Fill in this information to identify your case and this filing:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335  Check if this is an

amended filing

Official Form 106A/B

Schedule A/B: Property 12/15

In each category, separately list and describe items. List an asset only once. If an asset fits in more than one category, list the asset in the category where you

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

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

Answer every question.

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

1. Do you own or have any legal or equitable interest in any residence, building, land, or similar property?

 No. Go to Part 2.

 Yes. Where is the property?

Part 2: Describe Your Vehicles

Do you own, lease, or have legal or equitable interest in any vehicles, whether they are registered or not? Include any vehicles you own that

someone else drives. If you lease a vehicle, also report it on Schedule G: Executory Contracts and Unexpired Leases.

3. Cars, vans, trucks, tractors, sport utility vehicles, motorcycles

 No

 Yes

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

the amount of any secured claims on Schedule D:

Model: RX 300  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2000  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 205,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

 Check if this is community property $3,200.00 $3,200.00

 (see instructions)

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

the amount of any secured claims on Schedule D:

Model: Towncar  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2001  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 280,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

 Check if this is community property $2,755.00 $2,755.00

 (see instructions)

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

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Document Page 1 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

the amount of any secured claims on Schedule D:

Model: MDX  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2004  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 180,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

 Check if this is community property $4,425.00 $4,425.00

 (see instructions)

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

the amount of any secured claims on Schedule D:

Model: Sebring  Creditors Who Have Claims Secured by Property.

 Debtor 1 only

Year: 2006  Debtor 2 only Current value of the

entire property?

Current value of the

Approximate mileage: 190,000  Debtor 1 and Debtor 2 only portion you own?

Other information:  At least one of the debtors and another

 Check if this is community property $1,199.00 $1,199.00

 (see instructions)

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

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

 No

 Yes

5

.

Add the dollar value of the portion you own for all of your entries from Part 2, including any entries for

pages you have attached for Part 2. Write that number here.............................................................................=> $11,579.00

Part 3: Describe Your Personal and Household Items

Do you own or have any legal or equitable interest in any of the following items? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

6. Household goods and furnishings

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

 No

 Yes. Describe.....

3 Beds, LR Set, 2 Dresser's, Kitchen Table $1,500.00

Bed, 2 Dressers $500.00

7. Electronics

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

including cell phones, cameras, media players, games

 No

 Yes. Describe.....

3 TV's, 1 laptop $400.00

8. Collectibles of value

Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects; stamp, coin, or baseball card collections;

other collections, memorabilia, collectibles

 No

 Yes. Describe.....

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

9. Equipment for sports and hobbies

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

musical instruments

 No

 Yes. Describe.....

10. Firearms

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

 No

 Yes. Describe.....

handgun $100.00

11. Clothes

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

 No

 Yes. Describe.....

Wearing Apparel $600.00

12. Jewelry

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

 No

 Yes. Describe.....

Wedding Band $800.00

13. Non-farm animals

Examples: Dogs, cats, birds, horses

 No

 Yes. Describe.....

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

 No

 Yes. Give specific information.....

15. Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached

for Part 3. Write that number here .............................................................................. $3,900.00

Part 4: Describe Your Financial Assets

Do you own or have any legal or equitable interest in any of the following? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

16. Cash

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

 No

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

Cash $5.00

17. Deposits of money

Examples: Checking, savings, or other financial accounts; certificates of deposit; shares in credit unions, brokerage houses, and other similar

institutions. If you have multiple accounts with the same institution, list each.

 No

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

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

17.1. Checking Wells Fargo Unknown

18. Bonds, mutual funds, or publicly traded stocks

Examples: Bond funds, investment accounts with brokerage firms, money market accounts

 No

 Yes.................. Institution or issuer name:

19. Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in an LLC, partnership, and

joint venture

 No

 Yes. Give specific information about them...................

Name of entity: % of ownership:

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

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

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

 No

 Yes. Give specific information about them

Issuer name:

21. Retirement or pension accounts

Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sharing plans

 No

 Yes. List each account separately.

Type of account: Institution name:

22. Security deposits and prepayments

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

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

 No

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

Rental deposit Mr. Drinkwater $500.00

23. Annuities (A contract for a periodic payment of money to you, either for life or for a number of years)

 No

 Yes............. Issuer name and description.

24. Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tuition program.

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

 No

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

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

 No

 Yes. Give specific information about them...

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

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

 No

 Yes. Give specific information about them...

27. Licenses, franchises, and other general intangibles

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

 No

 Yes. Give specific information about them...

Money or property owed to you? Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

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

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Document Page 4 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

28. Tax refunds owed to you

 No

 Yes. Give specific information about them, including whether you already filed the returns and the tax years.......

29. Family support

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

 No

 Yes. Give specific information......

Thaddeus McCaine

Child Support $1,743.00

Abjula Vaughan

Child Support $1,301.00

30. Other amounts someone owes you

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

benefits; unpaid loans you made to someone else

 No

 Yes. Give specific information..

31. Interests in insurance policies

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

 No

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

Company name: Beneficiary: Surrender or refund

value:

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

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

someone has died.

 No

 Yes. Give specific information..

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

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

 No

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

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

 No

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

35. Any financial assets you did not already list

 No

 Yes. Give specific information..

36. Add the dollar value of all of your entries from Part 4, including any entries for pages you have attached

for Part 4. Write that number here..................................................................................................................... $3,549.00

Part 5: Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1.

