Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 1 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 2 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 3 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 4 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 5 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 6 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 7 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 8 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 9 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 10 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 11 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 12 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 13 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 14 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 15 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 16 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 17 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 18 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 19 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 20 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 21 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 22 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 23 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 24 of 61
Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of ___ 

Official Form 106E/F 

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

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY claims and Part 2 for creditors with NONPRIORITY claims. 

List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule 

A/B: Property (Official Form 106A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G). Do not include any 

creditors with partially secured claims that are listed in Schedule D: Creditors Who Hold Claims Secured by Property. If more space is 

needed, copy the Part you need, fill it out, number the entries in the boxes on the left. Attach the Continuation Page to this page. On the top of 

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

Part 1: List All of Your PRIORITY Unsecured Claims

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

 No. Go to Part 2.

 Yes.

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

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

nonpriority amounts. As much as possible, list the claims in alphabetical order according to the creditor’s name. If you have more than two priority

unsecured claims, fill out the Continuation Page of Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.

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

Total claim Priority 

amount

Nonpriority 

amount

2.1

____________________________________________

Priority Creditor’s Name

____________________________________________

Number Street

____________________________________________

____________________________________________

City State ZIP Code

Last 4 digits of account number ___ ___ ___ ___ $_____________ $___________ $____________

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of PRIORITY unsecured claim:

 Domestic support obligations

 Taxes and certain other debts you owe the government

 Claims for death or personal injury while you were 

intoxicated

 Other. Specify _________________________________

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

2.2

____________________________________________

Priority Creditor’s Name

____________________________________________

Number Street

____________________________________________

____________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of PRIORITY unsecured claim:

 Domestic support obligations

 Taxes and certain other debts you owe the government

 Claims for death or personal injury while you were 

intoxicated

 Other. Specify _________________________________

$_____________ $___________ $____________

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________________________

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

 Check if this is an 

amended filing

Charles David Skelton

Jessica Skelton

Northern District of Illinois

8

X

Joseph Gleason

1404 Navajo Dr.

Ottawa IL 61350

X

X

X

12,000.00 12,000.00 0.00

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 25 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: List All of Your NONPRIORITY Unsecured Claims

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

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

 Yes

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

priority unsecured claim, list the creditor separately for each claim. For each claim listed, identify what type of claim it is. Do not list claims already

included in Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.If you have more than four priority unsecured claims

fill out the Continuation Page of Part 2.

Total claim

4.1

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Last 4 digits of account number ___ ___ ___ ___

$__________________

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims

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

 Other. Specify ______________________________________

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

4.2

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Last 4 digits of account number ___ ___ ___ ___ $__________________

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims

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

 Other. Specify ______________________________________

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

4.3

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Last 4 digits of account number ___ ___ ___ ___

$_________________

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims

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

 Other. Specify ______________________________________

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

2 8

Charles David Skelton

X

CAPITAL ONE

P.O. BOX 6492

CAROL STREAM IL 60197

X X

6 7 4 9

Credit Card Charges

1,525.38

CAPITAL ONE

P.O. BOX 6492

CAROL STREAM IL 60197

X X

2 5 9 7

Credit Card Charges

738.66

COLLECTION PROFESSIONALS

P.O. BOX 416

LASALLE IL 61301

X

X Medical Services

222.00

X

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 26 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: Your NONPRIORITY Unsecured Claims ─Continuation Page

After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth. Total claim

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

3 8

Charles David Skelton

4.4

4.5

4.6

CREDIT ONE

P.O. BOX 98873

LAS VEGAS NV 89193

X

X

5 5 0 7

Credit Card Charges

342.45

CREDITORS DISCOUNT AND AUDIT

P.O. BOX 213

STREATOR IL 61364

X

X Medical Services

4,050.00

X

DELL FINANCIAL

P.O. BOX 6403

CAROL STREAM IL 60197

X

X

4 5 9 1

Credit Card Charges

2,305.79

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 27 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: Your NONPRIORITY Unsecured Claims ─Continuation Page

