was the debt incurred?

Opened 09/05 Last Active

4/30/19

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

Educational

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 11 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 33 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.2

9 FedLoan Servicing Last 4 digits of account number 0001 $7,668.00

Nonpriority Creditor's Name

Po Box 60610

Harrisburg, PA 17106

When was the debt incurred?

Opened 07/01 Last Active

4/30/19

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

Educational

4.3

0 First Premier Bank Last 4 digits of account number 0828 $413.12

Nonpriority Creditor's Name

Post Office Box 5147

Sioux Falls, SD 57117-5147

When was the debt incurred?

Opened 05/17 Last Active

8/11/17

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

4.3

1 First Premier Bank Last 4 digits of account number 0828 $345.00

Nonpriority Creditor's Name

3820 N Louise Ave

Sioux Falls, SD 57107

When was the debt incurred?

Opened 5/19/17 Last Active

09/17

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 12 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 34 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.3

2 FOAA Anesthesia Services Last 4 digits of account number $40.00

Nonpriority Creditor's Name

3998 Fair Ridge Dr

Ste 300

Fairfax, VA 22033

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 Medical

4.3

3 Focused Recovery Solutions Last 4 digits of account number 1676 $276.00

Nonpriority Creditor's Name

9701 Metropolitan Court

Richmond, VA 23236

When was the debt incurred? Opened 2/11/14

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

4.3

4 Focused Recovery Solutions Last 4 digits of account number 2973 $287.00

Nonpriority Creditor's Name

9701 Metropolitan Court

Richmond, VA 23236

When was the debt incurred? Opened 1/02/13

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

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 13 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 35 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.3

5 Focused Recovery Solutions Last 4 digits of account number 5909 $409.00

Nonpriority Creditor's Name

9701 Metropolitan Court

Richmond, VA 23236

When was the debt incurred? Opened 12/31/12

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

4.3

6 Gastrointestinal Medicine Asso Last 4 digits of account number 9001 $70.00

Nonpriority Creditor's Name

3620 Joseph Siewick Dr

Ste 307

Fairfax, VA 22033

When was the debt incurred?

Opened 06/13 Last Active

08/11

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

4.3

7 Geico Last 4 digits of account number $214.00

Nonpriority Creditor's Name

One Geico Plaza

Bethesda, MD 20811-0001

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 Account balance

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 14 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 36 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.3

8 Henrico Doctors Hospital Last 4 digits of account number $700.00

Nonpriority Creditor's Name

PO Box 740760

Cincinnati, OH 45274

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 Medical

4.3

9

Inova Last 4 digits of account number $25.00

Nonpriority Creditor's Name

PO Box 37013

Baltimore, MD 21297

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 Medical

4.4

0

Inova Fair Oaks Hospital Last 4 digits of account number $1,310.00

Nonpriority Creditor's Name

3600 Joseph Siewick Dr

Fairfax, VA 22033

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 15 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 37 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.4

1

Inova Fair Oaks Hospital Last 4 digits of account number $100.00

Nonpriority Creditor's Name

PO Box 37013

Baltimore, MD 21297

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 Medical

4.4

2

Inova Fairfax Hospital Last 4 digits of account number $741.00

Nonpriority Creditor's Name

3300 Gallows Road

Falls Church, VA 22042

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 Medical

4.4

3

Inpatient Medical Services Last 4 digits of account number $404.00

Nonpriority Creditor's Name

P.O. Box 41367

Houston, TX 77240

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 16 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 38 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.4

4 James Hurst, DPM Last 4 digits of account number $128.00

Nonpriority Creditor's Name

5729 Centre Square Dr

Centreville, VA 20120

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 Medical

4.4

5 James River Emergency Group Last 4 digits of account number $791.00

Nonpriority Creditor's Name

PO Box 660827

Dallas, TX 75266

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 Medical

4.4

6 Liberty Mutual Last 4 digits of account number $547.00

Nonpriority Creditor's Name

PO Box 970

Mishawaka, IN 46546

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 Account balance

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 17 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 39 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.4

7 MedExpress Urgent Care Last 4 digits of account number $199.00

Nonpriority Creditor's Name

11603 Midlothian Turnpike

Midlothian, VA 23113

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 Medical

4.4

8 Memorial Health Last 4 digits of account number $1,053.00

Nonpriority Creditor's Name

4700 Waters Ave

Savannah, GA 31414

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 Medical

4.4

9 Neurological Associates Last 4 digits of account number $590.00

Nonpriority Creditor's Name

PO Box 668

Brentwood, TN 37024

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 18 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 40 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.5

0 Neuroscience Consultants PC Last 4 digits of account number $2,000.00

Nonpriority Creditor's Name

12007 Sunrise Valley Dr

Ste 120

Reston, VA 20191

When was the debt incurred? 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 Medical

4.5

1 NoVa Oral Surgery Last 4 digits of account number $113.00

Nonpriority Creditor's Name

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 Medical

4.5

2 Novant Health PW Medical Ctr Last 4 digits of account number $250.00

Nonpriority Creditor's Name

8700 Sudley Rd

Manassas, VA 20110

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 19 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 41 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.5

3 Novec Last 4 digits of account number $130.00

Nonpriority Creditor's Name

10223 Lomond Dr

Manassas, VA 20109

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

4.5

4 One Hampton Medical Last 4 digits of account number $486.00

Nonpriority Creditor's Name

PO Box 3475

Toledo, OH 43607

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 Medical

4.5

5 Ortho Virginia Last 4 digits of account number $150.00

Nonpriority Creditor's Name

PO Box 17047

Baltimore, MD 21297

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 20 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 42 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.5

6 Patient First Last 4 digits of account number 3705 $348.45

Nonpriority Creditor's Name

P.O. Box 758941

Baltimore, MD 21275

When was the debt incurred?

Opened 12/14 Last Active

10/14

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

4.5

7 Patient First Last 4 digits of account number $145.00

Nonpriority Creditor's Name

P.O. Box 758941

Baltimore, MD 21275

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 Medical

4.5

8 Patient First Last 4 digits of account number 2974 $112.00

Nonpriority Creditor's Name

P.O. Box 758941

Baltimore, MD 21275

When was the debt incurred?

Opened 05/18 Last Active

11/17

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

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 21 of 36

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 Document Page 43 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.5

9 Physical Medicine Associates Last 4 digits of account number $155.00

Nonpriority Creditor's Name

P.O. Box 713666

Cincinnati, OH 45271

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 Medical

4.6

0 PNC Bank, N.A. Last 4 digits of account number $877.00

Nonpriority Creditor's Name

Post Office Box 747066

Pittsburgh, PA 15274-7066

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 Account Balance

4.6

1 Professional Emerg Care Last 4 digits of account number 0018 $544.00

Nonpriority Creditor's Name

2987 Momentum Place

Chicago, IL 60689-5329

When was the debt incurred? Opened 02/17

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

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 22 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 44 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.6

2 Professional Emerg Care Last 4 digits of account number 8528 $218.00

Nonpriority Creditor's Name

PO Box 3475

Toledo, OH 43607

When was the debt incurred? Opened 02/17

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

4.6

3 Progressive Insurance Last 4 digits of account number $231.00

Nonpriority Creditor's Name

200 Westgate Pkwy

Ste. 310

Henrico, VA 23233

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 Account balance

4.6

4 Quest Diagnostics Last 4 digits of account number $35.00

Nonpriority Creditor's Name

P. O. Box 64797

Baltimore, MD 21264

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 23 of 36

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

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 Document Page 45 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.6

5 Radiology Assc of Richmond Last 4 digits of account number $222.00

Nonpriority Creditor's Name

2602 Buford Road

Richmond, VA 23235

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 Medical

4.6

6 Rocky Run Family Medicine Last 4 digits of account number $30.00

Nonpriority Creditor's Name

5645 Stone Rd

Centreville, VA 20120

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 Medical

4.6

7 Skinner, Ossakow & Assoc DDS Last 4 digits of account number $126.00

Nonpriority Creditor's Name

5651 Stone Rd

Centreville, VA 20120

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 24 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 46 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.6

8 St Francis Medical Center Last 4 digits of account number $1,174.00

Nonpriority Creditor's Name

P.O. Box 404893

Atlanta, GA 30384

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 Medical

4.6

9 St Francis Medical Center Last 4 digits of account number $792.00

Nonpriority Creditor's Name

P.O. Box 404893

Atlanta, GA 30384

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 Medical

4.7

0 Surgical Assoc of Richmond Last 4 digits of account number Unknown

Nonpriority Creditor's Name

PO Box 759336

Baltimore, MD 21275-9336

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 Medical - Debtor believes this was satisfied

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 25 of 36

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

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 Document Page 47 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.7

1 The Little Clinic Last 4 digits of account number $29.00

Nonpriority Creditor's Name

2620 Elm Hill Pike

Nashville, TN 37214

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 Medical

4.7

2 The Money Tree/rinco Last 4 digits of account number 0293 $0.00

Nonpriority Creditor's Name

When was the debt incurred?

