11/28/16 12:28PM

Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 202

Declaration Under Penalty of Perjury for Non-Individual Debtors 12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this

form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any

amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document,

and the date. Bankruptcy Rules 1008 and 9011.

WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341,

1519, and 3571.

Declaration and signature

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or another

individual serving as a representative of the debtor in this case.

I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:

 Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)

 Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

 Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

 Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)

 Schedule H: Codebtors (Official Form 206H)

 Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)

 Amended Schedule

 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)

 Other document that requires a declaration

I declare under penalty of perjury that the foregoing is true and correct.

Executed on November 28, 2016 X /s/ Francis E. Froelich

Signature of individual signing on behalf of debtor

Francis E. Froelich

Printed name

President

Position or relationship to debtor

Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors

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Case 16-13903-BFK Doc 11 Filed 11/28/16 Entered 11/28/16 12:34:45 Desc Main

 Document Page 1 of 39
11/28/16 12:28PM

Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206Sum

Summary of Assets and Liabilities for Non-Individuals 12/15

Part 1: Summary of Assets

1. Schedule A/B: Assets-Real and Personal Property (Official Form 206A/B)

1a. Real property:

 Copy line 88 from Schedule A/B............................................................................................................................. $ 0.00

1b. Total personal property:

 Copy line 91A from Schedule A/B......................................................................................................................... $ 250,500.00

1c. Total of all property:

 Copy line 92 from Schedule A/B........................................................................................................................... $ 250,500.00

Part 2: Summary of Liabilities

2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D.................................... $ 750,000.00

3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

3a. Total claim amounts of priority unsecured claims:

 Copy the total claims from Part 1 from line 5a of Schedule E/F.......................................................................... $ 43,080.67

3b. Total amount of claims of nonpriority amount of unsecured claims:

 Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F................................................ +$ 2,659,751.65

4. Total liabilities .......................................................................................................................................................

Lines 2 + 3a + 3b $ 3,452,832.32

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals page 1

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11/28/16 12:28PM

Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206A/B

Schedule A/B: Assets - Real and Personal Property 12/15

Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest.

Include all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties

which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts

or unexpired leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).

Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write

the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an

additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.

For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset

schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the

debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.

Part 1: Cash and cash equivalents

1. Does the debtor have any cash or cash equivalents?

 No. Go to Part 2.

 Yes Fill in the information below.

All cash or cash equivalents owned or controlled by the debtor Current value of

debtor's interest

Part 2: Deposits and Prepayments

6. Does the debtor have any deposits or prepayments?

 No. Go to Part 3.

 Yes Fill in the information below.

Part 3: Accounts receivable

10. Does the debtor have any accounts receivable?

 No. Go to Part 4.

 Yes Fill in the information below.

Part 4: Investments

13. Does the debtor own any investments?

 No. Go to Part 5.

 Yes Fill in the information below.

Part 5: Inventory, excluding agriculture assets

18. Does the debtor own any inventory (excluding agriculture assets)?

 No. Go to Part 6.

 Yes Fill in the information below.

General description Date of the last

physical inventory

Net book value of

debtor's interest

(Where available)

Valuation method used

for current value

Current value of

debtor's interest

19. Raw materials

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 1

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Debtor Chops SG I INC Case number (If known) 16-13903

Name

20. Work in progress

21. Finished goods, including goods held for resale

22. Other inventory or supplies

Non perishable canned

food, spices, liqour &

other inventory Unknown $500.00

23. Total of Part 5. $500.00

Add lines 19 through 22. Copy the total to line 84.

24. Is any of the property listed in Part 5 perishable?

 No

 Yes

25. Has any of the property listed in Part 5 been purchased within 20 days before the bankruptcy was filed?

 No

 Yes. Book value Valuation method Current Value

26. Has any of the property listed in Part 5 been appraised by a professional within the last year?

 No

 Yes

Part 6: Farming and fishing-related assets (other than titled motor vehicles and land)

27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?

 No. Go to Part 7.

 Yes Fill in the information below.

Part 7: Office furniture, fixtures, and equipment; and collectibles

38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?

 No. Go to Part 8.

 Yes Fill in the information below.

General description Net book value of

debtor's interest

(Where available)

Valuation method used

for current value

Current value of

debtor's interest

39. Office furniture

Restaurant tables, chairs, bar stoles, booths,

file cabinets $100,000.00 Estimate $50,000.00

40. Office fixtures

41. Office equipment, including all computer equipment and

communication systems equipment and software

Kitchen equipment, TV's, Bar equipment,Small

wares $400,000.00 Estimate $200,000.00

42. Collectibles Examples: Antiques and figurines; paintings, prints, or other artwork;

books, pictures, or other art objects; china and crystal; stamp, coin, or baseball card

collections; other collections, memorabilia, or collectibles

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 2

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Debtor Chops SG I INC Case number (If known) 16-13903

Name

43. Total of Part 7. $250,000.00

Add lines 39 through 42. Copy the total to line 86.

44. Is a depreciation schedule available for any of the property listed in Part 7?

 No

 Yes

45. Has any of the property listed in Part 7 been appraised by a professional within the last year?

 No

 Yes

Part 8: Machinery, equipment, and vehicles

46. Does the debtor own or lease any machinery, equipment, or vehicles?

 No. Go to Part 9.

 Yes Fill in the information below.

Part 9: Real property

54. Does the debtor own or lease any real property?

 No. Go to Part 10.

 Yes Fill in the information below.

