United States Bankruptcy Court for the: 

Northern ~i~~~~~~ of Illinois 

Case number (/fkno~.n): Chapter you are filing under: 

(X Chapter 7 

a Chapter I I 

0 Chapter 12 

0 Chapter I3 

--- 

Official Form 101 

0 Check if this is an 

amended filing 

Voluntary Petition for Individuals Filing for Bankruptcy 

The bankruptcy forms use youand Debtor I to refer to a debtor filing alone. A married couple may file a bankruptcy case together--called a 

joint case--and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, "Do you own a car," 

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

Debtor 2 to distinguish between them. In joint cases, one of the spouses must report information as Debtor I and the other as Debtor 2. The 

same person must be Debtor I in all of the forms. 

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

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

(if known). Answer every question. 

Identify Yourself 

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

I. Your full name 

Write the name that is on your 

government-issued picture 

identification (for example, First name First name 

your driver's license or 

passport). Middle name Middle name 

Bring your picture Gregoriou 

identification to your meeting Last name Last name 

with the trustee. 

Suffix (Sr., Jr., 11, 111) Suffix (Sr., Jr.. 11, 111) 

2. All other names you 

have used in the last 8 

years 

Include your married or 

maiden names. 

3. Only the last 4 digits of 

your Social Security 

number or federal 

Individual Taxpayer 

Identification number 

(ITIN) 

First name Ftnt name 

Middle name Middle name 

Last name Last name 

First name First name 

Middle name Middle name 

Last name Last name 

Official Form 101 Voluntary Petition for lndividuals Filing for Bankruptcy 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 1 of 30
Debtor 1 Nickie Gregoriou 

Fna Name w&e Nane ~aat ~ame 

4. Any business names 

and Employer 

Identification Numbers 

(EIN) you have used in 

the last 8 years 

Include trade names and 

doing business as names 

5. Where you live 

About Debtor I: 

a I have not used any business names or ElNs 

Case number (nhmvn) 

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

I have not used any business names or EINs. 

Business name Business name 

Business name Business name 

-- - ------A 

EIN -- - ------- EIN 

If Debtor 2 lives at a different address: 

8925 N.Oriole 

Number Street Number Street 

Morton Grove IL. 60053 

city State ZIP Code City State ZIP Code 

Cook 

County County 

If your mailing address is different from the one 

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

any notices to you at this mailing address. 

If Debtor 2's mailing address is different from 

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

any notices to this mailing address. 

Number Street ,Number Street 

P.O. Box P.O. Box 

citv State ZIP Code City State ZIP Code 

6. Why you are choosing Check one: 

this district to file for 

bankruptcy a Over the last 180 days before filing this petition, 

I have lived in this district lonaer than - in anv 

other district. 

a I have another reason. Explain. 

(See 28 U.S.C. 3 1408.) 

Check one: 

0 Over the last 180 days before filing this petition, 

I have lived in this district longer than in any 

other district. 

I have another reason. Explain. 

(See 28 U.S.C. § 1408.) 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 2 of 30
Debtor 1 Nickie Gregoriou 

Firat Nam MUdk Nm Last Name 

Case number (it kmn) 

Tell the Court About Your Bankruptcy Case 

7. The chapter of the 

Bankruptcy Code you 

are choosing to file 

under 

Check one. (For a brief description of each, see Notice Required by 71 U. S. C. 5 342(b) for Individuals Filing 

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

DChapter 7 

Chapter 11 

Chapter I2 

0 Chapter 13 

8. How you will pay the fee UI will pay the entire fee when I flle my petition. Please check with the clerk's office in your 

local court for more details about how you may pay. Typically, if you are paying the fee 

yourself, you may pay with cash, cashier's check, or money order. If your attorney is 

submitting your payment on your behalf, your attorney may pay with a credit card or check 

with a pre-printed address. 

0 I need to pay the fee in installments. If you choose this option, sign and attach the 

Application for Individuals to Pay The Filing Fee in Installments (Official Form 103A). 

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

By law, a judge may, but is not required to, waive your fee, and may do so only if your income is 

less than 150% of the official poverty line that applies to your family size and you are unable to 

pay the fee in installments). If you choose this option, you must fill out the Application to Have the 

Chapter 7 Filing Fee Wa~ved (Official Form 103B) and file it with your petition. 

9. Have you filed for 

bankruptcy within the 

last 8 years? 

UNO 

0 Yes. District When Case number 

MMI DDIYYYY 

District When Case number 

MM I DD I YYYY 

District When Case number 

MMI DDIWYY 

10. Are any bankruptcy 

cases pending or being 

~ NO 

filed by a spouse who is Yes. Debtor Relationship to you 

not filing this case with 

you, or by a business 

partner, or by an 

affiliate? 

11. Do you rent your 

residence? 

District When Case number, if known 

MM I DD 1 YYYY 

Debtor Relationsh~p to you 

District When Case number, if known 

MMIDDIYYYY 

MNO. 

Q Yes. 

Go to line 12. 

Has your landlord obtained an eviction judgment against you and do you want to stay in your 

residence? 

0 No. Go to line 12. 

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

this bankruptcy petition. 

Official Form 101 Voluntary Peutlon for Individuals Filing for Bankruptcy 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 3 of 30
Debtor Nickie Gregoriou 

Fi Name Middle Name la3l Nama 

Case number (ifwn) 

Report About Any Businesses You Own as a Sole Proprietor 

12. Are you a sole proprietor MN~. GO to Part 4. 

of any full- or part-time 

business? 0 Yes. Name and location of business 

A sole proprietorship is a 

business you operate as an 

individual, and is not a 

separate legal entity such as 

a corporation, partnership, or 

LLC. 

If you have more than one 

sole proprietorship, use a 

separate sheet and attach it 

to this petition. 

