B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 1 

B 101 

Voluntary Petition for Individuals Filing for Bankruptcy 12/15

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

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

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

Debtor 2 to distinguish between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The 

same person must be Debtor 1 in all of the forms. 

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

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

(if known). Answer every question. 

Part 1: Identify Yourself

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

1. Your full name 

Write the name that is on your 

government-issued picture 

identification (for example, 

your driver’s license or 

passport).

Bring your picture 

identification to your meeting 

with the trustee. 

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

___________________________ 

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

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

___________________________ 

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

2. All other names you 

have used in the last 8 

years 

Include your married or 

maiden names. 

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

__________________________________________________ 

First name 

__________________________________________________ 

Middle name 

__________________________________________________ 

Last name 

3. Only the last 4 digits of 

your Social Security 

number or federal 

Individual Taxpayer 

Identification number

(ITIN)

xxx – xx – ____ ____ ____ ____

OR

9 xx – xx – ____ ____ ____ ____ 

xxx – xx – ____ ____ ____ ____

OR

9 xx – xx – ____ ____ ____ ____ 

United States Bankruptcy Court for the: 

__________ District of __________ 

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

Chapter 7 

Chapter 11 

Chapter 12 

Chapter 13 

Fill in this information to identify your case: 

Check if this is an 

amended filing

Northern District of Illinois

✔

Rosalie

J.

Davis

RJ

Davis

8434

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 Document Page 1 of 12
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 2 

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

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 

I have not used any business names or EINs.

_________________________________________________ 

Business name

_________________________________________________ 

Business name 

___ ___ – ___ ___ ___ ___ ___ ___ ___ 

EIN 

___ ___ – ___ ___ ___ ___ ___ ___ ___ 

EIN 

I have not used any business names or EINs.

_________________________________________________ 

Business name

_________________________________________________ 

Business name 

___ ___ – ___ ___ ___ ___ ___ ___ ___ 

EIN 

___ ___ – ___ ___ ___ ___ ___ ___ ___ 

EIN 

5. Where you live 

_________________________________________________ 

Number Street 

_________________________________________________ 

_________________________________________________ 

City State ZIP Code 

_________________________________________________ 

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.

_________________________________________________ 

Number Street 

_________________________________________________ 

P.O. Box 

_________________________________________________ 

City State ZIP Code 

If Debtor 2 lives at a different address: 

_________________________________________________ 

Number Street 

_________________________________________________ 

_________________________________________________ 

City State ZIP Code 

_________________________________________________ 

County

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 

_________________________________________________ 

P.O. Box 

_________________________________________________ 

City State ZIP Code 

6. Why you are choosing 

this district to file for 

bankruptcy 

Check one: 

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.) 

________________________________________ 

________________________________________ 

________________________________________ 

________________________________________ 

Check one: 

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.) 

________________________________________ 

________________________________________ 

________________________________________ 

________________________________________

Rosalie J. Davis

Rosalie J. Davis

uses Social Security Number

20035 Delphi Drive

Olympia Fields IL 60461

Cook

✔

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Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 3 

Part 2: Tell the Court About Your Bankruptcy Case

7. The chapter of the 

Bankruptcy Code you 

are choosing to file 

under 

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

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

Chapter 7 

Chapter 11 

Chapter 12 

Chapter 13

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

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

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

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

with a pre-printed address. 

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

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

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

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

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

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

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

9. Have you filed for 

bankruptcy within the 

last 8 years?

No

Yes. District __________________________ When _______________ Case number ___________________________

 MM / DD / YYYY

District __________________________ When _______________ Case number ___________________________

 MM / DD / YYYY

 District __________________________ When _______________ Case number ___________________________ 

 MM / DD / YYYY

10. Are any bankruptcy 

cases pending or being 

filed by a spouse who is 

not filing this case with 

you, or by a business 

partner, or by an 

affiliate?

No

Yes. Debtor _________________________________________________ Relationship to you _____________________

 District __________________________ When _______________ Case number, if known____________________ 

 MM / DD / YYYY

 Debtor _________________________________________________ Relationship to you _____________________ 

District __________________________ When _______________ Case number, if known____________________

 MM / DD / YYYY

11. Do you rent your 

residence?

