Fill in this information to identify your case:

United States Bankruptcy Court for the:

NORTHERN DISTRICT OF ILLINOIS

Case number (if known) Chapter you are filing under:

 Chapter 7

 Chapter 11

 Chapter 12

 Chapter 13  Check if this an

amended filing

Official Form 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.

Josefina

First name First name

Middle name Middle name

Mendoza

Last name and Suffix (Sr., Jr., II, III) Last name and Suffix (Sr., Jr., II, III)

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)

xxx-xx-9523

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 1

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Debtor 1 Josefina Mendoza Case number (if known)

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

 I have not used any business name or EINs.  I have not used any business name or EINs.

Include trade names and

doing business as names

Business name(s) Business name(s)

EINs EINs

5. Where you live If Debtor 2 lives at a different address:

2238 N Kostner Ave

Chicago, IL 60639

Number, Street, City, State & ZIP Code Number, Street, 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, P.O. Box, Street, City, State & ZIP Code Number, P.O. Box, Street, 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.)

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 2

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Debtor 1 Josefina Mendoza Case number (if known)

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

District When Case number

District When Case number

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

Debtor Relationship to you

District When Case number, if known

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.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 3

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Debtor 1 Josefina Mendoza Case number (if known)

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?

 No. Go to Part 4.

 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.

Name of business, if any

If you have more than one

sole proprietorship, use a

separate sheet and attach

it to this petition.

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?

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).

For a definition of small

business debtor, see 11

U.S.C. § 101(51D).

 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?

 No.

 Yes.

What is the hazard?

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 property?

Number, Street, City, State & Zip Code

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 4

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Debtor 1 Josefina Mendoza Case number (if known)

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

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

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.

You must check one: 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, 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 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 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:

 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.

 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.

 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.

 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 credit counseling with the court.

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.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 5

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Debtor 1 Josefina Mendoza Case number (if known)

Part 6: Answer These Questions for Reporting Purposes

16. What kind of debts do

you have?

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.”

 No. Go to line 16b.

 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.

 No. Go to line 16c.

 Yes. Go to line 17.

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

17. Are you filing under

Chapter 7?

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

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?

 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?

 No

 Yes

18. How many Creditors do

you estimate that you

owe?

 1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than100,000

19. How much do you

estimate your assets to

be worth?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

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

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

 More than $50 billion

20. How much do you

estimate your liabilities

to be?

 $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

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

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

 More than $50 billion

Part 7: Sign Below

For you 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 making a false statement, concealing property, or obtaining money or property by fraud in connection with a

bankruptcy case can result in fines up to $250,000, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519,

and 3571.

/s/ Josefina Mendoza

Josefina Mendoza Signature of Debtor 2

Signature of Debtor 1

Executed on August 9, 2016 Executed on

MM / DD / YYYY MM / DD / YYYY

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 6

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Debtor 1 Josefina Mendoza Case number (if known)

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.

I, the attorney for the debtor(s) named in this petition, declare that I have informed 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 knowledge after an inquiry that the information in the

schedules filed with the petition is incorrect.

/s/ Michael S. Fabinski Date August 9, 2016

Signature of Attorney for Debtor MM / DD / YYYY

Michael S. Fabinski

Printed name

MSF Law

Firm name

One Lincoln Center

18W140 Butterfield Road, Suite 1500

Oakbrook terrace, IL 60181

Number, Street, City, State & ZIP Code

Contact phone (630) 726-4609 Email address

6315331

Bar number & State

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 7

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In re Case No.

Debtor(s)

FORM 1.VOLUNTARY PETITION

·Attachment A

DEBTOR(S)' REPRESENTATIONS & RESPONSIBILITIES:

1. Debtor understands that it is Debtor's responsibility to promptly tender a security deposit to all

utility companies.

2. Debtor understands that it is Debtor's responsibility to provide copies of the 2014, 2013, 2012 and

2011 federal tax returns. Debtor has agreed to tender these tax returns to debtor's counsel by Federal

Express no later than 10 days before the date first set for the first meeting of creditors (Section 341

meeting). Debtor has agreed to tender these tax returns directly to the Chapter 13 Trustee by Federal

Express no later than 7 days before the date first set for the first meeting of creditors (Section 341

meeting), unless said tax returns were Federal Expressed to debtor's counsel no later than 10 days

before the Section 341 meeting. Debtor understands further that the court could dismiss the case if the

tax returns are not tendered on a timely basis.

