Fill in this information to identify your case:

United States Bankruptcy Court for the:

Eastern District of Virginia

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

Chapter 7

Chapter 11

Chapter 12

Chapter 13 Check if this is an

amended filing

Official Form 101

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

cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,” the answer would be yes if either debtor owns

a car. When information is needed about the spouses separately, the form uses Debtor 1 and Debtor 2 to distinguish between them. In joint cases, one of the

spouses must report information as Debtor 1 and the other as Debtor 2. The same person must be Debtor 1 in all of the forms.

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

needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.

Part 1: Identify Yourself

1. Your full name

Write the name that is on your

government-issued picture

identification (for example, your

driver’s license or passport).

Bring your picture identification to

your meeting with the trustee.

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

Melissa

First name First name

G

Middle name Middle name

Krumbein

Last name Last name

Suffix (Sr., Jr, II, III) Suffix (Sr., Jr, II, III)

2. All other names you have used

in the last 8 years

Include your married or maiden

names.

First name First name

Middle name Middle name

Last name Last name

First name First name

Middle name Middle name

Last name Last name

3. Only the last 4 digits of your

Social Security number or

federal Individual Taxpayer

Identification number

(ITIN)

xxx - xx - 5 1 5 1 xxx - xx -

OR OR

9xx - xx - 9xx - xx -

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

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Voluntary Petition for Individuals Filing for Bankruptcy 04/20

Case 20-12128-BFK Doc 1 Filed 09/22/20 Entered 09/22/20 12:15:35 Desc Main

Document Page 1 of 12
Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

4. Any business names and

Employer Identification

Numbers (EIN) you have used

in the last 8 years

Include trade names and doing

business as names

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

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

Business name Business name

Business name Business name

-

EIN

-

EIN

-

EIN

-

EIN

5. Where you live

If Debtor 2 lives at a different address:

450 N Washington St Apt 312

Number Street Number Street

Falls Church, VA 22046-3454

City State ZIP Code City State ZIP Code

Falls Church (city)

County County

If your mailing address is different from the one above, fill

it in here. Note that the court will send any notices to you at

this mailing address.

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

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

mailing address.

Number Street Number Street

P.O. Box P.O. Box

City State ZIP Code City State ZIP Code

6. Why you are choosing this

district to file for bankruptcy

Check one: Check one:

Over the last 180 days before filing this petition, I have

lived in this district longer than in any other district.

Over the last 180 days before filing this petition, I have

lived in this district longer than in any other district.

I have another reason. Explain.

(See 28 U.S.C. § 1408)

I have another reason. Explain.

(See 28 U.S.C. § 1408)

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

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Document Page 2 of 12
Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

Part 2: Tell the Court About Your Bankruptcy Case

7. The chapter of the Bankruptcy

Code you are choosing to file

under

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

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

Chapter 7

Chapter 11

Chapter 12

Chapter 13

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

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

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

a pre-printed address.

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

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

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

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

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

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

9. Have you filed for bankruptcy

within the last 8 years?

No.

Yes. District When

MM / DD / YYYY

Case number

District When

MM / DD / YYYY

Case number

District When

MM / DD / YYYY

Case number

10. Are any bankruptcy cases

pending or being filed by a

spouse who is not filing this

case with you, or by a business

partner, or by an affiliate?

No.

Yes. Debtor Relationship to you

District When

MM / DD / YYYY

Case number, if known

Debtor Relationship to you

District When

MM / DD / YYYY

Case number, if known

11. Do you rent your residence?

No. Go to line 12.

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

No. Go to line 12.

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

of this bankruptcy petition.

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

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Document Page 3 of 12
Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

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

12. Are you a sole proprietor of any

full- or part-time business?

A sole proprietorship is a business

you operate as an individual, and is

not a separate legal entity such as

a corporation, partnership, or LLC.

If you have more than one sole

proprietorship, use a separate

sheet and attach it to this petition.

No. Go to Part 4.

Yes. Name and location of business

Name of business, if any

Number Street

City State ZIP Code

Check the appropriate box to describe your business:

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

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

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

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

None of the above

13. Are you filing under Chapter 11

of the Bankruptcy Code, and

are you a small business debtor

or a debtor as defined by 11

U.S. C. § 1182(1)?

For a definition of small business

debtor, see 11 U.S.C. § 101(51D).

If you are filing under Chapter 11, the court must know whether you are a small business debtor or a debtor choosing to proceed

under Subchapter V so that it can set appropriate deadlines. If you indicate that you are a small business debtor or you are

choosing to proceed under Subchapter V, you must attach your most recent balance sheet, statement of operations, cash-flow

statement, and federal income tax return or if any of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B).

No. I am not filing under Chapter 11.

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

Bankruptcy Code.

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

Code, and I do not choose to proceed under Subchapter V of Chapter 11.

Yes. I am filing under Chapter 11, I am a debtor according to the definition in § 1182(1) of the Bankruptcy Code,

and I choose to proceed under Subchapter V of Chapter 11.