37. Do you own or have any legal or equitable interest in any business-related property?

 No. Go to Part 6.

 Yes. Go to line 38.

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

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

46. Do you own or have any legal or equitable interest in any farm- or commercial fishing-related property?

 No. Go to Part 7.

 Yes. Go to line 47.

Part 7: Describe All Property You Own or Have an Interest in That You Did Not List Above

53. Do you have other property of any kind you did not already list?

Examples: Season tickets, country club membership

 No

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

54. Add the dollar value of all of your entries from Part 7. Write that number here .................................... $0.00

Part 8: List the Totals of Each Part of this Form

55. Part 1: Total real estate, line 2 ...................................................................................................................... $0.00

56. Part 2: Total vehicles, line 5 $11,579.00

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

58. Part 4: Total financial assets, line 36 $3,549.00

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

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

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

62. Total personal property. Add lines 56 through 61... $19,028.00 Copy personal property total $19,028.00

63. Total of all property on Schedule A/B. Add line 55 + line 62 $19,028.00

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

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Document Page 6 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335

(if known)  Check if this is an

amended filing

Official Form 106C

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

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

the property you listed on Schedule A/B: Property (Official Form 106A/B) as your source, list the property that you claim as exempt. If more space is

needed, fill out and attach to this page as many copies of Part 2: Additional Page as necessary. On the top of any additional pages, write your name and

case number (if known).

For each item of property you claim as exempt, you must specify the amount of the exemption you claim. One way of doing so is to state a

specific dollar amount as exempt. Alternatively, you may claim the full fair market value of the property being exempted up to the amount of

any applicable statutory limit. Some exemptions—such as those for health aids, rights to receive certain benefits, and tax-exempt retirement

funds—may be unlimited in dollar amount. However, if you claim an exemption of 100% of fair market value under a law that limits the

exemption to a particular dollar amount and the value of the property is determined to exceed that amount, your exemption would be limited

to the applicable statutory amount.

Part 1: Identify the Property You Claim as Exempt

1. Which set of exemptions are you claiming? Check one only, even if your spouse is filing with you.

 You are claiming state and federal nonbankruptcy exemptions. 11 U.S.C. § 522(b)(3)

 You are claiming federal exemptions. 11 U.S.C. § 522(b)(2)

2. For any property you list on Schedule A/B that you claim as exempt, fill in the information below.

Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

2000 Lexus RX 300 205,000 miles

Line from Schedule A/B: 3.1

$3,200.00  $3,200.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

2001 Lincoln Towncar 280,000 miles

Line from Schedule A/B: 3.2

$2,755.00  $91.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

2006 Chrysler Sebring 190,000 miles

Line from Schedule A/B: 3.4

$1,199.00  $0.00 Va. Code Ann. § 34-26(8)

 100% of fair market value, up to

any applicable statutory limit

3 Beds, LR Set, 2 Dresser's, Kitchen

Table

Line from Schedule A/B: 6.1

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

 100% of fair market value, up to

any applicable statutory limit

Bed, 2 Dressers

Line from Schedule A/B: 6.2

$500.00  $0.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

Official Form 106C Schedule C: The Property You Claim as Exempt page 1 of 2

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

Brief description of the property and line on

Schedule A/B that lists this property

Current value of the

portion you own

Copy the value from

Schedule A/B

Amount of the exemption you claim

Check only one box for each exemption.

Specific laws that allow exemption

3 TV's, 1 laptop

Line from Schedule A/B: 7.1

$400.00  $400.00 Va. Code Ann. § 34-26(4a)

 100% of fair market value, up to

any applicable statutory limit

handgun

Line from Schedule A/B: 10.1

$100.00  $100.00 Va. Code Ann. § 34-26(4b)

 100% of fair market value, up to

any applicable statutory limit

Wearing Apparel

Line from Schedule A/B: 11.1

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

 100% of fair market value, up to

any applicable statutory limit

Wedding Band

Line from Schedule A/B: 12.1

$800.00  $800.00 Va. Code Ann. § 34-26(1a)

 100% of fair market value, up to

any applicable statutory limit

Cash

Line from Schedule A/B: 16.1

$5.00  $5.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Rental deposit: Mr. Drinkwater

Line from Schedule A/B: 22.1

$500.00  $500.00 Va. Code Ann. § 34-4

 100% of fair market value, up to

any applicable statutory limit

Child Support: Thaddeus McCaine

Line from Schedule A/B: 29.1

$1,743.00  $1,743.00 Va. Code Ann. § 34-26(10)

 100% of fair market value, up to

any applicable statutory limit

Child Support: Abjula Vaughan

Line from Schedule A/B: 29.2

$1,301.00  $1,301.00 Va. Code Ann. § 34-26(10)

 100% of fair market value, up to

any applicable statutory limit

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

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

 No

 Yes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case?

 No

 Yes

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

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Document Page 8 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335

(if known)  Check if this is an

amended filing

Official Form 106E/F

Schedule E/F: Creditors Who Have Unsecured Claims 12/15

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY claims and Part 2 for creditors with NONPRIORITY claims. List the other party to

any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Property (Official Form 106A/B) and on

Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G). Do not include any creditors with partially secured claims that are listed in

Schedule D: Creditors Who Have Claims Secured by Property. If more space is needed, copy the Part you need, fill it out, number the entries in the boxes on the

left. Attach the Continuation Page to this page. If you have no information to report in a Part, do not file that Part. On the top of any additional pages, write your

name and case number (if known).

