Fill in this information to 1dent1fy your case: 

United States Bankruptcy Court for the: 

SOUTHERN DISTRICT OF FLORIDA 

Case number (if known) 

Official Form 101 

Chapter you are filing under: 

• Chapter7 

D Chapter 11 

D Chapter 12 

D Chapter 13 

Voluntary Petition for Individuals Filing for Bankruptcy 

D Check if this an 

amended filing 

12/17 

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. 

!HF Identify Yourself 

1. Your full name 

Write the name that is on 

your government-issued 

picture identification (for 

example, your driver's 

license or passp~. 

Bring your picture 

identification to your 

meeting with the trustee. 

2. All other names you have 

used in the last 8 years 

Include your married or 

maiden names. 

About DeMol' 1: About Detltor 2 (8pouH Only In. Joint Case): 

Andy 

First name First name 

Middle name Middle name 

Devalcin 

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

-------·-------------------------------------· 

3. Only the last 4 digits of 

your Social Security 

number or federal 

Individual Taxpayer 

Identification number 

(ITIN) 

• 

Official Form 101 

xxx-xx-5742 

• • • • ------·----------

Voluntary Petition for Individuals Filing for Bankruptcy page 1 

[ 

• 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 1 of 43
Debtor 1 Andy Devalcin 

4. Any business names and 

Employer Identification 

About Debtor 1: 

Numbers (EIN) you have • I have not used any business name or EINs. 

used in the last 8 years 

Include trade names and Business name(s) 

doing business as names 

5. Where you live 

6. Why you are choosing 

this district to file for 

bankruptcy 

• 

EINs 

1135NW108th Terrace 

Miami, FL 33168 

Number, Street, City, State & ZIP Code 

Miami-Dade 

County 

If your malling 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, P.O. Box, Street, City, State & ZIP Code 

Check one: 

• Over the last 180 days before filing this petition, 

I have liv.in this district longer than in 8'f 

other district. 

D I have another reason. 

Explain. (See 28 U.S.C. § 1408.) 

• • 

Case number (ff known) 

About Debtor z (8pouM Only 1n a Joint case): 

D I have not used any business name or EINs. 

Business name(s) 

EINs 

If Debtor 2 lives at a different address: 

Number, Street, City, State & ZIP Code 

County 

If Debtor 2's malling 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 

Check one: 

D Over the last 180 days before filing this petition, I 

have liv9in this district longer than in ap other 

district. 

D I have another reason. 

Explain. (See 28 U.S.C. § 1408.) 

---------------------·---. 

• • • 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page2 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 2 of 43
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Debtor 1 Andy Devalcin Case number (ff known) -Tel the Court About Your Bankruptc)'_c_ase __________________________________ _ 

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

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

choosing to file under 

• Chapter 7 

0 Chapter 11 

0 Chapter 12 

0 Chapter 13 

8. How you will pay the fee 0 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. 

O 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? 

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? 

11. Do you rent your 

residence? 

• 

Official Form 101 

• No. 

0Yes. 

•No 

DYes. 

•No. 

DYes. 

• 

District 

District 

District 

, Debtor 

District 

Debtor 

District 

__________ When 

When 

When ----------

, 

When 

When 

Go to line 12. 

Case number --------

Case number --------

Case number --------

' Relationship to you 

Case number, if known 

Relationship to you 

Case number, if known 

Has your landlord obtained an eviction judgment against you? 

O No. Go to line 12. 

, 

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

this bankruptcy petition. 

• • • 

Voluntary Petition for Individuals Filing for Bankruptcy page 3 

• 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 3 of 43
Debtor 1 Andy Devalcin Case number (if known) 

fiff Report About Any Businesses You Own as a Sole Proprietor -------------------------

12. Are you a sole proprietor 

of any full- or part-time • No. Go to Part 4. 

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. 

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(510). 

DYes. Name and location of business 

Name of business, if any 

Number, Street, City, State & ZIP Code 

Check the appropriate box to describe your business: 

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

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

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

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

D None of the above 

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. 

DNo. 

DYes. 

I am not filing under Chapter 11. 