After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth. Total claim

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

4 8

Charles David Skelton

4.7

4.8

4.9

FINANCIAL PLUS CREDIT UNION

220 E. HIGH ST.

MORRIS IL 60450

X

X Personal Loan

1,305.42

FINANCIAL PLUS CREDIT UNION

220 E. HIGH ST.

MORRIS IL 60450

X

X Credit Card Charges

500.00

FINANCIAL PLUS CREDIT UNION

P.O. BOX 125

MORRIS IL 60450

X

X Credit Card Charges

1,000.00

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 28 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: Your NONPRIORITY Unsecured Claims ─Continuation Page

After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth. Total claim

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

5 8

Charles David Skelton

4.10

4.11

4.12

FINANCIAL PLUS CREDIT UNION

220 E. HIGH ST.

MORRIS IL 60450

X

X

5 7 6 7

Credit Card Charges

10,000.00

LENDING CLUB

71 STEVENSON ST., SUITE 300

SAN FRANCISCO CA 94105

X

X

2 6 1 8

Personal Loan

8,500.00

MEDICAL BUSINESS BUREAU

P.O. BOX 1219

PARK RIDGE IL 60068

X

X Medical Services

1,020.00

X

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 29 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: Your NONPRIORITY Unsecured Claims ─Continuation Page

After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth. Total claim

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

6 8

Charles David Skelton

4.13

4.14

4.15

RISE

ATTN: BANKRUPTCY P.O. BOX 101808

FORT WORTH TX 76185

X

X Personal Loan

2,700.00

STATE COLLECTION SERVICES

P.O. BOX 6250

MADISON WI 53701

X

X Medical Services

235.00

X

WALMART/SYNCHRONY BANK

P.O. BOX 530927

ATLANTA GA 30353

X

X

2 5 1 5

Credit Card Charges

497.91

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 30 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

Part 2: Your NONPRIORITY Unsecured Claims ─Continuation Page

After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth. Total claim

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

_____________________________________________________________

Nonpriority Creditor’s Name

_____________________________________________________________

Number Street

_____________________________________________________________

City State ZIP Code

Who incurred the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another 

 Check if this claim is for a community debt

Is the claim subject to offset?

 No

 Yes

Last 4 digits of account number ___ ___ ___ ___

When was the debt incurred? ____________

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

 Student loans 

 Obligations arising out of a separation agreement or divorce that 

you did not report as priority claims

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

 Other. Specify________________________________

$____________

7 8

Charles David Skelton

4.16

4.17

4.18

WALMART/SYNCRHONY

P.O. BOX 530927

ATLANTA GA 30353

X

X

5 1 6 3

Credit Card Charges

800.00

WORLD FINANCE CORPORATION OF ILLINOIS

1459 DIVISION ST.

MORRIS IL 60450

X

X Personal Loan

2,564.70

X

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 31 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page __ of ___ 

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

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

Add the amounts for each type of unsecured claim.

Total claim

Total claims 

from Part 1

6a. Domestic support obligations 6a. $_________________________

6b. Taxes and certain other debts you owe the 

government 6b.

$_________________________

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

intoxicated 6c.

$_________________________

6d. Other. Add all other priority unsecured claims. 

Write that amount here. 6d. +$_________________________

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

$_________________________

Total claim

Total claims 

from Part 2

6f. Student loans 6f.

$_________________________

6g. Obligations arising out of a separation agreement 

or divorce that you did not report as priority 

claims 6g. $_________________________

6h. Debts to pension or profit-sharing plans, and other 

similar debts 6h. $_________________________

6i. Other. Add all other nonpriority unsecured claims. 