Part 1: List All of Your PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims against you?

 No. Go to Part 2.

 Yes.

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

identify what type of claim it is. If a claim has both priority and nonpriority amounts, list that claim here and show both priority and nonpriority amounts. As much as

possible, list the claims in alphabetical order according to the creditor’s name. If you have more than two priority unsecured claims, fill out the Continuation Page of

Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.

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

Total claim Priority

amount

Nonpriority

amount

2.1 Nottoway County Treasurer Off. Last 4 digits of account number Unknown Unknown Unknown

Priority Creditor's Name

P.O. Box 85

Nottoway, VA 23955

When was the debt incurred?

2014. 2015, 2016 and

2017

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

 Contingent

 Unliquidated

 Disputed

Type of PRIORITY unsecured claim:

 Domestic support obligations

 Taxes and certain other debts you owe the government

 Claims for death or personal injury while you were intoxicated

 Other. Specify

PP Tax

Part 2: List All of Your NONPRIORITY Unsecured Claims

3. Do any creditors have nonpriority unsecured claims against you?

 No. You have nothing to report in this part. Submit this form to the court with your other schedules.

 Yes.

4. List all of your nonpriority unsecured claims in the alphabetical order of the creditor who holds each claim. If a creditor has more than one nonpriority

unsecured claim, list the creditor separately for each claim. For each claim listed, identify what type of claim it is. Do not list claims already included in Part 1. If more

than one creditor holds a particular claim, list the other creditors in Part 3.If you have more than three nonpriority unsecured claims fill out the Continuation Page of

Part 2.

Total claim

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 1 of 14

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Document Page 9 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.1 Billy's Auto Service Center Last 4 digits of account number 3356 $1,439.00

Nonpriority Creditor's Name

P.O. Box 821

Kenbridge, VA 23944

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Consumer Debt

4.2 Cfw Credit & Collectio Last 4 digits of account number 8555 Unknown

Nonpriority Creditor's Name

Attn:Collections

19 N Washington St

Winchester, VA 22601

When was the debt incurred? Opened 08/12

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney Shentel

4.3 CMG Southside Women's Center Last 4 digits of account number A221 $151.00

Nonpriority Creditor's Name

ATTN # 11971Y

P.O. Box 14000

Belfast, ME 04915

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 14

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Document Page 10 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.4 Creditors Collection Service/CCS Last 4 digits of account number 6592 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 01/15

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Emerg

Services

4.5 Creditors Collection Service/CCS Last 4 digits of account number 7972 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 10/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside

Womens Center

4.6 Creditors Collection Service/CCS Last 4 digits of account number 3608 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 05/12

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Centra Health Prof

Southside

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 11 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.7 Creditors Collection Service/CCS Last 4 digits of account number 8359 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 01/13

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Centra Health Prof

Southside

4.8 Creditors Collection Service/CCS Last 4 digits of account number 0170 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 08/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Emerg

Services

4.9 Creditors Collection Service/CCS Last 4 digits of account number 4301 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 04/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Emerg

Services

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 12 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.1

0 Creditors Collection Service/CCS Last 4 digits of account number 4267 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 04/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Emerg

Services

4.1

1 Creditors Collection Service/CCS Last 4 digits of account number 5065 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 01/14

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney Cmg Burkeville

4.1

2 Creditors Collection Service/CCS Last 4 digits of account number 7007 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 12/14

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Emerg

Services

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 13 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.1

3 Creditors Collection Service/CCS Last 4 digits of account number 2362 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 05/13

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Centra Health Prof

Southside

4.1

4 Creditors Collection Service/CCS Last 4 digits of account number 8741 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 12/14

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney Cmg Burkeville

4.1

5 Creditors Collection Service/CCS Last 4 digits of account number 4542 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 09/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Comm

Hosp

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 6 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 14 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.1

6 Creditors Collection Service/CCS Last 4 digits of account number 4487 $0.00

Nonpriority Creditor's Name

Po Box 21504

Roanoke, VA 24018

When was the debt incurred? Opened 09/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Cmg Southside Comm

Hosp

4.1

7 Dept Of Ed/582/nelnet Last 4 digits of account number 3859 $4,823.00

Nonpriority Creditor's Name

Attn: Claims/Bankruptcy

Po Box 82505

Lincoln, NE 68501

When was the debt incurred?

Opened 06/15 Last Active

6/30/17

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Educational

4.1

8 Dept Of Ed/582/nelnet Last 4 digits of account number 3759 $0.00

Nonpriority Creditor's Name

Attn: Claims/Bankruptcy

Po Box 82505

Lincoln, NE 68501

When was the debt incurred?