- ~- 

Name of business. if any 

Number Street 

City State ZIP Code 

Check the appropriate box to describe your business: 

0 Health Care Business (as defined in 11 U.S.C. 3 lOl(27A)) 

0 Single Asset Real Estate (as defined in 11 U.S.C. § lOl(518)) 

0 Stockbroker (as defined in 11 U.S.C. 3 lOl(53A)) 

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

a None of the above 

13. Are you filing under If you are filing under Chapter I I, the court must know whether you are a small business debtor so that it 

Chapter 11 of the can set appropriate deadlines. If you indicate that you are a small business debtor, you must attach your 

~~~k~~~t~~ Code and most recent balance sheet, Statement of operations, cash-flow statement, and federal income tax return or if 

are you a small business any of these documents do not exist, follow the procedure in 11 U.S.C. $ 1116(1)(B). 

debtor? NO. I am not filing under Chapter 11. For a definition of small 

business debtor, see 

11 U.S.C. 3 lOl(51D). 

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

the Bankruptcy Code. 

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

Bankruptcy Code. 

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

14. DO you own or have any m~~ 

property that poses or is 

alleged to pose a threat 0 Yes. What is the hazard? 

of imminent and 

identifiable hazard to 

public health or safety? 

Or do you own any 

property that needs 

immediate attention? If immediate attention is needed, why is it needed? 

For example, do you own 

perishable goods, or livestock 

that must be fed, or a building 

that needs urgent repairs? 

Where is the properly? 

Number Street 

Official Form 101 

City State ZIP Code 

Voluntary Petition for individuals Filing for Bankruptcy page 4 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 4 of 30
Debtor 1 Nickie Gregoriou 

Fii Name Mlddls Name LIU1 Name 

Case number (a known) 

Answer These Questions for Reporting Purposes 

16a. Are your debts primarily consumer debts? Consumerdebtsare defined in 11 U.S.C. 9 101(8) 16. What kind of debts do as "incurred by an individual primarily for a personal, family, or household purpose." 

you have? 0 No. Go to line 16b. 

II( Yes. Go to line 17. 

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

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

0 No. Go to line 16c. 

0 Yes. Go to line 17. 

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

I?. Are you filing under 

Chapter 77 0 No. I am not filing under Chapter 7. Go to line 18. 

DO you estimate that after ayes. I am filing under Chapter 7. DO you estimate that after any exempt property is excluded and 

anv exempt ~roaertv is administrative expenses are paid that funds will be available to distribute to unsecured creditors? . - 

excluded and 

administrative expenses 

are paid that funds will be 

available for distribution 

to unsecured creditors? 

Ck NO 

C1 Yes 

18. HOW many creditors do a 1-49 

you estimate that you 0 50-99 

owe? 5 100-199 

0 200-999 

is. How much do you 0 $0-$50,000 

be worth? 

$500,001-$1 million 

20. How much do you 0 $0-S50,OOO 

estimate your liabilities 0 $50,001-$100,000 

to be? d$100,001-$500,000 

0 $500.001-$1 million 

0 25,001-50,000 

50,001-100,000 

0 More than 100.000 

- -- 

a S1,000,001-$10 million ~$500,000,001-$1 billion 

0 $10,000,001-$50 million 0 $1,000,000,001-$10 billion 

$50,000,001-$100 million a $10,000,000,001-$50 billion 

0 $100.000,001-$500 million 0 More than $50 billion 

0 51,000.001$10 million ~$500,000,001-$1 billion 

0 S10,000,001-$50 million 0 $1,000,000,001-$10 billion 

a S50,000,001-$100 million 0 $10,000,000,001-$50 billion 

$100,000,001-$500 million a More than S50 billion 

Sign Below 

For you 

Official Form 101 

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

correct. 

If I have chosen to file under Chapter 7, 1 am aware that I may proceed, if eligible, under Chapter 7. 11,12, or 13 

of title 11, United States Code. I understand the relief available under each chapter, and I choose to proceed 

under Chapter 7. 

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

this document. I have obtained and read the notice required by 11 U.S.C. 3 342(b). 

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

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

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

18 U.S.C. 55 152; 1341,15i19, and3571. 

q.&&& Si nature of Deb or 

-. 

~ignafure of debtor 2 

Executed on 

MM I OD IYWY 

Voluntary Petition for Individuals Flllng for Bankruptcy 

Executed on 

MM I DD l WY 

Dage 6 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 5 of 30
Debtor I Nickie Gregoriou 

FlPU Name Middle Nas Last NPmO 

Case number (tknaun) 

I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility For your attorney, if you are to proceed under Chapter 7, 11. 12, or 13 of title 11, United States Code, and have explained the relief 

represented by one available under each chapter for which the person is eligible. I also certify that I have delivered to the debtor(s) 

the notice required by I I U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, certify that I have no 

If you are not represented knowledge after an inquiry thatpe infomlation in the schedules filed with the petition is incorrect. 

by an attorney, you do not 

need to file this page. % Date 

Ggnature of Attorney for bdor MM I OD lW 

Martin Y. Joseph 

Printed name 

Firm name 

221 N. LaSalle Ste 1906 

Official Form 101 

Number Street 

Chicago IL. 60601 

Cify State ZIP Code 

1369563 Illinois 

Bar number State 

Voluntary Petition for Individuals Filing for Bankruptcy 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 6 of 30
(Spouse. if filing) Fim Name Middle Nane Larl Name 

United States Bankruptcy court for the: Northem Distfict of Illinois 

Official Form 106AlB 

0 Check if this is an 

amended filing 

Schedule AIB: Property 1211 5 

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? 

a No. Go to Part 2. 

[81 Yes. Where is the property'? 

What is the property? Check all that apply 

Single-family home 

1 1. 8925 N. Oriole 0 Duplex or multi-unit building 

Street address, if available, or other description Condominium or cooperative 

Do not deduct secured claims or exemptions. Put 

the amount of any secured claims on Schedule 0: 

Creditors Who Have Claims Secured by Property. 

Current value of the Current value of the 

0 Manufactured or mobile home entire property? portion you own? 

a Land $ 220.000.00 $ 220,000.00 

a Investment property 

Morton Grove IL. 'OoS3 a Timeshare Describe the nature of your ownership 

CltY State ZIP Code a Other interest (such as fee simple, tenancy by 

the entireties, or a life estate), if known. 

Who has an interest in the property? Check one. 

Fee Simple 

Cook Debtor 1 only 

County 0 Debtor 2 only 

a Debtor 1 and Debtor 2 only a Check if this is community property 

(see instructions) a At least one of the debtors and another 

Other information you wish to add about this item, such as local 

property identification number: 

If you own or have more than one, list here: 

What is the property? Check all that apply. 

a Single-family home 

1.2. 0 Duplex or multi-unit building Street address, if available, or other description a Condominium or cooperative 

Manufactured or mobile home 

Do not deduct secured Claims or exemptions. Put 