Opened 07/08 Last Active

06/09

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 Note Loan

4.7

3 The Pediatric Group Last 4 digits of account number $45.00

Nonpriority Creditor's Name

13001 Summit School Rd

Ste A

Woodbridge, VA 22192

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 26 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 48 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.7

4 The Women's Club Last 4 digits of account number $765.00

Nonpriority Creditor's Name

14175 Sullyfield Cir

Unit 100

Chantilly, VA 20151

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 Account balance

4.7

5 Verizon Last 4 digits of account number 0001 $345.30

Nonpriority Creditor's Name

Po Box 650584

Dallas, TX 75265

When was the debt incurred?

Opened 01/14 Last Active

5/19/17

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 Agriculture

4.7

6 Verizon Last 4 digits of account number $277.60

Nonpriority Creditor's Name

500 Technology Dr Ste 550

Saint Charles, MO 63304

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

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 27 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 49 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.7

7 Verizon Last 4 digits of account number 0001 $288.00

Nonpriority Creditor's Name

500 Technology Dr

Weldon Spring, MO 63304

When was the debt incurred?

Opened 1/06/14 Last Active

5/19/17

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 Agriculture

4.7

8 Virginia Emergency Phy Last 4 digits of account number 69N1 $55.00

Nonpriority Creditor's Name

75 Remittance Drive

Suite 1151

Chicago, IL 60675

When was the debt incurred?

Opened 07/17 Last Active

09/13

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

4.7

9 Virginia Physicians Last 4 digits of account number $100.00

Nonpriority Creditor's Name

Rhematology Division

7650 E Parham Rd #304

Henrico, VA 23294

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 28 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 50 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.8

0 Virginia Radiology Assoc Last 4 digits of account number $770.00

Nonpriority Creditor's Name

8629 Sudley Rd Ste 102

Manassas, VA 20110

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 Medical

4.8

1 Washington Gas & Light Last 4 digits of account number $311.00

Nonpriority Creditor's Name

Attn: Rosallin Boutte

6801 Industrial Road

Springfield, VA 22151

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 Account balance

4.8

2 West End Anesthesia Group Last 4 digits of account number $2,288.00

Nonpriority Creditor's Name

5855 Bremo Rd

Ste 100

Richmond, VA 23226

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 Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 29 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 51 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

4.8

3 Michael D. Wilburn Last 4 digits of account number $8,250.00

Nonpriority Creditor's Name

2740 East Brigstock Rd

Midlothian, VA 23113

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 Unpaid Rent - Judgment 3/2017

4.8

4 Zan's Refuse Services Last 4 digits of account number $84.00

Nonpriority Creditor's Name

PO Box 651

Midlothian, VA 23113

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 Account balance

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?

Acceptance Now

Attn: Bankruptcy

5501 Headquarters Drive

Plano, TX 75024

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?

AFNI

404 Brock Drive

P.O. Box 3097

Bloomington, IL 61702

Line 4.75 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?

Allied Interstate

P. O. Box 361317

Columbus, OH 43236

Line 4.20 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?

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 30 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 52 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

AMCA

4 Westchester Plaza

Building 4

Elmsford, NY 10523

Line 4.64 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?

BCC Financial Management

PO Box 590067

Fort Lauderdale, FL 33359

Line 4.68 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?

Berk Credit & Collections

PO Box 329

Temple, PA 19560

Line 4.32 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?

Berks Credit & Collections

Po Box 329

Temple, PA 19560

Line 4.23 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?

Bon Secours

P.O. Box 28538

Richmond, VA 23228

Line 4.69 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?

Caine & Weiner

Po Box 5010

Woodland Hills, CA 91365

Line 4.63 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?

Capio Partners LLC

2222 Texoma Pkwy

Ste 150

Sherman, TX 75090

Line 4.14 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?

Capio Partners Llc

Attn: Bankruptcy

Po Box 3498

Sherman, TX 75091

Line 4.61 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?

Capio Partners Llc

Attn: Bankruptcy

Po Box 3498

Sherman, TX 75091

Line 4.62 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?

Cash Flow Management

PO Box 740776

Cincinnati, OH 45274

Line 4.65 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?

CMRE Financial Serives

3075 E. Imperial Hwy #200

Brea, CA 92821

Line 4.59 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 31 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 53 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

Coast to Coast Financial Solut

101 Hodencamp Rd #120

Thousand Oaks, CA 91360

Line 4.17 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?

Commonwealth Financial Systems

245 Main St

Dickson City, PA 18519

Line 4.78 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?

Complete Collection Service

P. O. Box 10052

Alexandria, VA 22310

Line 4.39 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?

Credit Collection Services

PO Box 9134

Needham Heights, MA 02494

Line 4.37 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?

Credit Control Corp

P. O. Box 409553

Atlanta, GA 30384

Line 4.18 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?

Durham & Durham LLP

5665 New Northside Drie

Ste 510

Atlanta, GA 30328

Line 4.45 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?

FedLoan Servicing

Attn: Bankruptcy

Po Box 69184

Harrisburg, PA 17106

Line 4.28 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?

FedLoan Servicing

Attn: Bankruptcy

Po Box 69184

Harrisburg, PA 17106

Line 4.29 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?

First National Collection

P.O. Box 4115

Concord, CA 94524

Line 4.3 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?

First Premier Bank

Attn: Bankruptcy

Po Box 5524

Sioux Falls, SD 57117

Line 4.31 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?

Focused Recovery Solutions

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

Line 4.14 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 32 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 54 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Last 4 digits of account number

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

Focused Recovery Solutions

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

Line 4.33 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?

Focused Recovery Solutions

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

Line 4.34 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?

Focused Recovery Solutions

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

Line 4.35 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?

Fst Premier

601 S Minneapolis Ave

Sioux Falls, SD 57104

Line 4.30 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?

Gilliam Law Group

7821 Ironbridge Rd North

Richmond, VA 23237

Line 4.70 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?

Healthcare Collection LLC

2224 W Northern Ave

Ste D100

Phoenix, AZ 85021

Line 4.9 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?

Horizon Financial Mangement

Attention: Bankruptcy Dept.

9980 Georgia Street

Crown Point, IN 46307

Line 4.68 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?

I.C. System Inc.

Po Box 64378

Saint Paul, MN 55164

Line 4.5 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?

I.c. System Inc.

Po Box 64378

Saint Paul, MN 55164

Line 4.36 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?

INOVA Health System

2990 Teleston Ct

Falls Church, VA 22042

Line 4.39 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?

INOVA Health System Line 4.40 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 33 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 55 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

2990 Teleston Ct

Falls Church, VA 22042

 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?

Jefferson Capital Syst

16 Mcleland Rd

Saint Cloud, MN 56303

Line 4.30 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?

Lhr Inc

1 Main Street

Hamburg, NY 14075

Line 4.60 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?

Lvnv Funding

P.O. Box 10584

Greenville, SC 29603

Line 4.30 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?

Medicredit Corporation

P. O. Box 411187

Saint Louis, MO 63141

Line 4.14 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?

Midland Funding

8875 Aero Dr Ste 200

San Diego, CA 92123

Line 4.76 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?

MiraMed

991 Oak Creek Dr

Lombard, IL 60148

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?

Nationwide Credit Corp.

5503 Cherokee Ave

Alexandria, VA 22312

Line 4.74 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?

NCO Financial

P. O. Box 15740

Wilmington, DE 19850

Line 4.47 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?

NPAS Inc.

PO Box 99400

Louisville, KY 40269

Line 4.14 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?

Receivable Management Inc

7206 Hull Rd

Ste 211

Richmond, VA 23235

Line 4.56 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?

Receivable Management Inc

7206 Hull Rd

Ste 211

Line 4.58 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 34 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 56 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Richmond, VA 23235

Last 4 digits of account number

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

Receivables Management Systems

PO Box 8630

Richmond, VA 23226-0630

Line 4.57 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?

Receivables Outsourcing LLC

PO Box 549

Lutherville Timonium, MD 21094

Line 4.69 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?

Rjm Acq Llc

575 Underhill Blvd Ste 2

Syosset, NY 11791

Line 4.13 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?

Stellar Recovery Inc

Attn: Bankruptcy

4500 Salisbury Road Ste 105

Jackonville, FL 32216

Line 4.20 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?

Suburban Credit Corporation

Post Office Box 30640

6142 Franconia Road

Alexandria, VA 22310-2521

Line 4.42 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?

Transworld Sys Inc

507 Prudential Rd

Horsham, PA 19044

Line 4.55 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?