Opened 06/15 Last Active

6/30/17

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Educational

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 7 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 15 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.1

9 Discount Furniture Center Last 4 digits of account number 2361 $1,985.00

Nonpriority Creditor's Name

1407 South Main St.

Farmville, VA 23901

When was the debt incurred? 02/2017

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Consumer Debt

4.2

0 Elizabeth River Tunnels Last 4 digits of account number 3356 $342.00

Nonpriority Creditor's Name

P O Box 702118

San Antonio, TX 78270

When was the debt incurred? 2017

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Unpaid Tolls

4.2

1 ERC/Enhanced Recovery Corp Last 4 digits of account number 1195 $0.00

Nonpriority Creditor's Name

Attn: Bankruptcy

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 12/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney At T

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 8 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 16 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.2

2 ERC/Enhanced Recovery Corp Last 4 digits of account number 8533 $0.00

Nonpriority Creditor's Name

Attn: Bankruptcy

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 12/13

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney Sprint

4.2

3 ERC/Enhanced Recovery Corp Last 4 digits of account number 6086 $0.00

Nonpriority Creditor's Name

Attn: Bankruptcy

8014 Bayberry Rd

Jacksonville, FL 32256

When was the debt incurred? Opened 04/17

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Collection Attorney Dish

4.2

4 Focused Recovery Solutions Last 4 digits of account number 850B $0.00

Nonpriority Creditor's Name

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

When was the debt incurred? Opened 05/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Radiology Consultants

Of Lynch

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 9 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 17 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.2

5 Focused Recovery Solutions Last 4 digits of account number 850A $0.00

Nonpriority Creditor's Name

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

When was the debt incurred? Opened 02/15

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Radiology Consultants

Of Lynch

4.2

6 Focused Recovery Solutions Last 4 digits of account number 5850 $0.00

Nonpriority Creditor's Name

9701-Metropolitan Ct

Ste B

Richmond, VA 23236

When was the debt incurred? Opened 12/13

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Radiology Consultants

Of Lynch

4.2

7 Nationwide Last 4 digits of account number 3356 $18,281.00

Nonpriority Creditor's Name

PO Box 182021

Columbus, OH 43218

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Consumer Debt

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 10 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 18 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.2

8 Penn Credit Last 4 digits of account number 2516 $0.00

Nonpriority Creditor's Name

Attn:Bankruptcy

Po Box 988

Harrisburg, PA 17108

When was the debt incurred? Opened 10/16

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify

Collection Attorney Dominion Energy

Virginia

4.2

9 Richmond Womens Specialist Last 4 digits of account number 9464 $40.00

Nonpriority Creditor's Name

P.O. Box 668

Brentwood, TN 37024

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Consumer Debt

4.3

0 S. N. Jordan Bridge Tolls Last 4 digits of account number 4026,6875 Unknown

Nonpriority Creditor's Name

Professional Account Mang.

P.O. Box 3032

Milwaukee, WI 53201

When was the debt incurred? 2015

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Tolls

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 11 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 19 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.3

1 SCA Credit Svcs Last 4 digits of account number 4467 $0.00

Nonpriority Creditor's Name

1502 Williamson Road

Roanoke, VA 24012

When was the debt incurred? Opened 7/06/15

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Centra Southside Emer Svcs

4.3

2 Southern Dominion Health Sys Last 4 digits of account number 3356 $187.00

Nonpriority Creditor's Name

P.O. Box 70

Victoria, VA 23974

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.3

3 Virginia Credit Union Last 4 digits of account number 1400 $339.00

Nonpriority Creditor's Name

Po Box 90010

Richmond, VA 23225

When was the debt incurred?

Opened 06/17 Last Active

6/30/17

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Unsecured

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 12 of 14

Software Copyright (c) 1996-2020 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 20 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

4.3

4 Virginia South Psychiatric Last 4 digits of account number 4808 $250.00

Nonpriority Creditor's Name

269 Medical Park Blvd

Petersburg, VA 23805

When was the debt incurred? 2017

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Medical

4.3

5 Wells Fargo Bank, N.A Last 4 digits of account number 3356 $321.00

Nonpriority Creditor's Name

P.O. Box 5169

Sioux Falls, SD 57117

When was the debt incurred? 2019

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

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this claim is for a community

debt

Is the claim subject to offset?

 No

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans

 Obligations arising out of a separation agreement or divorce that you did not

report as priority claims

 Debts to pension or profit-sharing plans, and other similar debts

 Yes  Other. Specify Consumer Debt

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

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

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

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

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

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

DMV

PO Box 27412

Richmond, VA 23269

Line 4.30 of (Check one):  Part 1: Creditors with Priority Unsecured Claims

 Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number

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

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

type of unsecured claim.

Total Claim

6a. Domestic support obligations 6a. $ 0.00

Total

claims

from Part 1 6b. Taxes and certain other debts you owe the government 6b. $ 0.00

6c. Claims for death or personal injury while you were intoxicated 6c. $ 0.00

6d. Other. Add all other priority unsecured claims. Write that amount here. 6d. $ 0.00

6e. Total Priority. Add lines 6a through 6d. 6e. $ 0.00

Total Claim

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 13 of 14

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Document Page 21 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

6f. Student loans 6f. $ 4,823.00

Total

claims

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

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

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

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

here.

6i.

$ 23,335.00

6j. Total Nonpriority. Add lines 6f through 6i. 6j. $ 28,158.00

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

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Document Page 22 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335 Check if this is:

(If known)  An amended filing

 A supplement showing postpetition chapter

13 income as of the following date:

 3/10/2020 Official Form 106I MM / DD/ YYYY

Schedule I: Your Income 12/15

Be as complete and accurate as possible. If two married people are filing together (Debtor 1 and Debtor 2), both are equally responsible for

supplying correct information. If you are married and not filing jointly, and your spouse is living with you, include information about your

spouse. If you are separated and your spouse is not filing with you, do not include information about your spouse. If more space is needed,

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

Part 1: Describe Employment

1. Fill in your employment

information. Debtor 1 Debtor 2 or non-filing spouse

If you have more than one job,

attach a separate page with

information about additional

employers.