I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in the Bankruptcy 

Code. 

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

fffi Report If You Own or Have Any Hmrdous Property or Any Property Tim Needs Immediate Attention 

14. Do you own or have any •No. 

property that poses or Is 

alleged to po• a threat D Yes. 

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? 

• 

Official Form 101 

• 

, 

What is the hazard? 

If immediate attention is 

needed, why is it needed? 

Where is the property? 

• 

Number, Street, City, State & Zip Code 

• 

Voluntary Petition for Individuals Filing for Bankruptcy 

• 

page4 

• 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 4 of 43
l 

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Debtor 1 Andy Devalcin 

iiffi Expl8ln Your Efforts to Rec:elve • 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. 

About Debtor 1: 

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. 

You must truthfully check D one of the following 

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. 

choices. If you cannot do 

so, you are not eligible to 

file. 

Within 14 days after you file this bankruptcy 

petition, you MUST file a copy of the certificate and 

payment plan, if any. 

If you file anyway, the court 

can dismiss your case, you 

will lose whatever filing fee 

you paid, and your D 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. 

creditors can begin 

collection activities again. 

• 

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 ca~ and is limited to a maximum., 15 

days. 

D I am not required to receive a briefing about 

credit counseling because of: 

D Incapacity. 

I have a mental illness or a mental deficiency 

that makes me incapable of realizing or 

making rational decisions about finances. 

D 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. 

D 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 couseling with the court. 

Case number (if known) 

About Debtor 2 (Spouse Only In. Joint C..): 

You must check one: 

D 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. 

D 

D 

D 

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: 

D Incapacity. 

I have a mental illness or a mental deficiency that 

makes me incapable of realizing or making rational 

decisions about finances. 

D 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. 

D 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 thecourt. • 

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page5 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 5 of 43
Debtor 1 Andy Devalcin Case number (if known) 

Iliff Answer These Questions for Reporting Purposes 

16. What kind of debts do 

you have? 

17. Are you filing under 

Chapter?? 

18. 

19. 

20. 

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? 

How many Creditors do 

you estimate that you 

owe? 

How much do you 

estimate your assets to 

be worth? 

How much do you 

estimate your liabilities 

to be? ' 

Sign Below 

For you 

• 

Official Form 101 

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." 

D 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. 

D No. Go to line 16c. 

D Yes. Go to line 17. 

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

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

•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? 

• 1-49 

D 50-99 

•No 

DYes 

D 100-199 

D 200-999 

• $0 - $50,000 

D $50,001 - $100,000 

D $100.001 - $500,000 

D $500,001 - $1 million 

• $0 - $50,000 

D 1.000-5,ooo D 25,001-50,000 

D 5001-10,000 D 50,001-100.000 

D 10.001-25,000 D More than100,000 

D $1,000,001 - $10 million D $500,000,001 - $1 billion 

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

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

D $100,000,001 - $500 million D More than $50 billion 

D $1,000,001 - $10 million D $500,000,001 - $1 billion 

D $50,001 .-ioo.ooo tfJ $10,000,001 - $50 million' D $1,000.000,001 r10 billion 

D D $10,000,000,001 - $50 billion $100,001 - $500.000 D $50,000,001 - $100 million 

D $500,001 - $1 million D $100,000,001 - $500 million 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 making a false statement, concealing property, or obtaining money or property by fraud in connection with a 

:~~~~~~~Y case can reJ:1~tt '" fioo• ~· oc lmpriso"m'"t fo'"p to 2Q yeara, oc both. 18 U.S.C. §§ 152, t 341, 1519, 

Isl Andy Dev~lcin_ ~._,, eAndy Devalcm __ - . •Signature of Debtor 2 • • 

Signature of Debtor 1 1 

Executed on June 12, 2019 

MM/ DD /YYYY 

Executed on 

Voluntary Petition for Individuals Filing for Bankruptcy 

MM/DD/YYYY 

page6 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 6 of 43
Debtor 1 Andy Devalcin 

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. 

• 

Official Form 101 

• 

Case number (if known) 

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. 