United Consumers

P.O. Box 4466

Woodbridge, VA 22194-4466

Line 4.40 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?

United Consumers

PO Box 4466

Woodbridge, VA 22194

Line 4.80 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?

United Consumers, Inc

14205 Telegraph Rd

Woodbridge, VA 22192

Line 4.22 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?

Verizon

Verizon Wireless Bankruptcy

Administrati

500 Tecnolgy Dr Ste 500

Weldon Springs, MO 63304

Line 4.75 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?

Verizon Line 4.77 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 35 of 36

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 57 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Verizon Wireless Bk Admin

500 Technology Dr Ste 550

Weldon Springs, MO 63304

 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. $ 19,291.37

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. $ 19,291.37

Total Claim

6f. Student loans 6f. $ 9,625.00

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.

$ 60,069.60

6j. Total Nonpriority. Add lines 6f through 6i. 6j. $ 69,694.60

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 36 of 36

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Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 58 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106G

Schedule G: Executory Contracts and Unexpired Leases 12/15

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).

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 contacts of leases are listed on Schedule A/B:Property (Official Form 106 A/B).

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

Name, Number, Street, City, State and ZIP Code

State what the contract or lease is for

2.1 Michael D. Wilburn

2740 E. Brigstock Rd

Midlothian, VA 23113

Residential Lease

2.2 Young Soohan Residential Lease ASSUME

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

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 59 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

Official Form 106H

Schedule H: Your Codebtors 12/15

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.

1. Do you have any codebtors? (If you are filing a joint case, do not list either spouse as a codebtor.

 No

 Yes

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?

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

Name, Number, Street, City, State and ZIP Code

Column 2: The creditor to whom you owe the debt

Check all schedules that apply:

3.1  Schedule D, line

Name  Schedule E/F, line

 Schedule G, line

Number Street

City State ZIP Code

3.2  Schedule D, line

Name  Schedule E/F, line

 Schedule G, line

Number Street

City State ZIP Code

Official Form 106H Schedule H: Your Codebtors Page 1 of 1

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 60 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

Debtor 2 Jennifer M. Lundeen

(Spouse, if filing)

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number Check if this is:

(If known)  An amended filing

 A supplement showing postpetition chapter

13 income as of the following date:

Official Form 106I MM / DD/ YYYY

Schedule I: Your Income 12/15

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.

Part 1: Describe Employment

1. Fill in your employment

information. Debtor 1 Debtor 2 or non-filing spouse

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.

Employment status

 Employed

 Not employed

 Employed

 Not employed

Occupation Property Management Architectural Design & Drafting

Employer's name HRG Management Services TM Vavra Associates, PC

Employer's address 5065 Craig Rath Boulevard

Midlothian, VA 23112

How long employed there? May 2019 January 2015

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.

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.

For Debtor 1 For Debtor 2 or

non-filing spouse

2.

List monthly gross wages, salary, and commissions (before all payroll

deductions). If not paid monthly, calculate what the monthly wage would be. 2. $ 3,813.33 $ 5,076.63

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

4. Calculate gross Income. Add line 2 + line 3. 4. $ 3,813.33 $ 5,076.63

Official Form 106I Schedule I: Your Income page 1

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 61 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

For Debtor 1 For Debtor 2 or

non-filing spouse

Copy line 4 here 4. $ 3,813.33 $ 5,076.63

5. List all payroll deductions:

5a. Tax, Medicare, and Social Security deductions 5a. $ 782.43 $ 936.91

5b. Mandatory contributions for retirement plans 5b. $ 0.00 $ 0.00

5c. Voluntary contributions for retirement plans 5c. $ 0.00 $ 0.00

5d. Required repayments of retirement fund loans 5d. $ 0.00 $ 0.00

5e. Insurance 5e. $ 1,006.72 $ 0.00

5f. Domestic support obligations 5f. $ 0.00 $ 0.00

5g. Union dues 5g. $ 0.00 $ 0.00

5h. Other deductions. Specify: 5h.+ $ 0.00 + $ 0.00

6. Add the payroll deductions. Add lines 5a+5b+5c+5d+5e+5f+5g+5h. 6. $ 1,789.15 $ 936.91

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. $ 2,024.18 $ 4,139.72

8. List all other income regularly received:

8a. 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. 8a. $ 0.00 $ 0.00

8b. Interest and dividends 8b. $ 0.00 $ 0.00

8c. 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. 8c. $ 0.00 $ 0.00

8d. Unemployment compensation 8d. $ 0.00 $ 0.00

8e. Social Security 8e. $ 0.00 $ 0.00

8f. Other government assistance that you regularly receive

Include cash assistance and the value (if known) of any non-cash assistance

that you receive, such as food stamps (benefits under the Supplemental

Nutrition Assistance Program) or housing subsidies.

Specify: 8f. $ 0.00 $ 0.00

8g. Pension or retirement income 8g. $ 0.00 $ 0.00

8h. Other monthly income. Specify: 8h.+ $ 0.00 + $ 0.00

9. Add all other income. Add lines 8a+8b+8c+8d+8e+8f+8g+8h. 9. $ 0.00 $ 0.00

10. Calculate monthly income. Add line 7 + line 9. 10. $ 2,024.18 + $ 4,139.72 = $ 6,163.90

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

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

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.

Specify: 11. +$ 0.00

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

12. $ 6,163.90

Write that amount on the Summary of Schedules and Statistical Summary of Certain Liabilities and Related Data, if it

applies

Combined

monthly income

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

 No.

 Yes. Explain: See Schedule J

Official Form 106I Schedule I: Your Income page 2

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 62 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen Check if this is:

 An amended filing

Debtor 2 Jennifer M. Lundeen  A supplement showing postpetition chapter

(Spouse, if filing) 13 expenses as of the following date:

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA MM / DD / YYYY

Case number

(If known)

Official Form 106J

Schedule J: Your Expenses 12/15

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.

Part 1: Describe Your Household

1. Is this a joint case?

 No. Go to line 2.

 Yes. Does Debtor 2 live in a separate household?

 No

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

2. Do you have dependents?  No

Do not list Debtor 1 and

Debtor 2.

 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?

Do not state the

dependents names. Daughter 3/2003

 No

 Yes

 No

 Yes

 No

 Yes

 No

 Yes

3. Do your expenses include

expenses of people other than

yourself and your dependents?

 No

 Yes

Part 2: Estimate Your Ongoing Monthly Expenses

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.) 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. $ 1,670.00

If not included in line 4:

4a. Real estate taxes 4a. $ 0.00

4b. Property, homeowner’s, or renter’s insurance 4b. $ 0.00

4c. Home maintenance, repair, and upkeep expenses 4c. $ 50.00

4d. Homeowner’s association or condominium dues 4d. $ 0.00

5. Additional mortgage payments for your residence, such as home equity loans 5. $ 0.00

Official Form 106J Schedule J: Your Expenses page 1

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 63 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

6. Utilities:

6a. Electricity, heat, natural gas 6a. $ 280.00

6b. Water, sewer, garbage collection 6b. $ 65.00

6c. Telephone, cell phone, Internet, satellite, and cable services 6c. $ 440.00

6d. Other. Specify: 6d. $ 0.00

7. Food and housekeeping supplies 7. $ 1,034.00

8. Childcare and children’s education costs 8. $ 120.00

9. Clothing, laundry, and dry cleaning 9. $ 169.00

10. Personal care products and services 10. $ 200.00

11. Medical and dental expenses 11. $ 500.00

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

Do not include car payments. 12. $ 433.33

13. Entertainment, clubs, recreation, newspapers, magazines, and books 13. $ 200.00

14. Charitable contributions and religious donations 14. $ 0.00

15. Insurance.

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

15a. Life insurance 15a. $ 0.00

15b. Health insurance 15b. $ 0.00

15c. Vehicle insurance 15c. $ 370.00

15d. Other insurance. Specify: 15d. $ 0.00

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

Specify: Personal Property Tax $400/year 16. $ 33.33

17. Installment or lease payments:

17a. Car payments for Vehicle 1 17a. $ 328.00

17b. Car payments for Vehicle 2 17b. $ 0.00

17c. Other. Specify: Misc. Expenses 17c. $ 150.00

17d. Other. Specify: Tolls 17d. $ 50.00

Vehicle upkeep 2001 & 2015 $ 170.00

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

deducted from your pay on line 5, Schedule I, Your Income (Official Form 106I). 18. $ 0.00

19. Other payments you make to support others who do not live with you. $ 0.00

Specify: 19.