Include part-time, seasonal, or

self-employed work.

Occupation may include student

or homemaker, if it applies.

Employment status

 Employed

 Not employed

 Employed

 Not employed

Occupation

Employer's name

Employer's address

How long employed there?

Part 2: Give Details About Monthly Income

Estimate monthly income as of the date you file this form. If you have nothing to report for any line, write $0 in the space. Include your non-filing

spouse unless you are separated.

If you or your non-filing spouse have more than one employer, combine the information for all employers for that person on the lines below. If you need

more space, attach a separate sheet to this form.

For Debtor 1 For Debtor 2 or

non-filing spouse

2.

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

deductions). If not paid monthly, calculate what the monthly wage would be. 2. $ 0.00 $ 0.00

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

4. Calculate gross Income. Add line 2 + line 3. 4. $ 0.00 $ 0.00

Official Form 106I Schedule I: Your Income page 1

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

For Debtor 1 For Debtor 2 or

non-filing spouse

Copy line 4 here 4. $ 0.00 $ 0.00

5. List all payroll deductions:

5a. Tax, Medicare, and Social Security deductions 5a. $ 0.00 $ 0.00

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

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

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

5e. Insurance 5e. $ 0.00 $ 0.00

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

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

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

6. Add the payroll deductions. Add lines 5a+5b+5c+5d+5e+5f+5g+5h. 6. $ 0.00 $ 0.00

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. $ 0.00 $ 0.00

8. List all other income regularly received:

8a. Net income from rental property and from operating a business,

profession, or farm

Attach a statement for each property and business showing gross

receipts, ordinary and necessary business expenses, and the total

monthly net income. 8a. $ 0.00 $ 0.00

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

8c. Family support payments that you, a non-filing spouse, or a dependent

regularly receive

Include alimony, spousal support, child support, maintenance, divorce

settlement, and property settlement. 8c. $ 300.00 $ 0.00

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

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

8f. Other government assistance that you regularly receive

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

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

Nutrition Assistance Program) or housing subsidies.

Specify: SNAP 8f. $ 870.00 $ 0.00

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

8h. Other monthly income. Specify: Amortized Tax Refunds 8h.+ $ 708.00 + $ 0.00

9. Add all other income. Add lines 8a+8b+8c+8d+8e+8f+8g+8h. 9. $ 1,878.00 $ 0.00

10. Calculate monthly income. Add line 7 + line 9. 10. $ 1,878.00 + $ 0.00 = $ 1,878.00

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

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

Include contributions from an unmarried partner, members of your household, your dependents, your roommates, and

other friends or relatives.

Do not include any amounts already included in lines 2-10 or amounts that are not available to pay expenses listed in Schedule J.

Specify: 11. +$ 0.00

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

12. $ 1,878.00

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

applies

Combined

monthly income

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

 No.

 Yes. Explain: Debtor lost her job and is currently looking for FT employment.

Official Form 106I Schedule I: Your Income page 2

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Document Page 24 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green Check if this is:

 An amended filing

Debtor 2  A supplement showing postpetition chapter

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

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

Case number 17-34335

(If known)

Official Form 106J

Schedule J: Your Expenses 12/15

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

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

number (if known). Answer every question.

Part 1: Describe Your Household

1. Is this a joint case?

 No. Go to line 2.

 Yes. Does Debtor 2 live in a separate household?

 No

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

2. Do you have dependents?  No

Do not list Debtor 1 and

Debtor 2.

 Yes. Fill out this information for

each dependent..............

Dependent’s relationship to

Debtor 1 or Debtor 2

Dependent’s

age

Does dependent

live with you?

Do not state the

dependents names. Daughter 3

 No

 Yes

Son 13

 No

 Yes

Stepdaughter 13

 No

 Yes

Daughter 15

 No

 Yes

3. Do your expenses include

expenses of people other than

yourself and your dependents?

 No

 Yes

Part 2: Estimate Your Ongoing Monthly Expenses

Estimate your expenses as of your bankruptcy filing date unless you are using this form as a supplement in a Chapter 13 case to report

expenses as of a date after the bankruptcy is filed. If this is a supplemental Schedule J, check the box at the top of the form and fill in the

applicable date.

Include expenses paid for with non-cash government assistance if you know

the value of such assistance and have included it on Schedule I: Your Income

(Official Form 106I.) Your expenses

4. The rental or home ownership expenses for your residence. Include first mortgage

payments and any rent for the ground or lot. 4. $ 500.00

If not included in line 4:

4a. Real estate taxes 4a. $ 0.00

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

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

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

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

Official Form 106J Schedule J: Your Expenses page 1

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

6. Utilities:

6a. Electricity, heat, natural gas 6a. $ 300.00

6b. Water, sewer, garbage collection 6b. $ 130.00

6c. Telephone, cell phone, Internet, satellite, and cable services 6c. $ 50.00

6d. Other. Specify: Cell phones 6d. $ 100.00

7. Food and housekeeping supplies 7. $ 650.00

8. Childcare and children’s education costs 8. $ 0.00

9. Clothing, laundry, and dry cleaning 9. $ 125.00

10. Personal care products and services 10. $ 75.00

11. Medical and dental expenses 11. $ 60.00

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

Do not include car payments. 12. $ 200.00

13. Entertainment, clubs, recreation, newspapers, magazines, and books 13. $ 75.00

14. Charitable contributions and religious donations 14. $ 0.00

15. Insurance.

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

15a. Life insurance 15a. $ 0.00

15b. Health insurance 15b. $ 0.00

15c. Vehicle insurance 15c. $ 0.00

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

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

Specify: 16. $ 0.00

17. Installment or lease payments:

17a. Car payments for Vehicle 1 17a. $ 0.00

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

17c. Other. Specify: 17c. $ 0.00

17d. Other. Specify: 17d. $ 0.00

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

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

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

Specify: 19.