No. Go to line 12.

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

residence?

No. Go to line 12.

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

this bankruptcy petition.

Rosalie J. Davis

✔

✔

✔ Northern District of IL 04/20/2016 16 B 13481 (13)

Northern District of IL 03/14/2016 16 B 08680 (13)

Northern District of IL 03/09/2015 15 B 08137 (13)

✔

✔

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 Document Page 3 of 12
DEBTOR:

b101 Voluntary Petition

CONTINUATION PAGE

PART 2

9. Have you filed for

bankruptcy within the

last 8 years?

District When Case Number

QBHFB

Rosalie J. Davis

Northern District of IL

Northern District of IL

08/10/2011

06/10/2013

11 B 32691 (13)

13 B 23919 (13)

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Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 4 

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

12. Are you a sole proprietor 

of any full- or part-time 

business?

A sole proprietorship is a 

business you operate as an 

individual, and is not a 

separate legal entity such as 

a corporation, partnership, or 

LLC. 

If you have more than one 

sole proprietorship, use a 

separate sheet and attach it 

to this petition.

No. Go to Part 4.

Yes. Name and location of business

_______________________________________________________________________________________ 

Name of business, if any 

_______________________________________________________________________________________ 

Number Street 

_______________________________________________________________________________________ 

_______________________________________________ _______ __________________________ 

 City State ZIP Code 

Check the appropriate box to describe your business:

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

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

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

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

None of the above 

13. Are you filing under 

Chapter 11 of the 

Bankruptcy Code and 

are you a small business 

debtor?

For a definition of small 

business debtor, see

11 U.S.C. § 101(51D). 

If you are filing under Chapter 11, the court must know whether you are a small business debtor so that it 

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

most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return or if 

any of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B).

No. I am not filing under Chapter 11. 

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

the Bankruptcy Code. 

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

Bankruptcy Code. 

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

14. Do you own or have any 

property that poses or is 

alleged to pose a threat 

of imminent and 

identifiable hazard to 

public health or safety? 

Or do you own any 

property that needs

immediate attention?

For example, do you own 

perishable goods, or livestock 

that must be fed, or a building 

that needs urgent repairs?

No

Yes. What is the hazard? ________________________________________________________________________

 

 ________________________________________________________________________ 

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

 ________________________________________________________________________ 

 Where is the property? ________________________________________________________________________ 

 Number Street 

 

 ________________________________________________________________________ 

________________________________________ _______ ____________________ 

City State ZIP Code 

Rosalie J. Davis

✔

Rosalie J. Davis (Independent Contractor)

20035 Delphi Drive

Olympia Fields IL 60461

✔

✔

✔

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Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page 5 

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

15. Tell the court whether 

you have received a 

briefing about credit 

counseling. 

The law requires that you 

receive a briefing about credit 

counseling before you file for 

bankruptcy. You must 

truthfully check one of the 

following choices. If you 

cannot do so, you are not 

eligible to file. 

If you file anyway, the court 

can dismiss your case, you 

will lose whatever filing fee 

you paid, and your creditors 

can begin collection activities 

again.

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

You must check one: 

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, and I received a 

certificate of completion. 

Attach a copy of the certificate and the payment 

plan, if any, that you developed with the agency. 

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, but I do not have a 

certificate of completion. 

Within 14 days after you file this bankruptcy petition, 

you MUST file a copy of the certificate and payment 

plan, if any.

I certify that I asked for credit counseling 

services from an approved agency, but was 

unable to obtain those services during the 7 

days after I made my request, and exigent 

circumstances merit a 30-day temporary waiver 

of the requirement. 

To ask for a 30-day temporary waiver of the 

requirement, attach a separate sheet explaining 

what efforts you made to obtain the briefing, why 

you were unable to obtain it before you filed for 

bankruptcy, and what exigent circumstances 

required you to file this case.

