Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1

Fill in this information to identify the case:

United States Bankruptcy Court for the:

Eastern District of Virginia

(State)

Case number (if known): Chapter 11

☐ Check if this is an

 amended filing

Official Form 201

Voluntary Petition for Non-Individuals Filing for 

Bankruptcy 04/20

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 the 

case number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is 

available.

1. Debtor’s Name Ascena Retail Group, Inc.

N/A

2. All other names debtor used

in the last 8 years

Include any assumed names,

trade names, and doing

business as names

3. Debtor’s federal Employer

Identification Number (EIN) 30-0641353

4. Debtor’s address Principal place of business

933 MacArthur Boulevard

Mailing address, if different from principal place

of business

Number Street Number Street

Mahwah NJ 07430

P.O. Box

City State Zip Code

Bergen County

City State Zip Code

Location of principal assets, if different from

principal place of business

County Number Street

City State Zip Code

5. Debtor’s website (URL) https://www.ascenaretail.com/

☒ Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP))

☐ Partnership (excluding LLP)

6. Type of debtor

☐ Other. Specify:

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 1 of 18
Debtor Ascena Retail Group, Inc. Case number (if known)

Name

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 2

7. Describe debtor’s business

A. Check One:

☐ 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))

☐ Railroad (as defined in 11 U.S.C. § 101(44))

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

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

☐ Clearing Bank (as defined in 11 U.S.C. § 781(3))

☒ None of the above

B. Check all that apply:

☐ Tax-exempt entity (as described in 26 U.S.C. § 501)

☐ Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C. 

§ 80a-3)

☐ Investment advisor (as defined in 15 U.S.C. § 80b-2(a)(11))

C. NAICS (North American Industry Classification System) 4-digit code that best describes debtor. See

 http://www.uscourts.gov/four-digit-national-association-naics-codes .

4481 (Clothing Stores)

8. Under which chapter of the 

Bankruptcy Code is the 

debtor filing?

A debtor who is a “small 

business debtor” must 

check the first sub-box. A 

debtor as defined in § 

1182(1) who elects to 

proceed under subchapter 

V of chapter 11 (whether or 

not the debtor is a “small 

business debtor”) must 

check the second sub-box.

Check One:

☐ Chapter 7

☐ Chapter 9

☒ Chapter 11. Check all that apply:

☐ The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and its 

aggregate noncontingent liquidated debts (excluding debts owed to insiders or 

affiliates) are less than $2,725,625. If this sub-box is selected, attach the 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).

☐ The debtor is a debtor as defined in 11 U.S.C. § 1182(1). Its aggregate noncontingent 

liquidated debts (excluding debts owed to insiders or affiliates) are less than $7,500,000 

and it chooses to proceed under Subchapter V of Chapter 11. If this sub-box is 

selected, attach the 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).

☐ A plan is being filed with this petition.

☐ Acceptances of the plan were solicited prepetition from one or more classes of

creditors, in accordance with 11 U.S.C. § 1126(b).

☒ The debtor is required to file periodic reports (for example, 10K and 10Q) with the 

Securities and Exchange Commission according to § 13 or 15(d) of the Securities

Exchange Act of 1934. File the Attachment to Voluntary Petition for Non-Individuals 

Filing for Bankruptcy under Chapter 11 (Official Form 201A) with this form. 

☐ The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule

12b-2. 

☐ Chapter 12

☒ No

☐ Yes. District When

MM/DD/YYYY

Case number

9. Were prior bankruptcy cases

filed by or against the debtor 

within the last 8 years?

If more than 2 cases, attach a 

separate list.

District When

MM/DD/YYYY

Case number

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 2 of 18
Debtor Ascena Retail Group, Inc. Case number (if known)

Name

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 3

Relationship Affiliate

☐ No

☒ Yes. Debtor See Rider 1

District Eastern District of Virginia

07/23/2020

10. Are any bankruptcy cases

pending or being filed by a

business partner or an

affiliate of the debtor?

List all cases. If more than 1,

attach a separate list. Case number, if known _______________________

When

MM / DD / YYYY

11. Why is the case filed in this

district?

Check all that apply:

☐ Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days

immediately preceding the date of this petition or for a longer part of such 180 days than in any other

district.

☒ A bankruptcy case concerning debtor's affiliate, general partner, or partnership is pending in this district.

12. Does the debtor own or have

possession of any real

property or personal property

that needs immediate

attention?

☒ No

☐ Yes. Answer below for each property that needs immediate attention. Attach additional sheets if needed.

Why does the property need immediate attention? (Check all that apply.)

☐ It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or

safety.

What is the hazard?

☐ It needs to be physically secured or protected from the weather.

☐ It includes perishable goods or assets that could quickly deteriorate or lose value without attention

(for example, livestock, seasonal goods, meat, dairy, produce, or securities-related assets or

other options).

☐ Other

Where is the property?

Number Street

City State Zip Code

Is the property insured?

☐ No

☐ Yes. Insurance agency

Contact name

Phone

Statistical and administrative information

13. Debtor's estimation of

available funds

Check one:

☒ Funds will be available for distribution to unsecured creditors.