20. Other real property expenses not included in lines 4 or 5 of this form or on Schedule I: Your Income.

20a. Mortgages on other property 20a. $ 0.00

20b. Real estate taxes 20b. $ 0.00

20c. Property, homeowner’s, or renter’s insurance 20c. $ 0.00

20d. Maintenance, repair, and upkeep expenses 20d. $ 0.00

20e. Homeowner’s association or condominium dues 20e. $ 0.00

21. Other: Specify: 21. +$ 0.00

22. Calculate your monthly expenses

22a. Add lines 4 through 21. $ 6,262.66

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. $ 6,262.66

23. Calculate your monthly net income.

23a. Copy line 12 (your combined monthly income) from Schedule I. 23a. $ 6,163.90

23b. Copy your monthly expenses from line 22c above. 23b. -$ 6,262.66

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

The result is your monthly net income. 23c. $ -98.76

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

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?

 No.

 Yes. Explain here: The Debtors anticipate the following changes to income or expenses: Husband is no longer

working for Michael & Son's. He is making approx. $571 less monthly. He no longer receives commision

and earns $22 an hour for a 40 hour work week.

HH Size: 4

Son is 18 and just finished school. He is trying to find employment, but is currenly unemployed.

Official Form 106J Schedule J: Your Expenses page 2

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 64 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(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/ John A. Lundeen X /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Date May 13, 2019 Date May 13, 2019

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 65 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(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

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)

From January 1 of current year until

the date you filed for bankruptcy:

 Wages, commissions,

bonuses, tips

 Operating a business

$11,615.50  Wages, commissions,

bonuses, tips

 Operating a business

$21,703.50

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 66 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

$50,000.00  Wages, commissions,

bonuses, tips

 Operating a business

$60,000.00

For last calendar year:

(January 1 to December 31, 2018 )

 Wages, commissions,

bonuses, tips

 Operating a business

$46,254.00  Wages, commissions,

bonuses, tips

 Operating a business

$60,002.00

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)

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.

 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 ...

Young Soohan March 2019 - May

2019

Monthly Rent

$1,670 x 3

$5,010.00 $0.00  Mortgage

 Car

 Credit Card

 Loan Repayment

 Suppliers or vendors

 Other Rent 

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 67 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Creditor's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Was this payment for ...

C & F Finance Company

1313 E Main St Ste 400

Richmond, VA 23219

March 2019 - May

2019

Monthly payment

$328 x 3

$984.00 $13,612.85  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

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

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

Michael D. Wilburn

2740 E. Brigstock Rd

Midlothian, VA 23113

Pending Garnishment

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

Pending

hearing on

October 7,

2019

Unknown

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 68 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

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

North Law Bar# 29672

5913 Harbour Park Drive

Midlothian, VA 23112

www.pianorth.com

TOTAL Received: $ 2,500

Fees: $458.70 (includes USB filing fee,

credit report, credit counseling, due

diligence reports, debtor education,

Circuit Court filing fee and Priority mail

for Homestead deed).

Attorney fee = $ 2,041.30

May 2019 $2,500.00

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 69 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

None There have been NO

transfers of property in the

last three years.

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

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

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?

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 70 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

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

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

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 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 71 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

 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

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

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/ John A. Lundeen /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Date May 13, 2019 Date May 13, 2019

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 7

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 72 of 94
Fill in this information to identify your case:

Debtor 1 John A. Lundeen

First Name Middle Name Last Name

Debtor 2 Jennifer M. Lundeen

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number

(if known)  Check if this is an

amended filing

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 C&F Finance Company  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement. Description of 2015 Kia Soul 82,000 miles

property  Retain the property and [explain]:

securing debt:

Creditor's Title Max Bankruptcy Dept  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 2001 Dodge Ram 200,000 miles Reaffirmation Agreement.

property  Retain the property and [explain]:

securing debt: Retain & Keep Current

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?

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

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Lessor's name: Michael D. Wilburn  No

 Yes

Description of leased

Property:

Residential Lease

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.

X /s/ John A. Lundeen X /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Date May 13, 2019 Date May 13, 2019

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

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United States Bankruptcy Court

Eastern District of Virginia

In re

John A. Lundeen

Jennifer M. Lundeen Case No.

Debtor(s) Chapter 7

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

1. Pursuant to 11 U.S.C. § 329(a) and Bankruptcy Rule 2016(b), I certify that I am the attorney for the above-named debtor(s) and that

compensation 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:

For legal services, I have agreed to accept $ 2,041.30

Prior to the filing of this statement I have received $ 2,041.30

Balance Due $ 0.00

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 a 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, statement 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;

d. Other provisions as needed:

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

Negotiations with secured creditors to reduce to market value; exemption planning; preparation and filing of

reaffirmation agreements and applications as needed; preparation and filing of motions pursuant to 11 USC 522

for avoidance of liens.

Representation for above-referenced fees are subject to firm's effective hourly rates or a percentage of recovery

if additional legal services are required such as attendance of continued hearings, additional notices to creditors,

negotiations, settlements, filing Motions or Adversarial Proceedings and additional legal research.

Representation of the debtors in any motions, dischargeability actions, judicial lien avoidances, redemption,

reaffirmation, relief from stay actions, adversary proceedings, actions for sanctions and civil contempt due to

creditor misconduct, actions to avoid Judicial liens, Adversary Proceedings, negotiations or actions to avoid

Preferential Transfers, actions in any appeals court including the Virginia Court of Appeals, the Supreme Court of

Virginia and the United States Supreme Court.

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CERTIFICATION

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.

May 13, 2019 /s/ Pia J. North

Date Pia J. North 29672

Signature of Attorney

North Law Bar# 29672

Name of Law Firm

5913 Harbour Park Drive

Midlothian, VA 23112

(804) 739-3700 Fax: (804) 739-2550

[2030edva ver. 01/19]

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 Document Page 76 of 94
Fill in this information to identify your case: Check one box only as directed in this form and in Form

122A-1Supp: Debtor 1 John A. Lundeen

 1. There is no presumption of abuse

 2. The calculation to determine if a presumption of abuse

applies will be made under Chapter 7 Means Test

Calculation (Official Form 122A-2).

 3. The Means Test does not apply now because of

qualified military service but it could apply later.

Debtor 2 Jennifer M. Lundeen

(Spouse, if filing)

United States Bankruptcy Court for the: Eastern District of Virginia

Case number

(if known)

 Check if this is an amended filing

Official Form 122A - 1

Chapter 7 Statement of Your Current Monthly Income 12/15

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). If you believe that you are exempted from a presumption of abuse because you do not have primarily consumer debts or because of

qualifying military service, complete and file Statement of Exemption from Presumption of Abuse Under § 707(b)(2) (Official Form 122A-1Supp) with this form.

Part 1: Calculate Your Current Monthly Income

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

 Not married. Fill out Column A, lines 2-11.

 Married and your spouse is filing with you. Fill out both Columns A and B, lines 2-11.

 Married and your spouse is NOT filing with you. You and your spouse are:

 Living in the same household and are not legally separated. Fill out both Columns A and B, lines 2-11.

 Living separately or are legally separated. Fill out Column A, lines 2-11; do not fill out Column B. By checking this box, you declare under

penalty of perjury that you and your spouse are legally separated under nonbankruptcy law that applies or that you and your spouse are

living apart for reasons that do not include evading the Means Test requirements. 11 U.S.C § 707(b)(7)(B).

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 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.

Column A

Debtor 1

Column B

Debtor 2 or

non-filing spouse

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

payroll deductions). $ 4,384.61 $ 5,076.63

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

Column B is filled in. $ 0.00 $ 0.00

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

of you or your dependents, including child support. Include regular contributions

from an unmarried partner, members of your household, your dependents, parents,

and roommates. Include regular contributions from a spouse only if Column B is not

filled in. Do not include payments you listed on line 3. $ 0.00 $ 0.00

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

Debtor 1

Gross receipts (before all deductions) $ 0.00

Ordinary and necessary operating expenses -$ 0.00

Net monthly income from a business, profession, or farm $ 0.00 Copy here -> $ 0.00 $ 0.00

6. Net income from rental and other real property

Debtor 1

Gross receipts (before all deductions) $ 0.00

Ordinary and necessary operating expenses -$ 0.00

Net monthly income from rental or other real property $ 0.00 Copy here -> $ 0.00 $ 0.00

7. Interest, dividends, and royalties $ 0.00 $ 0.00

Official Form 122A-1 Chapter 7 Statement of Your Current Monthly Income page 1

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Column A

Debtor 1

Column B

Debtor 2 or

non-filing spouse

8. Unemployment compensation $ 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:

For you $ 0.00

For your spouse $ 0.00

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

benefit under the Social Security Act. $ 0.00 $ 0.00

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

. $ 0.00 $ 0.00

$ 0.00 $ 0.00

Total amounts from separate pages, if any. + $ 0.00 $ 0.00

11. Calculate your total current monthly income. Add lines 2 through 10 for

each column. Then add the total for Column A to the total for Column B. $ 4,384.61 + $ 5,076.63 = $ 9,461.24

Total current monthly

income

Part 2: Determine Whether the Means Test Applies to You

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

12a. Copy your total current monthly income from line 11 Copy line 11 here=> $ 9,461.24

Multiply by 12 (the number of months in a year) x 12

12b. The result is your annual income for this part of the form 12b. $

113,534.88

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

Fill in the state in which you live. VA

Fill in the number of people in your household. 4

Fill in the median family income for your state and size of household. 13. $

105,261.00

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.