the amount of any secured claims on Schedule D: 

Creditors Who Have Claims Secured by Property. 

Current value of the Current value of the 

entire property? portion you own? 

0 Land $ $ 

D Investment property 

a Timeshare Describe the nature of your ownership 

city State ZIP Code interest (such as fee simple, tenancy by 0 Other the entireties, or a life estate), if known. 

Who has an interest in the property? Check one. 

0 Debtor 1 only 

County Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

a At least one of the debtors and another 

a Check if this is community property 

(see instructions) 

Other information you wish to add about this item, such as local 

property identification number: 

Official Form 106NB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 7 of 30
Nickie Gregoriou 

Fmi Name Middle Nane Last Name 

What is the property? Check all that apply 

13 

a Stngle-fam~ly home 

Street address. ~f available, or other description 0 Duplex or mulh-unft building 

a Condominium or cooperat~e 

C] Manufactured or rnob~le home 

a Land 

C] Investment property 

CltY State ZIP Code a Tfmeshare 

a Other 

Do not deduct secured clalms or exemptions. Put 

the amount of any secured claims on Schedule D 

Cmd~tors Who Have Claims Secured by Property. 

Current value of the Current value of the 

entire property? portion you own? 

Describe the nature of your ownership 

interest (such as fee simple, tenancy by 

the entireties, or a life estate), if known. 

Who has an interest in the property? Check one. 

0 Debtor 1 only 

County a Debtor 2 only 

a Debtor 1 and Debtor 2 only 0 Check if this is community property 

C] At least one of the debtors and another (see ~nstructions) 

Other information you wish to add about this item, such as local 

property identification number. 

2 Add the dollar value of the portion you own for all of your entries from Part 1, including any entries for pages 

you have attached for Part I. Write that number here. ............. .. . .. ....... . .. . ... .... .... ..... . ..... ..... ........ ....... ........... . 

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

you own that someone else drives If you lease a vehlcle, also report it on Schedule G Executory Contracts and Unexp~red Leases 

3 Can, vans, trucks, tractors, sport utility vehicles, motorcycles 

C1 No 

O Yes 

3.1. Make: 

Model: 

. . 

has an in the propew Check One D, not deduct secured clams or exernptlons Put 

0 Debtor 1 only the amount of any secured cla~ms on Schedule D 

Cred~tors Who Have Claims Secured by Properly a Debtor 2 only Year. 

Approxlmate mileage, 

a Debtor 1 and Debtor 2 only 

a At least one of the debtors and another 

Current value of the Current value of the 

entire property? portion you own? 

Other ~nformation: 

C] Check if this is community property (see $ $ 

~nstruct~ons) 

If you own or have more than one, describe here 

3 2. Make. 

Model. 

has an interest in the properL'? One D, not deduct secured clams or exernptlons Put 

C] Debtor ? only the amount of any secured cla~ms on Schedule D 

Cred,tors Who Have Clatms Secu& by Properly Debtor 2 onlv Year 

Approxlmate mlleage. 

Other informahon. 

- 

Debtor 1 and Debtor 2 only 

At least one of the debtors and another 

Current value of the Current value of the 

entire property? portion you own? 

C] Check if this is community property (see $ $ 

Instruct~ons) 

Offic~al Form 106AIB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 8 of 30
Debtor 1 Nickie Gregoriou 

F~SI me Middle Nane Last Namc 

Case number (dlmavn) 

3.3. Make: 

Model: 

Year: 

Approximate mileage: 

Other information: 

3.4. Make: 

Model: 

Year: 

Approximate mileage: 

Other information: 

Who has an interest in the property? Check one. D, not deduct secured claims or exemptions. Put 

the amount of any secured claims on Schedule 0: 0 Debtor 1 only Creditors Who Have Claims Secured by Property. 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

At least one of the debtors and another 

Current value of the Current value of the 

entire property? portion you own? 

0 Check if this is community property (see $ $ 

instructions) 

Who has an interest in the property? Check one DO not deduct secured claims or exernptlons. put 

0 Debtor I only the amount of any secured claims on Schedule D: 

Creditors Who Have Claims Secured by Property. 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

Current value of the Current value of the 

entire property? portion you own? 

P Check if this is community property (see $ $ 

instructions) 

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

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

0 No 

0 Yes 

4.1. Make: 

Model: 

Year: 

Other information: 

Who has an interest in the property? Check one DO not deduct secured claims or exemptions. Put 

0 Debtor 1 only the amount of any secured claims on Schedule D: 

Cred~tors Who Have Claims Secured by Property. 

0 Debtor 2 only 

[II Debtor 1 and Debtor 2 only Current value of the Current value of the 

[II At least one of the debtors and another entire property? portion you own? 

Check if this is community property (see $ $ 

instructions) 

If you own or have more than one, list here: 

4.2. Make: 

Model: 

Year: 

Other information: 

Who has an interest in the property? Check one. DO not deduct secured daims or exemptions. Put 

0 Debtor 1 only the amount of any secured daims on Schedule 0. 

- Creditors Who Have Claims Secured by Property, 

Oebtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

Current value of the Current value of the 

entire property? portion you own? 

0 Check if this is community property (see $ $ 

instructions) 

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 * 

Official Form 106NB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 9 of 30
Debtor I Nickie Gregoriou 

Fm N&ne Me Hane Lasl Name 

Case number (dwn) 

Descrlbe Your Personal and Household Items 

Current value of the 

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

Do not deduct secured daims 

or exemptions. 

6. Household goods and furnishings 

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

0 No 

a Yes. Describe. ........ Furniture and China 

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 

0 No 

a Yes. Describe. ......... set 

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 

0 No 

0 Yes. Describe. ......... 

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 

0 No 

0 Yes. Describe. ......... 

lo. Firearms 

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

0 No 

0 Yes. Describe. ......... 

11. Clothes 

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

0 No 

a Yes. Describe. ......... Everyday Clothes 

12. Jewelry 

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

gold, silver 

0 No 

0 Yes. Describe. ....... 

13. Non-farm animals 

Examples: Dogs, cats, birds, horses 

0 No 

0 Yes. Describe .......... 

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

0 No 

0 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 ...................................................................................................................................................... 

Official Form 106NB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 10 of 30
Debtor 1 Nickie Gregoriou 

FntNsme MadlsName la$! Name 

Case number (8-n) 