☐ After any administrative expenses are paid, no funds will be available for distribution to unsecured creditors.

14. Estimated number of

creditors1

☐ 1-49 ☐ 1,000-5,000 ☐ 25,001-50,000

☐ 50-99 ☐ 5,001-10,000 ☐ 50,001-100,000

☐ 100-199 ☐ 10,001-25,000 ☒ More than 100,000

☐ 200-999

1 The Debtors’ estimated number of creditors noted here are provided on a consolidated basis.

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 3 of 18
Debtor Ascena Retail Group, Inc. Case number (if known)

Name

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 4

15. Estimated assets ☐ $0-$50,000 ☐ $1,000,001-$10 million ☐ $500,000,001-$1 billion

☐ $50,001-$100,000 ☐ $10,000,001-$50 million ☐ $1,000,000,001-$10 billion

☐ $100,001-$500,000 ☐ $50,000,001-$100 million ☒ $10,000,000,001-$50 billion

☐ $500,001-$1 million ☐ $100,000,001-$500 million ☐ More than $50 billion

16. Estimated liabilities ☐ $0-$50,000 ☐ $1,000,001-$10 million ☐ $500,000,001-$1 billion

☐ $50,001-$100,000 ☐ $10,000,001-$50 million ☐ $1,000,000,001-$10 billion

☐ $100,001-$500,000 ☐ $50,000,001-$100 million ☒ $10,000,000,001-$50 billion

☐ $500,001-$1 million ☐ $100,000,001-$500 million ☐ More than $50 billion

Request for Relief, Declaration, and Signatures

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement 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.

17. Declaration and signature of

authorized representative of

debtor

The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this 

petition.

I have been authorized to file this petition on behalf of the debtor.

I have examined the information in this petition 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 07/23/2020

MM/ DD / YYYY

 /s/ Carrie W. Teffner Carrie W. Teffner

Signature of authorized representative of debtor Printed name

Title Authorized Signatory

18. Signature of attorney  /s/ Cullen D. Speckhart Date 07/23/2020

Signature of attorney for debtor MM/DD/YYYY

Cullen D. Speckhart

Printed name

Cooley LLP

Firm name

1299 Pennsylvania Avenue, NW, Suite 700

Number Street

Washington DC 20004-2400

City

(202) 842-7800

State ZIP Code

cspeckhart@cooley.com

Contact phone

79096 Virginia

Email address

Bar number State

(Admitted to practice in New York, Virginia, Missouri and Texas; Not admitted to practice in DC, 

supervised by members of DC bar)

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 4 of 18
Official Form 201A (12/15)

IN THE UNITED STATES BANKRUPTCY COURT

FOR THE EASTERN DISTRICT OF VIRGINIA

RICHMOND DIVISION

)

In re: ) Chapter 11

)

ASCENA RETAIL GROUP, INC., ) Case No. 20-___________(___)

)

Debtor. )

)

Attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11

1. If any of the debtor’s securities are registered under Section 12 of the Securities Exchange Act of 1934, the SEC file 

number is 0-11736

2. The following financial data is the latest available information and refers to the debtor’s condition on

The Most Recent 10Q was filed on March 9, 2020, which reflected data as of February 1, 2020.

(a) Total assets $ 13,690,710,379.40

(b) Total debts (including debts listed in 2.c., below) $ 12,516,261,149.25

(c) Debt securities held by more than 500 holders N/A

Approximate

number of 

holders:

secured ☐ unsecured ☐ subordinated ☐ $

secured ☐ unsecured ☐ subordinated ☐ $

secured ☐ unsecured ☐ subordinated ☐ $

secured ☐ unsecured ☐ subordinated ☐ $

secured ☐ unsecured ☐ subordinated ☐ $

(d) Number of shares of preferred stock 0 issued

(e) Number of shares of common stock

Approximately 

10,000,000 issued 

shares

Comments, if any: Ascena Retail Group, Inc. does not and cannot know the precise number of beneficial 

holders of any of the debt securities it has issued and does not believe that any such securities are held by more than

500 holders.

3. Brief description of debtor’s business: Ascena Retail Group, Inc. (Nasdaq: ASNA) is a national specialty retailer 

offering apparel, shoes, and accessories for women under the Premium Fashion segment (Ann Taylor, LOFT, and 

Lou & Grey), Plus Fashion segment (Lane Bryant, Catherines, and Cacique) and for tween girls under the Kids Fashion 

Segment (Justice). Ascena Retail Group, Inc. through its retail brands operates e-commerce websites and 

approximately 2,800 stores throughout the United States, Canada, and Puerto Rico.

4. List the names of any person who directly or indirectly owns, controls, or holds, with power to vote, 5% or more of the 

voting securities of debtor: 

Stadium Capital Management LLC; Charles Schwab Investment Management, Inc.; Dimensional Fund Advisors LP;

BlackRock Fund Advisors; Renaissance Technologies LLC; David R. Jaffe; Elise Jaffe.