Date June 12, 2019 

Signature of Attorney for Debtor MM/DD/YYYY 

Printed name 

Firm name 

Number. Street. City, State & ZIP Code 

Contact phone Email address 

Bar number & State 

, 

• • • 

Voluntary Petition for Individuals Filing for Bankruptcy page 7 

• 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 7 of 43
Debtor 1 Andy Devalcin 

For you If you are filing this 

bankruptcy without an 

attorney 

If you are represented by an 

attorney, you do not need to 

file this page. 

, 

• 

Official Form 101 

Case number (if known) 

The law allows you, as an individual, to represent yourself in bankruptcy court, but you should understand that many 

people find it extremely difficult to represent themselves successfully. Because bankruptcy has long-term 

financial and legal consequences, you are strongly urged to hire a qualified attorney. 

To be successful, you must correctly file and handle your bankruptcy case. The rules are very technical, and a mistake or 

inaction may affect your rights. For example, your case may be dismissed because you did not file a required document, 

pay a fee on time, attend a meeting or hearing, or cooperate with the court, case trustee, U.S. trustee, bankruptcy 

administrator, or audit firm if your case is selected for audit. If that happens, you could lose your right to file another case, 

or you may lose protections, including the benefit of the automatic stay. 

You must list all your property and debts in the schedules that you are required to file with the court. Even if you plan to pay 

a particular debt outside of your bankruptcy, you must list that debt in your schedules. If you do not list a debt, the debt may 

not be discharged. If you do not list property or properly claim it as exempt, you may not be able to keep the property. The 

judge can also deny you a discharge of all your debts if you do something dishonest in your bankruptcy case, such as 

destroying or hiding property, falsifying records, or lying. Individual bankruptcy cases are randomly audited to determine if 

debtors have been accurate, truthful, and complete. Bankruptcy fraud is a serious crime; you could be fined and 

imprisoned. 

If you decide to file without an attorney, the court expects you to follow the rules as if you had hired an attorney. The court 

will not treat you differently because you are filing for yourself. To be successful, you must be familiar with the United 

States Bankruptcy Code, the Federal Rules of Bankruptcy Procedure, and the local rules of the court in which your case is 

filed. You must also be familiar with any state exemption laws that apply. 

Are you aware that filing for bankruptcy is a serious action with long-term financial and legal consequences? 

DNo 

•Yes 

Are you aware that bankruptcy fraud is a serious crime and that if your bankruptcy forms are inaccurate or incomplete, you 

could be fined or imprisoned? 

DNo 

•Yes 

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

DNo 

•Yes Name of Person Fabiola Bouchette 

Attach Bankruptcy Petition Preparer's Notice, Declaration, and Signature (Official Form 119). 

By signing here, I acknowledge that I understand the risks involved in filing without an attorney. I have read and understood 

this notice, and I am aware that filing a bankruptcy case without an attorney may cause me to lose my rights or property if I do 

not properly handle the case. 

Isl Andy Def&lcin __L____ ' ' 

Andy Devalcin Signature of Debtor 2 

Signature of Debtor 1 

Date June 12, 2019 

MM/DD/YYYY 

Contact phone 

Cell phone 

Email address 

• • 

Date 

MM/DD/YYYY 

Contact phone 

Cell phone 

Email address 

• 

Voluntary Petition for Individuals Filing for Bankruptcy 

• • 

pages 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 8 of 43
• 

Fill in this information to 1dent1fy your case: 

Debtor 1 

Debtor2 

(Spouse if, filing) 

Andy Devalcin First Name 

First Name 

Middle Name Last Name 

Middle Name Last Name 

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

{ff known) D Check if this is an 

amended filing 

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. 

Summarize Your Assets 

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

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

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

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

Summarize Your Liabilities 

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. Cof the total claims from Part 2 ~npriority unsecured claims) f~ line 6j of Schedule EIF ....... , ........... :·:·" 

Your assets 

Value of what you own 

$ 0.00 

$ ____ 1-'-'.,9.'-3_5_.o_o 

$ ____ 1~,9_3_5._00_ 

Your llabllltles 

Amount you awe 

$ __ _, ..... 2_5~,9_44_._oo_ 

Yo"' total l~bllltlu j 1 _____ 2_5~,9_44_._oo_ 

Summarize Your Income and Expenses 

4. Schedule I: Your Income (Official Form 1061) 3,214.42 Copy your combined monthly income from line 12 of Schedule 1 ............................................................................... . 