Your case may be dismissed if the court is 

dissatisfied with your reasons for not receiving a 

briefing before you filed for bankruptcy. 

If the court is satisfied with your reasons, you must 

still receive a briefing within 30 days after you file. 

You must file a certificate from the approved 

agency, along with a copy of the payment plan you 

developed, if any. If you do not do so, your case 

may be dismissed. 

Any extension of the 30-day deadline is granted 

only for cause and is limited to a maximum of 15 

days. 

I am not required to receive a briefing about 

credit counseling because of:

Incapacity. I have a mental illness or a mental 

deficiency that makes me 

incapable of realizing or making 

rational decisions about finances. 

Disability. My physical disability causes me 

to be unable to participate in a 

briefing in person, by phone, or 

through the internet, even after I 

reasonably tried to do so. 

Active duty. I am currently on active military 

duty in a military combat zone.

If you believe you are not required to receive a 

briefing about credit counseling, you must file a 

motion for waiver of credit counseling with the court. 

You must check one: 

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, and I received a 

certificate of completion. 

Attach a copy of the certificate and the payment 

plan, if any, that you developed with the agency. 

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, but I do not have a 

certificate of completion. 

Within 14 days after you file this bankruptcy petition, 

you MUST file a copy of the certificate and payment 

plan, if any.

I certify that I asked for credit counseling 

services from an approved agency, but was 

unable to obtain those services during the 7 

days after I made my request, and exigent 

circumstances merit a 30-day temporary waiver 

of the requirement. 

To ask for a 30-day temporary waiver of the 

requirement, attach a separate sheet explaining 

what efforts you made to obtain the briefing, why 

you were unable to obtain it before you filed for 

bankruptcy, and what exigent circumstances 

required you to file this case. 

Your case may be dismissed if the court is 

dissatisfied with your reasons for not receiving a 

briefing before you filed for bankruptcy. 

If the court is satisfied with your reasons, you must 

still receive a briefing within 30 days after you file. 

You must file a certificate from the approved 

agency, along with a copy of the payment plan you 

developed, if any. If you do not do so, your case 

may be dismissed. 

Any extension of the 30-day deadline is granted 

only for cause and is limited to a maximum of 15 

days. 

I am not required to receive a briefing about 

credit counseling because of: 

Incapacity. I have a mental illness or a mental 

deficiency that makes me 

incapable of realizing or making 

rational decisions about finances. 

Disability. My physical disability causes me 

to be unable to participate in a 

briefing in person, by phone, or 

through the internet, even after I 

reasonably tried to do so. 

Active duty. I am currently on active military 

duty in a military combat zone.

If you believe you are not required to receive a 

briefing about credit counseling, you must file a 

motion for waiver of credit counseling with the court.

Rosalie J. Davis

✔

Case 16-24429 Doc 1 Filed 07/29/16 Entered 07/29/16 14:32:49 Desc Main

 Document Page 6 of 12
Debtor 1 Rosalie J. Davis Case number (dknownl _____________ _ 

First Name Middle Name Last Name 

f If M Answer These Questions for Reporting Purposes 

16. What kind of debts do 

you have? 

17. Are you filing under 

Chapter7? 

Do you estimate that after 

any exempt property is 

excluded and 

administrative expenses 

are paid that funds will be 

available for distribution 

to unsecured creditors? 

1a. How many creditors do 

you estimate that you 

owe? 

19. How much do you 

estimate your assets to 

be worth? 

20. How much do you 

estimate your liabilities 

to be? 

1¥11 Sign Below 

For you 

16a. Are your debts primarily consumer debts? Consumer debts are defined in 11 U.S.c. § 101 (8) 

as "incurred by an individual primarily for a personal, family, or household purpose." 

1:J No. Go to line 16b. 

!;a 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. 

!;a No. Go to line 16c. 

l:J Yes. Go to line 17. 

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

l;,a No. I am not filing underChapter7. Goto line 18. 