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 5 of 18
Fill in this information to identify the case:

United States Bankruptcy Court for the:

,

Eastern District of Virginia

(State)

Case number (if known): Chapter 11

☐ Check if this is an

 amended filing

Rider 1

Pending Bankruptcy Cases Filed by the Debtor and Affiliates of the Debtor

On the date hereof, each of the entities listed below (collectively, the “Debtors”) filed a petition in the United 

States Bankruptcy Court for the Eastern District of Virginia for relief under chapter 11 of title 11 of the United States 

Code. The Debtors have moved for joint administration of these cases under the case number assigned to the 

chapter 11 case of Ascena Retail Group, Inc. 

 Ascena Retail Group, Inc.

 933 Inspiration LLC

 Ann Card Services, Inc.

 Ann, Inc.

 AnnCo, Inc.

 AnnTaylor Distribution Services, Inc.

 AnnTaylor of Puerto Rico, Inc.

 AnnTaylor Retail, Inc.

 AnnTaylor, Inc.

 Ascena Retail Holdings, Inc.

 Ascena Trade Services, LLC

 ASNA Plus Fashion, Inc.

 ASNA Value Fashion LLC

 BackingBrands Buying Agent, LLC

 BackingBrands Solutions, LLC

 C.S.F. Corp.

 Catalog Receivables LLC

 Catalog Seller LLC

 Catherines #5124, Inc.

 Catherines #5147, Inc.

 Catherines Stores Corporation

 Catherines, Inc.

 CCTM, Inc.

 Charming Sales Co. Four, Inc.

 Charming Sales Co. One, Inc.

 Charming Sales Co Three, Inc.

 Charming Sales Co. Two, Inc.

 Charming Shoppes of Delaware, Inc.

 Charming Shoppes Receivables 

Corp.

 Charming Shoppes Seller, Inc.

 Charming Shoppes Street, Inc.

 Charming Shoppes, Inc.

 Chestnut Acquisition Sub Inc.

 Crosstown Traders, Inc.

 CS HoldCo II Inc.

 CSGC, Inc.

 CSI Industries, Inc.

 CSPE, LLC

 DBCM Holdings, LLC

 DBI Holdings, Inc.

 DBX, Inc.

 Duluth Real Estate LLC

 Etna Retail DC, LLC

 Fashion Apparel Sourcing LLC

 Fashion Service Fulfillment 

Corporation

 Fashion Service LLC

 GC Fulfillment, LLC

 Lane Bryant #6243, Inc.

 Lane Bryant of Pennsylvania, Inc.

 Lane Bryant Outlet 4106, Inc.

 Lane Bryant Purchasing Corp.

 Lane Bryant, Inc.

 PSTM, Inc.

 Sonsi, Inc.

 Spirit of America, Inc.

 Too GC, LLC

 Tween Brands Agency, Inc.

 Tween Brands Direct Services Inc.

 Tween Brands Investment, LLC

 Tween Brands Marketing, Inc.

 Tween Brands Service Co.

 Tween Brands, Inc.

 Winks Lane, Inc.

 Worldwide Retail Holdings, Inc.

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 6 of 18
IN THE UNITED STATES BANKRUPTCY COURT

FOR THE EASTERN DISTRICT OF VIRGINIA

RICHMOND DIVISION

)

In re: ) Chapter 11

)

ASCENA RETAIL GROUP, INC., ) Case No. 20-___________(___)

)

Debtor. )

)

LIST OF EQUITY SECURITY HOLDERS1

Debtor Equity Holders Address of Equity Holder Percentage 

Held

Stadium Capital 

Management LLC

199 Elm Street 

New Canaan, CT 06840-5321 9.6%

Charles Schwab Investment 

Management, Inc.

211 Main Street 

San Francisco, CA 94105-1905 9.4%

Dimensional Fund Advisors 

LP

1299 Ocean Ave. 

Santa Monica, CA 90401-1038 7.0%

David R Jaffe [Redacted] 6.0%

BlackRock Fund Advisors 400 Howard St. 

San Francisco, CA 94105-2618 5.9%

Renaissance Technologies 

LLC

600 Route 25 A 

East Setauket, NY 11733-1235 5.5%

Ascena Retail 

Group, Inc.

Elise Jaffe [Redacted] 5.1%

1

 This list reflects holders of five percent or more of Ascena Retail Group, Inc.’s common stock. This list 

serves as the disclosure required to be made by the debtor pursuant to rule 1007 of the Federal Rules 

of Bankruptcy Procedure. By the Debtors’ Motion for Entry of an Order (I) Extending Time to File 

Schedules and Statements of Financial Affairs (II) Authorizing the Debtors to File a Consolidated List 

of Creditors in Lieu of Submitting a Separate Mailing Matrix for Each Debtor, (III) Authorizing the 

Debtors to File a Consolidated List of the Debtors’ 50 Largest Unsecured Creditors, (IV) Authorizing 

the Debtors to Redact Certain Personal Identification Information, (V) Waiving the Requirement to File 

a List of Equity Security Holders, and (VI) Granting Related Relief filed contemporaneously herewith, 

the Debtor is requesting a waiver of the requirement under Bankruptcy Rule 1007 to file a list of all of 

its equity security holders. 

