UNITED STATES BANKRUPTCY COURT

 

 

 DISTRICT OF 

 DIVISION

 

CHAPTER 7 TRUSTEE’S FINAL ACCOUNT AND DISTRIBUTION

REPORT CERTIFICATION THAT THE ESTATE HAS BEEN FULLY

ADMINISTERED AND APPLICATION TO BE DISCHARGED (TDR)

Zane L. Zielinski, Trustee, chapter 7 trustee, submits this Final Account, Certification

that the Estate has been Fully Administered and Application to be Discharged.

1) All funds on hand have been distributed in accordance with the Trustee’s Final Report

and, if applicable, any order of the Court modifying the Final Report. The case is fully

administered and all assets and funds which have come under the trustee’s control in this case

have been properly accounted for as provided by law. The trustee hereby requests to be

discharged from further duties as a trustee.

2) A summary of assets abandoned, assets exempt, total distributions to claimants, claims

discharged without payment, and expenses of administration is provided below:

3) Total gross receipts of $ (see Exhibit 1), minus funds paid to the debtor and

third parties of $ (see Exhibit 2), yielded net receipts of $ from the liquidation of

the property of the estate, which was distributed as follows:

In re: §

§

Sarah R Peterson § Case No. 16-37803

§

Debtor §

Assets Abandoned:

(Without deducting any secured claims)

Assets Exempt:

Total Distributions to Claimants: Claims Discharged

Without Payment: 

Total Expenses of Administration: 

UST Form 101-7-TDR (10/1/2010) (Page: 1)

2,869.50 3,879.00 NORTHERN 95,538.92 0.00 

101-7-TDR /2009 2

ILLINOIS 3,879.00 EASTERN 1,009.50 21,160.23 2,400.00 

ems Inc. /2010 A

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4) This case was originally filed under chapter on . The case was pending

for months.

5) All estate bank statements, deposit slips, and canceled checks have been submitted to

the United States Trustee.

6) An individual estate property record and report showing the final accounting of the

assets of the estate is attached as Exhibit 8. The cash receipts and disbursements records for each

estate bank account, showing the final accounting of the receipts and disbursements of estate

funds is attached as Exhibit 9.

Pursuant to Fed R Bank P 5009, I hereby certify, under penalty of perjury, that the

foregoing report is true and correct.

STATEMENT: This Uniform Form is associated with an open bankruptcy case, therefore, Paperwork Reduction Act

exemption 5 C.F.R. § 1320.4(a)(2) applies.

CLAIMS

SCHEDULED

CLAIMS

ASSERTED

CLAIMS

ALLOWED

CLAIMS

PAID

SECURED CLAIMS

(from Exhibit 3) $ $ $ $

PRIORITY CLAIMS:

CHAPTER 7 ADMIN. FEES

AND CHARGES

(from Exhibit 4)

PRIOR CHAPTER

ADMIN. FEES AND

CHARGES (from Exhibit 5)

PRIORITY UNSECURED

CLAIMS (from Exhibit 6)

GENERAL UNSECURED

CLAIMS (from Exhibit 7)

TOTAL DISBURSEMENTS $ $ $ $

Dated: By:/s/Zane L. Zielinski, Trustee

Trustee

UST Form 101-7-TDR (10/1/2010) (Page: 2)

7

NA 0.00 NA NA 13 27,560.49 27,560.49 0.00 0.00 28,569.99 0.00 NA 1,009.50 88,781.93 NA NA 28,569.99 3,879.00 1,009.50 1,009.50 0.00 2,869.50 0.00 01/03/2018 98,187.93 9,406.00 11/30/2016

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EXHIBITS TO

FINAL ACCOUNT

EXHIBIT 1 – GROSS RECEIPTS

EXHIBIT 2 – FUNDS PAID TO DEBTOR & THIRD PARTIES

EXHIBIT 3 – SECURED CLAIMS

DESCRIPTION UNIFORM

TRAN. CODE1

$ AMOUNT

RECEIVED

TOTAL GROSS RECEIPTS $

1

The Uniform Transaction Code is an accounting code assigned by the trustee for statistical reporting purposes.