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

14. Do you own or have any

property that poses or is

alleged to pose a threat of

imminent and identifiable

hazard to public health or

safety? Or do you own any

property that needs immediate

attention?

For example, do you own

perishable goods, or livestock that

must be fed, or a building that

needs urgent repairs?

No.

Yes. What is the hazard?

If immediate attention is needed, why is it needed? 

Where is the property?

Number Street

City State ZIP Code

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

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Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

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

15. Tell the court whether you

have received a briefing

about credit counseling.

The law requires that you

receive a briefing about credit

counseling before you file for

bankruptcy. You must truthfully

check one of the following

choices. If you cannot do so, you

are not eligible to file.

If you file anyway, the court can

dismiss your case, you will lose

whatever filing fee you paid, and

your creditors can begin

collection activities again.

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

You must check one: You must check one:

I received a briefing from an approved credit counseling

agency within the 180 days before I filed this bankruptcy

petition, and I received a certificate of completion.

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

any, that you developed with the agency.

I received a briefing from an approved credit counseling

agency within the 180 days before I filed this bankruptcy

petition, and I received a certificate of completion.

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

any, that you developed with the agency.

I received a briefing from an approved credit counseling

agency within the 180 days before I filed this bankruptcy

petition, but I do not have a certificate of completion.

Within 14 days after you file this bankruptcy petition, you

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

any.

I received a briefing from an approved credit counseling

agency within the 180 days before I filed this bankruptcy

petition, but I do not have a certificate of completion.

Within 14 days after you file this bankruptcy petition, you

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

any.

I certify that I asked for credit counseling services from an

approved agency, but was unable to obtain those services

during the 7 days after I made my request, and exigent

circumstances merit a 30-day temporary waiver of the

requirement.

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

attach a separate sheet explaining what efforts you made

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

before you filed for bankruptcy, and what exigent

circumstances required you to file this case.

I certify that I asked for credit counseling services from an

approved agency, but was unable to obtain those services

during the 7 days after I made my request, and exigent

circumstances merit a 30-day temporary waiver of the

requirement.

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

attach a separate sheet explaining what efforts you made

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

before you filed for bankruptcy, and what exigent

circumstances required you to file this case.

Your case may be dismissed if the court is dissatisfied

with your reasons for not receiving a briefing before you

filed for bankruptcy.

Your case may be dismissed if the court is dissatisfied

with your reasons for not receiving a briefing before you

filed for bankruptcy.

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

receive a briefing within 30 days after you file.

You must file a certificate from the approved agency,

along with a copy of the payment plan you developed, if

any. If you do not do so, your case may be dismissed.

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

receive a briefing within 30 days after you file.

You must file a certificate from the approved agency,

along with a copy of the payment plan you developed, if

any. If you do not do so, your case may be dismissed.

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

cause and is limited to a maximum of 15 days.

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

cause and is limited to a maximum of 15 days.

I am not required to receive a briefing about credit

counseling because of:

Incapacity. I have a mental illness or a mental

deficiency that makes me incapable

of realizing or making rational

decisions about finances.

Disability. My physical disability causes me to

be unable to participate in a briefing

in person, by phone, or through the

internet, even after I reasonably tried

to do so.

Active duty. I am currently on active military duty in

a military combat zone.

I am not required to receive a briefing about credit

counseling because of:

Incapacity. I have a mental illness or a mental

deficiency that makes me incapable

of realizing or making rational

decisions about finances.

Disability. My physical disability causes me to

be unable to participate in a briefing

in person, by phone, or through the

internet, even after I reasonably tried

to do so.

Active duty. I am currently on active military duty in

a military combat zone.

If you believe you are not required to receive a briefing

about credit counseling, you must file a motion for waiver

of credit counseling with the court.

If you believe you are not required to receive a briefing

about credit counseling, you must file a motion for waiver

of credit counseling with the court.

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

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Document Page 5 of 12
Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

Part 6: Answer These Questions for Reporting Purposes

16. What kind of debts do you

have?

16a. Are your debts primarily consumer debts? Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by

an individual primarily for a personal, family, or household purpose.”

No. Go to line 16b.

Yes. Go to line 17.

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

business or investment or through the operation of the business or investment.

No. Go to line 16c.

Yes. Go to line 17.

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

17. Are you filing under Chapter 7?

Do you estimate that after any

exempt property is excluded and

administrative expenses are paid

that funds will be available for

distribution to unsecured

creditors?

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

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

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

No

Yes

18. How many creditors do you

estimate that you owe?

1-49

50-99

100-199

200-999

1,000-5,000

5,001-10,000

10,001-25,000

25,001-50,000 50,000-100,000 More than 100,000

19. How much do you estimate your

assets to be worth?

$0-$50,000

$50,001-$100,000

$100,001-$500,000

$500,001-$1 million

$1,000,001-$10 million

$10,000,001-$50 million

$50,000,001-$100 million

$100,000,001-$500 million

$500,000,001-$1 billion

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

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

More than $50 billion

20. How much do you estimate your

liabilities to be?