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

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

D No 

D Yes 

i;a 1-49 

D 50-99 

D 100-199 

D 200-999 

1!(;0-$50,000 

D $50,001-s100.ooo 

Cl $100,001-$500,000 

a $500,001-$1 million 

D $0-$50,000 

a $50.001-s100.ooo 

ij1 $100,001-$500,000 

D $500,001-$1 million 

D 1,000-5,ooo 

D 5,001-10,000 

D 10.001-25,000 

D $1,000,001-$10 million 

a $10,000,001-$50 million 

D $50,000,001-$100 million 

D $100,000,001-$500 million 

D $1,000,001-$10 million 

D $10,000,001-$50 million 

D $50,000,001-$100 million 

a $100,000,001-$500 million 

a 25,001-50.000 

D 50.001-100.000 

l:J More than 100,000 

D $500,000,001-$1 billion 

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

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

1:J More than $50 billion 

D $500,000,001-$1 billion 

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

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

D More than $50 billion 

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

correct. 

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

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

under Chapter 7. 

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

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

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

I understand i~~ A false statement, conceali[lQ property, or obtaining money or property by fraud in connection 

with a ban ptcy r,S'se can result in fines up $250,000, or imprisonment for up to 20 years, or both. 

18 U.S. § 15~{ 1341, 1519, and 3 

~· ~ 

..___....,._,,, 

I Signature of~ Deto 

Executed on ~ I /? 

Signature of Debtor 2 

Executed on 

M I D /YYYY MM I DD /YYYY 

B 101 (Official Form 101) Voluntary Petition for Individuals Filing for Bankruptcy page6 

.. Case 16-24429 Doc 1 Filed 07/29/16 Entered 07/29/16 14:32:49 Desc Main

 Document Page 7 of 12
Debtor 1 Rosalie J. Davis ·Case number.{ffknown) _____________ _ 

First Name Middle Name 

For your attorney, if you are 

represented by one 

If you are not represented 

by an attorney, you do not 

need to file this page. 

B 101 (Official Fonn 101) 

Last Name 

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

to proceed under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief 

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

the notice required by 11 U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, certify that I have no 

knowled9e after an inquiry that the information in the schedules filed with the petition is incorrect. 

X I Date t:J{»(; I .2-0 /<(;, 

MM DD /YYYY 

Martin J. O'Hearn 

Printed name 

Law Offices of Martin J. O'Hearn 

Firm name 

10047 South Western Avenue 

Number Street 

Chicago IL 60643 -Ci_ty _ ___..~----------------~St-at_e ___ ZIP Code 

Contact phone (773) 238-4400 Email address martinohearnlaw@sbcglobal.net 

6185904 IL 

Bar number State 

Voluntary Petition for Individuals Filing for Bankl"'!ptcy page 7 

• 

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 Document Page 8 of 12
Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 1

Notice Required by 11 U.S.C. § 342(b) for 

Individuals Filing for Bankruptcy (Form 2010)

This notice is for you if:

 You are an individual filing for bankruptcy,

and 

 Your debts are 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.”

The types of bankruptcy that are 

available to individuals

Individuals who meet the qualifications may file 

under one of four different chapters of the 

Bankruptcy Code:

 Chapter 7 — Liquidation

 Chapter 11— Reorganization

 Chapter 12— Voluntary repayment plan 

for family farmers or 

fishermen

 Chapter 13— Voluntary repayment plan 

for individuals with regular 

income

You should have an attorney review your 

decision to file for bankruptcy and the choice of 

chapter. 

Chapter 7: Liquidation 

$245 filing fee

$75 administrative fee

+ $15 trustee surcharge

$335 total fee

Chapter 7 is for individuals who have financial 

difficulty preventing them from paying their 

debts and who are willing to allow their nonexempt property to be used to pay their 

creditors. The primary purpose of filing under 

chapter 7 is to have your debts discharged. The 

bankruptcy discharge relieves you after 

bankruptcy from having to pay many of your 

pre-bankruptcy debts. Exceptions exist for

particular debts, and liens on property may still 

be enforced after discharge. For example, a 

creditor may have the right to foreclose a home 

mortgage or repossess an automobile.