PAYEE DESCRIPTION UNIFORM

TRAN. CODE

$ AMOUNT

PAID

NA

TOTAL FUNDS PAID TO DEBTOR &

THIRD PARTIES

$

CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form 6D)

CLAIMS

ASSERTED

CLAIMS

ALLOWED CLAIMS PAID

Ally Financial, P.O. Box

9001951 Louisville, KY

40290

TOTAL SECURED CLAIMS $ $ $ $ 

UST Form 101-7-TDR (10/1/2010) (Page: 3)

0.00 NA NA 1229-000 1229-000 1,379.00 2,500.00 9,406.00 3,879.00 NA NA 0.00 Chase Business Checking - Dutch Girl Photo

Photographic Equipment for Dutch Girl

Photography 9,406.00 0.00 0.00 NA

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EXHIBIT 4 – CHAPTER 7 ADMINISTRATIVE FEES and CHARGES

EXHIBIT 5 – PRIOR CHAPTER ADMINISTRATIVE FEES and CHARGES

EXHIBIT 6 – PRIORITY UNSECURED CLAIMS

PAYEE

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

CLAIMS

ASSERTED

CLAIMS

ALLOWED CLAIMS PAID

Zane L. Zielinski, Trustee

Zane L. Zielinski, Trustee

Associated Bank

TOTAL CHAPTER 7 ADMIN. FEES

AND CHARGES

$ $ $ $ 

PAYEE

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

CLAIMS

ASSERTED

CLAIMS

ALLOWED CLAIMS PAID

NA

TOTAL PRIOR CHAPTER ADMIN.

FEES AND CHARGES

$ $ $ $ 

CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form

6E)

CLAIMS

ASSERTED

(from Proofs of

Claim)

CLAIMS

ALLOWED CLAIMS PAID

TOTAL PRIORITY UNSECURED

CLAIMS

$ $ $ $ 

UST Form 101-7-TDR (10/1/2010) (Page: 4)

NA 0.00 0.00 30.00 9.75 969.75 NA NA NA 1,009.50 1,009.50 0.00 NANA 1,009.50 NA 2200-000 2100-000 2600-000 NA NA NA NA NA 9.75 969.75 NA 30.00 0.00 30.00 9.75 NA 969.75 0.00 NA NA

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EXHIBIT 7 – GENERAL UNSECURED CLAIMS

CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form

6F)

CLAIMS

ASSERTED

(from Proofs of

Claim)

CLAIMS

ALLOWED CLAIMS PAID

Accelarated Rehab Centers,

625 Enterspise Drive Oak

Brook, IL 60523

Ally Financial, 200

Renaissance Ctr Detroit, MI

48243

Bankamerica, Po Box 982238

El Paso, TX 79998

Bk Of Amer, Po Box 982238

El Paso, TX 79998

Cap1/bstby

Capital One Bank Usa N,

15000 Capital One Dr

Richmond, VA 23238

Chase Card, Po Box 15298

Wilmington, DE 19850

Chase Card, Po Box 15298

Wilmington, DE 19850

Citi, Po Box 6241 Sioux Falls,

SD 57117

UST Form 101-7-TDR (10/1/2010) (Page: 5)

5,237.00 0.00 1,904.26 6,144.00 9,406.00 0.00 6,550.00 0.00 0.00 NANANANANANANANANA NANANANANANANANANA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

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CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form

6F)

CLAIMS

ASSERTED

(from Proofs of

Claim)

CLAIMS

ALLOWED CLAIMS PAID

Citi, Po Box 6241 Sioux Falls,

SD 57117

Citi, Po Box 6497 Sioux Falls,

SD 57117

Comenity Bank/lnbryant,

4590 E Broad St Columbus,

OH 43213

Comenity Bank/valctyfr, Po

Box 182789 Columbus, OH

43218

Fifth Third Bank, 5050

Kingsley Dr Cincinnati, OH

45227

Golden Pacific Bank Na

Loyola university Medical

Center, PO Box 3021

Milwaukee, WI 53201

Loyola university Medical

Center, PO Box 3021

Milwaukee, WI 53201

Loyola University Medical

Center, PO Box 3021

Milwaukee, WI 53201

UST Form 101-7-TDR (10/1/2010) (Page: 6)

NANANANANANANANANA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NANANANANANANANANA 4,123.00 0.00 0.00 0.00 0.00 200.73 7.05 18,827.00 3,993.67

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CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form

6F)

CLAIMS

ASSERTED

(from Proofs of

Claim)

CLAIMS

ALLOWED CLAIMS PAID

Morris Hospital, 150 W High

St Morris, IL 60450

Morris Hospital, 150 W High

St Morris, IL 60450

Morris Hospital, 150 W High

Street Morris, IL 60450

Morris Hospital, 150 W High

Street Morris, IL 60450

Morris Hospital, 150 W High

Street Morris, IL 60450

Morris Hospital, 150 W High

Street Morris, IL 60450

Morris Hospital, 150 W High

Street Morris, IL 60450

State Farm Fncl Svcs F, 3

State Farm Plz Bloomington,

IL 61791

Syncb/la-z-boy, C/o Po Box

965036 Orlando, FL 32896

Syncb/sleep Number, C/o Po

Box 965036 Orlando, FL

32896

UST Form 101-7-TDR (10/1/2010) (Page: 7)

NANANANANANANANANANA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 750.00 0.00 2,636.19 922.54 110.07 146.42 NANANANANANANANANANA 22.94 74.65 386.41

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CLAIM NO. CLAIMANT

UNIFORM

TRAN.