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 7 of 18
IN THE UNITED STATES BANKRUPTCY COURT

FOR THE EASTERN DISTRICT OF VIRGINIA

RICHMOND DIVISION

)

In re: ) Chapter 11

)

ASCENA RETAIL GROUP, INC., ) Case No. 20-___________(___)

)

Debtor. )

)

CORPORATE OWNERSHIP STATEMENT

Pursuant to rules 1007(a)(1) and 7007.1 of the Federal Rules of Bankruptcy Procedure, the 

following are corporations, other than a government unit, that directly or indirectly own 10% or more of any 

class of the debtor’s equity interest:

Shareholder Approximate Percentage of Shares Held

N/A N/A

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 8 of 18


Official Form 204

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

1 SIMON PROPERTY GROUP

ATTN: DAVID SIMON

CHIEF EXECUTIVE OFFICER

SIMON PROPERTY GROUP, INC.

225 WEST WASHINGTON STREET

INDIANAPOLIS, IN 46204

DAVID SIMON

EMAIL - 

PHONE - 317-636-1600

FAX - 

TRADE 

PAYABLE C $31,664,060

2 BROOKFIELD PROPERTIES

ATTN: STACIE L. HERRON

EXECUTIVE VICE PRESIDENT, 

GENERAL COUNSEL AND SECRETARY

BROOKFIELD PLACE NEW YORK

250 VESEY STREET, 15TH FLOOR

NEW YORK, NY 10281

STACIE L. HERRON

EMAIL - 

STACIE.HERRON@BROOKFIELDPROPERTIES

RETAIL.COM;

LINDSAY.KAHN@BROOKFIELDPROPERTIES

RETAIL.COM; 

ANDREW.BRENT@BROOKFIELDPROPERTIES

.COM

PHONE - 212-417-7000

TRADE 

PAYABLE C $16,619,835

3 BOSTON PROPERTIES LIMITED 

PARTNERSHIP

ATTN: DOUGLAS T. LINDE

PRESIDENT

800 BOYLSTON STREET AT THE 

PRUDENTIAL CENTER

BOSTON, MA 02199-8103

DOUGLAS T. LINDE

EMAIL - 

PHONE - 617-236-3300

FAX - 617-536-5087 TRADE 

PAYABLE C $8,809,477

4 TANGER PROPERTIES, LP

ATTN: STEVEN B. TANGER

CHIEF EXECUTIVE OFFICER

3200 NORTHLINE AVENUE SUITE 360

GREENSBORO, NC 27408

STEVEN B. TANGER

EMAIL - SBTANGER@TANGEROUTLET.COM

PHONE - 336-292-3010

FAX - 336-852-2096 TRADE 

PAYABLE C $7,228,481

A list of creditors holding the 50 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor disputes. 

Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by secured creditors, 

unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 50 largest unsecured claims.

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

Chapter 11 or Chapter 9 Cases: Consolidated List of Creditors Who Have the 50 Largest 

Unsecured Claims and Are Not Insiders 12/15

Fill in this information to identify the case:

Debtor name Ascena Retail Group, Inc., et al. 

United States Bankruptcy Court for the: Eastern District of Virginia

Case number (If known): ______________ Check if this is an 

amended filing 

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 9 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

5 PAN PACIFIC CO LTD

ATTN: SUK-WON LIM

CHIEF EXECUTIVE OFFICER

(08380) 12

DIGITAL-RO 31-GIL

GURO-GU

SEOUL, GURO-DONG, 197-21

KOREA

SUK-WON LIM

EMAIL - PANPACIFIC@PANPACIFIC.CO.KR

PHONE - +82-2-3494-9000

FAX - +82-2-830-1011 TRADE 

PAYABLE $6,831,314

6 MGF SOURCING

ATTN: JAMES SCHWARTZ

CHIEF EXECUTIVE OFFICER

4200 REGENT STREET

SUITE 205

COLUMBUS, OH 43219

JAMES SCHWARTZ

EMAIL - 

JAMES.SCHWARTZ@MGFSOURCING.COM

PHONE - 614-904-3269

FAX - 614-415-7242 TRADE 

PAYABLE $6,726,982

7 SAE A TRADING CO. LTD

ATTN: WOONG-KI KIM

CHAIRMAN

SAE-A BLDG.