3. Debtor understands that it is Debtor's responsibility to provide copies of (a) all payment advices or

other evidence of income received within 60 days before the date of the filing of the bankruptcy petition

by the debtor from any employer of the debtor, and (b) proof of any 1099 or self employed income within 

60 days before the date of the filing of the petition (hereinafter, collectively the "Payment Advices") .

Said Payment Advices shall be provided to the trustee (or, if no trustee has been appointed to the United

States trustee), and to any creditor who timely requests copies of the payment advices or other evidence

of payment, at least seven days before the time of the meeting of creditors conducted pursuant to 11

U.S.C. Section 341. Debtor has agreed to tender said Payment Advices to debtor's counsel by Federal

Express no later than 10 days before the date first set for the first meeting of creditors (Section 341

meeting). Debtor has agreed to tender said Payment Advices directly to the Chapter 13 Trustee and any

requesting creditor by Federal Express no later than 7 days before the date first set for the first meeting 

of creditors (Section 341 meeting), unless said Payment Advices were Federal Expressed to debtor's

counsel no later than 10 days before the Section 341 meeting. Debtor understands further that the court

could dismiss the case if said Payment Advices are not tendered on a timely basis.

4. Debtor understands that it is Debtor's responsibility to complete an instructional course concerning

personal financial management before the conclusion of the repayment plan. After completion of the

instructional course, Debtor has agreed to tender a certificate of completion to debtor's counsel by

Federal Express. Debtor has also agreed to file the certificate of completion with the Clerk of the US

Bankruptcy Court at 219 S. Dearborn, Chicago, IL 60604, unless a copy of said certificate is tendered to

debtor's counsel via email or Federal Express and received at least 7 days prior to the case being

closed. Debtor understands further that no discharge will be granted without the filing of said certificate

of completion with the Clerk of the US Bankruptcy Court on a timely basis.

5. Debtor understands that prior to the final Chapter 13 plan payment debtor must complete and tender

to debtor's counsel a "Declaration re Domestic Support Obligations" certifying that either (a) "During the

pendency of this bankruptcy, Ihave not been required to pay a domestic support obligation by any order

of a court or administrative agency or by any statute", or (b) "During the pendency of this bankruptcy

case, I have paid all domestic support obligations that have become due under any order of a court, or

administrative agency or under any statute. Debtor further understands that this declaration must be

signed under penalty of perjury. Finally, debtor has been advised that the failure to complete and file

said declaration would result in debtor not receiving a Chapter 13discharge of debts.

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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.”

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;

The types of bankruptcy that are available to

individuals

Individuals who meet the qualifications may file under

one of four different chapters of 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.

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

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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.

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

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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.

Chapter 12: Repayment plan for family

farmers or fishermen

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.

$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.

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

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Warning: File Your Forms on Time

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.

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.

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.

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

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UNITED STATES BANKRUPTCY COURT

NORTHERN DISTRICT OF ILLINOIS

RIGHTS AND RESPONSIBILITIES AGREEMENT BETWEEN

CHAPTER 13 DEBTORS AND THEIR ATTORNEYS

(Court-Approved Retention Agreement, Revised as of 4/20/2015)

Chapter 13 gives debtors important rights, such as the right to keep property that could

otherwise be lost through repossession or foreclosure, but Chapter 13 also puts burdens on

debtors, such as the burden of making complete and truthful disclosures of their financial

situation. It is important for debtors who file a Chapter 13 bankruptcy case to understand their

rights and responsibilities in bankruptcy. In this connection, the advice of an attorney is often

crucial. Debtors are entitled to certain services from their attorneys, but debtors also have

responsibilities to their attorneys. In order to assure that debtors and their attorneys understand

their rights and responsibilities in the Chapter 13 process, the judges of the Bankruptcy Court for

the Northern District of Illinois have approved this agreement, setting out the rights and

responsibilities of both debtors in Chapter 13 and their attorneys, including how their attorneys

will be paid for their services in the Chapter 13 case. By signing this agreement, debtors and

their attorneys accept these responsibilities.