CODE

CLAIMS

SCHEDULED

(from Form

6F)

CLAIMS

ASSERTED

(from Proofs of

Claim)

CLAIMS

ALLOWED CLAIMS PAID

Target N.b., Po Box 673

Minneapolis, MN 55440

Us Bank, 4325 17th Ave S

Fargo, ND 58125

Xls, Pob 2461 Harrisburg, PA

17105

Xls, Pob 2461 Harrisburg, PA

17105

Xls, Pob 2461 Harrisburg, PA

17105

3 Capital One Bank (Usa), N.A.

1 Discover Bank

4 Efs

2

Quantum3 Group Llc As

Agent For

TOTAL GENERAL UNSECURED

CLAIMS

$ $ $ $ 

UST Form 101-7-TDR (10/1/2010) (Page: 8)

7100-000 7100-000 7100-000 7100-000 2,869.50 NA 88,781.93 27,560.49 0.00 10,959.17 478.50 NANA 5,544.53 10,578.29 NANA 0.00 0.00 577.28 1,101.37 0.00 0.00 NANANA 10,959.17 1,141.03 49.82 10,578.29 5,544.53 NA 478.50 27,560.49 0.00 0.00 0.00 0.00 296.00 9,945.00 11,654.00 0.00 5,445.00 NA

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Exhibit 8

FORM 1

INDIVIDUAL ESTATE PROPERTY RECORD AND REPORT

ASSET CASES

Case No: 16-37803 BWB Judge: Bruce W. Black Trustee Name: Zane L. Zielinski, Trustee

Case Name: Sarah R Peterson Date Filed (f) or Converted (c): 11/30/2016 (f)

341(a) Meeting Date: 12/29/2016

For Period Ending: 01/03/2018 Claims Bar Date: 09/11/2017

1 2 3 4 5 6

Asset Description

(Scheduled and Unscheduled (u) Property)

Petition/

Unscheduled

Values

Est Net Value

(Value Determined by 

Trustee, Less Liens, 

Exemptions,

and Other Costs)

Property Formally

Abandoned

OA=554(a)

Sale/Funds

Received by

the Estate

Asset Fully

Administered (FA)/

Gross Value of Remaining 

Assets

1. 2015 Jeep Wrangler Mileage: 8000 Location: 1223 Liberty 

Stre

20,649.00 0.00 0.00 FA

2. Household Furnishings Location: 1223 Liberty Street, Unit 2, 500.00 0.00 0.00 FA

3. Clothes For One Woman Location: 1223 Liberty Street, Unit 2, 500.00 0.00 0.00 FA

4. Chase Bank Checking Account Location: 1223 Liberty Street 266.75 0.00 0.00 FA

5. Refund 2015 Joint Tax Return

Location: 1223 Liberty Street,

752.00 0.00 0.00 FA

6. Chase Business Checking - Dutch Girl Photo (u) 4,261.18 1,379.00 1,379.00 FA

7. Chase Business Savings - Dutch Girl Photo (u) 861.92 0.00 0.00 FA

8. Capitol One Savings (u) 23.18 0.00 0.00 FA

9. Capitol One Savings (u) 7.38 0.00 0.00 FA

10. Photographic Equipment for Dutch Girl Photography (u) 3,500.00 3,500.00 2,500.00 FA

INT. Void (u) 0.00 N/A 0.00 FA

Gross Value of Remaining Assets

TOTALS (Excluding Unknown Values) $31,321.41 $4,879.00 $3,879.00 $0.00

(Total Dollar Amount in Column 6)

Major activities affecting case closing which are not reflected above, and matters pending, date of hearing or sale, and other action:

Order approving settlement entered 10/13/17; The Trustee is preparing the Trustee's final report.

Page: 1

UST Form 101-7-TDR (10/1/2010) (Page: 9)

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Exhibit 8

RE PROP # 4 -- This was original lsited as a single account of $1500. The Debtor amended her 

schedules.

RE PROP # 6 -- This asset was added in the Debtor's amended schedules.

RE PROP # 7 -- This asset was added in the Debtor's amended schedules.

RE PROP # 8 -- This asset was added in the Debtor's amended schedules.

RE PROP # 9 -- This asset was added in the Debtor's amended schedules.

RE PROP # 10 -- This asset was added in the Debtor's amended schedules.

Initial Projected Date of Final Report (TFR): 11/30/2017 Current Projected Date of Final Report (TFR): 11/30/2017

Page: 2

UST Form 101-7-TDR (10/1/2010) (Page: 10)

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Exhibit 9

FORM 2

ESTATE CASH RECEIPTS AND DISBURSEMENTS RECORD

Case No: 16-37803 Trustee Name: Zane L. Zielinski, Trustee

Case Name: Sarah R Peterson Bank Name: Associated Bank

Account Number/CD#: XXXXXX1759

Checking

Taxpayer ID No: XX-XXX3772 Blanket Bond (per case limit): $5,000,000.00

For Period Ending: 01/03/2018 Separate Bond (if applicable):

1 2 3 4 5 6 7

Transaction Date Check or 

Reference

Paid To / Received From Description of Transaction Uniform Tran. 