Part 10: Intangibles and intellectual property

59. Does the debtor have any interests in intangibles or intellectual property?

 No. Go to Part 11.

 Yes Fill in the information below.

General description Net book value of

debtor's interest

(Where available)

Valuation method used

for current value

Current value of

debtor's interest

60. Patents, copyrights, trademarks, and trade secrets

61. Internet domain names and websites

Www.Chopscrafthouse.com $100.00 Estimate Unknown

62. Licenses, franchises, and royalties

63. Customer lists, mailing lists, or other compilations

500 Customer Emails Unknown Unknown

64. Other intangibles, or intellectual property

65. Goodwill

66. Total of Part 10. $0.00

Add lines 60 through 65. Copy the total to line 89.

67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C.§§ 101(41A) and 107?

 No

 Yes

68. Is there an amortization or other similar schedule available for any of the property listed in Part 10?

 No

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 3

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Debtor Chops SG I INC Case number (If known) 16-13903

Name

 Yes

69. Has any of the property listed in Part 10 been appraised by a professional within the last year?

 No

 Yes

Part 11: All other assets

70. Does the debtor own any other assets that have not yet been reported on this form?

Include all interests in executory contracts and unexpired leases not previously reported on this form.

 No. Go to Part 12.

 Yes Fill in the information below.

Current value of

debtor's interest

71. Notes receivable

Description (include name of obligor)

72. Tax refunds and unused net operating losses (NOLs)

Description (for example, federal, state, local)

73. Interests in insurance policies or annuities

74. Causes of action against third parties (whether or not a lawsuit

has been filed)

Potential lawsuit for fraud against general contractor Unknown

Nature of claim Breach of contract and fraud

Amount requested $0.00

75. Other contingent and unliquidated claims or causes of action of

every nature, including counterclaims of the debtor and rights to

set off claims

76. Trusts, equitable or future interests in property

77. Other property of any kind not already listed Examples: Season tickets,

country club membership

Business premises lease with Mail 9959 LLC Unknown

78. Total of Part 11. $0.00

Add lines 71 through 77. Copy the total to line 90.

79. Has any of the property listed in Part 11 been appraised by a professional within the last year?

 No

 Yes

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 4

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Debtor Chops SG I INC Case number (If known) 16-13903

Name

Part 12: Summary

In Part 12 copy all of the totals from the earlier parts of the form

Type of property Current value of

personal property

Current value of real

property

80. Cash, cash equivalents, and financial assets.

Copy line 5, Part 1 $0.00

81. Deposits and prepayments. Copy line 9, Part 2. $0.00

82. Accounts receivable. Copy line 12, Part 3. $0.00

83. Investments. Copy line 17, Part 4. $0.00

84. Inventory. Copy line 23, Part 5. $500.00

85. Farming and fishing-related assets. Copy line 33, Part 6. $0.00

86. Office furniture, fixtures, and equipment; and collectibles.

Copy line 43, Part 7. $250,000.00

87. Machinery, equipment, and vehicles. Copy line 51, Part 8. $0.00

88. Real property. Copy line 56, Part 9.........................................................................................> $0.00

89. Intangibles and intellectual property. Copy line 66, Part 10. $0.00

90. All other assets. Copy line 78, Part 11. + $0.00

91. Total. Add lines 80 through 90 for each column $250,500.00 + 91b. $0.00

92. Total of all property on Schedule A/B. Add lines 91a+91b=92 $250,500.00

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 5

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Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206D

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

Be as complete and accurate as possible.

1. Do any creditors have claims secured by debtor's property?

 No. Check this box and submit page 1 of this form to the court with debtor's other schedules. Debtor has nothing else to report on this form.

 Yes. Fill in all of the information below.

Part 1: List Creditors Who Have Secured Claims

2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one secured

claim, list the creditor separately for each claim.

Column A

Amount of claim

Do not deduct the value

of collateral.

Column B

Value of collateral

that supports this

claim

2.1 Sandy Spring Bank Describe debtor's property that is subject to a lien $410,000.00 Unknown

Creditor's Name Restaurant equipment and fixtures

9910 Main Street

Fairfax, VA 22031

Creditor's mailing address Describe the lien

Security Agreement

Is the creditor an insider or related party?

 No

Creditor's email address, if known  Yes

Is anyone else liable on this claim?

Date debt was incurred  No

 Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of account number

0070

Do multiple creditors have an

interest in the same property?

As of the petition filing date, the claim is:

Check all that apply

 No  Contingent

 Unliquidated

 Disputed

 Yes. Specify each creditor,

including this creditor and its relative

priority.

2.2 Sandy Spring Bank Describe debtor's property that is subject to a lien $340,000.00 Unknown

Creditor's Name Restaurant equipment & fixtures

9910 Main Street

Fairfax, VA 22031

Creditor's mailing address Describe the lien

Security Agreement

Is the creditor an insider or related party?

 No

Creditor's email address, if known  Yes

Is anyone else liable on this claim?

Date debt was incurred  No

 Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of account number

0071

Do multiple creditors have an

interest in the same property?

As of the petition filing date, the claim is:

Check all that apply

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 2

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Debtor Chops SG I INC Case number (if know) 16-13903

Name

 No  Contingent

 Unliquidated

 Disputed

 Yes. Specify each creditor,

including this creditor and its relative

priority.

3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional Page, if any. $750,000.00

Part 2: List Others to Be Notified for a Debt Already Listed in Part 1

List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection agencies,

assignees of claims listed above, and attorneys for secured creditors.

If no others need to notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page.