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 

O No 

a yes ................................................................................................................................................................... Cash: ....................... $ 1.100.00 

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. 

O No 

Dl yes ..................... Institution name: 

17.1. Checking account: Citibank 

17.2. Checking account: 

17.3. Savings account: 

17.4. Savings account: 

17.5. Certificates of deposit 

17.6. Other financial account: 

17.7. Other financial account 

17.8. Other financial account: 

17.9. Other financial account 

18. Bonds, mutual funds, or publicly traded stocks 

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

O No 

0 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 

0 No Name of entity: % of ownership: 

a Yes. Give specific Pandorams Gifts 100 % 

information about 

them. ........................ % 

Schedule A/B: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 11 of 30
Debtor 1 Nickie Gregoriou 

First Name Mm Name LaYNane 

Case number (dm) 

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. 

R No 

0 Yes. Give specific Issuer name: 

information about 

them. ...................... $ 

21. Retirement or pension accounts 

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

0 No 

Yes. List each 

account separately.. Type of account Institution name: 

401(k) or similar plan: Mmpo'itan Life 

Pension plan: 

IRA: $ 

Retirement account: 3 

Keogh: $ 

Additional account: $ 

Additional account: $ 

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 

R No 

0 yes ........................ 

Electric; 

Gas: 

lnstitution name or individual: 

Heating oil; $ 

Security deposit on rental unit $ 

Prepaid rent: $ 

Telephone: $ 

Water: 

Rented furniture: $ 

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

0 No 

P Yes ........................... Issuer name and description: 

Official Form 106NB Schedule NB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 12 of 30
Debtor I Nickie Gregoriou 

F- Me Male Name Laat Name 

Case number (rMaYn) 

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)(l). 529A(b), and 529(b)(1) 

O No 

0 Yes lnstrtutron name and descnptron Separately file the records of any Interests 11 U S C 5 521(c) 

25 Trusts, equitable or future interests in property (other than anything listed in line I), and rights or powers 

exercisable for your benefit 

R No 

Yes Give specific 

tnformation about them 

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

Examples lntemet domain names, websites, proceeds from royaltres and licensing agreements 

0 No 

0 Yes G~ve spec~fic 

~nformation about them 

27 Licenses, franchises, and other general intangibles 

Examples Bu~ldlng permits, excluscve Iccenses, cooperatcve assoctation hold~ngs, Irquor Ilcenses, professional l~censes 

0 No 

a Yes Give specific 

inforrnat~on about them 

Money or property owed to you? 

28 Tax refunds owed to you 

R No 

Yes Give specific rnforrnatron 

about them, including whether 

you already filed the returns 

and the tax years. .................... 

Federal 

State' 

Local 

Current value of the 

portion you own? 

Do not deduct secured 

claims or exemphons 

29 Family support 

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

a No 

0 Yes Give specific lnformat~on 

Alimony: S 

Maintenance: $ 

support: $ 

Divorce settlement S 

Property settlement: $ 

30 Other amounts someone owes you 

Examples Unpa~d wages, d~sabllity insurance payments, drsability benefits, sick pay, vacation pay, workers' compensatron, 

Social Secunty benefits, unpaid loans you made to someone else 

0 No 

a Yes Glve specific ~nformation 

Offic~al Form 106NB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 13 of 30
Debtor I Nickie Gregoriou Rrsl Name Middle Name LanName 

31. Interests in insurance policies 

Examples: Health, disability, or l~fe insurance; health savlngs account (HSA); cred~t, homeowner's, or renter's insurance 

a No 

0 Yes. Name the insurance company Comwny name: of each policy and list its value. .. 

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. 

0 No 

0 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 

0 No 

a Yes. Describe each claim. ..................... Contract and Fraud Judgment against Mario Pappas and & Ellis TV inc.for $148,704.00 plus interest and costs C ook 

County case #2011CH-0003 1 s unknown 

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

to set off claims 

a No 

II) Yes. Describe each claim ...................... 

35.Any financial assets you did not already list 

m No 

0 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 ................................................................................................................................................... 

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? 

a No. Go to Part 6. 

0 Yes. Go to line 38. 

Current value of the 

portion you own? 

Do not deduct secured claims 

or exemptions. 

38 Accounts receivable or commissions you already earned 

O No 

0 Yes. Describe ....... 

39. Office equipment, furnishings, and supplies 

Examples: Business-related computers, software, modems. printers. copiers, fax machines, rugs, telephones, desks, chairs. electronic devices 

O No 

a Yes. Describe ....... 

Official Form 106AIB Schedule AIB: Property 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 14 of 30
Debtor 1 Nickie Gregoriou 

FL~ PIame MlWie Nxne La9 Name 

Case number (Kmnl 

40 Machinergr, fixtures, equlpment, supplies you use in business, and tools of your trade 

O No 

C1 Yes. Descr~be . 

41. Inventory 

a No 

0 Yes. Descnbe ....... 

42 Interests in partnerships or joint ventures 

a No 

a Yes. Descnbe . . Name ofentlty: % of ownershtp: 

43 Customer lists, mailing lists, or other compilations 

0 No 

[;I Yes. Do your lists include personally identifiable information (as defined in 11 U S.C § 101(41A))? 

0 No 

0 Yes Descrlbe 

44 Any business-related property you did not already list 

0 No 

0 Yes. Give specific 

information ......... 

45. Add the dollar value of all of your entries from Part 5, including any entries for pages you have attached 

for Part 5. Write that number here ........................................................................................................................................................ 

Part 6: I 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? 

a NO. GO to Part 7. 

Yes. Go to line 47. 

Current value of the 

portion you own? 

47. Farm animals 

Examples: Livestock, poultry, farm-raised fish 

O No 

yes ........................... 

Do not deduct secured claims 

or exemptions. 

Official Form 106AIB Schedule AIB: Property oage 9 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 15 of 30
Debtor I Nickie Gregoriou 

Fvsi tiam MWName ~asl Namc 

48. Crops-either growing or hawested 

a No 

0 Yes. Give specific 

information. ............ 

49. Farm and fishing equipment, implements, machinery, fixtures, and tools of trade 

a No 

0 yes ........................... 

Case number (rrmaun) 

50. Farm and fishing supplies, chemicals, and feed 

0 No 

P yes .......................... 

5i.Any farm- and commercial fishing-related property you did not already list 

R No 

0 Yes. Give specific 