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

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

20b. Real estate taxes 20b. $ 0.00

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

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

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

21. Other: Specify: 21. +$ 0.00

22. Calculate your monthly expenses

22a. Add lines 4 through 21. $ 2,315.00

22b. Copy line 22 (monthly expenses for Debtor 2), if any, from Official Form 106J-2 $

22c. Add line 22a and 22b. The result is your monthly expenses. $ 2,315.00

23. Calculate your monthly net income.

23a. Copy line 12 (your combined monthly income) from Schedule I. 23a. $ 1,878.00

23b. Copy your monthly expenses from line 22c above. 23b. -$ 2,315.00

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

The result is your monthly net income. 23c. $ -437.00

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

For example, do you expect to finish paying for your car loan within the year or do you expect your mortgage payment to increase or decrease because of a

modification to the terms of your mortgage?

 No.

 Yes. Explain here:

Official Form 106J Schedule J: Your Expenses page 2

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Document Page 26 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335

(if known)  Check if this is an

amended filing

Official Form 106Dec

Declaration About an Individual Debtor's Schedules 12/15

If two married people are filing together, both are equally responsible for supplying correct information.

You must file this form whenever you file bankruptcy schedules or amended schedules. Making a false statement, concealing property, or

obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20

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

Sign Below

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

 No

 Yes. Name of person Attach Bankruptcy Petition Preparer’s Notice,

Declaration, and Signature (Official Form 119)

Under penalty of perjury, I declare that I have read the summary and schedules filed with this declaration and

that they are true and correct.

X /s/ Nichelle Monique Green X

Nichelle Monique Green Signature of Debtor 2

Signature of Debtor 1

Date May 20, 2020 Date

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

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Case 17-34335-KRH Doc 51 Filed 06/09/20 Entered 06/09/20 14:53:36 Desc Main

Document Page 27 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335

(if known)  Check if this is an

amended filing

Official Form 107

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

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

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

number (if known). Answer every question.

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

1. What is your current marital status?

 Married

 Not married

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

 No

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

Debtor 1 Prior Address: Dates Debtor 1

lived there

Debtor 2 Prior Address: Dates Debtor 2

lived there

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

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

 No

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

Part 2 Explain the Sources of Your Income

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

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

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

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Check all that apply.

Gross income

(before deductions and

exclusions)

Sources of income

Check all that apply.

Gross income

(before deductions

and exclusions)

From January 1 of current year until

the date you filed for bankruptcy:

 Wages, commissions,

bonuses, tips

 Operating a business

$12,002.00  Wages, commissions,

bonuses, tips

 Operating a business

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

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Document Page 28 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

Debtor 1 Debtor 2

Sources of income

Check all that apply.

Gross income

(before deductions and

exclusions)

Sources of income

Check all that apply.

Gross income

(before deductions

and exclusions)

For last calendar year:

(January 1 to December 31, 2016 )

 Wages, commissions,

bonuses, tips

 Operating a business

$16,779.00  Wages, commissions,

bonuses, tips

 Operating a business

For the calendar year before that:

(January 1 to December 31, 2015 )

 Wages, commissions,

bonuses, tips

 Operating a business

$20,674.00  Wages, commissions,

bonuses, tips

 Operating a business

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

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

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

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

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

 No

 Yes. Fill in the details.

Debtor 1 Debtor 2

Sources of income

Describe below.

Gross income from

each source

(before deductions and

exclusions)

Sources of income

Describe below.

Gross income

(before deductions

and exclusions)

From January 1 of current year until

the date you filed for bankruptcy:

Child Support and

Food Stamps

$4,548.00

For last calendar year:

(January 1 to December 31, 2016 )

Food Stamps $6,980.00

For the calendar year before that:

(January 1 to December 31, 2015 )

Food Stamps $7,230.00

Part 3: List Certain Payments You Made Before You Filed for Bankruptcy

6. Are either Debtor 1’s or Debtor 2’s debts primarily consumer debts?

 No. Neither Debtor 1 nor Debtor 2 has primarily consumer debts. Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by an

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

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $6,825* or more?

 No. Go to line 7.

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

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

not include payments to an attorney for this bankruptcy case.

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

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

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

 No. Go to line 7.

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

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

attorney for this bankruptcy case.

Creditor's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Was this payment for ...

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

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Document Page 29 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

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

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

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

alimony.

 No

 Yes. List all payments to an insider.

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

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

insider?

Include payments on debts guaranteed or cosigned by an insider.

 No

 Yes. List all payments to an insider

Insider's Name and Address Dates of payment Total amount

paid

Amount you

still owe

Reason for this payment

Include creditor's name

Part 4: Identify Legal Actions, Repossessions, and Foreclosures

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

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

modifications, and contract disputes.