Name and address On which line in Part 1 did

you enter the related creditor?

Last 4 digits of

account number for

this entity

Official Form 206D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page 2 of 2

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Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206E/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 unsecured claims and Part 2 for creditors with NONPRIORITY unsecured 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: Assets - Real and

Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and

2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1: List All Creditors with PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507).

 No. Go to Part 2.

 Yes. Go to line 2.

2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than 3 creditors

with priority unsecured claims, fill out and attach the Additional Page of Part 1.

Total claim Priority amount

2.1 Priority creditor's name and mailing address As of the petition filing date, the claim is: $29.99 $29.99

Aleksey P. Conners

9100 Vosger Ct.,

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.2 Priority creditor's name and mailing address As of the petition filing date, the claim is: $12.78 $12.78

Alex Young

11715 Briggs Ct.,

Fairfax, VA 22030

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.3 Priority creditor's name and mailing address As of the petition filing date, the claim is: $116.47 $116.47

Amanda C. Hopkins

1501 Providence St., #204,

Stafford, VA 22554

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.4 Priority creditor's name and mailing address As of the petition filing date, the claim is: $63.71 $63.71

Brian P. Coffin

8415 Stone Gate Drive

Annandale, VA 22003

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.5 Priority creditor's name and mailing address As of the petition filing date, the claim is: $42.80 $42.80

Christopher Brooks

6384 James Harris Way

Centreville, VA 20121

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.6 Priority creditor's name and mailing address As of the petition filing date, the claim is: $1,283.58 $1,283.58

Christopher Crogan

8529 Forest Street

Annandale, VA 22003

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.7 Priority creditor's name and mailing address As of the petition filing date, the claim is: $22.94 $22.94

Daeun Moon

6163 Hatches Ct.,

Burke, VA 22015

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.8 Priority creditor's name and mailing address As of the petition filing date, the claim is: $10.41 $10.41

Daisy Delekajew

7616 Boulder St.,

Springfield, VA 22151

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.9 Priority creditor's name and mailing address As of the petition filing date, the claim is: $16.68 $16.68

David Blackshire

9629 Blake Ln

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.10 Priority creditor's name and mailing address As of the petition filing date, the claim is: $222.14 $222.14

Domingo Jara Guerrero

6007 Bonnie Bern Court

Burke, VA 22015

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.11 Priority creditor's name and mailing address As of the petition filing date, the claim is: $545.88 $545.88

Elder Casasola

9926 Fairfax Sq.,, Apt. 34

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.12 Priority creditor's name and mailing address As of the petition filing date, the claim is: $39.02 $39.02

Erika Rodgers

3822 Mode St

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.13 Priority creditor's name and mailing address As of the petition filing date, the claim is: $934.26 $934.26

Fernando Barillas Tobar

9315 Humphries Drive

Burke, VA 22015

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number N/A

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.14 Priority creditor's name and mailing address As of the petition filing date, the claim is: $15,849.31 $12,850.00

Francis E. Froelich

7405 Windy Hill Court

Mc Lean, VA 22102

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.15 Priority creditor's name and mailing address As of the petition filing date, the claim is: $1,195.89 $1,195.89

Hanna Yoon

3939 Persimmon Dr,

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.16 Priority creditor's name and mailing address As of the petition filing date, the claim is: $179.38 $179.38

Jack Caldwell

9703 Flintridge Ct.,

Fairfax, VA 22032

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.17 Priority creditor's name and mailing address As of the petition filing date, the claim is: $51.37 $51.37

Jake Salewski

4920 Oakcrest Dr

Fairfax, VA 22030

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.18 Priority creditor's name and mailing address As of the petition filing date, the claim is: $134.58 $134.58

Jessa D Liquido

1614 S Taylor St.,

Arlington, VA 22204

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.19 Priority creditor's name and mailing address As of the petition filing date, the claim is: $78.62 $78.62

John F Brixius

4123 Evergreen Drive

Fairfax, VA 22032

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.20 Priority creditor's name and mailing address As of the petition filing date, the claim is: $193.90 $193.90

John Petrakes

3439 Lyrac St.,

Oakton, VA 22124

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.21 Priority creditor's name and mailing address As of the petition filing date, the claim is: $174.57 $174.57

John R. Froelich

6486 Birch Grove Court

Mc Lean, VA 22101

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.22 Priority creditor's name and mailing address As of the petition filing date, the claim is: $2,363.48 $2,363.48

Jose Mendes

6316 Alforth Ave

Alexandria, VA 22315

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.23 Priority creditor's name and mailing address As of the petition filing date, the claim is: $81.62 $81.62

Joseph F. Lambiasi

9105 Wood Pointe Way

Fairfax Station, VA 22039

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.24 Priority creditor's name and mailing address As of the petition filing date, the claim is: $47.65 $47.65

Josephine N. Bolanos

3909 Carolyn Ave.,

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.25 Priority creditor's name and mailing address As of the petition filing date, the claim is: $487.88 $487.88

Juana Lopez

10716 Orchard St.,

Fairfax, VA 22030

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.26 Priority creditor's name and mailing address As of the petition filing date, the claim is: $107.80 $107.80

Kayla M. Shoultz

7977 Almeda Ct.,

Lorton, VA 22079

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.27 Priority creditor's name and mailing address As of the petition filing date, the claim is: $58.48 $58.48

Kendra S. Playuk

3986 Bradwater St.,

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.28 Priority creditor's name and mailing address As of the petition filing date, the claim is: $5.64 $5.64