5. Schedule J: Your Expenses (Official Form 106J) 3,081.00 Copy your monthly expenses from line 22c of Schedule J ......................................................................... . 

Answer These Questions for Administrative and Statistical Records 

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

7. 

D 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 

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 8-9g for statistical purposes. 28 U.S.C. § 159. 

C 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. 

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

Software Copyright {c) 1996-2019 Best Case, LLC -www.bestcase.com Best Case Bankruptcy 

• 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 9 of 43
• 

Debtor 1 Andy Devalcin Case number (if known) ------,----~~~~~~----, 

8. From the Statement of Your Current Monthly Income: Copy your total current monthly income from Official Form 1

1 

$ 

122A-1Line11; OR, Form 1228Line11; OR, Form 122C-1Line14. ______ 3_,3_1_4_.0_0_ 

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

From Part 4 on SchedUlrJ E/F, copy the foHowlng: 

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. 

• • • 

Totalclalm 

$ 0.00 

$ 0.00 

$ 0.00 

$ 0.00 

$ 0.00 

+$ 0.00 

1$ 0.00 

• 

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

Software Copyright (c) 1996-2019 Best Case, LLC -www.bestcase.com 

• 

page 2 of2 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 10 of 43
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Debtor 2 

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

Official Form 106A/B 

Schedule A/B: Property 

D Check if this is an 

amended filing 

12/15 

In each category, separately list and describe items. List an asset only once. If an asset fits in more than one category, list the asset in the category where you 

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

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

Answer every question. 

Describe Each Residence, Building, Land, or Other Real Estate You Own or Have an Interest In 

1. Do you own or have any legal or equitable interest in any residence, building, land, or similar property? 

• No. Go to Part 2. 

0 Yes. Where is the property? 

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

someone else drives. If you lease a vehicle, also report it on Schedule G: Executory Contracts and Unexpired Leases. 

3. Cars, vans, trucks, tractors, sport utility vehicles, motorcycles 

•No 

DYes 

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

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

, , , 

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

.pages you have attached for Part 2. Write that number here ............................................................................. => 

Describe Your Personal and Household Items 

Do you own or hav. any legal or equltllble lmerut In any of th• following Items? 

6. Household goods and furnishings 

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

ONo 

•Yes. Describe ..... 

7. Electronics 

bedrooms set including (Queen size beds, dressers, night stands 

Location: 1135NW108th Terrace, Miami FL 33168 

• 

, 

$0.00 

Curr.nt value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

$250.00 

Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners; music collections; electronic devices 

including cell phones, cameras, media players, games 

ONo 

Official Form 106A/B 

Software Copyright (c} 1996-2019 Best Case. LLC - www.bestcase.com 

Schedule A/B: Property page 1 

Best Case Bankruptcy 

' 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 11 of 43
• 

Debtor 1 Andy Devalcin Case number (if known) 

• Yes. Describe ..... 

Television, , cell phones, , 

Location: 1135NW108th Terrace, Miami FL 33168 $180.00 

8. Collectibles of value 

Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects; stamp, coin, or baseball card collections; 

other collections, memorabilia, collectibles 

•No 

D Yes. Describe ..... 

9. Equipment for sports and hobbies 

Examples: Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; canoes and kayaks; carpentry tools; 

musical instruments 

•No 

D Yes. Describe ..... 

10. Firearms 

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

•No 

D Yes. Describe ..... 

11. Clothes 

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

DNo 

•Yes. Describe ..... 

shirts, pants, shoes, belts, socks- under garments; work uniformsdebtor only 

Location: 1135NW108th Terrace, Miami FL 33168 $95.00 

12. Jewelry 

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

•No 

D Yes. Describe ..... 

13. Non-farm animals 

Examples: Dogs, cats, birds, horses 

-~ , 

, 

D Yes. Describe ..... 