14. How do the lines compare?

14a.  Line 12b is less than or equal to line 13. On the top of page 1, check box 1, There is no presumption of abuse.

Go to Part 3.

14b.  Line 12b is more than line 13. On the top of page 1, check box 2, The presumption of abuse is determined by Form 122A-2.

Go to Part 3 and fill out Form 122A-2.

Part 3: Sign Below

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

X /s/ John A. Lundeen X /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Date May 13, 2019 Date May 13, 2019

MM / DD / YYYY MM / DD / YYYY

If you checked line 14a, do NOT fill out or file Form 122A-2.

If you checked line 14b, fill out Form 122A-2 and file it with this form.

Official Form 122A-1 Chapter 7 Statement of Your Current Monthly Income page 2

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Fill in this information to identify your case: Check the appropriate box as directed in

lines 40 or 42:

Debtor 1 John A. Lundeen

According to the calculations required by this

Statement:

 1. There is no presumption of abuse.

 2. There is a presumption of abuse.

Debtor 2 Jennifer M. Lundeen

(Spouse, if filing)

United States Bankruptcy Court for the: Eastern District of Virginia

Case number

(if known)

 Check if this is an amended filing

Official Form 122A - 2

Chapter 7 Means Test Calculation 04/19

To fill out this form, you will need your completed copy of Chapter 7 Statement of Your Current Monthly Income (Official Form 122A-1).

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 additional information applies. On the top any

additional pages, write your name and case number (if known).

Part 1: Determine Your Adjusted Income

1. Copy your total current monthly income. Copy line 11 from Official Form 122A-1 here=>........ $ 9,461.24

2. Did you fill out Column B in Part 1 of Form 122A-1?

 No. Fill in $0 for the total on line 3.

 Yes. Is your spouse Filing with you?

 No. Go to line 3.

 Yes. Fill in $0 for the total on line 3.

3. Adjust your current monthly income by subtracting any part of your spouse's income not used to pay for the

household expenses of you or your dependents. Follow these steps:

On line 11, Column B of Form 122A–1, was any amount of the income you reported for your spouse NOT regularly used for the household

expenses of you or your dependents?

 No. Fill in 0 for the total on line 3.

 Yes. Fill in the information below:

State each purpose for which the income was used

For example, the income is used to pay your spouse's tax debt or to

support other than you or your dependents.

Fill in the amount you

are subtracting from

your spouse's income

$

$

$

Total. $ 0.00

Copy total here=>... - $ 0.00

4. Adjust your current monthly income. Subtract line 3 from line 1. $ 9,461.24

Official Form 122A-2 Chapter 7 Means Test Calculation page 1

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Part 2: Calculate Your Deductions from Your Income

The Internal Revenue Service (IRS) issues National and Local Standards for certain expense amounts. Use these amounts

to answer the questions in lines 6-15. To find the IRS standards, go online using the link specified in the separate

instructions for this form. This information may also be available at the bankruptcy clerk's office.

Deduct the expense amounts set out in lines 6-15 regardless of your actual expense. In later parts of the form, you will use some of

your actual expenses if they are higher than the standards. Do not deduct any amounts that you subtracted fro your spouse's

income in line 3 and do not deduct any operating expenses that you subtracted from in income in lines 5 and 6 of form 122A-1.

If your expenses differ from month to month, enter the average expense.

Whenever this part of the from refers to you, it means both you and your spouse if Column B of Form 122A-1 is filled in.

5. The number of people used in determining your deductions from income

Fill in the number of people who could be claimed as exemptions on your federal income tax return,

plus the number of any additional dependents whom you support. This number may be different from

the number of people in your household.

4

National Standards You must use the IRS National Standards to answer the questions in lines 6-7.

6. Food, clothing, and other items: Using the number of people you entered in line 5 and the IRS National

Standards, fill in the dollar amount for food, clothing, and other items. $ 1,786.00

7. Out-of-pocket health care allowance: Using the number of people you entered in line 5 and the IRS National Standards, fill in

the dollar amount for out-of-pocket health care. The number of people is split into two categories--people who are under 65 and

people who are 65 or older--because older people have a higher IRS allowance for health care costs. If your actual expenses are

higher than this IRS amount, you may deduct the additional amount on line 22.

People who are under 65 years of age

7a. Out-of-pocket health care allowance per person $ 55.00

7b. Number of people who are under 65 X 4

7c. Subtotal. Multiply line 7a by line 7b. $ 220.00 Copy here=> $ 220.00

People who are 65 years of age or older

7d. Out-of-pocket health care allowance per person $ 114.00

7e. Number of people who are 65 or older X 0

7f. Subtotal. Multiply line 7d by line 7e. $ 0.00 Copy here=> +$ 0.00

7g. Total. Add line 7c and line 7f $ 220.00 Copy total here=> $ 220.00

Official Form 122A-2 Chapter 7 Means Test Calculation page 2

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Local Standards You must use the IRS Local Standards to answer the questions in lines 8-15.

Based on information from the IRS, the U.S. Trustee Program has divided the IRS Local Standard for housing for

bankruptcy purposes into two parts:

 Housing and utilities - Insurance and operating expenses

 Housing and utilities - Mortgage or rent expenses

To answer the questions in lines 8-9, use the U.S. Trustee Program chart.

To find the chart, go online using the link specified in the separate instructions for this form.

This chart may also be available at the bankruptcy clerk's office.

8. Housing and utilities - Insurance and operating expenses: Using the number of people you entered in line 5, fill

in the dollar amount listed for your county for insurance and operating expenses. ........................................... $ 669.00

9. Housing and utilities - Mortgage or rent expenses:

9a. Using the number of people you entered in line 5, fill in the dollar amount

listed for your county for mortgage or rent expenses................................... $ 1,471.00

9b. Total average monthly payment for all mortgages and other debts secured by your home.

To calculate the total average monthly payment, add all amounts that are

contractually due to each secured creditor in the 60 months after you file

for bankruptcy. Then divide by 60.

Name of the creditor Average monthly

payment

-NONE- $

Total average monthly payment $ 0.00

Copy

here=> -$ 0.00

Repeat this

amount on

line 33a.

9c. Net mortgage or rent expense.

Subtract line 9b (total average monthly payment) from line 9a (mortgage

or rent expense). If this amount is less than $0, enter $0. ........................ $ 1,471.00

Copy

here=> $ 1,471.00

10. If you claim that the U.S. Trustee Program's division of the IRS Local Standard for housing is incorrect and

affects the calculation of your monthly expenses, fill in any additional amount you claim. $ 199.00

Explain why: Rent $1,670

11. Local transportation expenses: Check the number of vehicles for which you claim an ownership or operating expense.

 0. Go to line 14.

 1. Go to line 12.

 2 or more. Go to line 12.

12. Vehicle operation expense: Using the IRS Local Standards and the number of vehicles for which you claim the

operating expenses, fill in the Operating Costs that apply for your Census region or metropolitan statistical area. $ 836.66

Official Form 122A-2 Chapter 7 Means Test Calculation page 3

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

13. Vehicle ownership or lease expense: Using the IRS Local Standards, calculate the net ownership or lease expense for each vehicle below.

You may not claim the expense if you do not make any loan or lease payments on the vehicle. In addition, you may not claim the expense for

more than two vehicles.

Vehicle 1 Describe Vehicle 1: 2015 Kia Soul 82,000 miles

13a. Ownership or leasing costs using IRS Local Standard.......................................... $ 508.00

13b. Average monthly payment for all debts secured by Vehicle 1.

Do not include costs for leased vehicles.

To calculate the average monthly payment here and on line 13e, add all amounts that

are contractually due to each secured creditor in the 60 months after you filed for

bankruptcy. Then divide by 60.

Name of each creditor for Vehicle 1 Average monthly

payment

C&F Finance Company $ 240.53

Total Average Monthly Payment $ 240.53

Copy

here => -$ 240.53

Repeat this

amount on

line 33b.

13c. Net Vehicle 1 ownership or lease expense

Subtract line 13b from line 13a. if this amount is less than $0, enter $0.

$ 267.47

Copy net

Vehicle 1

expense

here => $

267.47

Vehicle 2 Describe Vehicle 2: 2001 Dodge Ram 200,000 miles

13d. Ownership or leasing costs using IRS Local Standard................................................... $ 508.00

13e. Average monthly payment for all debts secured by Vehicle 2. Do not include costs for

leased vehicles.