information. ........... 

52. Add the dollar value of all of your entries from Part 6, including any entries for pages you have attached $ 0.00 

for Part 6. Write that number here ....................................................................................................................................................... * I 

Part 7: E Bescribe 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 

[iP No 

a Yes. Give specific 

information. ............ 

List the Totals of Each Part of this Fonn 

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

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

56. Part 2: Total vehicles, line 5 

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

58. Part 4: Total financial assets, line 36 

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

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

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

62. Total personal property. Add lines 56 through 61. ................... 

$ 0.00 

$5.100.00 copy personal property total + + $ 5,100.00 

63.Total of all property on Schedule AIB. Add line 55 + line 62 ...................................................................................... 

Official Form 106,416 Schedule AIB: Property page 10 

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 Document Page 16 of 30
Nickie Gregoriou Debtor 1 F!m Name Mlddle Name LB~ Name 

Debtor 2 

(Spouse. if filing) FIN Nms Middle Nane ~asl Name 

United States Bankruptcy Court for the: of Ulinois 

(State) 

Case number 

(If known) 

0 Check if this is an 

amended filing 

Official Form 106C 

Schedule C: The Property You Claim as Exempt 

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 AB: Property (Official Form 106NB) as your source, list the properly 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. 

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) 

a 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 Current value of the Amount of the exemption you claim Specific laws that allow exemption 

Schedule A/B that lists this property portion you own 

Copy the value from Check only one box for each exemption. 

Schedule AA 

Brief 

description: 

Line from 

Schedule A5: 

Sinale Familv House $ 220,000.00 O$ 735-5112-901 

a 100% of far market value, up to 

1.1 any applicable statutory limit 

Brief Furniture $ 300.00 CIS 735-5112-1001(b) description: 

Line from 6 a 100% of fair market value, up to 

Schedule ,443: - any applicable statutory limit 

Brief TV $ 300.00 a$ 735-5112-100l(b) description: 

Line from 100% of fair market value, up to 

Schedule A,: 7 any applicable statutory limit 

3 Are you claiming a homestead exemption of more than $155,675? 

(Subject to adjustment on 4/01/16 and every 3 years after that for cases filed on or after the date of adjustment ) 

5 No 

0 Yes Did you acqulre the property covered by the exemption within 1,215 days before you filed th~s case? 

IXI No 

0 Yes 

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

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 Document Page 17 of 30
Debtor 1 Nickie Gregoriou Fm Ninv Mddk Name LwtNane 

Case number (nxnavn] 

Additional Page 

Brief description of the property and line Current value of the Amount of the exemption you claim Specific laws that allow exemption 

on Schedule NB that lists this property portion you own 

Copy the value from Check only one box for each exemption 

Schedule A/B 

Brief Clothes 735-5112-1001(a) 

description: $ 300.00 a$ 

Line from 11 a 100% of fair market value, up to 

Schedule A/B: any applicable statutory limit 

Bnef 735-5112-1001(b) 

description: Cash $ 1100.00 0s 

Line from [;t 100% of fair market value, up to 

16 Schedule A/B: - any applicable statutory limit 

Brief Checking Account 0s 735-5112-1001(b) 

description: $ 100.00 

Line from l;): 100% of fair market value, up to 

17 

Schedule A/?3: - any applicable statutory limit 

Brief Stock s 200.00 a$ 735-5112-lOOl(b), 735-5h2-1001(b) 

description: 

L~ne from 19 a 100% of fair market value, up to 

Schedule AfB: any applicable statutory limit 

Brief Judgment 735-5112-lOOl(b), 735-5112-1001(b) 

description. $ unknown O$ 

Line from a 100% of fair market value, up to 

33 Schedule AfB: - any applicable statutory limit 

Brief IRA $ 3000.00 Q$ 735-5112-1001tb). 735-5/12-1006 descnption: 

Line from 2 1 a 100% of fair market value, up to 

Schedule ,443: - any applicable statutory limit 

Brief 

description: S 0s 

Line from q 100% of fair market value, up to 

Schedule A/B: any applicable statutory limit 

Brief 

description: $ a$ 

Line from 0 100% of fair market value, up to 

Schedule AB: - any applicable statutory limit 

Brief 

descrtption: $ a$ 

Line from 0 100% of fair market value, up to 

Schedule AB: - any applicable statutory limit 

Bnef 

description: $ 0% 

Line from 0 100% of fair market value, up to 

Schedule A/B: any applicable statutory limit 

Brief 

description: $ 0s 

Line from 0 100% of fair market value, up to 

11 Schedule AfB: - any applicable statutory limit 

Brief 

description: 

Line from 

Schedule AB: - 0 100% of fair market value, up to 

any applicable statutory limit 

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

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 Document Page 18 of 30
Fill in this information to iderltify your case: I 

Debtor I Niche Gregoriou F~I me Udde Name LBSI ~ame 

I Debtor 2 

(Spouse, lf tillng) Flrat Name Middle Name La9 Name I 

United States Bankruptcy Court for the: Northern District of Illinois 

(State) I 

Case number llf known) 0 Check if this is an 

amended filing 

Official Form 106D 

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

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

information. If more space is needed, copy the Additional Page, fill it out, number the entries, and attach it to this form. On the top of any 

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

I. Do any creditors have claims secured by your property? 

a No. Check this box and submit this form to the court with your other schedules. You have nothing else to report on this form 

Yes. Fill in all of the information below. 

List All Secured Claims 

Cdumn A Column 5 Column C 

2. List all secured claims. If a creditor has more than one secured claim, list the creditor separately ~~~~~t df value of collateral unsecured 

for each claim. If more than one creditor has a particular claim, list the other creditors in Part 2. D, notdmct the that supPo* this wrtbn 

As much as possible, list the claims in alphabetical order according to the creditor's name. value of collateral. claim If any 

Citimortgage Describe the property that secures the claim: $96793.00 $ 220.000.00 S 

Creditor's Name 8925 N. Oriole Morton Grove, IJ., 

P.O. Box 9438 

Number Strwt 

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

0 Contingent 

Gaitherburg MD 20898 Unliquidated 

City State ZIP Code Q ~~~~~ed 

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

a Debtor I only a An agreement you made (such as mortgage or secured 

a Debtor 2 only car loan) 

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

O ~t least one of the debtors and another P Judgment lien from a lawsuit 

0 Other (including a right to offset) 

Check if this claim relates to a 

community debt 

Date debt was incurred Last 4 digits of account number 