The Bankruptcy Code may require a debtor's attorney to provide the debtor with certain

documents and agreements at the start of the representation. The terms of this court-approved

agreement take the place of any conflicting provision in an earlier agreement. This agreement

cannot be modified in any way by other agreements. Any provision of another agreement

between the debtors and the attorney that conflicts with this agreement is void.

A. BEFORE THE CASE IS FILED

THE DEBTOR AGREES TO:

1. Discuss with the attorney the debtor's objectives in filing the case.

2. Provide the attorney with full, accurate and timely information, financial and otherwise,

including properly documented proof of income.

THE ATTORNEY AGREES TO:

1. Personally counsel the debtor regarding the advisability of filing either a Chapter 13 or a Chapter 7

case, discuss both procedures (as well as non-bankruptcy options) with the debtor, and answer the

debtor's questions.

2. Personally explain to the debtor that the attorney is being engaged to represent the debtor on all

matters arising in the case, as required by Local Bankruptcy Rule, and explain how and when the

attorney's fees and the trustee's fees are determined and paid.

3. Personally review with the debtor and sign the completed petition, plan, statements, and schedules,

as well as all amendments thereto, whether filed with the petition or later. (The schedules may be

initially prepared with the help of clerical or paralegal staff of the attorney's office, but personal

attention of the attorney is required for the review and signing.)

4. Timely prepare and file the debtor's petition, plan, statements, and schedules.

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5. Explain to the debtor how, when, and where to make all necessary payments, including both

payments that must be made directly to creditors and payments that must be made to the Chapter 13

trustee, with particular attention to housing and vehicle payments.

6. Advise the debtor of the need to maintain appropriate insurance.

B. AFTER THE CASE IS FILED

THE DEBTOR AGREES TO:

1. Make the required payments to the trustee and to whatever creditors are being paid

directly, or, if required payments cannot be made, to notify the attorney immediately.

2. Appear punctually at the meeting of creditors (also called the "341 meeting") with recent

proof of income and a picture identification card. (If the identification card does not include

the debtor's social security number, the debtor must also bring to the meeting a social security

card.) The debtor must be present in time for check-in and when the case is called for the

actual examination.

3. Notify the attorney of any change in the debtor's address or telephone number.

4. Inform the attorney of any wage garnishments or liens or levies on assets that occur or

continue after the filing of the case.

5. Contact the attorney immediately if the debtor loses employment, has a significant change

in income, or experiences any other significant change in financial situation (such as serious

illness, marriage, divorce or separation, lottery winnings, or an inheritance).

6. Notify the attorney if the debtor is sued or wishes to file a lawsuit (including divorce.)

7. Inform the attorney if any tax refunds to which the debtor is entitled are seized or not

received when due from the IRS or Illinois Department of Revenue.

8. Contact the attorney before buying, refinancing, or selling real property, and before

entering into any loan agreement.

9. Supply the attorney with copies of all tax returns filed while the case is pending.

THE ATTORNEY AGREES TO:

1. Advise the debtor of the requirement to attend the meeting of creditors, and notify the

debtor of the date, time, and place of the meeting.

2. Inform the debtor that the debtor must be punctual and, in the case of a joint filing, that

both spouses must appear at the same meeting.

3. Provide knowledgeable legal representation for the debtor at the meeting of creditors (in

time for check-in and the actual examination) and, unless excused by the trustee, for the

confirmation hearing.

4. If the attorney will be employing another attorney to attend the 341 meeting or any court

hearing, personally explain to the debtor in advance, the role and identity of the other

2

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attorney and provide the other attorney with the file in sufficient time to review it and

properly represent the debtor.

5. Timely submit to the Chapter 13 trustee properly documented proof of income for the

debtor, including business reports for self-employed debtors.

6. Timely respond to objections to plan confirmation and, where necessary, prepare, file, and

serve an amended plan.

7. Timely prepare, file, and serve any necessary statements, amended statements, and

schedules and any change of address, in accordance with information provided by the debtor.

8. Monitor all incoming case information (including, but not limited to, Order Confirming

Plan, Notice of Intent to Pay Claims, and 6-month status reports) for accuracy and

completeness. Contact the trustee promptly regarding any discrepancies.