Write that amount here. 6i. + $_________________________

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

$_________________________

Charles David Skelton

12,000.00

0.00

0.00

0.00

12,000.00

0.00

0.00

0.00

38,307.31

38,307.31

8 8

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 32 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 33 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 34 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 35 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 36 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 37 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 38 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 39 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 40 of 61
Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 1 of 2 

Official Form 106Sum

Summary of Your Assets and Liabilities and Certain Statistical Information 12/15

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

information. Fill out all of your schedules first; then complete the information on this form. If you are filing amended schedules after you file 

your original forms, you must fill out a new Summary and check the box at the top of this page. 

Part 1: Summarize Your Assets

Your assets

Value of what you own

1. Schedule A/B: Property (Official Form 106A/B)

1a. Copy line 55, Total real estate, from Schedule A/B........................................................................................................

$ ________________

1b. Copy line 62, Total personal property, from Schedule A/B............................................................................................. $ ________________

1c. Copy line 63, Total of all property on Schedule A/B ....................................................................................................... $ ________________

Part 2: Summarize Your Liabilities

Your liabilities

Amount you owe

2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D)

2a. Copy the total you listed in Column A, Amount of claim, at the bottom of the last page of Part 1 of Schedule D ............

$ ________________

3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F)

3a. Copy the total claims from Part 1 (priority unsecured claims) from line 6e of Schedule E/F ..........................................

$ ________________

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F......................................

+ $ ________________

Your total liabilities $ ________________

Part 3: Summarize Your Income and Expenses

4. Schedule I: Your Income (Official Form 106I)

Copy your combined monthly income from line 12 of Schedule I ........................................................................................

$ ________________

5. Schedule J: Your Expenses (Official Form 106J)

Copy your monthly expenses from line 22, Column A, of Schedule J.................................................................................. $ ________________

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________________________

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

 Check if this is an 

amended filing

Charles David Skelton

Jessica Skelton

Northern District of Illinois

191,565.00

12,936.00

204,501.00

307,216.47

12,000.00

38,307.31

357,523.78

5,503.60

4,700.67

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 41 of 61
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

 Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 2 of 2 

Part 4: Answer These Questions for Administrative and Statistical Records

6. Are you filing for bankruptcy under Chapters 7, 11, or 13?

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

 Yes

7. What kind of debt do you have?

 Your debts are primarily consumer debts. Consumer debts are those “incurred by an individual primarily for a personal, 

family, or household purpose.” 11 U.S.C. § 101(8). Fill out lines 8-10 for statistical purposes. 28 U.S.C. § 159.

 Your debts are not primarily consumer debts. You have nothing to report on this part of the form. Check this box and submit 

this form to the court with your other schedules.

8. From the Statement of Your Current Monthly Income: Copy your total current monthly income from Official

Form 122A-1 Line 11; OR, Form 122B Line 11; OR, Form 122C-1 Line 14. $ _________________

9. Copy the following special categories of claims from Part 4, line 6 of Schedule E/F:

Total claim

From Part 4 on Schedule E/F, copy the following:

9a. Domestic support obligations (Copy line 6a.)

$_____________________

9b. Taxes and certain other debts you owe the government. (Copy line 6b.)

$_____________________

9c. Claims for death or personal injury while you were intoxicated. (Copy line 6c.)

$_____________________

9d. Student loans. (Copy line 6f.)

$_____________________

9e. Obligations arising out of a separation agreement or divorce that you did not report as 

priority claims. (Copy line 6g.) $_____________________

9f. Debts to pension or profit-sharing plans, and other similar debts. (Copy line 6h.) + $_____________________

9g. Total. Add lines 9a through 9f. $_____________________

Charles David Skelton

X

Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 42 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 43 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 44 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 45 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 46 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 47 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 48 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 49 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 50 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 51 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 52 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 53 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 54 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 55 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 56 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 57 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 58 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 59 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 60 of 61
Case 16-26162 Doc 1 Filed 08/15/16 Entered 08/15/16 16:18:41 Desc Main

 Document Page 61 of 61