Name of each creditor for Vehicle 2 Average monthly

payment

Title Max Bankruptcy Dept $ 26.88

Total Average Monthly Payment $ 26.88

Copy

here

=> -$ 26.88

Repeat this

amount on

line 33c.

13f. Net Vehicle 2 ownership or lease expense

Subtract line 13e from line 13d. if this amount is less than $0, enter $0. ......................

$ 481.12

Copy net

Vehicle 2

expense

here => $

481.12

14. Public transportation expense: If you claimed 0 vehicles in line 11, using the IRS Local Standards, fill in the Public

Transportation expense allowance regardless of whether you use public transportation. $ 0.00

15. Additional public transportation expense: If you claimed 1 or more vehicles in line 11 and if you claim that you may

also deduct a public transportation expense, you may fill in what you believe is the appropriate expense, but you may

not claim more than the IRS Local Standard for Public Transportation. $ 0.00

Official Form 122A-2 Chapter 7 Means Test Calculation page 4

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Other Necessary Expenses In addition to the expense deductions listed above, you are allowed your monthly expenses for

the following IRS categories.

16. Taxes: The total monthly amount that you will actually owe for federal, state and local taxes, such as income taxes,

self-employment taxes, social security taxes, and Medicare taxes. You may include the monthly amount withheld from

your pay for these taxes. However, if you expect to receive a tax refund, you must divide the expected refund by 12

and subtract that number from the total monthly amount that is withheld to pay for taxes.

Do not include real estate, sales, or use taxes. $ 1,718.74

17. Involuntary deductions: The total monthly payroll deductions that your job requires, such as retirement

contributions, union dues, and uniform costs.

Do not include amounts that are not required by your job, such as voluntary 401(k) contributions or payroll savings. $ 0.00

18. Life Insurance: The total monthly premiums that you pay for your own term life insurance. If two married people are

filing together, include payments that you make for your spouse's term life insurance. Do not include premiums for life

insurance on your dependents, for a non-filing spouse's life insurance, or for any form of life insurance other than

term. $ 0.00

19. Court-ordered payments: The total monthly amount that you pay as required by the order of a court or

administrative agency, such as spousal or child support payments.

Do not include payments on past due obligations for spousal or child support. You will list these obligations in line 35. $ 0.00

20. Education: The total monthly amount that you pay for education that is either required:

 as a condition for your job, or

 for your physically or mentally challenged dependent child if no public education is available for similar services. $ 0.00

21. Childcare: The total monthly amount that you pay for childcare, such as babysitting, daycare, nursery, and preschool.

Do not include payments for any elementary or secondary school education. $ 0.00

22. Additional health care expenses, excluding insurance costs: The monthly amount that you pay for health care

that is required for the health and welfare of you or your dependents and that is not reimbursed by insurance or paid

by a health savings account. Include only the amount that is more than the total entered in line 7.

Payments for health insurance or health savings accounts should be listed only in line 25. $ 280.00

23. Optional telephone and telephone services: The total monthly amount that you pay for telecommunication services

for you and your dependents, such as pagers, call waiting, caller identification, special long distance, or business cell

phone service, to the extent necessary for your health and welfare or that of your dependents or for the production of

income, if it is not reimbursed by your employer.

Do not include payments for basic home telephone, internet and cell phone service. Do not include self-employment

expenses, such as those reported on line 5 of Official Form 122A-1, or any amount you previously deducted. +$ 0.00

24. Add all of the expenses allowed under the IRS expense allowances. $ 7,928.99

Add lines 6 through 23.

Official Form 122A-2 Chapter 7 Means Test Calculation page 5

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Additional Expense Deductions These are additional deductions allowed by the Means Test.

Note: Do not include any expense allowances listed in lines 6-24.

25. Health insurance, disability insurance, and health savings account expenses. The monthly expenses for health

insurance, disability insurance, and health savings accounts that are reasonably necessary for yourself, your spouse, or

your dependents.

Health insurance $ 1,006.74

Disability insurance $ 0.00

Health savings account + $ 0.00

Total $ 1,006.74 Copy total here=> $ 1,006.74

Do you actually spend this total amount?

 No. How much do you actually spend?

 Yes $

26. Continued contributions to the care of household or family members. The actual monthly expenses that you will

continue to pay for the reasonable and necessary care and support of an elderly, chronically ill, or disabled member of

your household or member of your immediate family who is unable to pay for such expenses. These expenses may

include contributions to an account of a qualified ABLE program. 26 U.S.C.§ 529A(b). $ 0.00

27. Protection against family violence. The reasonably necessary monthly expenses that you incur to maintain the

safety of you and your family under the Family Violence Prevention and Services Act or other federal laws that apply.

By law, the court must keep the nature of these expenses confidential. $ 0.00

28. Additional home energy costs. Your home energy costs are included in your insurance and operating expenses on

line 8.

If you believe that you have home energy costs that are more than the home energy costs included in expenses on line

8, then fill in the excess amount of home energy costs.

You must give your case trustee documentation of your actual expenses, and you must show that the additional

amount claimed is reasonable and necessary. $ 0.00

29. Education expenses for dependent children who are younger than 18. The monthly expenses (not more than

$170.83* per child) that you pay for your dependent children who are younger than 18 years old to attend a private or

public elementary or secondary school.

You must give your case trustee documentation of your actual expenses, and you must explain why the amount

claimed is reasonable and necessary and not already accounted for in lines 6-23.

* Subject to adjustment on 4/01/22, and every 3 years after that for cases begun on or after the date of adjustment. $ 120.00

30. Additional food and clothing expense. The monthly amount by which your actual food and clothing expenses are

higher than the combined food and clothing allowances in the IRS National Standards. That amount cannot be more

than 5% of the food and clothing allowances in the IRS National Standards.

To find a chart showing the maximum additional allowance, go online using the link specified in the separate

instructions for this form. This chart may also be available at the bankruptcy clerk's office.

You must show that the additional amount claimed is reasonable and necessary. $ 0.00

31. Continuing charitable contributions. The amount that you will continue to contribute in the form of cash or financial

instruments to a religious or charitable organization. 26 U.S.C. § 170(c)(1)-(2). +$ 0.00

32. Add all of the additional expense deductions. $ 1,126.74

Add lines 25 through 31.

Official Form 122A-2 Chapter 7 Means Test Calculation page 6

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Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Deductions for Debt Payment

33. For debts that are secured by an interest in property that you own, including home mortgages, vehicle

loans, and other secured debt, fill in lines 33a through 33e.

To calculate the total average monthly payment, add all amounts that are contractually due to each secured

creditor in the 60 months after you file for bankruptcy. Then divide by 60.

Mortgages on your home: Average monthly

payment

33a. Copy line 9b here => $ 0.00

Loans on your first two vehicles:

33b. Copy line 13b here => $ 240.53

33c. Copy line 13e here => $ 26.88

33d. List other secured debts:

Name of each creditor for other secured debt Identify property that secures the debt Does payment

include taxes or

insurance?

-NONE-

 No

 Yes $

 No

 Yes $

 No

 Yes +$

33e. Total average monthly payment. Add lines 33a through 33d $ 267.41

Copy

total

here=> $ 267.41

34. Are any debts that you listed in line 33 secured by your primary residence, a vehicle,

or other property necessary for your support or the support of your dependents?

 No. Go to line 35.

 Yes. State any amount that you must pay to a creditor, in addition to the payments

listed in line 33, to keep possession of your property (called the cure amount).

Next, divide by 60 and fill in the information below.

Name of the creditor Identify property that secures the debt Total cure

amount

Monthly cure

amount

-NONE- $ ÷ 60 = $

Total $ 0.00

Copy

total

here=> $ 0.00

35. Do you owe any priority claims such as a priority tax, child support, or alimony - that

are past due as of the filing date of your bankruptcy case? 11 U.S.C. § 507.

 No. Go to line 36.

 Yes. Fill in the total amount of all of these priority claims. Do not include current or

ongoing priority claims, such as those you listed in line 19.

Total amount of all past-due priority claims $ 5,230.35 ÷ 60 = $ 87.18

Official Form 122A-2 Chapter 7 Means Test Calculation page 7

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 85 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

36. Are you eligible to file a case under Chapter 13? 11 U.S.C. § 109(e).

For more information, go online using the link for Bankruptcy Basics specified in the separate

instructions for this form. Bankruptcy Basics may also be available at the bankruptcy clerk's office.

 No. Go to line 37.

 Yes. Fill in the following information.

Projected monthly plan payment if you were filing under Chapter 13 $ 670.00

Current multiplier for your district as stated on the list issued by the

Administrative Office of the United States Courts (for districts in Alabama

and North Carolina) or by the Executive Office for United States Trustees

(for all other districts). X 10.00

To find a list of district multipliers that includes your district, 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.