429 YEONGDONG-DAERO GANGNAMGU

SEOUL, 

KOREA

WOONG-KI KIM

EMAIL - 

PHONE - +82 2 6252 7000

FAX - +82-2-6252-7005 TRADE 

PAYABLE $6,347,041

8 ORIENT CRAFT

ATTN: SUDHIR DHINGRA

CHIEF EXECUTIVE OFFICER

PLOT NO. 80P SECTOR-34

NEAR HERO HONDA CHOWK

GURGAON, 122001

INDIA

SUDHIR DHINGRA

EMAIL - 

SUDHIR.DHINGRA@ORIENTCRAFT.COM

PHONE - +0124-4511300

FAX - +0124-4511330 TRADE 

PAYABLE $5,309,190

9 THE MACERICH COMPANY

ATTN: ANN C. MENARD

SENIOR EXECUTIVE VICE PRESIDENT, 

CHIEF LEGAL OFFICER AND 

SECRETARY

401 WILSHIRE BOULEVARD, SUITE 700

SANTA MONICA, CA 90401

ANN C. MENARD

EMAIL - ANN.MENARD@MACERICH.COM

PHONE - 310-394-6000; 424-229-3575

FAX - 310-395-2791 TRADE 

PAYABLE C $5,252,749

10 HIP SING CHINA INDUSTRIAL LINITED

ATTN: ADA LAU

UNIT B5, 6/F BLK 2, CAMELPAINT BLDG

62 HOI YUEN ROAD

KWUN TONG, KOWLOON, 

HONG KONG

ADA LAU

EMAIL - 

PHONE - +852-23905128

FAX - +852-23915128 TRADE 

PAYABLE $5,075,819

7/22/2020 Page ‐ 2

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 10 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

11 PT. ERATEX (HONG KONG) LTD

ATTN: MR. MANIWANEN 

PRESIDENT

SPAZIO BUILDING 3RD FLOOR UNIT.319-

321

GRAHA FESTIVAL KAV.3 – GRAHA 

FAMILY

JL. MAYJEND YONO SOEWOYO

SURABAYA, 60226

INDONESIA

MR. MANIWANEN 

EMAIL - 

PHONE - +62-31-99001101

FAX - +62-31-99001115

TRADE 

PAYABLE $5,026,842

12 THE TAUBMAN COMPANY

ATTN: CHRIS HEAPHY

EXECUTIVE VICE PRESIDENT, 

GENERAL COUNSEL & SECRETARY

200 E. LONG LAKE ROAD, SUITE 300

BLOOMFIELD HILLS, MI 48304-2324

CHRIS HEAPHY

EMAIL - CHEAPHY@TAUBMAN.COM; 

RHURREN@TAUBMAN.COM; 

MMAINVILLE@TAUBMAN.COM

PHONE - 248-258-6800

FAX - 

TRADE 

PAYABLE C $4,550,301

13 POONGIN TRADING CO.LTD

ATTN: PAUL PARK

CHIEF EXECUTIVE OFFICER

18F~20F ACE HIGH TECH CITY

 B/D 2 DONG, GYEONGLN-RO

YEONGDEUNGPO-GU

SEOUL, 755

KOREA

PAUL PARK

EMAIL - 

PHONE - +82-2-549-8313

FAX - +82-2-549-8310 TRADE 

PAYABLE $4,507,327

14 TAINAN ENTERPRISES CO. LTD

ATTN: CHING-HON YANG

CHAIRMAN

5-1, SECTION 1 HANGZHOU SOUTH 

ROAD

ZHONGZHENG DISTRICT

TAIPEI CITY, 100

TAIWAN

CHING-HON YANG

EMAIL - 

PHONE - +886 2 2391 6421

FAX - +886 2 2397 1413 TRADE 

PAYABLE $4,402,392

15 CBL & ASSOCIATES, INC.

ATTN: STEPHEN D. LEBOVITZ

CHIEF EXECUTIVE OFFICER

CBL CENTER, SUITE 500

2030 HAMILTON PLACE BLVD.

CHATTANOOGA, TN 37421

STEPHEN D. LEBOVITZ

EMAIL - 

PHONE - 432-855-0001

FAX - 

TRADE 

PAYABLE C $4,244,203

16 ORACLE AMERICA INC

ATTN: DORIAN DALEY

GENERAL COUNSEL

REDWOOD SHORES ORACLE 

CORPORATION

500 ORACLE PARKWAY

REDWOOD SHORES, CA 94065

DORIAN DALEY

EMAIL - DORIAN.DALEY@ORACLE.COM

PHONE - 650-506-7000

FAX - 650-633-1813 TRADE 

PAYABLE $4,158,303

7/22/2020 Page ‐ 3

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 11 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