However, if the court finds that you have 

committed certain kinds of improper conduct 

described in the Bankruptcy Code, the court 

may deny your discharge. 

You should know that even if you file 

chapter 7 and you receive a discharge, some 

debts are not discharged under the law. 

Therefore, you may still be responsible to pay:

 most taxes; 

 most student loans; 

 domestic support and property settlement 

obligations; 

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Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 2

 most fines, penalties, forfeitures, and 

criminal restitution obligations; and

 certain debts that are not listed in your 

bankruptcy papers.

You may also be required to pay debts arising 

from:

 fraud or theft;

 fraud or defalcation while acting in breach 

of fiduciary capacity;

 intentional injuries that you inflicted; and 

 death or personal injury caused by 

operating a motor vehicle, vessel, or 

aircraft while intoxicated from alcohol or 

drugs. 

If your debts are primarily consumer debts, the 

court can dismiss your chapter 7 case if it finds 

that you have enough income to repay 

creditors a certain amount. You must file 

Chapter 7 Statement of Your Current Monthly 

Income (Official Form 122A–1) if you are an 

individual filing for bankruptcy under 

chapter 7. This form will determine your 

current monthly income and compare whether 

your income is more than the median income 

that applies in your state. 

If your income is not above the median for 

your state, you will not have to complete the 

other chapter 7 form, the Chapter 7 Means 

Test Calculation (Official Form 122A–2). 

If your income is above the median for your 

state, you must file a second form —the 

Chapter 7 Means Test Calculation (Official 

Form 122A–2). The calculations on the form—

sometimes called the Means Test—deduct 

from your income living expenses and 

payments on certain debts to determine any

amount available to pay unsecured creditors. If

your income is more than the median income 

for your state of residence and family size, 

depending on the results of the Means Test, the 

U.S. trustee, bankruptcy administrator, or 

creditors can file a motion to dismiss your case

under § 707(b) of the Bankruptcy Code. If a 

motion is filed, the court will decide if your 

case should be dismissed. To avoid dismissal, 

you may choose to proceed under another 

chapter of the Bankruptcy Code.

If you are an individual filing for chapter 7 

bankruptcy, the trustee may sell your property

to pay your debts, subject to your right to 

exempt the property or a portion of the 

proceeds from the sale of the property. The 

property, and the proceeds from property that

your bankruptcy trustee sells or liquidates that 

you are entitled to, is called exempt property.

Exemptions may enable you to keep your 

home, a car, clothing, and household items or 

to receive some of the proceeds if the property 

is sold.

Exemptions are not automatic. To exempt

property, you must list it on Schedule C: The 

Property You Claim as Exempt (Official Form 

106C). If you do not list the property, the 

trustee may sell it and pay all of the proceeds 

to your creditors.

Chapter 11: Reorganization 

$1,167 filing fee

+ $550 administrative fee

$1,717 total fee

Chapter 11 is often used for reorganizing a 

business, but is also available to individuals. 

The provisions of chapter 11 are too 

complicated to summarize briefly. 

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 Document Page 10 of 12
Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 3

Chapter 12: Repayment plan for family 

farmers or fishermen

$200 filing fee

+ $75 administrative fee

$275 total fee

Similar to chapter 13, chapter 12 permits 

family farmers and fishermen to repay their 

debts over a period of time using future 

earnings and to discharge some debts that are 

not paid.

Chapter 13: Repayment plan for 

individuals with regular 

income

$235 filing fee

+ $75 administrative fee

$310 total fee

Chapter 13 is for individuals who have regular 

income and would like to pay all or part of 

their debts in installments over a period of time

and to discharge some debts that are not paid.

You are eligible for chapter 13 only if your 

debts are not more than certain dollar amounts 

set forth in 11 U.S.C. § 109.

Under chapter 13, you must file with the court 

a plan to repay your creditors all or part of the 

money that you owe them, usually using your 

future earnings. If the court approves your 

plan, the court will allow you to repay your 

debts, as adjusted by the plan, within 3 years or 

5 years, depending on your income and other 

factors.