Average monthly administrative expense if you were filing under Chapter 13 $ 67.00

Copy total

here=> $ 67.00

37. Add all of the deductions for debt payment. $ 421.59

Add lines 33e through 36.

Total Deductions from Income

38. Add all of the allowed deductions.

Copy line 24, All of the expenses allowed under IRS

expense allowances $ 7,928.99

Copy line 32, All of the additional expense deductions $ 1,126.74

Copy line 37, All of the deductions for debt payment +$ 421.59

Total deductions $ 9,477.32 Copy total here...........=> $ 9,477.32

Part 3: Determine Whether There is a Presumption of Abuse

39. Calculate monthly disposable income for 60 months

39a. Copy line 4, adjusted current monthly income $ 9,461.24

39b. Copy line 38,Total deductions - $ 9,477.32

39c. Monthly disposable income. 11 U.S.C. § 707(b)(2).

Subtract line 39b from line 39a $ -16.08

Copy

here=>$ -16.08

For the next 60 months (5 years) x 60

39d. Total. Multiply line 39c by 60 39d. $ -964.80 Copy

here=> $ -964.80

40. Find out whether there is a presumption of abuse. Check the box that applies:

 The line 39d is less than $8,175*. On the top of page 1 of this form, check box 1, There is no presumption of abuse. Go to Part 5.

 The line 39d is more than $13,650*. On the top of page 1 of this form, check box 2, There is a presumption of abuse. You may fill out

Part 4 if you claim special circumstances. Go to Part 5.

 The line 39d is at least $8,175*, but not more than $13,650*. Go to line 41.

*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 122A-2 Chapter 7 Means Test Calculation page 8

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 86 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

41. 41a. Fill in the amount of your total nonpriority unsecured debt. If you filled out

A Summary of Your Assets and Liabilities and Certain Statistical Information

Schedules (Official Form 106Sum), you may refer to line 3b on that form. $

x .25

41b. 25% or your total nonpriority unsecured debt. 11 U.S.C. § 707(b)(2)(A)(i)(I) $

Copy

here=> $

Multiply line 41a by 0.25.....................................................................................

42. Determine whether the income you have left over after subtracting all allowed deductions is enough to pay

25% of your unsecured, nonpriority debt.

Check the box that applies:

 Line 39d is less than line 41b. On the top of page 1 of this form, check box 1, There is no presumption of abuse.

Go to Part 5.

 Line 39d is equal to or more than line 41b. On the top of page 1 of this form, check box 2, There is a

presumption of abuse. You may fill out Part 4 if you claim special circumstances. Then go to Part 5.

Part 4: Give Details About Special Circumstances

43. Do you have any special circumstances that justify additional expenses or adjustments of current monthly income for which there is no

reasonable alternative? 11 U.S.C. § 707(b)(2)(B).

 No. Go to Part 5.

 Yes. Fill in the following information. All figures should reflect your average monthly expense or income adjustment for each

item. You may include expenses you listed in line 25.

You must give a detailed explanation of the special circumstances that make the expenses or income adjustments

necessary and reasonable. You must also give your case trustee documentation of your actual expenses or income

adjustments.

Give a detailed explanation of the special circumstances Average monthly expense

or income adjustment

Husband no longer working for MichaelSon $571.00

$

$

$

Part 5: Sign Below

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

X /s/ John A. Lundeen X /s/ Jennifer M. Lundeen

John A. Lundeen Jennifer M. Lundeen

Signature of Debtor 1 Signature of Debtor 2

Date May 13, 2019 Date May 13, 2019

MM / DD / YYYY MM / DD / YYYY

Official Form 122A-2 Chapter 7 Means Test Calculation page 9

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 87 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Current Monthly Income Details for the Debtor

Debtor Income Details:

Income for the Period 11/01/2018 to 04/30/2019.

Line 2 - Gross wages, salary, tips, bonuses, overtime, commissions

Source of Income: Michael & Son

Year-to-Date Income:

Last Year:

Starting Year-to-Date Income: $43,414.55 from check dated 10/31/2018 .

Ending Year-to-Date Income: $58,106.71 from check dated 12/31/2018 .

This Year:

Current Year-to-Date Income: $11,615.50 from check dated 4/30/2019 .

Income for six-month period (Current+(Ending-Starting)): $26,307.66 .

Average Monthly Income: $4,384.61 .

Official Form 122A-2 Chapter 7 Means Test Calculation page 10

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 88 of 94
Debtor 1

Debtor 2

John A. Lundeen

Jennifer M. Lundeen Case number (if known)

Current Monthly Income Details for the Debtor's Spouse

Spouse Income Details:

Income for the Period 11/01/2018 to 04/30/2019.

Line 2 - Gross wages, salary, tips, bonuses, overtime, commissions

Source of Income: TM VAVRA Assoc.

Year-to-Date Income:

Last Year:

Starting Year-to-Date Income: $48,541.75 from check dated 10/31/2018 .

Ending Year-to-Date Income: $60,002.00 from check dated 12/31/2018 .

This Year:

Current Year-to-Date Income: $18,999.50 from check dated 4/30/2019 .

Income for six-month period (Current+(Ending-Starting)): $30,459.75 .

Average Monthly Income: $5,076.63 .

Official Form 122A-2 Chapter 7 Means Test Calculation page 11

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

Case 19-32566-KLP Doc 1 Filed 05/13/19 Entered 05/13/19 16:22:14 Desc Main

 Document Page 89 of 94
}bk1{Credito AresMatix}bk{

TransUnion

P.O. Box 2000

Chester, PA 19022

Certegy Check Services, Inc.

11601 Roosevelt Blvd.

Saint Petersburg, FL 33716

ChexSystems

Attn: Consumer Relations

7805 Hudson Rd., Suite 100

Saint Paul, MN 55125

Experian

Dispute Department

P.O. Box 4500

Allen, TX 75013

Equifax Information Services

PO Box 740241

Atlanta, GA 30374

TransUnion Consumer Relations

2 Baldwin Place

PO Box 1000

Chester, PA 19022

Weimark Credit Information

PO Box 994

Brick, NJ 08723

Acceptance Now

5501 Headquarters Dr

Plano, TX 75024

Acceptance Now

Attn: Bankruptcy

5501 Headquarters Drive

Plano, TX 75024

AFNI

404 Brock Drive

P.O. Box 3097

Bloomington, IL 61702

Allied Interstate

P. O. Box 361317

Columbus, OH 43236

AMCA

4 Westchester Plaza

Building 4

Elmsford, NY 10523

American Disposal Services

PO Box 28150

Miami, FL 33102

Applied Bank

P.O. Box 11170

Wilmington, DE 19850

Auto Credit Of Charl

952 Houston Northcutt Blvd.

Mount Pleasant, SC 29464

Banfield Pet Hospital

Attn: Billing & Collections

PO Box 13998

Portland, OR 97213

Barry Ekdom PHD

3040 Williams Dr #402

Fairfax, VA 22031

BCC Financial Management

PO Box 590067

Fort Lauderdale, FL 33359

Berk Credit & Collections

PO Box 329

Temple, PA 19560

Berks Credit & Collections

Po Box 329

Temple, PA 19560

BetterMed Urgent Care

PO Box 14099

Belfast, ME 04915

Bon Secours

P.O. Box 28538

Richmond, VA 23228

C&F Finance Company

1313 E Main St Ste 400

Richmond, VA 23219

C&f Finance Company

Attn: Bankruptcy Department

1313 E. Main St., Ste 400

Richmond, VA 23219

Caine & Weiner

Po Box 5010

Woodland Hills, CA 91365

Capio Partners LLC

2222 Texoma Pkwy

Ste 150

Sherman, TX 75090

Capio Partners Llc

Attn: Bankruptcy

Po Box 3498

Sherman, TX 75091

Capital Spine & Pain Center

3031 Javier Rd Ste 210

Fairfax, VA 22031

Cash Flow Management

PO Box 740776

Cincinnati, OH 45274

Centreville Childrens Dentist

14245 Centreville Square

Centreville, VA 20121

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Chesterfield Fire & EMS

Post Office Box 70

Chesterfield, VA 23832

Chesterfield Imaging Center

P.O. Box 13342

Richmond, VA 23225

Children's Book of the Month C

Customer Service Center

Post Office Box 6404

Camp Hill, PA 17012-6404

CJW Medical Center

P.O. Box 13620

Richmond, VA 23225

CMRE Financial Serives

3075 E. Imperial Hwy #200

Brea, CA 92821

Coast to Coast Financial Solut

101 Hodencamp Rd #120

Thousand Oaks, CA 91360

Commonwealth Financial Systems

245 Main St

Dickson City, PA 18519

Commonwealth of VA-Tax

P.O. Box 2156

Richmond, VA 23218-2156

Commonwealth Radiology

1508 William Lawn Drive

Suite 117

Richmond, VA 23230

Complete Collection Service

P. O. Box 10052

Alexandria, VA 22310

County Waste

12230 Deergrove Rd

Midlothian, VA 23112

Cox Communications

PO Box 62549

Virginia Beach, VA 23466

Credit Collection Services

PO Box 9134

Needham Heights, MA 02494

Credit Control Corp

P. O. Box 409553

Atlanta, GA 30384

Dermatology Assoc. of NOVA

13880 Braddock Rd Ste 301

Centreville, VA 20121

Dish Network

PO Box 94063

Palatine, IL 60094

Duck's Disposal

P.O. Box 5657

Midlothian, VA 23112

Durham & Durham LLP

5665 New Northside Drie

Ste 510

Atlanta, GA 30328

EMA Novant Health

20010 Century Blvd Ste 200

Germantown, MD 20874

Fair Oaks Anesthesia

3998 Fair Ridge Dr

Fairfax, VA 22033

Fair Oaks ER Physicians

3600 Joseph Siewick Dr

Fairfax, VA 22033

Fair Oaks Orthopaedic Assoc.