14. Any other personal and household Items you did not already list, including any health aids you did not list 

•No 

D Yes. Give specific information ..... 

15. Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached 

for Part 3. Write that number here ............................................................................. . 

16. Cash 

Examples: Money YiU have in your wallet, in your ~me, in a safe deposit box, ancwm hand when you file your pe;ion 

•No 

DYes ............................................................................................................... . 

Official Form 106A/B Schedule A/B: Property 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 

, 

$525.00 

Current V11lue of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

• 

page2 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 12 of 43
• 

Debtor 1 Andy Devalcin Case number (if known) 

17. Deposits of money 

Examples: Checking, savings, or other financial accounts; certificates of deposit; shares in credit unions, brokerage houses, and other similar 

institutions. If you have multiple accounts with the same institution, list each. 

ONo 

•Yes ...................... .. Institution name: 

17.1. Checking Chase bank $410.00 

18. Bonds, mutual funds, or publicly traded stocks 

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

•No 

DYes ................. . Institution or issuer name: 

19. Non-publicly traded stock and Interests in Incorporated and unincorporated businesses, including an Interest in an LLC, partnership, and 

joint venture 

•No 

0 Yes. Give specific information about them ................. .. 

Name of entity: % of ownership: 

20. Government and corporate bonds and other negotiable and non-negotiable instruments 

Negotiable instruments include personal checks, cashiers' checks, promissory notes, and money orders. 

Non-negotiable instruments are those you cannot transfer to someone by signing or delivering them. 

•No 

0 Yes. Give specific information about them 

Issuer name: 

21. Retirement or pension accounts 

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

ONo 

• Yes. List each account separately. 

Type of account: Institution name: 

401 k though employer HMS 

22. Security deposits and prepayments 

Your share of all unused deposits you have made so that you may continue service or use from a company 

Examples: Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommunications companies, or others 

~ ?. ..................... ' lnstitufon name or individual: ' ' 

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

•No 

OYes ........... .. Issuer name and description. 

24. Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tuition program. 

26 U.S.C. §§ 530(b)(1), 529A(b), and 529(b)(1). 

•No 

DYes ............ . Institution name and description. Separately file the records of any interests.11 U.S.C. § 521 (c): 

$1,000.00 

25. Trusts, equitable or future Interests in property (other than anything listed in line 1), and rights or powers exercisable for your benefit 

•No 

0 Yes. Give specific information about them ... 

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

Examples: Internet domain names, websites, proceeds from royalties and licensing agreements 

•No 

0 Yes. Give specific41nformation about them ... • • • 

27. Licenses, franchises, and other general Intangibles 

Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses, professional licenses 

•No 

0 Yes. Give specific information about them ... 

Official Form 106A/B Schedule A/B: Property 

Software Copyright (c) 1996-2019 Best Case. LLC - www.bestcase.com 

• 

page3 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 13 of 43
• 

Debtor 1 Andy Devalcin 

Money orproperty owed tD you? 

Case number (if known) 

Cunent value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

28. Tax refunds owed to you 

•No 

D Yes. Give specific information about them, including whether you already filed the returns and the tax years ....... 

29. Family support 

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

•No 

D Yes. Give specific information ...... 

30. Other amounts someone owes you 

Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers' compensation, Social Security 

benefits; unpaid loans you made to someone else 

•No 

D Yes. Give specific information .. 

31. Interests in insurance policies 

Examples: Health, disability, or life insurance; health savings account (HSA); credit, homeowner's, or renter's insurance 

•No 

D Yes. Name the insurance company of each policy and list its value. 

Company name: Beneficiary: 

32. Any interest in property that is due you from someone who has died 

Surrender or refund 

value: 

If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receive property because 

someone has died. 

•No 

D Yes. Give specific information .. 

33. Claims against third parties, whether or not you have filed a lawsuit or made a demand for payment 

Examples: Accidents, employment disputes, insurance claims, or rights to sue 

•No 

D 

, 

Yes. Describe each claim ......... , 

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

•No 

D Yes. Describe each claim ......... 

35. Any financial assets you did not already list 

•No 

D Yes. Give specific information .. 