Kevin Zibari

8904 Laurel Overlook Dr.,

Lorton, VA 22079

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.29 Priority creditor's name and mailing address As of the petition filing date, the claim is: $19.13 $19.13

Kylie P. Broderick

3039 Cyrandall Valley Road

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.30 Priority creditor's name and mailing address As of the petition filing date, the claim is: $312.42 $312.42

Luis A. Reyes-Arias

4312 Pickett Road

Fairfax, VA 22032

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.31 Priority creditor's name and mailing address As of the petition filing date, the claim is: $738.57 $738.57

Malik J. Burr

5517 heston Court

Springfield, VA 22151

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.32 Priority creditor's name and mailing address As of the petition filing date, the claim is: $72.07 $72.07

Michael C. Lee

8105 Whirlwind Ct.,

Gaithersburg, MD 20882

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.33 Priority creditor's name and mailing address As of the petition filing date, the claim is: $28.74 $28.74

Michael Roble

45618 Iron Horse Terr.,

Sterling, VA 20166

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.34 Priority creditor's name and mailing address As of the petition filing date, the claim is: $32.03 $32.03

Michelle G Mejia

3901 Lyndhurst Drive, #102

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 9 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.35 Priority creditor's name and mailing address As of the petition filing date, the claim is: $1,266.97 $1,266.97

Nicholas Delullo

5114 Kings Grove St.,

Burke, VA 22015

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.36 Priority creditor's name and mailing address As of the petition filing date, the claim is: $7.57 $7.57

Nina M. Fowler

4281 Mazarin Pl., Apt. 203

Fairfax, VA 22033

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.37 Priority creditor's name and mailing address As of the petition filing date, the claim is: $87.65 $87.65

Ricardo A. Salguero

7733 Sebrell St.,

Lorton, VA 22079

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.38 Priority creditor's name and mailing address As of the petition filing date, the claim is: $380.00 $380.00

Roton R. Rozario

10238 Cub Run Ct.,

Manassas, VA 20109

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 10 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.39 Priority creditor's name and mailing address As of the petition filing date, the claim is: $47.25 $47.25

Samantha G. Robertson

10109 Alice Ct.,

Fairfax, VA 22032

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.40 Priority creditor's name and mailing address As of the petition filing date, the claim is: $7.49 $7.49

Sarah D. Hink

4229 lley Ln

Fairfax, VA 22032

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.41 Priority creditor's name and mailing address As of the petition filing date, the claim is: $16.03 $16.03

Sierra R. Williams

10419 Courthouse Dr

Fairfax, VA 22030

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.42 Priority creditor's name and mailing address As of the petition filing date, the claim is: $65.51 $65.51

Steven Natale

7975 Almeda Ct.,

Lorton, VA 22079

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 11 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.43 Priority creditor's name and mailing address As of the petition filing date, the claim is: $31.27 $31.27

Terrell D. Hood II

3029 Chain Bridge Road

Oakton, VA 22124

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.44 Priority creditor's name and mailing address As of the petition filing date, the claim is: $25.77 $25.77

Thomas Anderson

11109 Robert Carter Rd.,

Fairfax Station, VA 22039

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number N/A

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.45 Priority creditor's name and mailing address As of the petition filing date, the claim is: $9,828.14 $9,828.14

Tracey DeBoissiere

7405 Windy Hill Court

Mc Lean, VA 22102

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.46 Priority creditor's name and mailing address As of the petition filing date, the claim is: $2,500.00 $2,500.00

Treasurer of City of Fairfax

10455 Armstrong Street

Room 224-City Hall

Fairfax, VA 22030

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

9/2016

Last 4 digits of account number 5856

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (8)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 12 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.47 Priority creditor's name and mailing address As of the petition filing date, the claim is: $70.63 $70.63

Trevor J Snelling

4929 35th Street N

Arlington, VA 22207

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.48 Priority creditor's name and mailing address As of the petition filing date, the claim is: $2,500.00 $2,500.00

VA Dept of Taxation

PO Box 26627

Richmond, VA 23218

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

9/2016

Last 4 digits of account number f001

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (8)

Is the claim subject to offset?

 No

 Yes

2.49 Priority creditor's name and mailing address As of the petition filing date, the claim is: $338.33 $338.33

Victor M. Marquina

220 Glengyle Drive

Vienna, VA 22181

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

2.50 Priority creditor's name and mailing address As of the petition filing date, the claim is: $279.46 $279.46

Walter Cho

10643 Lakeside Oak Ct.,

Burke, VA 22015

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 13 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

2.51 Priority creditor's name and mailing address As of the petition filing date, the claim is: $74.81 $74.81

Young Jin A. Yoon

3939 Persimmon Dr, #203

Fairfax, VA 22031

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (4)

Is the claim subject to offset?

 No

 Yes

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill

out and attach the Additional Page of Part 2.

Amount of claim

3.1 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $850.00

Alan Hamm Architects P.C.

10531 Metropolitan Ave.,

Kensington, MD 20895

Date(s) debt was incurred Unk 

Last 4 digits of account number Unk 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.2 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $145.00

American Disposal Services

PO Box 37053

Baltimore, MD 21297-0305

Date(s) debt was incurred unk 

Last 4 digits of account number 8216 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.3 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $450.00

AutoChlor 7900

Kincannon Place

Lorton, VA 22079

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.4 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,199.33

Benefit Mall

PO Box 418742

Boston, MA 02241-8742

Date(s) debt was incurred 

Last 4 digits of account number 9651 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.5 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $673.00

Coca-Cola Refreshments USA Inc

PO Box 602937

Charlotte, NC 28260-2937

Date(s) debt was incurred 

Last 4 digits of account number 2871 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 14 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

3.6 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,000.00

Cox Communications

Dept 781114 PO Box 78000

Detroit, MI 48278-1114

Date(s) debt was incurred ? 