$0-$50,000

$50,001-$100,000

$100,001-$500,000

$500,001-$1 million

$1,000,001-$10 million

$10,000,001-$50 million

$50,000,001-$100 million

$100,000,001-$500 million

$500,000,001-$1 billion

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

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

More than $50 billion

Part 7: Sign Below

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

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

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

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

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

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

I understand making a false statement, concealing property, or obtaining money or property by fraud in connection with a bankruptcy case

can result in fines up to $250,000, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

✘ /s/ Melissa G Krumbein

Melissa G Krumbein, Debtor 1

Executed on 09/19/2020

MM/ DD/ YYYY

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

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Debtor 1 Melissa G Krumbein

First Name Middle Name Last Name

Case number (if known)

For your attorney, if you are

represented by one

If you are not represented by an

attorney, you do not need to file this

page.

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

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

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

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

filed with the petition is incorrect.

✘ /s/ Robert R. Weed

Signature of Attorney for Debtor

Date 09/19/2020

MM / DD / YYYY

Robert R. Weed

Printed name

Law Offices Of Robert Weed

Firm name

13800 Coppermine Rd

Number Street

Herndon

City

VA

State

20171

ZIP Code

Contact phone (703) 335-7793 Email address robertweed@robertweed.com

24646

Bar number

VA

State

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

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CASE NO

CHAPTER 7

IN THE UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF VIRGINIA

ALEXANDRIA DIVISION

IN RE: Krumbein, Melissa G

VERIFICATION OF CREDITOR MATRIX

The above named Debtor hereby verifies that the attached list of creditors is true and correct to the best of his/her knowledge.

Date 09/19/2020 Signature /s/ Melissa G Krumbein

Melissa G Krumbein, Debtor

Case 20-12128-BFK Doc 1 Filed 09/22/20 Entered 09/22/20 12:15:35 Desc Main

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Altran Financial

Box 722929

Houston, TX 77272-2929

Barclays Bank Delaware

PO Box 8803

Wilmington, DE 19899

Best Buy/CBNA

PO Box 6217

Sioux Falls, SD 57117

BMW Financial Services

PO Box 3608

Dublin, OH 43016

C&F Bank

PO Box 790408

Saint Louis, MO 63179-0408

C&F Bank

Po Box 6335

Fargo, ND 58125-6335

Capital One

PO Box 30285

Salt Lake City, UT 84130

Capital One

PO Box 21887

Saint Paul, MN 55121

Case 20-12128-BFK Doc 1 Filed 09/22/20 Entered 09/22/20 12:15:35 Desc Main

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CBE/Dominion Energy VA

PO Box 2547

Waterloo, IA 50704

Citicards CBNA

POB 6241

Sioux Falls, SD 57117

Client Services/Chase Bank

3451 Harry S Truman

St Charles, MO 63301

Cody T Murphey Esq

Eckert Seamans

919 E Main St Ste 1300

Richmond, VA 23219-4624

County of Henrico Waterr

Po Box 90775

Henrico, VA 23228-9775

Dominion Energy Virginia

PO Box 26543

Richmond, VA 23290

E Duffy Myrtetus Esq

Eckert Seamans

919 E Main St Ste 1300

Richmond, VA 23219-4624

Elan Financial Svcs

PO BOX 790084

Saint Louis, MO 63179

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Henrico GDC

Attn Civil

4301 E Parham Rd

Henrico, VA 23228-2745

JPMBC

PO BOX 15298

Wilmington, DE 19850

Kohls Department Stores

PO Box 3115

Milwaukee, WI 53201

L.L. Bean Mastercard/CBNA

PO Box 6497

Sioux Falls, SD 57117

Liberty Mutual

175 Berkeley St

Boston, MA 02116-5066

McCarthy Burgess & Wolff

26000 Cannon Rd

Cleveland, OH 44146-1807

Merrick Bank

PO Box 9201

Old Bethpage, NY 11804

Midland Credit Management

320 E. BIG BEAVER RD. STE 300

Troy, MI 48083

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MRS BPO LLC

1930 Olney Ave.

Cherry Hill, NJ 08003

Old Towne Retail

Investments, LLC

1545 Faraday Ave

Carlsbad, CA 92008-7449

Payoff Inc

3200 Park Center Dr

Costa Mesa, CA 92626-7163

SIMM Associates Inc.

800 Pencader Drive

Newark, DE 19702

Target/TD Bank

7000 Target Pkwy N, Mail Stop NCD-0450

Minneapolis, MN 55445

Towne Insurance Agency

301 Bendix Rd Ste 300

Virginia Bch, VA 23452-1385

United Collection Bureau

5620 Southwyck Blvd 206

Toledo, OH 43614

Verizon Virginia, Inc.

500 Technology Dr # 500

Weldon Spring, MO 63304-2225

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