36. Add the dollar value of all of your entries from Part 4, Including any entries for pages you have attached 

for Part 4. Write that number here ................................................................................................................... .. 

37. Do you own or have any legal or equitable Interest in any business-related property? 

• No. Go to Part 6. 

D Yes. Go to line 38 . 

• • • 

$1,410.00 

• • 

Official Form 106A/B 

Software Copyright (c) 1996-2019 Best Case, LLC -www.bestcase.com 

Schedule A/B: Property page4 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 14 of 43
• 

Debtor 1 Andy Devalcin Case number (if known) 

Describe Any Fann- and Commercial Fishing-Related Property You Own or Have an Interest In. 

If you own or have an interest in farmland, list it in Part 1. ~~~~-~~~~~~~~~ 

46. Do you own or have any legal or equitable Interest in any farm- or commercial fishing-related property? 

•No. Go to Part 7. 

D Yes. Go to line 47. 

~r:tY You Own or Have an Interest in That You Did Not List Above 

53. Do you have other property of any kind you did not already list? 

Examples: Season tickets, country club membership 

•No 

D Yes. Give specific information ........ . 

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

- List the Totals of Each Part of this Fonn 

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

56. Part 2: Total vehicles, line 5 $0.00 

57. Part 3: Total personal and household items, line 15 $525.00 

58. Part 4: Total financial assets, line 36 $1,410.00 

59. Part 5: Total business-related property, line 45 $0.00 

60. Part 6: Total farm· and fishing-related property, line 52 $0.00 

61. Part 7: Total other property not listed, line 54 + $0.00 

$0.00 

$0.00 

62. Total personal property. Add lines 56 through 61 ... $1,935.00 Copy personal property total $1,935.00 

63. Total of all property on Schedule A/B. Add line 55 +line 62 

, 

• • • 

Official Form 106A/B Schedule A/B: Property 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 

• 

$1,935.00 L-==~~~~~~~~ 

• 

page 5 

Best Case Bankruptcy 

, 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 15 of 43
• 

fi8 Debtor 1 111HM"iH"*+i*·~ Andy Devalcin First Name Middle Name Last Name -

Debtor2 

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

(ff known) D Check if this is an 

amended filing 

Official Form 106C 

Schedule C: The Property You Clalm as Exempt 4/19 

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

the property you listed on Schedule A/B: Property (Official Form 106A/B) as your source, list the property that you claim as exempt. If more space is 

needed, fill out and attach to this page as many copies of Part 2: Additional Page as necessary. On the top of any additional pages, write your name and 

case number (if known). 

For each item of property you claim as exempt, you must specify the amount of the exemption you claim. One way of doing so is to state a 

specific dollar amount as exempt. Alternatively, you may claim the full fair market value of the property being exempted up to the amount of 

any applicable statutory limit. Some exemptions-such as those for health aids, rights to receive certain benefits, and tax-exempt retirement 

funds-may be unlimited in dollar amount. However, if you claim an exemption of 100% of fair market value under a law that limits the 

exemption to a particular dollar amount and the value of the property is determined to exceed that amount, your exemption would be limited 

to the applicable statutory amount. 

l:tMIM Identify the Property You Claim as Exempt 

1. Which set of exemptions are you claiming? Check one only, even if your spouse is filing with you. 

•You are claiming state and federal nonbankruptcy exemptions. 11 U.S.C. § 522(b)(3) 

D You are claiming federal exemptions. 11 U.S.C. § 522(b)(2) 

2. For any property you list on Schedule AIB that you claim as exempt, fill In the Information below. 

bedrooms set including (Queen size 

beds, dressers, night stands 

Lo-'ation: 1135NW108th Tei'ace, 

Mllmi FL 33168 

Line from Schedule A/8: 6.1 

Cumlnt wlue of the Amount of the IUll!pllln yell clelm 

portion yell -

Copy 119 v.1111 tom Chaclc only one boK for NCll ftWllP(ton. 