After you make all the payments under your 

plan, many of your debts are discharged. The

debts that are not discharged and that you may 

still be responsible to pay include:

 domestic support obligations, 

 most student loans, 

 certain taxes, 

 debts for fraud or theft,

 debts for fraud or defalcation while acting 

in a fiduciary capacity,

 most criminal fines and restitution 

obligations, 

 certain debts that are not listed in your 

bankruptcy papers, 

 certain debts for acts that caused death or 

personal injury, and 

 certain long-term secured debts.

Read These Important Warnings

Because bankruptcy can have serious long-term financial and legal consequences, including loss of 

your property, you should hire an attorney and carefully consider all of your options before you file. 

Only an attorney can give you legal advice about what can happen as a result of filing for bankruptcy 

and what your options are. If you do file for bankruptcy, an attorney can help you fill out the forms 

properly and protect you, your family, your home, and your possessions. 

Although the law allows you to represent yourself in bankruptcy court, you should understand that 

many people find it difficult to represent themselves successfully. The rules are technical, and a 

mistake or inaction may harm you. If you file without an attorney, you are still responsible for knowing 

and following all of the legal requirements. 

You should not file for bankruptcy if you are not eligible to file or if you do not intend to file the 

necessary documents.

Bankruptcy fraud is a serious crime; you could be fined and imprisoned if you commit fraud in your 

bankruptcy case. 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.

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Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 4

Bankruptcy crimes have serious 

consequences

 If you knowingly and fraudulently conceal 

assets or make a false oath or statement 

under penalty of perjury—either orally or 

in writing—in connection with a 

bankruptcy case, you may be fined, 

imprisoned, or both. 

 All information you supply in connection 

with a bankruptcy case is subject to 

examination by the Attorney General acting 

through the Office of the U.S. Trustee, the 

Office of the U.S. Attorney, and other 

offices and employees of the U.S. 

Department of Justice.

Make sure the court has your 

mailing address

The bankruptcy court sends notices to the 

mailing address you list on Voluntary Petition 

for Individuals Filing for Bankruptcy (Official 

Form 101). To ensure that you receive 

information about your case, Bankruptcy 

Rule 4002 requires that you notify the court of 

any changes in your address.

A married couple may file a bankruptcy case 

together—called a joint case. If you file a joint 

case and each spouse lists the same mailing 

address on the bankruptcy petition, the 

bankruptcy court generally will mail you and 

your spouse one copy of each notice, unless 

you file a statement with the court asking that 

each spouse receive separate copies.

Understand which services you 

could receive from credit 

counseling agencies

The law generally requires that you receive a

credit counseling briefing from an approved 

credit counseling agency. 11 U.S.C. § 109(h). 

If you are filing a joint case, both spouses must 

receive the briefing. With limited exceptions, 

you must receive it within the 180 days before

you file your bankruptcy petition. This briefing

is usually conducted by telephone or on the 

Internet. 

In addition, after filing a bankruptcy case, you 

generally must complete a financial 

management instructional course before you 

can receive a discharge. If you are filing a joint 

case, both spouses must complete the course. 

You can obtain the list of agencies approved to 

provide both the briefing and the instructional 

course from: 

http://justice.gov/ust/eo/hapcpa/ccde/cc_approved.html.

In Alabama and North Carolina, go to: 

http://www.uscourts.gov/FederalCourts/Bankruptcy/

BankruptcyResources/ApprovedCredit 

AndDebtCounselors.aspx.

If you do not have access to a computer, the 

clerk of the bankruptcy court may be able to 

help you obtain the list.

Warning: File Your Forms on Time

Section 521(a)(1) of the Bankruptcy Code 

requires that you promptly file detailed information 

about your creditors, assets, liabilities, income, 

expenses and general financial condition. The 

court may dismiss your bankruptcy case if you do 

not file this information within the deadlines set by 

the Bankruptcy Code, the Bankruptcy Rules, and

the local rules of the court. 

For more information about the documents and 

their deadlines, go to: 

http://www.uscourts.gov/bkforms/bankruptcy_form

s.html#procedure.

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