9. Be available to respond to the debtor’s questions throughout the term of the plan.

10. Prepare, file, and serve timely modifications to the plan after confirmation, when

necessary, including modifications to suspend, lower, or increase plan payments.

11. Prepare, file, and serve necessary motions to buy or sell property and to incur debt.

12. Object to improper or invalid claims.

13. Timely respond to the Chapter 13 trustee’s motions to dismiss the case, such as for

payment default, or unfeasibility, and to motions to increase the percentage payment to

unsecured creditors.

14. Timely respond to motions for relief from stay.

15. Prepare, file, and serve all appropriate motions to avoid liens.

16. Provide any other legal services necessary for the administration of the case.

C. TERMINATION OR CONVERSION OF THE CASE AFTER ENTRY OF AN

ORDER APPROVING FEES AND EXPENSES

1. Approved fees and expenses paid under the provisions set out below are generally not

refundable in the event that the case is dismissed prior to its completion, unless the dismissal is

due to a failure by the attorney to comply with the duties set out in this agreement. If such a

dismissal is due to a failure by the attorney, the court may order a refund of fees on motion by

the debtor.

2. If the case is dismissed after approval of the fees and expenses but before payment of all

allowed fees and expenses, the order entered by the Bankruptcy Court allowing the fees and

expenses is not a judgment against the debtor for the unpaid fees and expenses based on contract

law or otherwise.

3. If the case is converted to a case under chapter 7 after approval of the fees and expenses under

this agreement but before the payment of all fees and expenses, the attorney will be entitled to an

administrative claim in the chapter 7 case for any unpaid fees and expenses, pursuant to section

3

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726(b) of the Bankruptcy Code, plus any conversion fee the attorney pays on behalf of the

debtor.

D. RETAINERS AND PREVIOUS PAYMENTS

1. The attorney may receive a retainer or other payment before filing the case but may not

receive fees directly from the debtor after the filing of the case. Unless the following provision is

checked and completed, any retainer received by the attorney will be treated as a security

retainer, to be placed in the attorney's client trust account until approval of a fee application by

the court.

The attorney seeks to have the retainer received by the attorney treated as an advance

payment retainer, which allows the attorney to take the retainer into income immediately.

The attorney hereby provides the following further information and representations:

(a) The special purpose for the advance payment retainer and why it is advantageous to

the debtor is as follows:

 Debtor(s) are paying a fixed, flat fee of $4,000.00 for the legal services rendered in the 

Chapter 13 bankruptcy case. Debtor(s) understand that the entire fee shall be deemed earned 

when paid and that no refunds shall be given. 

(b) The retainer will not be held in a client trust account and will become property of the

attorney upon payment and will be deposited into the attorney's general account;

(c) The retainer is a flat fee for the services to be rendered during the chapter 13 case

and will be applied for such services without the need for the attorney to keep

detailed hourly time records for the specific services performed for the debtor;

(d) Any portion of the retainer that is not earned or required for expenses will be

refunded to the client; and

(e) The attorney is unwilling to represent the debtor without receiving an advanced

payment retainer because of the nature of the chapter 13 case, the fact that the great

majority of services for such case are performed prior to its filing, and the risks

associated with the representation of debtors in bankruptcy cases in general.

2. In any application for compensation the attorney must disclose to the court any fees or other

compensation paid by the debtor to the attorney for any reason within the one year before the

case filing.

E. CONDUCT AND DISCHARGE

4

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1. Improper conduct by the attorney. If the debtor disputes the sufficiency or quality of the legal

services provided or the amount of the fees charged by the attorney, the debtor may file an

objection with the court and request a hearing.

2. Improper conduct by the debtor. If the attorney believes that the debtor is not complying with

the debtor's responsibilities under this agreement or is otherwise engaging in improper conduct,

the attorney may apply for a court order allowing the attorney to withdraw from the case.