Last 4 digits of account number 0603 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.7 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $300,000.00

David & Krisan Marotta

1315 Chippendale Court

Charlottesville, VA 22901

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.8 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $3,500.00

Direct TV

PO Box 60036

Los Angeles, CA 90060-0036

Date(s) debt was incurred ??? 

Last 4 digits of account number 7122 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.9 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $6,700.00

Dominion Virginia Power

120 Tredegar Street

Richmond, VA 23219

Date(s) debt was incurred ???? 

Last 4 digits of account number 1108 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.10 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $0.00

Fairfax Water

PO Box 71076

Charlotte, NC 28272-1076

Date(s) debt was incurred ???? 

Last 4 digits of account number 6602 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.11 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $3,000.00

Geoff Bobsin

6302 Barsky Court Fairfax

Fairfax Station, VA 22039

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.12 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $130.00

Greenstar Pest Control

12109 Cadet Court

Manassas, VA 20109

Date(s) debt was incurred UNK 

Last 4 digits of account number 3543 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 15 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

3.13 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $0.00

Guidant Financial

1100 112th Ave. NE, Ste 100

Bellevue, WA 98004

Date(s) debt was incurred Unk 

Last 4 digits of account number Unk 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: HOW MUCH OWED???????? 

Is the claim subject to offset?  No  Yes

3.14 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,285.00

ID Studio 4, LLC

1431 Greenway Drive, Ste 510

Irving, TX 75038

Date(s) debt was incurred 

Last 4 digits of account number 7532 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.15 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $750.00

Landers Air Condition&Heat

8829 Lake Hill Drive

Lorton, VA 22079

Date(s) debt was incurred UNK 

Last 4 digits of account number 2861 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.16 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,300,000.00

Main 9959 LLC

c/o Stout & Teague

8001 Forbes Pl, #305

Springfield, VA 22151

Date(s) debt was incurred 2/2015 

Last 4 digits of account number Unk 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.17 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $695.00

NuCO1

PO Box 417902

Boston, MA 02241-7902

Date(s) debt was incurred Unk 

Last 4 digits of account number 2888 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.18 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,595.32

OpenTable, Inc.

PO Box 671198

Dallas, TX 75267

Date(s) debt was incurred Unk 

Last 4 digits of account number 3926 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.19 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $0.00

Payce Inc

1220 B East Joppa Road Ste 324

Towson, MD 21286

Date(s) debt was incurred Unk 

Last 4 digits of account number 8283 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: HOW MUCH OWED?? 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 16 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

3.20 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $8,690.00

Performance Foodservice MD

1333 Avondale Road

PO Box 779

New Windsor, MD 21776

Date(s) debt was incurred Unk 

Last 4 digits of account number 8964 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.21 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,525.00

Restaurant Technologies, Inc

2250 Pilot Know Road, Ste 100

Mendota Heights, MN 55120

Date(s) debt was incurred Unk 

Last 4 digits of account number 7565 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.22 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $17,267.00

Richard Bowden

7941 Community Drive

Manassas, VA 20109

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.23 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,002.00

S Freedman & Sons, Inc.

PO Box 1418

Hyattsville, MD 20785-0418

Date(s) debt was incurred Unk 

Last 4 digits of account number 4784 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.24 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $200.00

Security Central

PO Box 602371

Charlotte, NC 28260-2371

Date(s) debt was incurred Unk 

Last 4 digits of account number 4824 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.25 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $705.00

Tap26

11126 Airport Road, Suite E

Ashland, VA 23005

Date(s) debt was incurred 3/1/2016 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.26 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $210.00

Tech 24

410 E Washington Street

Greenville, SC 29601

Date(s) debt was incurred 3/18/16 

Last 4 digits of account number 5129 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 17 of 18

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Debtor Chops SG I INC Case number (if known) 16-13903

Name

3.27 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $4,530.00

The Hartford

PO Box 660916

Dallas, TX 75266-0916

Date(s) debt was incurred Unk 

Last 4 digits of account number 2547 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.28 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $200.00

Trenity Monitoring

8610 Virginia Meadows Drive

Manassas, VA 20109

Date(s) debt was incurred Unk 

Last 4 digits of account number ov38 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.29 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,450.00

Virginia Linen Service

6694 Fleet Drive

Alexandria, VA 22310

Date(s) debt was incurred Unk 

Last 4 digits of account number 3312 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

3.30 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $0.00

Washington Gas

6801 Industrial Road

Springfield, VA 22151

Date(s) debt was incurred Unk 

Last 4 digits of account number Unk 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset?  No  Yes

Part 3: List Others to Be Notified About Unsecured Claims

4. List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies,

assignees of claims listed above, and attorneys for unsecured creditors.

If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page.

Name and mailing address On which line in Part1 or Part 2 is the

related creditor (if any) listed?

Last 4 digits of

account number, if

any

Part 4: Total Amounts of the Priority and Nonpriority Unsecured Claims

5. Add the amounts of priority and nonpriority unsecured claims.

Total of claim amounts

5a. Total claims from Part 1 5a. $ 43,080.67

5b. Total claims from Part 2 5b. + $ 2,659,751.65

5c. Total of Parts 1 and 2

 Lines 5a + 5b = 5c. 5c. $ 2,702,832.32

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 18 of 18

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Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206G

Schedule G: Executory Contracts and Unexpired Leases 12/15

Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, number the entries consecutively.