17 CHOI & SHIN'S CO.,LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

61 BUKCHON-RO, JONGNO-GU

SEOUL, 110260

SOUTH KOREA

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - +82-232947200

FAX - 

TRADE 

PAYABLE $3,973,814

18 CRYSTAL ELEGANCE INDUSTRIAL 

LIMITED

ATTN: LAM ANTHONY

VICE PRESIDENT

71 HOW MING STREET

KWUN TONG, KOWLOON, 

HONG KONG

LAM ANTHONY

EMAIL - INFO@CRYSTALGROUP.COM

PHONE - 

FAX - 

TRADE 

PAYABLE $3,916,508

19 SNOGEN GREEN CO.,LTD

ATTN: JUNGKU HONG

CHIEF EXECUTIVE OFFICER

12, GWANGPYEONG-RO 56-GIL

GANGNAM-GU

SEOUL, 

KOREA

JUNGKU HONG

EMAIL - 

PHONE - +02-6496-6400

FAX - +02-6496-6501 TRADE 

PAYABLE $3,671,183

20 UBASE INTERNATIONAL INC

ATTN: YONG HOE KIM

CHIEF EXECUTIVE OFFICER

345, TTUKSEOM-RO

SEONGDONG-GU

SEOUL (SEONGSU-DONG), 04780

KOREA

YONG HOE KIM

EMAIL - 

CONTACTUS@UBASEINTERNATIONAL.COM

PHONE - +82 2-420-0001

FAX - +82 2-421-8787 TRADE 

PAYABLE $3,628,175

21 TEX WORLD PTE LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

PRESIDENT

610, ATL CORPORATE PARK

SAKI VIHAR ROAD, POWAI

MUMBAI, MAHARASHTRA 400072 

INDIA

PRESIDENT OR GENERAL COUNSEL

EMAIL - INFO@TEXWORLD.CO

PHONE - +91-22-42293542

FAX - 

TRADE 

PAYABLE $3,506,978

22 WESTFIELD CORPORATION, INC.

ATTN: PETER SCHWARTZ

GENERAL COUNSEL

2049 CENTURY PARK EAST, 40TH 

FLOOR

CENTURY CITY, CA 90067

PETER SCHWARTZ

EMAIL - 

PHONE - 310-478-4456

FAX - 310-478-1267 TRADE 

PAYABLE C $3,448,669

7/22/2020 Page ‐ 4

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 12 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

23 KYUNG SEUNG CO. LTD.

ATTN: J. J. PARK

CHIEF EXECUTIVE OFFICER

408 SAMSEOUNG-RO

GYEONGSEUNG

BUILDING GANGNAM-GU

SEOUL, 

KOREA

J. J. PARK

EMAIL - 

PHONE - +82-2-550-1414

FAX - +82-2-566-6867 TRADE 

PAYABLE $3,255,132

24 LAKONTRA INTERNATIONAL 

MERCHANDISING CORP

ATTN: PRESIDENT OR GENERAL 

COUNSEL

MERCHANDISING CORP NO.186 SEC.4

NANKINGE. RD

TAIPEI, 

TAIWAN

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - 

FAX - 

TRADE 

PAYABLE $3,031,988

25 MTL SOURCING DMCC

ATTN: PRESIDENT OR GENERAL 

COUNSEL

HDS BUSINESS CENTRE

JUMAIRA LAKE TOWERS

DUBAI, 

UNITED ARAB EMIRATES

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - 

FAX - 

TRADE 

PAYABLE $3,024,427

26 RICHA GLOBAL EXPORTS PVT LTD

ATTN: VIRENDER UPPAL

CHAIRMAN

219, UDYOG VIHAR PHASE-I GURGAON

HARYANA, 122001

INDIA

VIRENDER UPPAL

EMAIL - INFO@RICHAGLOBAL.COM

PHONE - +91-124-4314000

FAX - 

TRADE 

PAYABLE $3,020,253

27 IBM CORPORATION

ATTN: PRESIDENT OR GENERAL 

COUNSEL

1 NEW ORCHARD ROAD

ARMONK, NY 10504-1722

PRESIDENT OR GENERAL COUNSEL

EMAIL - ARVIND.KRISHNA@IBM.COM

PHONE - 914-499-1900

FAX - 914-765-4190 TRADE 

PAYABLE $2,952,280

28 BUSANA APPAREL PTE LTD

ATTN: MR. MANIWANEN 

CHAIRMAN

AXA TOWER 41ST & 43RD FLOOR

KUNINGAN CITY

JALAN PROF. DR. SATRIO KAV. 18

KUNINGAN, SETIABUDI, JAKARTA 

12940

INDONESIA

MR. MANIWANEN 

EMAIL - 

PHONE - +6221-522-9344

FAX - +6221-3005-6052 TRADE 

PAYABLE $2,847,689

7/22/2020 Page ‐ 5

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 13 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

29 WASHINGTON PRIME GROUP, INC.

ATTN: ROBERT P. DEMCHAK, ESQ.

EXECUTIVE VICE PRESIDENT, 

GENERAL COUNSEL AND CORPORATE 

SECRETARY

180 EAST BROAD STREET

COLUMBUS, OH 43215

ROBERT P. DEMCHAK, ESQ.