Sdtedf'8NB 

$250.00 • 

D 

$250.00 

100% of fair market vjjlle, up to 

any applicable statutdfy limit 

Fla. Const. art. X, § 4(a)(2) 

Television, , cell phones, , 

Location: 1135NW108th Terrace, 

Miami FL 33168 

$180.00 • $180.00 Fla. Const. art. X, § 4(a)(2) 

Line from Schedule A/B: 7 .1 

shirts, pants, shoes, belts, socksunder garments; work uniformsdebtor only 

Location: 1135NW108th Terrace, 

Miami FL 33168 

Line from Schedule AIB: 11.1 

Checking: Chase bank 

Line from Schedule AIB: 17 .1 

• 

$95.00 

$410.00 

• 

D 100% of fair market value, up to 

any applicable statutory limit 

• $95.00 Fla. Const. art. X, § 4(a)(2) 

D 100% of fair market value, up to 

any applicable statutory limit 

• $410.00 Fla. Const. art. X, § 4(a)(2) 

D 100% affair market value, up to 

any ap~cable statutory limit • • 

Official Form 106C Schedule C: The Property You Claim as Exempt page 1of2 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 16 of 43
• 

Debtor 1 Andy Devalcin Case number (if known) 

BrW~oltlle pnipertyMCI lneon 

ScfNdr*A/8 ........... pnlp9ftJ 

C-..t-.. ...... Amountoltlle ......,aon J'DU cllllm Speclllc .......... ........-on 

401k though employer HMS 

Line from Schedule AIB: 21.1 

portion J'DU - Copy lhe ,,..,. from Check only one box for eecll e1«llnplion. 

ScheduleMJ 

$1,000.00 • $1,000.00 

D 100% of fair market value, up to 

any applicable statutory limit 

3. Are you clalmlng a homestead exemption of more than $170,350? 

Fla. Stat. Ann.§§ 121.131, 

121.055(6)(e) 

(Subject to adjustment on 4/01/22 and every 3 years after that for cases filed on or after the date of adjustment.) 

• No 

D Yes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case? 

D No 

D Yes 

Official Form 106C 

, 

• • • 

Schedule C: The Property You Claim as Exempt 

Software Copyright (c} 1996-2019 Best Case. LLC - www.bestcase.com 

• • 

page 2 of 2 

Best Case Bankruptcy 

' 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 17 of 43
• 

I First Name 

Debtor2 

(Spouse if, filing) First Name 

United States Bankruptcy Court for the: 

Case number 

(Wknown) 

Official Form 1060 

Middle Name Last Name 

Middle Name Last Name 

SOUTHERN DISTRICT OF FLORIDA 

Schedule D: Creditors Who Have Clalms Secured by Property 

D Check if this is an 

amended filing 

12/15 

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

is needed, copy the Additional Page, fill it out, number the entries, and attach It to this form. On the top of any addltlonal pages, write your name and case 

number (If known). 

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

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

D Yes. Fill in all of the information below. 

, 

• • • • 

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

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• 

page 1 of 1 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 18 of 43
• 

Debtor 2 

(Spouse if, filing) First Name 

United States Bankruptcy Court for the: 

Case number 

(ttknown) 

Official Form 106E/F 

Middle Name Last Name 

SOUTHERN DISTRICT OF FLORIDA 

Schedule E/F: Creditors Who Have Unsecured Claims 

D Check if this is an 

amended filing 

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 Have 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. If you have no information to report in a Part, do not file that Part. On the top of any additional pages, write your 

name and case number (if known). 

i#IM List All of Your PRIORITY Unsecured Claims 

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

• No. Go to Part 2. 

DYes. 

i#M List All of Your NON PRIORITY Unsecured Claims 

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

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

•ves. 

4. List• ol ,our nonpriorlty unMCUNd clelma In the lllphabetiClll order ol the cndltar who holds each clelm. If a creditor has more than one nonpriorlty 

Ul1HQ.Qd claim, 1st the credllor eeparal8ly for each claim. For each claim listed, Identify what t)'P8 of claim it Is. Do not list clUna already Included In Part 1. If more '*' one credftor holds a par11cular claim, lilt the other creditors In Part 3.lf you hava more than three nonpriority unaecurac:t claims Ill out the Conllnuatlon Page of 

Part 2. 