1. Does the debtor have any executory contracts or unexpired leases?

 No. Check this box and file this form with the debtor's other schedules. There is 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: Assets - Real and Personal Property

(Official Form 206A/B).

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

2.1. State what the contract or

lease is for and the nature of

the debtor's interest

Waste Disposal

Contract

American Disposal Services

PO Box 37053

Baltimore, MD 21297

State the term remaining

List the contract number of any

government contract

2.2. State what the contract or

lease is for and the nature of

the debtor's interest

Soft drink

Coca-Cola Refreshments USA Inc

PO Box 602937

Charlotte, NC 28260-2937

State the term remaining

List the contract number of any

government contract

2.3. State what the contract or

lease is for and the nature of

the debtor's interest

TV programs

Direct TV

PO Box 60036

Los Angeles, CA 90060-0036

State the term remaining

List the contract number of any

government contract

2.4. State what the contract or

lease is for and the nature of

the debtor's interest

Merchant

services/Credit card

processing

Elavon North America

Two Concourse Parkway, Suite 8

Atlanta, GA 30328

State the term remaining

List the contract number of any

government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 1 of 3

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Debtor 1 Chops SG I INC Case number (if known) 16-13903

First Name Middle Name Last Name

Additional Page if You Have More Contracts or Leases

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

2.5. State what the contract or

lease is for and the nature of

the debtor's interest

Pest removal services

Greenstar Pest Control

12109 Cadet Court

Manassas, VA 20109

State the term remaining

List the contract number of any

government contract

2.6. State what the contract or

lease is for and the nature of

the debtor's interest

Lease on commercial

premises at 9959 Main

Street, Fairfax, VA

22032

Main 9959 LLC

9959 Elden Street Suite 201

Herndon, VA 20170

State the term remaining 8 years and 3 months

List the contract number of any

government contract

2.7. State what the contract or

lease is for and the nature of

the debtor's interest

Gas

NuCO2

Po Box 417902

Boston, MA 02241-7902

State the term remaining

List the contract number of any

government contract

2.8. State what the contract or

lease is for and the nature of

the debtor's interest

Reservation services

Open Table, Inc.

PO Box 671198

Dallas, TX 75267-1198

State the term remaining

List the contract number of any

government contract

2.9. State what the contract or

lease is for and the nature of

the debtor's interest

Payroll services

Payce Inc

1220 B East Joppa Road Ste 324

Towson, MD 21286

State the term remaining

List the contract number of any

government contract

2.10. State what the contract or

lease is for and the nature of

the debtor's interest

Oil

Restaurant Technologies, Inc

2250 Pilot Know Road, Ste 100

Mendota Heights, MN 55120

State the term remaining

List the contract number of any

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 2 of 3

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Debtor 1 Chops SG I INC Case number (if known) 16-13903

First Name Middle Name Last Name

Additional Page if You Have More Contracts or Leases

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

government contract

2.11. State what the contract or

lease is for and the nature of

the debtor's interest

Fire alarm monitoring

Security Central

PO Box 602371

Charlotte, NC 28260-2371

State the term remaining

List the contract number of any

government contract

2.12. State what the contract or

lease is for and the nature of

the debtor's interest

Insurance

The Hartford

PO Box 660916

Dallas, TX 75266-0916

State the term remaining

List the contract number of any

government contract

2.13. State what the contract or

lease is for and the nature of

the debtor's interest

Security Monitoring

Trenity Monitoring

8610 Virginia Meadows Dr

Manassas, VA 20109

State the term remaining

List the contract number of any

government contract

2.14. State what the contract or

lease is for and the nature of

the debtor's interest

Linen service

Virginia Lien Service

6694 Fleet Drive

Alexandria, VA 22310

State the term remaining

List the contract number of any

government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 3 of 3

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Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 206H

Schedule H: Your Codebtors 12/15

Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach the

Additional Page to this page.

1. Do you have any codebtors?

 No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form.

 Yes

2. In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of

creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule

on which the creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.

Column 1: Codebtor Column 2: Creditor

Name Mailing Address Name Check all schedules

that apply:

2.1 Francis E.

Froelich

7405 Windy Hill ct

Mc Lean, VA 22102

Sandy Spring Bank  D 2.1 

 E/F 

 G 

2.2 Francis Froelich 7405 Windy Hill Ct

Mc Lean, VA 22102

Sandy Spring Bank  D 2.2 

 E/F 

 G 

Official Form 206H Schedule H: Your Codebtors Page 1 of 1

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Fill in this information to identify the case:

Debtor name Chops SG I INC

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number (if known) 16-13903

 Check if this is an

amended filing

Official Form 207

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

The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,

write the debtor’s name and case number (if known).

Part 1: Income

1. Gross revenue from business

 None.

Identify the beginning and ending dates of the debtor’s fiscal year,

which may be a calendar year

Sources of revenue

Check all that apply

Gross revenue

(before deductions and

exclusions)

From the beginning of the fiscal year to filing date:

From 1/01/2016 to Filing Date

 Operating a business $474,896.00

 Other

2. Non-business revenue

Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits,

and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.

 None.