~~~f.11 ~ympic M~~ G~~~ Tmt series pscribe the property that secures the claim: $ 120,000.00 $ 220,000.00 S 

Credltofs Name 8925 N. Oriole Morton Grove, IL 

C/o Quarles & Brady 

Number street 

300 N. LaSalle Suite 4000 As of the date you file, the claim is: Check all that apply. 

0 Contingent 

Chicago, U. 60654 0 Unliqu~dated 

cob State ZIP Code 0 ~i~,,t~d 

Who owes the debt? Check one. Nature of lien. Check a(l that apply 

(56 Debtor 1 only An agreement you made (such as mortgage or secured 

0 Debtor 2 only car loan) 

0 Debtor 1 and Debtor 2 only Statutory !len (such as tax Iten, mechanc's hen) 

0 At least one of the debtors and another 0 Judgment lien from a lawsuit 

a Other (including a r~ght to offset) 0 Check if this claim relates to a 

community debt 

Date debt was incurred Last 4 digits of account number - 

Add the dollar value of your entries in Column A on this page. Write that number here: IS 216.793.00 1 

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

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 19 of 30
Fill in this information to identify your case: 

I I 

Nickie Gregoriou Debtor I F~ffi Me ~ldele Name Lasi Name 

Debtor 2 

(Spouse lf fillng) ~lffi ~ama Mlddle me Las Name 

Un~ted States Bankruptcy Court for the Northern D~strict of 'Iinois 

(State) 

Case number 

(If knavn) 

Official Form 106ElF 

0 Check if this is an 

amended filing 

Schedule UF: Creditors Who Have Unsecured Claims 

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY claims and Part 2 for creditors with NONPRlORlN 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/& Property (Official Form 106AIB) and on Schedule G: Execufory 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 nead, fill it out, number the entries in the boxes on the left. Attach the Continuation Page to this page. On the top of 

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

Part 1: List All of Your PRiORlTY Unsecured Claims 

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

G NO. GO to Part 2. 

0 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 I. 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.) 

Last 4 digits of account number _ 

Priority Creditor's Name 

Total claim Priority Nonpriority 

amount amount 

When was the debt incurred? 

Number Street 

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

City State ZIP Code 0 Contingent 

0 Unliquidated Who incurred the debt? Check one. 0 Disputed 0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim is for a community debt 

Is the claim subject to offset? 

0 NO 

R Yes 

- 

Priority Creditois Name 

Number Street 

City State ZIP Code 

Who incurred the debt? Check one. 

Debtor 1 only 

0 Debtor 2 only 

P Debtor 1 and Debtor2 only 

At least one of the debtors and another 

Type of PRIORITY unsecured clairn: 

0 Domestic support obligations 

0 Taxes and certain other debts you owe the government 

Claims for death or personal injury while you were 

intoxicated 

Other. Specify 

Last 4 digits of account number s S S 

When was the debt incurred? 

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

0 Contingent 

0 Unliquidated 

0 Disputed 

Type of PRIORITY unsecured claim: 

0 Domestic support obligations 

0 Taxes and certain other debts you owe the government 

0 0 Claims for death or personal injury while you were Check if this claim is for a community debt intoxicated 

Is the claim subject to offset? 0 Other. Specify 

P NO 

0 Yes 

OffEdal Form 106UF 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 20 of 30
Nickie Gregoriou 

Fm Nane lrhddtC Name LasrNsme 

Case number (rm) Debtor 1 

List All of Your NONPRlORlTY Unsecured Claims 

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

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

t2 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.lf you have more than three nonpriority unsecured 

claims fill out the Continuation Page of Part 2. 

Total claim 

6.748.00 1.1 I 1 Discover Bank I nst 4 diaits of ; 

P.O. Box 15316 When was the d - - 

Number Street 

Wilmington DE. 19850 

city state ZIP Coda As of the date you file, the claim is: Check all that apply. 

0 Contingent 

Unliquidated 

Q Disputed 

Who incurred the debt? Check one. 

dC Debtor 1 only 

a Debtor 2 only 

0 Debtor 1 and Debtor 2 onlv Type of NONPRlORlTY unsecured claim: 

0 At least one of the debtors and another 0 Student loans 

Obligations arising out of a separation agreement or divorce 

that vou did not report as vrioritv cI~~s 0 Check if this claim is for a community debt . . 

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

a Other. Specify Card 

Is the claim subject to offset? 

GY NO 

0 Yes 

BankofAmerica Last 4 digits of account number 

Nonpriority Creditois Name When was the debt incurred? 

P.O. Box 982238 Number Street 

El Paso 'IX 79998 As of the date you file, the claim is: Check all that apply. 

City state ZIP Code Q Contingent 

Who incurred the debt? Check one. 

a Debtor 1 only 

Unliquidated 

a Disputed 

0 ~&tor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

Type of NONPRIORITY unsecured claim: 

a Student loans 

0 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 

[B Other. Specify Credit Card 

0 Check if this claim is for a community debt 

Is the claim subject to offset? 

CX NO 

0 Yes 

El Segundo CA. 

ZIP Code As of the date you file, the claim is: Check all that apply. City State 

Who incurred the debt? Check one 

n Debtor i only 

Debtor 2 onty 

0 Contingent 

a Unliquidated 

0 Disputed 

a Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another Type of NONPRlORlTY unsecured claim: 

Student loans 

0 Check if this clalm is for a community debt Obligatmns arising out of a separation agreement or divorce 

that you did not report as priority claims 

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

a Other. Specify TV service 

Is the claim subject to offset? 