Code

Deposits ($) Disbursements ($) Account/CD Balance 

($)

06/19/17 10 Law Offices of Ruben Sanmiguel

Payment from the Debtor

Settlement Payment 1229-000 $2,000.00 $2,000.00

07/17/17 Sarah Peterson

1223 Liberty Street, Unit 2

Morris, IL 60450

Settlement Payment $1,879.00 $3,879.00

Gross Receipts $1,879.00

6 Chase Business Checking - 

Dutch Girl Photo

$1,379.00 1229-000

10 Photographic Equipment for 

Dutch Girl Photography 

$500.00 1229-000

08/07/17 Associated Bank Bank Service Fee under 11 

U.S.C.  330(a)(1)(B), 503(b)

(1), and 507(a)(2)

2600-000 $10.00 $3,869.00

09/08/17 Associated Bank Bank Service Fee under 11 

U.S.C.  330(a)(1)(B), 503(b)

(1), and 507(a)(2)

2600-000 $10.00 $3,859.00

10/06/17 Associated Bank Bank Service Fee under 11 

U.S.C.  330(a)(1)(B), 503(b)

(1), and 507(a)(2)

2600-000 $10.00 $3,849.00

12/15/17 5001 Trustee Zane L. Zielinski

6336 N. Cicero Avenue

Suite 201

Chicago, Illinois 60646

Distribution $979.50 $2,869.50

Trustee Zane L. Zielinski Final distribution representing a 

payment of 100.00 % per court 

order.

($969.75) 2100-000

Trustee Zane L. Zielinski Final distribution representing a 

payment of 100.00 % per court 

order.

($9.75) 2200-000

12/15/17 5002 Discover Bank

Discover Products Inc

Po Box 3025

New Albany, Oh 43054-3025

Final distribution to claim 1 

representing a payment of 

10.41 % per court order.

7100-000 $1,101.37 $1,768.13

12/15/17 5003 Quantum3 Group Llc As Agent For

Moma Funding Llc

Po Box 788

Kirkland, Wa 98083-0788

Final distribution to claim 2 

representing a payment of 

10.41 % per court order.

7100-000 $49.82 $1,718.31

Page Subtotals: $3,879.00 $2,160.69

Page: 1

UST Form 101-7-TDR (10/1/2010) (Page: 11)

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Exhibit 9

FORM 2

ESTATE CASH RECEIPTS AND DISBURSEMENTS RECORD

Case No: 16-37803 Trustee Name: Zane L. Zielinski, Trustee

Case Name: Sarah R Peterson Bank Name: Associated Bank

Account Number/CD#: XXXXXX1759

Checking

Taxpayer ID No: XX-XXX3772 Blanket Bond (per case limit): $5,000,000.00

For Period Ending: 01/03/2018 Separate Bond (if applicable):

1 2 3 4 5 6 7

Transaction Date Check or 

Reference

Paid To / Received From Description of Transaction Uniform Tran. 

Code

Deposits ($) Disbursements ($) Account/CD Balance 

($)

12/15/17 5004 Capital One Bank (Usa), N.A.

Po Box 71083

Charlotte, Nc 28272-1083

Final distribution to claim 3 

representing a payment of 

10.41 % per court order.

7100-000 $577.28 $1,141.03

12/15/17 5005 Efs

American Education Services

Po Box 8183

Harrisburg, Pa 17105

Final distribution to claim 4 

representing a payment of 

10.41 % per court order.

7100-000 $1,141.03 $0.00

COLUMN TOTALS $3,879.00 $3,879.00

Less: Bank Transfers/CD's $0.00 $0.00

Subtotal $3,879.00 $3,879.00

Less: Payments to Debtors $0.00 $0.00

Net $3,879.00 $3,879.00

Page Subtotals: $0.00 $1,718.31

Page: 2

UST Form 101-7-TDR (10/1/2010) (Page: 12)

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Exhibit 9

TOTAL OF ALL ACCOUNTS

NET ACCOUNT

NET DEPOSITS DISBURSEMENTS BALANCE

XXXXXX1759 - Checking $3,879.00 $3,879.00 $0.00

$3,879.00 $3,879.00 $0.00

(Excludes account

transfers)

(Excludes payments

to debtors)

Total Funds on Hand

Total Allocation Receipts: $0.00

Total Net Deposits: $3,879.00

Total Gross Receipts: $3,879.00

Page Subtotals: $0.00 $0.00

Page: 3

UST Form 101-7-TDR (10/1/2010) (Page: 13)

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