3620 Joseph Siewick Dr Ste 201

Fairfax, VA 22033

Fairfax Radiological Consult

2722 Merritee Dr Ste 230

Fairfax, VA 22031

Family Medicine of Clifton/Cen

6201 Centreville Rd #100

Centreville, VA 20121

FedLoan Servicing

Po Box 60610

Harrisburg, PA 17106

FedLoan Servicing

Attn: Bankruptcy

Po Box 69184

Harrisburg, PA 17106

First National Collection

P.O. Box 4115

Concord, CA 94524

First Premier Bank

Post Office Box 5147

Sioux Falls, SD 57117-5147

First Premier Bank

3820 N Louise Ave

Sioux Falls, SD 57107

First Premier Bank

Attn: Bankruptcy

Po Box 5524

Sioux Falls, SD 57117

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FOAA Anesthesia Services

3998 Fair Ridge Dr

Ste 300

Fairfax, VA 22033

Focused Recovery Solutions

9701 Metropolitan Court

Richmond, VA 23236

Focused Recovery Solutions

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

Fst Premier

601 S Minneapolis Ave

Sioux Falls, SD 57104

Gastrointestinal Medicine Asso

3620 Joseph Siewick Dr

Ste 307

Fairfax, VA 22033

Geico

One Geico Plaza

Bethesda, MD 20811-0001

Gilliam Law Group

7821 Ironbridge Rd North

Richmond, VA 23237

Healthcare Collection LLC

2224 W Northern Ave

Ste D100

Phoenix, AZ 85021

Henrico Doctors Hospital

PO Box 740760

Cincinnati, OH 45274

Horizon Financial Mangement

Attention: Bankruptcy Dept.

9980 Georgia Street

Crown Point, IN 46307

I.C. System Inc.

Po Box 64378

Saint Paul, MN 55164

Inova

PO Box 37013

Baltimore, MD 21297

Inova Fair Oaks Hospital

3600 Joseph Siewick Dr

Fairfax, VA 22033

Inova Fair Oaks Hospital

PO Box 37013

Baltimore, MD 21297

Inova Fairfax Hospital

3300 Gallows Road

Falls Church, VA 22042

INOVA Health System

2990 Teleston Ct

Falls Church, VA 22042

Inpatient Medical Services

P.O. Box 41367

Houston, TX 77240

Internal Revenue Service

Centralized Insolvency Unit

P O Box 7346

Philadelphia, PA 19101-7346

James Hurst, DPM

5729 Centre Square Dr

Centreville, VA 20120

James River Emergency Group

PO Box 660827

Dallas, TX 75266

Jefferson Capital Syst

16 Mcleland Rd

Saint Cloud, MN 56303

Lhr Inc

1 Main Street

Hamburg, NY 14075

Liberty Mutual

PO Box 970

Mishawaka, IN 46546

Lvnv Funding

P.O. Box 10584

Greenville, SC 29603

MedExpress Urgent Care

11603 Midlothian Turnpike

Midlothian, VA 23113

Medicredit Corporation

P. O. Box 411187

Saint Louis, MO 63141

Memorial Health

4700 Waters Ave

Savannah, GA 31414

Midland Funding

8875 Aero Dr Ste 200

San Diego, CA 92123

MiraMed

991 Oak Creek Dr

Lombard, IL 60148

Nationwide Credit Corp.

5503 Cherokee Ave

Alexandria, VA 22312

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NCO Financial

P. O. Box 15740

Wilmington, DE 19850

Neurological Associates

PO Box 668

Brentwood, TN 37024

Neuroscience Consultants PC

12007 Sunrise Valley Dr

Ste 120

Reston, VA 20191

NoVa Oral Surgery

Novant Health PW Medical Ctr

8700 Sudley Rd

Manassas, VA 20110

Novec

10223 Lomond Dr

Manassas, VA 20109

NPAS Inc.

PO Box 99400

Louisville, KY 40269

One Hampton Medical

PO Box 3475

Toledo, OH 43607

Ortho Virginia

PO Box 17047

Baltimore, MD 21297

Patient First

P.O. Box 758941

Baltimore, MD 21275

Physical Medicine Associates

P.O. Box 713666

Cincinnati, OH 45271

PNC Bank, N.A.

Post Office Box 747066

Pittsburgh, PA 15274-7066

Professional Emerg Care

2987 Momentum Place

Chicago, IL 60689-5329

Professional Emerg Care

PO Box 3475

Toledo, OH 43607

Progressive Insurance

200 Westgate Pkwy

Ste. 310

Henrico, VA 23233

Quest Diagnostics

P. O. Box 64797

Baltimore, MD 21264

Radiology Assc of Richmond

2602 Buford Road

Richmond, VA 23235

Receivable Management Inc

7206 Hull Rd

Ste 211

Richmond, VA 23235

Receivables Management Systems

PO Box 8630

Richmond, VA 23226-0630

Receivables Outsourcing LLC

PO Box 549

Lutherville Timonium, MD 21094

Rjm Acq Llc

575 Underhill Blvd Ste 2

Syosset, NY 11791

Rocky Run Family Medicine

5645 Stone Rd

Centreville, VA 20120

Skinner, Ossakow & Assoc DDS

5651 Stone Rd

Centreville, VA 20120

St Francis Medical Center

P.O. Box 404893

Atlanta, GA 30384

Stellar Recovery Inc

Attn: Bankruptcy

4500 Salisbury Road Ste 105

Jackonville, FL 32216

Suburban Credit Corporation

Post Office Box 30640

6142 Franconia Road

Alexandria, VA 22310-2521

Surgical Assoc of Richmond

PO Box 759336

Baltimore, MD 21275-9336

The Little Clinic

2620 Elm Hill Pike

Nashville, TN 37214

The Money Tree/rinco

The Pediatric Group

13001 Summit School Rd

Ste A

Woodbridge, VA 22192

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The Women's Club

14175 Sullyfield Cir

Unit 100

Chantilly, VA 20151

Title Max Bankruptcy Dept

TMX Finance LLC

15 Bull St, Ste 200

Savannah, GA 31401

TitleMax of Virginia

6221 Hull Street Road

Richmond, VA 23224

Transworld Sys Inc

507 Prudential Rd

Horsham, PA 19044

United Consumers

P.O. Box 4466

Woodbridge, VA 22194-4466

United Consumers

PO Box 4466

Woodbridge, VA 22194

United Consumers, Inc

14205 Telegraph Rd

Woodbridge, VA 22192

Verizon

Po Box 650584

Dallas, TX 75265

Verizon

500 Technology Dr Ste 550

Saint Charles, MO 63304

Verizon

500 Technology Dr

Weldon Spring, MO 63304

Verizon

Verizon Wireless Bankruptcy Administrati

500 Tecnolgy Dr Ste 500

Weldon Springs, MO 63304

Verizon

Verizon Wireless Bk Admin

500 Technology Dr Ste 550

Weldon Springs, MO 63304

Virginia Emergency Phy

75 Remittance Drive

Suite 1151

Chicago, IL 60675

Virginia Physicians

Rhematology Division

7650 E Parham Rd #304

Henrico, VA 23294

Virginia Radiology Assoc

8629 Sudley Rd Ste 102

Manassas, VA 20110

Washington Gas & Light

Attn: Rosallin Boutte

6801 Industrial Road

Springfield, VA 22151

West End Anesthesia Group

5855 Bremo Rd

Ste 100

Richmond, VA 23226

Michael D. Wilburn

2740 East Brigstock Rd

Midlothian, VA 23113

Zan's Refuse Services

PO Box 651

Midlothian, VA 23113

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