Q No 

O Yes 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 21 of 30
Part 4: 

Debtor I Nickit Gregoriou Case number (#mi 

Fm Nane MNane Las Name 

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. 5 159. 

Add the amounts for each type of unsecured claim. 

Total claim 

6a. Domestic support obligations Total claims 

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

government 

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. 

6e. Total. Add lines 6a through 6d. 

Total claim 

Total claims 6f. Student loans 6f. 

s 0.00 

from Part 69. Obligations arising out of a separation agreement 

or divorce that you did not report as priority 

claims 0.00 

69. s 

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. 

6j. Total. Add lines 6f through 6i. 

Official Form IWUF Schedule UF: Creditors Who Have Unsecured Claims 

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 Document Page 22 of 30
Debtor Nickie Gregoriou 

Firnt Nme Muddle Nme LPrl Name 

I Debtor 2 

(spouse If filrng) Finn Name Mtddle Nun.¶ Lasl Name I 

United States Bankruptcy Court for the: District of 'linois 

(Slate) I 

Case number 

(If known) I 

Official Form 106G 

Schedule G: Executorv Contracts and Unexpired Leases 

Check if this is an 

amended filing 

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

information. If more space is needed, copy the additional page, fill it out, number the entries, and attach it to this page. On the top of any 

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

1. Do you have any executory contracts or unexpired leases? 

a No. Check this box and file this form with the court with your other schedules. You have nothing else to report on this form. 

a Yes. Fill in all of the information below even if the contracts or leases are listed on Schedule Am: Propefiy (Official Form 106AlB). 

2. List separately each person or company with whom you have the contract or lease. Then state what each contract or lease is for (for 

example, rent, vehicle lease, cell phone). See the instructions for this form in the instruction booklet for more examples of executory contracts ana 

unexpired leases. 

Person or company with whom you have the contract or lease 

Name 

Numkr Street 

CltY State ZIP Code 

2.2 

Name 

Number Street 

City State ZIP Code 

2.3 

Name 

Number Street 

City State ZIP Code 

Name 

Number Street 

City State ZIP Code 

2.5 

Name 

Number Street 

City State ZIP Code 

State what the contract or lease is for 

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

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 Document Page 23 of 30
Fill in this inforrnafion to identify your case: 

Debtor I Nickie Gregoriou 

Fm Name k~~e Name LdY Name 

Debtor 2 

(Spouse. 11 filing) Frst Name we ~ame La Name 

Northern Distria or Illinois United States Bankruptcy Court for the: 

(State) 

Case number Ilf known) 0 Check if this is an 

amended filing 

Official Form 106H pp -- 

Schedule H: Your Codebtors 

Codebtors are people or entities who are also liable for any debts you may have. Be as complete and accurate as possible. If two married people 

are filing together, both are equally responsible for supplying correct information. If more space is needed, copy the Additional Page, fill it out, 

and number the entries in the boxes on the left. Attach the Additional Page to this page. On the top of any Additional Pages, write your name and 

case number (if known). Answer every question. 

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

S No 

0 Yes 

2. Within the last 8 years, have you lived in a community property state or territory? (Community propelty states and territories include 

Arizona. California, Idaho, Louisiana. Nevada, New Mexico, Puerto Rim. Texas, Washington, and Wisconsin.) 

5 No. Go to line 3. 

0 Yes. Did your spouse, former spouse, or legal equivalent live with you at the time? 

No 

0 Yes. In which community state or territory did you live? . Fill in the name and current address of that person 

Name of your spouse. fmr spowe, or legal equivalent 

Nunhr Street 

3. In Column 1, list all of your codebtors. Do not include your spouse as a codebtor if your spouse is filing with you. List the person 

shown in line 2 again as a codebtor only if that person is a guarantor or cosigner. Make sure you have listed the creditor on 

Schedule D (Official Form 106D), Schedule E/F (Official Form lOBEF), or Schedule G (Official Form 106G). Use Schedule D, 

Schedule UF, or Schedule G to flll out Column 2. 

Column 1: Your codebtor Column 2: The creditor to whom you owe the debt 

Check all schedules that apply: 

Name 0 Schedule D, line 

a Schedule EIF, line 

Number Sueet 0 Schedule G, line 

Citv State n~ Code 

Name 0 Schedule D, line 

0 Schedule EIF, line 

Number Street 0 Schedule G, line 

State ZIP Code 

Name a Schedule D, line 

a Schedule €IF, line 

Number Streel a schedule G, line 

Cily Slate ZIP Code 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 24 of 30
Debtor l Nickie Gregoriou 

Fa~l Name MWI~rma Lasl Name 

I Debtor 2 

(Spouse. if filing) Flm Name MlWle Name Last Name 

United States Bankruptcy Court for the: District of Illinois 

(State) 

I Case number 

(If known) 

Official Form 1061 

Check if this is: 

0 An amended filing 

A supplement showing postpetition chapter 13 

income as of the following date: 

MM I DD I WYY 

Schedule I: Your Income 1211 5 

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. 

Describe Employment 

I. Fill in your employment 

information. 

If you have more than one job, 

attach a separate page with 

information about additional Employment status 

employers. 

Include part-time, seasonal, or 

self-employed work. 

Occupation Occupation may include student 

or homemaker, if it applies. 

Employer's name 

Debtor I 

0 Employed 

a Not employed 

Debtor 2 or non-filing spouse 

0 Employed 

a Not employed 

Employer's address 

Number Street Number Street 

City State ZIP Code City State ZIP Code 

How long employed there? 

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 

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

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

3. Estimate and list monthly overtime pay. 

4. Calculate gross income. Add line 2 + line 3. 

For Debtor 2 or non-filing spouse 

Official Form 1061 Schedule I: Your Income 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 25 of 30
Nickie G~egoriou Debtor 1 Fm Name We Nane ~aa Mame 

Case number (dknavn) 

For Debtor 1 For Debtor 2 or 

non-filing spouse 

$ 0.00 

Copy line 4 here .................... ... ..... ......................... .... ~. 