3. Discharge of the attorney. The debtor may discharge the attorney at any time.

F. ALLOWANCE AND PAYMENT OF ATTORNEYS' FEES AND EXPENSES

1. Any attorney retained to represent a debtor in a Chapter 13 case is responsible for representing

the debtor on all matters arising in the case unless otherwise ordered by the court. For all of the

services outlined above, the attorney will be paid a flat fee of $4,000.00

2. In addition, the debtor will pay the filing fee required in the case of $310.00

3. Before signing this agreement, the attorney has received , $1,500.00

toward the flat fee, leaving a balance due of $2,500.00; and $23.00 for expenses,

leaving a balance due for the filing fee of $333.00

4. In extraordinary circumstances, such as extended evidentiary hearings or appeals, the attorney

may apply to the court for additional compensation for these services. Any such application must

be accompanied by an itemization of the services rendered, showing the date, the time expended,

and the identity of the attorney performing the services. The debtor must be served with a copy

of the application and notified of the right to appear in court to object.

Date: August 9, 2016 

Signed:

/s/ Josefina Mendoza /s/ Michael S. Fabinski

Josefina Mendoza Michael S. Fabinski

Attorney for the Debtor(s)

Debtor(s)

Do not sign this agreement if the amounts are blank.

Local Bankruptcy Form 23c

5

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B2030 (Form 2030) (12/15)

United States Bankruptcy Court

Northern District of Illinois

In re Josefina Mendoza Case No.

Debtor(s) Chapter 13

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR(S)

1. Pursuant to 11 U .S.C. § 329(a) and Fed. Bankr. P. 2016(b), I certify that I am the attorney for the above named debtor(s) and that

compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered or to

be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows:

For legal services, I have agreed to accept $ 4,000.00

Prior to the filing of this statement I have received $ 1,500.00

Balance Due $ 2,500.00

2. The source of the compensation paid to me was:

 Debtor  Other (specify):

3. The source of compensation to be paid to me is:

 Debtor  Other (specify): Chapter 13 Trustee

4.  I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm.

 I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm. A

copy of the agreement, together with a list of the names of the people sharing in the compensation is attached.

5. In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, including:

a. Preparation and filing of any petition, schedules, statement of affairs and plan which may be required;

b. Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;

c. [Other provisions as needed]

All items identified in the engagement letter and/or the court-approved retention agreement.

6. By agreement with the debtor(s), the above-disclosed fee does not include the following service:

Exludes all items not specifically included in the engagement letter and/or the court-approved retention

agreement.

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for representation of the debtor(s) in

this bankruptcy proceeding.

August 9, 2016 /s/ Michael S. Fabinski

Date Michael S. Fabinski

Signature of Attorney

MSF Law

One Lincoln Center

18W140 Butterfield Road, Suite 1500

Oakbrook terrace, IL 60181

(630) 726-4609

Name of law firm

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United States Bankruptcy Court

Northern District of Illinois

In re Josefina Mendoza Case No.

Debtor(s) Chapter 13

VERIFICATION OF CREDITOR MATRIX

Number of Creditors: 13

The above-named Debtor(s) hereby verifies that the list of creditors is true and correct to the best of my

(our) knowledge.

Date: August 9, 2016 /s/ Josefina Mendoza

Josefina Mendoza

Signature of Debtor

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}bk1{Credito AresMatix}bk{

Michael S. Fabinski

MSF Law

One Lincoln Center

18W140 Butterfield Road, Suite 1500

Oakbrook terrace, IL 60181

Josefina Mendoza

2238 N Kostner Ave

Chicago, IL 60639

Anselmo Lindberg Oliver, LLC

1771 West Diehl Road

Suite 120

Naperville, IL 60563

Bankruptcy Notices

One Lincoln Center

18W140 Butterfield Road, Suite 1500

Oakbrook Terrace, IL 60181

Credit Cntrl

5757 Phantom Dr.

Hazelwood, MO 63042

Illinois Department of Revenue

Bankruptcy Section, Level 7-400

100 W. Randolph Street

Chicago, IL 60601

Illinois Department of Revenue

PO Box 64338

Chicago, IL 60601

Internal Revenue Service

PO Box 7346

Philadelphia, PA 19101-7346

M3 Financial Services

10330 W Roosevelt Rd S-2

Westchester, IL 60154

Merchants Credit Guide

223 W Jackson Blvd Ste 4

Chicago, IL 60606

Peoples Engy

200 East Randolph

Chicago, IL 60601

US Trustee's Office, VIA ECF

219 S. Dearborn Street

Suite 800

Chicago, IL 60604

Wells Fargo Hm Mortgag

8480 Stagecoach Cir

Frederick, MD 21701

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