Description of sources of revenue Gross revenue from

each source

(before deductions and

exclusions)

Part 2: List Certain Transfers Made Before Filing for Bankruptcy

3. Certain payments or transfers to creditors within 90 days before filing this case

List payments or transfers--including expense reimbursements--to any creditor, other than regular employee compensation, within 90 days before

filing this case unless the aggregate value of all property transferred to that creditor is less than $6,425. (This amount may be adjusted on 4/01/19

and every 3 years after that with respect to cases filed on or after the date of adjustment.)

 None.

Creditor's Name and Address Dates Total amount of value Reasons for payment or transfer

Check all that apply

3.1. Coastal Sunbelt Produce 8/3/2016

9/17/2016

$10,238.00  Secured debt

 Unsecured loan repayments

 Suppliers or vendors

 Services

 Other 

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 1

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Debtor Chops SG I INC Case number (if known) 16-13903

Creditor's Name and Address Dates Total amount of value Reasons for payment or transfer

Check all that apply

3.2. Perrformance Food Service

1333 Avondale Rd

New Windsor, MD 21776

8/3/2016

9/14/2016

$17,704.00  Secured debt

 Unsecured loan repayments

 Suppliers or vendors

 Services

 Other 

3.3. Sandy Spring Bank

17801 Georgia Ave

Olney, MD 20832

8/3/2016

10/30/2016

$17,000.00  Secured debt

 Unsecured loan repayments

 Suppliers or vendors

 Services

 Other 

4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider

List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or guaranteed

or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than $6,425. (This amount

may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) Do not include any payments

listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their relatives; general partners of a partnership

debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and any managing agent of the debtor. 11 U.S.C. § 101(31).

 None.

Insider's name and address

Relationship to debtor

Dates Total amount of value Reasons for payment or transfer

5. Repossessions, foreclosures, and returns

List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor, sold at

a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6.

 None

Creditor's name and address Describe of the Property Date Value of property

6. Setoffs

List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account

of the debtor without permission or refused to make a payment at the debtor’s direction from an account of the debtor because the debtor owed a

debt.

 None

Creditor's name and address Description of the action creditor took Date action was

taken

Amount

Sandy Spring Bank

17801 Georgia ave

Olney, MD 20832

Seized Bank Accounts

Last 4 digits of account number: 

Unknown $8,000.00

Part 3: Legal Actions or Assignments

7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits

List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor was involved

in any capacity—within 1 year before filing this case.

 None.

Case title

Case number

Nature of case Court or agency's name and

address

Status of case

8. Assignments and receivership

List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the hands of a

receiver, custodian, or other court-appointed officer within 1 year before filing this case.

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 2

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Debtor Chops SG I INC Case number (if known) 16-13903

 None

Part 4: Certain Gifts and Charitable Contributions

9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of

the gifts to that recipient is less than $1,000

 None

Recipient's name and address Description of the gifts or contributions Dates given Value

Part 5: Certain Losses

10. All losses from fire, theft, or other casualty within 1 year before filing this case.

 None

Description of the property lost and

how the loss occurred

Amount of payments received for the loss

If you have received payments to cover the loss, for

example, from insurance, government compensation, or

tort liability, list the total received.

List unpaid claims on Official Form 106A/B (Schedule

A/B: Assets – Real and Personal Property).

Dates of loss Value of property

lost

Part 6: Certain Payments or Transfers

11. Payments related to bankruptcy

List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing

of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy

relief, or filing a bankruptcy case.

 None.

Who was paid or who received

the transfer?

Address

If not money, describe any property transferred Dates Total amount or

value

11.1. Sawyer & Azarcon

10605 B-2 Judicial Drive

Fairfax, VA 22030

Checks. $3,665.00 atty. fees; $335.00 filing

fees Nov., 2016 $4,000.00

Email or website address

sa@sawyerazarcon.com

Who made the payment, if not debtor?

12. Self-settled trusts of which the debtor is a beneficiary

List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case

to a self-settled trust or similar device.

Do not include transfers already listed on this statement.

 None.

Name of trust or device Describe any property transferred Dates transfers

were made

Total amount or

value

13. Transfers not already listed on this statement

List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within

2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include

both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 3

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Debtor Chops SG I INC Case number (if known) 16-13903

 None.

Who received transfer?

Address

Description of property transferred or

payments received or debts paid in exchange

Date transfer

was made

Total amount or

value

Part 7: Previous Locations

14. Previous addresses

List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.

 Does not apply

Address Dates of occupancy

From-To

Part 8: Health Care Bankruptcies

15. Health Care bankruptcies

Is the debtor primarily engaged in offering services and facilities for:

- diagnosing or treating injury, deformity, or disease, or

- providing any surgical, psychiatric, drug treatment, or obstetric care?

 No. Go to Part 9.

 Yes. Fill in the information below.

Facility name and address Nature of the business operation, including type of services

the debtor provides

If debtor provides meals

and housing, number of

patients in debtor’s care

Part 9: Personally Identifiable Information

16. Does the debtor collect and retain personally identifiable information of customers?

 No.

 Yes. State the nature of the information collected and retained.

17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other pension or

profit-sharing plan made available by the debtor as an employee benefit?

 No. Go to Part 10.

 Yes. Does the debtor serve as plan administrator?

 No Go to Part 10.

 Yes. Fill in below:

Name of plan Employer identification number of the plan

Chops SG I Inc. 401K Plan EIN: 47-2996399

Has the plan been terminated?