5 List all payroll deductions: 

5a Tax, Medicare, and Social Security deductions 

5b Mandatory contributions for retirement plans 

5c Voluntary contributions for retirement plans 

5d. Required repayments of retirement fund loans 

5e Insurance 

5f Domestic support obligations 

5g Union dues 

5h Other deductions. Specify 

5 Add the payroll deductions Add l~nes 5a + 5b + 5c + 5d + 5e +5f + 59 + 5h 

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

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 bus~ness showing gross 

rece~pts, ordinary and necessary business expenses, and the total 

monthly net income. 

8b. Interest and dividends 

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

regularly receive 

Include al~mony, spousal support, child support, marntenance, divorce 

sefflement, and property settlement. 8c $ $ 

8d. Unemployment compensation 

8e. Social Security 

8f. Other government assistance that you regularly receive 

Include cash asslstance and the value (~f known) of any noncash asslstance 

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

Nutnhon Assistance Program) or housing subsidies 

Specify: 8f. 3 $ 

89. Pension or retirement income 

8h Other monthly income. Spec~fy Income 8h +$ 990.00 +$ 

9 Add all other income. Add l~nes 8a + 8b + 8c + 8d + 8e + 8f +8g + 8h. 

9.p-Gcq 

lo Calculate monthly income. Add l~ne 7+ line 9 

Add the entries In l~ne 10 for Debtor 1 and Debtor 2 or non-fil~ng spouse. 10 

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

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

fr~ends or relat~ves. 

Do not Include any amounts already fncluded In l~nes 2-10 or amounts that are not available to pay expenses llsted in Schedule J 

Specify: 11. + $ 

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

Write that amount on the Summary of Your Assets and Llabrl~ties and Gertarn Stat~sbcal Infornabon, ~f it applies 

Combined 

monthly income 

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

Official Form 1061 

U No 

Schedule I: Your Income 

a Yes. Expla~n I 

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 Document Page 26 of 30
Fill in this information to identify your case: I 

Debtor I Nickie Greg0ri0~ Ftm Name Mle Nane Last Name 

Debtor 2 

(Spouse. ~f fil~ng) FI~S an hwrne Name LP~ ~ame 

United States Bankruptcy Court for the No*ern Distna of Illinois 

(State) 

Case number 

(If known) 

Official Form 106J 

Check if this is: 

a An amended filing 

0 A supplement showing postpetition chapter 13 

expenses as of the following date: 

MM I DDI W 

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. 

1. Is this a joint case? 

a No. Go to line 2. 

0 Yes. Does Debtor 2 live in a separate household? 

R No 

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

2. Do you have dependents? GI No Dependent's relationship to Dependent's Does dependent llve 

Do not list Debtor 1 and C] Yes. Fill out this information for Debtor 1 or Debtor 2 age with you? 

Debtor 2. each dependent ..... 

Do not state the dependents' 0 No 

names. a yes 

O No 

O Yes 

O No 

Yes 

O No 

0 Yes 

O No 

Ll Yes 

3. Do your expenses include 

expenses of people other than a No 

yourself and your dependents? a Yes 

Part 2: Estimate lour Ongoing Monthly Expenses 

Estimate your expenses as of your bankruptcy flling 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 1061.) Your expenses 

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

S 1,214.00 

any rent for the ground or lot. 

If not included in line 4: 

4a. Real estate taxes 

4b. Properly, homeowner's, or renter's insurance 

4c. Home maintenance, repair, and upkeep expenses 

4d. Homeowner's association or condominium dues 

Official Form 106J Schedule J: Your Expenses 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 27 of 30
Nickie Gregoriou 

Fm Name MuMa wane LES Name 

Debtor 1 Case number (nrmavn) 

Your expenses 

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

6. Utilities: 

6a. Electricity. heat, natural gas 

6b. Water, sewer. garbage collection 

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

6d. Other. Specify: 

7 Food and housekeeping supplies 

8 Childcare and children's education costs 

9 Clothing, laundry, and dry cleaning 

10 Personal care products and sewices 

11. Medical and dental expenses 

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

Do not ~nclude car payments. 

13. Entertainment, clubs, recreation, newspapers, magazines, 

14 Charitable contributions and religious donations 

and books 

15. Insurance. 

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

15a. Life insurance 

15b. Health insurance 

1.5~. Vehicle insurance 

15d. Other insurance. Specify: 

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

Specify: 

17. Installment or lease payments: 

17a. Car payments for Vehicle 1 

17b. Car payments for Vehicle 2 

17c. Other. Specify: 

176. Other. Specify: 

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 1061). 

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

Specify: 19. $ 

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

20a. Mortgages on other property 20a. $ 

20b. Real estate taxes 20b. $ 

20c. Property, homeowner's, or renter's insurance 20c. % 

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

20e. Homeowner's association or condominium dues 20e. $ 

Official Form 106J Schedule J: Your Expenses 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 28 of 30
Debtor 1 Nickie Gqoriou 

Flm ltme M&b Namc Last Name 

21. Other. Specify: 

22. Calculate your monthly expenses. 

22a. Add lines 4 through 21. 

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. 

23. Calculate your monthly net income. 

23a. Copy line 12 (yourcombined monthly income) from Schedule I. 

23b. Copy your monthly expenses from line 22c above. 

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

The result is your monthly net income. 

Case number (nlmavn) 

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 paylng for your car loan mth~n the year or do you expect your 

mortgage payment to increase or decrease because of a modification to the tens of your mortgage? 

O No. 

a Yes Explain here: 

Official Form 106J Schedule J: Your Expenses 

Case 16-27568 Doc 1 Filed 08/27/16 Entered 08/27/16 13:30:57 Desc Main

 Document Page 29 of 30
Mb3d.2 Nana 

(Spouse, if filing) Fm Nane me Name Las Name 

United States Bankruptcy Court for the: 

Northern 

Official Form 1 O6Dec 

Declaration About an Individual Debtor's Schedules 

a Check if this is an 

amended filing 

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

You must flle 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. tjs 152,1341,1519, and 3571. 

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

2! Yes. "" Name of person . Attach Bankruptcy Pehtion Preparer's Notice, Oeclarat!on, and 

Sig~iature (Official Fm 11 9) 

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 

Date 

MMI DD I Yi'fi 

X 

Signature of Debtor 2 

Date 

MMI DD 1 YYW 

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

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 Document Page 30 of 30