 No

 Yes. Fill in the details.

Case title

Case number

Nature of the case Court or agency Status of the case

Lendmark Financial Services v.

Nichelle Monique Green

GV17024046-00

Judgment Richmond General District

Ct.

400 North 9th Street

Richmond, VA 23219

 Pending

 On appeal

 Concluded

Mariner Finance v. Nichelle

Monique Green

GV16021569-02

Garnishment Chesterfield County GDC

P.O. Box 144

Chesterfield, VA 23832

 Pending

 On appeal

 Concluded

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

Check all that apply and fill in the details below.

 No. Go to line 11.

 Yes. Fill in the information below.

Creditor Name and Address Describe the Property

Explain what happened

Date Value of the

property

Mariner Finance LLC

13102 Midlothian Tnpk.

Midlothian, VA 23113

$982.00 Wages Garnished

 Property was repossessed.

 Property was foreclosed.

 Property was garnished.

 Property was attached, seized or levied.

07/2017-Curre

nt

$982.00

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

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Document Page 30 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

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

 No

 Yes. Fill in the details.

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

taken

Amount

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

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

 No

 Yes

Part 5: List Certain Gifts and Contributions

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

 No

 Yes. Fill in the details for each gift.

Gifts with a total value of more than $600

per person

Person to Whom You Gave the Gift and

Address:

Describe the gifts Dates you gave

the gifts

Value

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

 No

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

Gifts or contributions to charities that total

more than $600

Charity's Name

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

Describe what you contributed Dates you

contributed

Value

Part 6: List Certain Losses

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

or gambling?

 No

 Yes. Fill in the details.

Describe the property you lost and

how the loss occurred

Describe any insurance coverage for the loss

Include the amount that insurance has paid. List pending

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

Date of your

loss

Value of property

lost

Part 7: List Certain Payments or Transfers

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

consulted about seeking bankruptcy or preparing a bankruptcy petition?

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

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Email or website address

Person Who Made the Payment, if Not You

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

Kane & Papa, P.C.

P.O. Box 508

Richmond, VA 23218-0508

$375.00 Filing Fee, Credit Reports, and

Certificateof Service

08/29/2017 $375.00

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

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Document Page 31 of 37
Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

Person Who Was Paid

Address

Email or website address

Person Who Made the Payment, if Not You

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

Abacus Credit Counseling

17337 Ventura Boulevard

Suite 226

Encino, CA 91316

$25.00 Credit Counseling 08/29/2017 $25.00

Kane & Papa, P.C.

P.O. Box 508

Richmond, VA 23218-0508

$1450; conversion fees May 20, 2020 $1,450.00

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

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

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

 No

 Yes. Fill in the details.

Person Who Was Paid

Address

Description and value of any property

transferred

Date payment

or transfer was

made

Amount of

payment

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

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

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

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

 No

 Yes. Fill in the details.

Person Who Received Transfer

Address

Person's relationship to you

Description and value of

property transferred

Describe any property or

payments received or debts

paid in exchange

Date transfer was

made

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

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

 No

 Yes. Fill in the details.

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

made

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

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

sold, moved, or transferred?

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

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

 No

 Yes. Fill in the details.

Name of Financial Institution and

Address (Number, Street, City, State and ZIP

Code)

Last 4 digits of

account number

Type of account or

instrument

Date account was

closed, sold,

moved, or

transferred

Last balance

before closing or

transfer

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

cash, or other valuables?

 No

 Yes. Fill in the details.

Name of Financial Institution

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

Who else had access to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

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

 No

 Yes. Fill in the details.

Name of Storage Facility

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

Who else has or had access

to it?

Address (Number, Street, City,

State and ZIP Code)

Describe the contents Do you still

have it?

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

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

for someone.

 No

 Yes. Fill in the details.

Owner's Name

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

Where is the property?

(Number, Street, City, State and ZIP

Code)

Describe the property Value

Part 10: Give Details About Environmental Information

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

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

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

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

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

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

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

hazardous material, pollutant, contaminant, or similar term.

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

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

 No

 Yes. Fill in the details.

Name of site

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

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

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

 No

 Yes. Fill in the details.

Name of site

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

Governmental unit

Address (Number, Street, City, State and

ZIP Code)

Environmental law, if you

know it

Date of notice

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

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

 No

 Yes. Fill in the details.

Case Title

Case Number

Court or agency

Name

Address (Number, Street, City,

State and ZIP Code)

Nature of the case Status of the

case

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

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

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

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

 A partner in a partnership

 An officer, director, or managing executive of a corporation

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

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

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

Business Name

Address

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

Describe the nature of the business

Name of accountant or bookkeeper

Employer Identification number

Do not include Social Security number or ITIN.

Dates business existed

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

institutions, creditors, or other parties.

 No

 Yes. Fill in the details below.

Name

Address

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

Date Issued

Part 12: Sign Below

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

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

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

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

/s/ Nichelle Monique Green

Nichelle Monique Green Signature of Debtor 2

Signature of Debtor 1

Date May 20, 2020 Date

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

 No

 Yes

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

 No

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

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

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Document Page 34 of 37
Fill in this information to identify your case:

Debtor 1 Nichelle Monique Green

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: EASTERN DISTRICT OF VIRGINIA

Case number 17-34335

(if known)  Check if this is an

amended filing

Official Form 108

Statement of Intention for Individuals Filing Under Chapter 7 12/15

If you are an individual filing under chapter 7, you must fill out this form if:

 creditors have claims secured by your property, or

 you have leased personal property and the lease has not expired.