 No

 Yes

Part 10: Certain Financial Accounts, Safe Deposit Boxes, and Storage Units

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 4

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Debtor Chops SG I INC Case number (if known) 16-13903

18. Closed financial accounts

Within 1 year before filing this case, were any financial accounts or instruments held in the debtor’s name, or for the debtor’s benefit, closed, sold,

moved, or transferred?

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

cooperatives, associations, and other financial institutions.

 None

Financial Institution name and

Address

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

19. Safe deposit boxes

List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this

case.

 None

Depository institution name and address Names of anyone with

access to it

Address

Description of the contents Do you still

have it?

20. Off-premises storage

List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in

which the debtor does business.

 None

Facility name and address Names of anyone with

access to it

Description of the contents Do you still

have it?

Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own

21. Property held for another

List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do

not list leased or rented property.

 None

Owner's name and address Location of the property Describe the property Value

F. E. Froelich 7601 Lewinsville Rd

Mc Lean, VA 22102

POS Server $1,000.00

Part 12: Details About Environment Information

For the purpose of Part 12, the following definitions apply:

Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the

medium affected (air, land, water, or any other medium).

Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly

owned, operated, or utilized.

Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a

similarly harmful substance.

Report all notices, releases, and proceedings known, regardless of when they occurred.

22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.

 No.

 Yes. Provide details below.

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 5

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Debtor Chops SG I INC Case number (if known) 16-13903

Case title

Case number

Court or agency name and

address

Nature of the case Status of case

23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an

environmental law?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address

Environmental law, if known Date of notice

24. Has the debtor notified any governmental unit of any release of hazardous material?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address

Environmental law, if known Date of notice

Part 13: Details About the Debtor's Business or Connections to Any Business

25. Other businesses in which the debtor has or has had an interest

List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.

Include this information even if already listed in the Schedules.

 None

Business name address Describe the nature of the business Employer Identification number

Do not include Social Security number or ITIN.

Dates business existed

26. Books, records, and financial statements

26a. List all accountants and bookkeepers who maintained the debtor’s books and records within 2 years before filing this case.

 None

Name and address Date of service

From-To

26a.1. Geoff Bobsin

6302 Barsky Court Fairfax

Fairfax Station, VA 22039

2015 - 2016

26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of account and records or prepared a financial statement

within 2 years before filing this case.

 None

Name and address Date of service

From-To

26b.1. Geoff Bobsin

6302 Barsky Court Fairfax

Fairfax Station, VA 22039

26c. List all firms or individuals who were in possession of the debtor’s books of account and records when this case is filed.

 None

Name and address If any books of account and records are

unavailable, explain why

26c.1. Geoff Bobsin

6302 Barsky Court Fairfax

Fairfax Station, VA 22039

26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 6

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Debtor Chops SG I INC Case number (if known) 16-13903

statement within 2 years before filing this case.

 None

Name and address

26d.1. Sandy Spring Bank

17801 Georgia Ave

Olney, MD 20832

27. Inventories

Have any inventories of the debtor’s property been taken within 2 years before filing this case?

 No

 Yes. Give the details about the two most recent inventories.

Name of the person who supervised the taking of the

inventory

Date of inventory The dollar amount and basis (cost, market,

or other basis) of each inventory

28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other people

in control of the debtor at the time of the filing of this case.

Name Address Position and nature of any

interest

% of interest, if

any

Francis E. Froelich 7405 Windy Hill Court

Mc Lean, VA 22102

President/Director 100%

Name Address Position and nature of any

interest

% of interest, if

any

Tracey Froelich 7405 Windy Hill Ct

Mc Lean, VA 22102

Director 0

Name Address Position and nature of any

interest

% of interest, if

any

Geoff Bobsin 6302 Barsky Ct

Fairfax Station, VA 22039

Director/Secretary 0

29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in

control of the debtor, or shareholders in control of the debtor who no longer hold these positions?

 No

 Yes. Identify below.

30. Payments, distributions, or withdrawals credited or given to insiders

Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses,

loans, credits on loans, stock redemptions, and options exercised?

 No

 Yes. Identify below.

Name and address of recipient Amount of money or description and value of

property

Dates Reason for

providing the value

30.1

.

Francis E. Froelich

7405 Windy Hill Court

Mc Lean, VA 22102

Wages in 2016: $38,461.50

Additional checks for wages in the sum

of $19,230.75 were not cashed nor

deposited.

Biweekly in

2016 Work performed.

Relationship to debtor

Director/Officer/Stockholder

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 7

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Debtor Chops SG I INC Case number (if known) 16-13903

Name and address of recipient Amount of money or description and value of

property

Dates Reason for

providing the value

30.2

.

Tracey Froelich

7405 Windy Hill Ct

Mc Lean, VA 22102

Wages in 2016: $45,000.02.

Additional checks were issued in the

sumk of $6,230.75 were not cashed nor

deposited.

Biweekly in

20216 Work performed.

Relationship to debtor

Director/Officer

30.3

.

Geoff Bobsin

6302 Barsky Court Fairfax

Fairfax Station, VA 22039 $6,000.00

Monthly in

2016 Accounting work

Relationship to debtor

Director/Officer

31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?

 No

 Yes. Identify below.

Name of the parent corporation Employer Identification number of the parent

corporation

32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?

 No

 Yes. Identify below.

Name of the parent corporation Employer Identification number of the parent

corporation

Part 14: Signature and Declaration

WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both.

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

I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information is true

and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on November 28, 2016

/s/ Francis E. Froelich Francis E. Froelich

Signature of individual signing on behalf of the debtor Printed name

Position or relationship to debtor President

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?

 No

 Yes

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 8

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