EMAIL - 

WPGINFO@WASHINGTONPRIME.COM

PHONE - 614-621-9000

FAX - TRADE 

PAYABLE C $2,726,248

30 MOLAX TRADING LIMITED

ATTN: PRESIDENT OR GENERAL 

COUNSEL

75-95, SEOSOMUN-DONG

8RD FLOOR, YOUONE BUILDING

CHUNG-KU

SEOUL, 100-110

KOREA

PRESIDENT OR GENERAL COUNSEL

EMAIL - ADMIN@MOLAXTRADING.COM

PHONE - 02-773-3601

FAX - 02-757-2044 TRADE 

PAYABLE $2,656,298

31 GUANGDONG SINGWEAR GARMENTS 

CO LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

XIANGANG INDUSTRIAL PARK

SIMAPU TOWN, CHAONAN DISTRICT

GUANGDONG PROVINCE

SHANTOU CITY, 

CHINA

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - +86-0754-82201270

FAX - +86-754-87715720 TRADE 

PAYABLE $2,650,820

32 ASMARA INTERNATIONAL LIMITED

ATTN: VENKY NAGAN

CHIEF EXECUTIVE OFFICER

UNIT 8B, TONG YUEN FACTORY 

BUILDING

505 CASTLE PEAK ROAD

LAI CHI KOK, KOWLOON, 

HONG KONG

VENKY NAGAN

EMAIL - CONTACT@ASMARAGROUP.COM

PHONE - +852-27442255

FAX - +852-27442244 TRADE 

PAYABLE $2,604,654

33 ANANTA SPORTSWEAR LIMITED

ATTN: AMIN KHAN

PRESIDENT

2071, N. COLLINS BLVD.

STE 201

RICHARDSON, TX 75080

AMIN KHAN

EMAIL - AMIN@BIMPEX.COM; 

SAJED@ANANTA.COM.BD

PHONE - 972-759 0732

FAX - 972-692-8826 TRADE 

PAYABLE $2,595,148

34 ACCENTURE LLP

ATTN: JULIE SWEET

CHIEF EXECUTIVE OFFICER

1 GRAND CANAL SQUARE

DUBLIN, D02 P820

IRELAND

JULIE SWEET

EMAIL - JULIE.SWEET@ACCENTURE.COM

PHONE - +353-1646-2000

FAX - +353-1646-2020 TRADE 

PAYABLE $2,555,866

7/22/2020 Page ‐ 6

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 14 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

35 INTERNATIONAL TRADING SERVICES 

LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

VICTORIA LANE INDUSTRIAL PARK

7620 VICTORIA CT

BROWNSVILLE, TX 78521

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - 956-831-2740

FAX - 

TRADE 

PAYABLE $2,520,994

36 JIANGSU GUOTAI GUOSHENG CO LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

7-22/F GUOTAI NEW CENTURY PLAZA

NO.125 MIDDLE RENMIN RD

ZHANGJIAGANG JIANGSU, 215600

CHINA

PRESIDENT OR GENERAL COUNSEL

EMAIL - HUASHENG@GTHS.CN

PHONE - +0512-58988898

FAX - +0512-58686837 TRADE 

PAYABLE $2,465,288

37 HANGZHOU LINGXIU KNITTING CO LTD

ATTN: JARED LU

418 HENGFU ROAD

HENGCUN TOWN

TONGLU COUNTY

ZHEJIANG, 

CHINA

JARED LU

EMAIL - JARED_LU@LINXIU.COM

PHONE - +86-571-64673088 

FAX - 

TRADE 

PAYABLE $2,458,758

38 JOHN GALLIN & SON, INC.

ATTN: CHRISTOPHER GALLIN

PRESIDENT

102 MADISON AVENUE

9TH FLOOR

NEW YORK, NY 10016

CHRISTOPHER GALLIN

EMAIL - CHRISG@GALLIN.COM

PHONE - 212-252-8900

FAX - 212-252-8910 TRADE 

PAYABLE $2,437,642

39 JONES LANG LASALLE AMERICAS, INC.

ATTN: ALAN TSE

GLOBAL CHIEF LEGAL OFFICER AND 

CORPORATE SECRETARY

200 EAST RANDOLPH DRIVE

CHICAGO, IL 60601

ALAN TSE

EMAIL - ALAN.TSE@JLL.COM

PHONE - 312-228-2808

FAX - 

TRADE 

PAYABLE C $2,364,445

40 LEE & CO.

ATTN: ARLEN LEE

CHIEF EXECUTIVE OFFICER

1278 INDIANA ST

SUITE 101 

SAN FRANCISCO, CA 94107

ARLEN LEE

EMAIL - HELLO@LEEANDCO.COM

PHONE - 415-475-9029

FAX - 

TRADE 

PAYABLE $2,354,770

7/22/2020 Page ‐ 7

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 15 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

41 AJG INC

ATTN: J. PATRICK GALLAGHER JR.