You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors,

whichever is earlier, unless the court extends the time for cause. You must also send copies to the creditors and lessors you list

on the form

If two married people are filing together in a joint case, both are equally responsible for supplying correct information. Both debtors must

sign and date the form.

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

write your name and case number (if known).

Part 1: List Your Creditors Who Have Secured Claims

1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the

information below.

Identify the creditor and the property that is collateral What do you intend to do with the property that

secures a debt?

Did you claim the property

as exempt on Schedule C?

Creditor's Carway  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement. Description of 2006 Chrysler Sebring 190,000

property miles  Retain the property and [explain]:

securing debt:

Creditor's Lendmark Financial Services  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 2001 Lincoln Towncar 280,000 Reaffirmation Agreement.

property miles  Retain the property and [explain]:

securing debt:

Creditor's M&M Auto Sales  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 2004 Acura MDX 180,000 miles Reaffirmation Agreement.

property  Retain the property and [explain]:

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

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Debtor 1 Nichelle Monique Green Case number (if known) 17-34335

securing debt:

Creditor's Mariner Finance  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 2000 Lexus RX 300 205,000 Reaffirmation Agreement.

property miles  Retain the property and [explain]:

securing debt:

Part 2: List Your Unexpired Personal Property Leases

For any unexpired personal property lease that you listed in Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G), fill

in the information below. Do not list real estate leases. Unexpired leases are leases that are still in effect; the lease period has not yet ended.

You may assume an unexpired personal property lease if the trustee does not assume it. 11 U.S.C. § 365(p)(2).

Describe your unexpired personal property leases Will the lease be assumed?

Lessor's name: William Drinkwater  No

 Yes

Description of leased

Property:

Lease of Residence

Part 3: Sign Below

Under penalty of perjury, I declare that I have indicated my intention about any property of my estate that secures a debt and any personal

property that is subject to an unexpired lease.

X /s/ Nichelle Monique Green X

Nichelle Monique Green Signature of Debtor 2

Signature of Debtor 1

Date May 20, 2020 Date

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

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United States Bankruptcy Court

Eastern District of Virginia

In re Nichelle Monique Green Case No. 17-34335

Debtor(s) Chapter 7

AMENDMENT COVER SHEET

Amendment(s) to the following petition, list(s), schedule(s) or statement(s) are transmitted herewith:

Involuntary/Voluntary Petition [Specify reason for amendment: ]

Check if applicable: Soc. Sec. No. amended. [If applicable: An original, signed Official Form 121 was

mailed/hand-delivered to the Clerk's office on .*]

Summary of Your Assets and Liabilities (and Certain Statistical Information - Individuals Only)

Declaration (Individuals - Form 106Dec) (Non-Individuals - Form 202)

Schedule A/B – Property

Schedule C – The Property You Claim as Exempt

Schedule D – Creditors Who Hold Claims Secured by Property (See LBR 1009-1)

Schedule E/F – Creditors Who Have Unsecured Claims (See LBR 1009-1)

Schedule E/F Creditors Who Have Unsecured Claims (See LBR 1009-1)

($31.00 fee required if adding or deleting pre-petition creditors, changing amounts owed or classification of

debt.) Check applicable statement(s):

Creditor(s) added Creditor(s) deleted

Change in amounts owed or classification of debt

No pre-petition creditors added/deleted, or amounts owed or classification of debt changed. [Docket:

Amended Schedule(s) and/or Statement(s), List(s)-NO FEE)

Post-petition creditors added (Schedule of Unpaid Debts)

REMINDER: Conversion of Chapter 13 to Chapter 7 - only file Schedule of Unpaid Debts.

Schedule G – Executory Contracts and Unexpired Leases

Schedule H – Codebtors

Schedule I – Your Income

Schedule J – Your Expenses

[NOTE: The form “NOTICE TO CREDITOR(S) (RE AMENDMENT)” is still required when adding or deleting creditors.

*Amendment of debtor(s) Social Security Number requires that this cover sheet together with a completed Official Form 121 –

Statement About Your Social Security Numbers be electronically filed or submitted to the Clerk’s Office for “restricted”

entry of the amended Social Security Number into the case record.]

Statement of Financial Affairs

Statement of Intention for Individuals Filing Under Chapter 7

Chapter 11 List of Equity Security Holders

Chapter 11: The List of Creditors Who Have the 20 Largest Unsecured Claims Against You Who Are Not Insiders

Attorney’s Disclosure of Compensation

Other:

NOTICE OF AMENDMENT(S) TO AFFECTED PARTIES

Pursuant to Federal Rule of Bankruptcy Procedure 1009(a) and Local Rule 1009-1, I certify that notice of the filing of the

amendment(s) checked above has been given this date to the United States Trustee, the trustee in this case, and to any and all entities

affected by the amendment as follows: ECF and First Class Mail .

Date: June 9, 2020

/s/ James E. Kane, Esquire

James E. Kane, Esquire 30081

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

State Bar No.: 30081 VA

Mailing Address: Kane & Papa, P.C.

P.O. Box 508

Richmond, VA 23218-0508

Telephone No.: 804-225-9500

[amendcs ver. 12/16]

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