CHIEF EXECUTIVE OFFICER

2850 GOLF ROAD

ROLLING MEADOWS, IL 60008

J. PATRICK GALLAGHER JR.

EMAIL - 

PHONE - 630-773-3800

FAX - 630-285-4000 TRADE 

PAYABLE $2,258,832

42 WS TRADING LIMITED

ATTN: PRESIDENT OR GENERAL 

COUNSEL

50 TRADESTON STREET

GLASGOW, SCOTLAND, G5 8BH

UNITED KINGDOM

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - 

FAX - 

TRADE 

PAYABLE $2,248,644

43 SOLVE IT CO., LTD

ATTN: PRESIDENT OR GENERAL 

COUNSEL

3/F 556 CHEONHO-DAERO

GWANGJIN-GU SEOUL, 143847

SOUTH KOREA

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

PHONE - +82-24536868

FAX - 

TRADE 

PAYABLE $2,098,603

44 TISHMAN SPEYER PROPERTIES

ATTN: MICHAEL B. BENNER

SENIOR MANAGING DIRECTOR AND 

GENERAL COUNSEL

ROCKEFELLER CENTER, 45 

ROCKEFELLER PLAZA

NEW YORK, NY 10111

MICHAEL B. BENNER

EMAIL - NY@TISHMANSPEYER.COM

PHONE - 212-715-0300

FAX - 212-319-1745 TRADE 

PAYABLE C $2,026,953

45 MODINDIA EXIM PRIVATE LTD

ATTN: GAGAN GULATI

DIRECTOR

B-57 OKHLA INDUSTRIAL AREA, PHASEI 

NEW DELHI, 110020

INDIA

GAGAN GULATI

EMAIL - INFO@MODELAMAEXPORTS.COM

PHONE - 

FAX - 

TRADE 

PAYABLE $2,015,483

46 SOUTH ASIA KNITTING FTY LTD (NEW)

ATTN: PRESIDENT OR GENERAL 

COUNSEL

17/F, SOUTH ASIA BUILDING

108 HOW MING STREET

KWUN TONG

KOWLOON, 

HONG KONG

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

LEOYEUNG@SOUTHASIAGROUP.COM

PHONE - 852-2345-0261

FAX - 852-2343-3666 TRADE 

PAYABLE $1,936,284

7/22/2020 Page ‐ 8

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 16 of 18
Debtor    Ascena Retail Group, Inc., et al.                                     

                  Name

Case Number (if known)  ______________________________________

Total claim, if 

partially 

secured

Deduction 

for value of 

collateral or 

setoff

Unsecured

claim

Name of creditor and complete mailing 

address, including zip code

Name, telephone number, and email address of 

creditor contact

Nature of the 

claim 

Indicate if claim 

is contingent, 

unliquidated, 

disputed

Amount of unsecured claim

If the claim is fully unsecured, fill in only 

unsecured claim amount. If claim is partially 

secured, fill in total claim amount and deduction 

for value of collateral or setoff to calculate 

unsecured claim.

47 MEENU CREATION LLP

ATTN: PRESIDENT OR GENERAL 

COUNSEL

A-33. SECTOR - 64 NOIDA DISTT

GAUTAM BUDH NAGAR, UP-201301

INDIA

PRESIDENT OR GENERAL COUNSEL

EMAIL - ED@MEENUCREATION.COM

PHONE - 91-120-4080200

FAX - 91-120-4080200 TRADE 

PAYABLE $1,876,239

48 THE FORBES COMPANY

ATTN: PRESIDENT OR GENERAL 

COUNSEL

100 GALLERIA OFFICENTRE, SUITE 427

SOUTHFIELD, MI 48034

PRESIDENT OR GENERAL COUNSEL

EMAIL - 

NFORBES@THEFORBESCOMPANY.COM

PHONE - 248-827-4600

FAX - TRADE 

PAYABLE C $1,830,041

49 GAURAV INTERNATIONAL

ATTN: ANJU SACHDEVA

PD MANAGER

198, UDYOG VIHAR PHASE 1

UDYOG VIHAR, SECTOR 20

GURUGRAM, HARYANA, 122001

INDIA

ANJU SACHDEVA

EMAIL - GINTL@RICHAGROUP.COM

PHONE - +91 124 480 3900

FAX - +91 124 2439710 TRADE 

PAYABLE $1,820,631

50 CHRISTINE CLARK AND OTHER 

SIMILARLY SITUATED INDIVIDUALS

ATTN: WILLIAM B. SULLIVAN, ERIC K. 

YAECKEL, AND ANDREA TORRESFIGUEROA

ATTORNEYS FOR PLAINTIFFS

SULLIVAN LAW GROUP, APC

2330 THIRD AVENUE

SAN DIEGO, CA 92101

WILLIAM B. SULLIVAN, ERIC K. YAECKEL, 

AND ANDREA TORRES-FIGUEROA

EMAIL - 

HELEN@SULLIVANLAWGROUPAPC.COM, 

YAECKEL@SULLIVANLAWGROUPAPC.COM, 

ATORRES@SULLIVANLAWGROUPAPC.COM

PHONE - 619-702-6760

FAX - 619-702-6761

LITIGATION 

SETTLEMENT C Undetermined

7/22/2020 Page ‐ 9

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 17 of 18
Fill in this information to identify the case and this filing:

Debtor Name Ascena Retail Group, Inc.

United States Bankruptcy Court for the: Eastern District of Virginia

 (State)

Case number (If known):

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 50 Largest Unsecured Claims and Are Not Insiders

(Official Form 204)

☒ Other document that requires a declaration List of Equity Security Holders and Corporate Ownership

Statement

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

Executed on

07/23/2020

 /s/ Carrie W. Teffner

MM/ DD/YYYY Signature of individual signing on behalf of debtor 

Carrie W. Teffner

Printed name

Authorized Signatory

Position or relationship to debtor

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

Case 20-33113-KRH Doc 1 Filed 07/23/20 Entered 07/23/20 05:57:30 Desc Main

Document Page 18 of 18