~ Capital One Auto Finance 

Nonpriority Creditor's Name 

Po Box 259407 

Plano, TX 75025 

Number Street City State Zip Code 

Who incurred the debt? C~k one. 

• Debtor 1 only 

D Debtor 2 only 

D Debtor 1 and Debtor 2 only 

D At least one of the debtors and another 

D Check if this claim is for a community 

debt 

Is the claim subject to offset? 

•No 

Dves 

• • 

Last 4 digits of account number 5353 

------

When was the debt incurred? 

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

, 

D Contingent 

D Unliquidated 

D Disputed 

Type of NONPRIORITY unsecured claim: 

D Student loans 

D Obligations arising out of a separation agreement or divorce that you did not 

report as priority claims 

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

•Other. Specify 2015 Toyota Tacoma: REPO 

• • 

Official Form 106 E/F Schedule E/F: Creditors Who Have Unsecured Claims 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 43722 

TOUlclalm 

$24,631.00 

• 

Page 1 of2 

Best Case Bankruptcy 

f 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 19 of 43
• 

Debtor 1 Andy Devalcin 

~ Midland Funding LLC 

Nonpriority Creditor's Name 

8875 Aero Drive 

Suite 200 

San Diego, CA 92123 

Number Street City State Zip Code 

Who Incurred the debt? Check one. 

• Debtor 1 only 

D Debtor 2 only 

D Debtor 1 and Debtor 2 only 

D At least one of the debtors and another 

D Check If this claim Is for a community 

debt 

Is the claim subject to offset? 

•No 

Dves 

Case number (~known) 

Last 4 digits of account number SP25 

When was the debt incurred? 

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

D Contingent 

D Unliquidated 

D Disputed 

Type of NONPRIORITY unsecured claim: 

D Student loans 

D Obligations arising out of a separation agreement or divorce that you did not 

report as priority claims 

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

original creditor : CREDIT ONE 

• Other. Specify MIDLAND #857994 

ip List Others to Be Notified About a Debt That You Already Listed 

$1,313.00 

5. Use this page only if you have others to be notified about your bankruptcy, for a debt that you already listed In Parts 1 or 2. For example, if a collection agency 

is trying to collect from you for a debt you owe to someone else, list the original creditor in Parts 1 or 2, then list the collection agency here. Similarly, if you 

have more than one creditor for any of the debts that you listed in Parts 1 or 2, list the additional creditors here. If you do not have additional persons to be 

notified for any debts In Parts 1 or 2, do not fill out or submit this page. 

Name and Address 

Capital One Auto Finance 

7933 Preston Rd 

Plano, TX 75024 

Name and Address 

Molly Fitzpatrick, Esq 

Po Box 290335 

Tampa, FL 33687 

On which entry in Part 1 or Part 2 did you list the original creditor? 

Line 4.1 of (Check one): D Part 1: Creditors with Priority Unsecured Claims 

• Part 2: Creditors with Nonpriority Unsecured Claims 

Last 4 digits of account number 

On which entry in Part 1 or Part 2 did you list the original creditor? 

Line 4.2 of (Check one): D Part 1: Creditors with Priority Unsecured Claims 

• Part 2: Creditors with Nonpriority Unsecured Claims 

Last 4 digits of account number SP25 

ipiM 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 

,. of unsecured claim. , , • , 

Tot.I Claim 

Ga. Domestic support obligations Ga. $ 0.00 

Toal 

claims 

from Part1 Gb. Taxes and certain other debts you owe the government Gb. $ 0.00 

Ge. Claims for death or personal Injury while you were Intoxicated Ge. $ 0.00 

Gd. Other. Add all other priority unsecured claims. Write that amount here. Gd. $ 0.00 

Ge. Total Priority. Add lines Ga through Gd. Ge. I $ 0.00 

Tot.I Claim 

Gf. Student loans Gf. $ 0.00 

Tot.I 

claims 

from Part2 Gg. Obligations arising out of a separation agreement or divorce that 

$ you did not report as priority claims Gg. 0.00 

Gh. Debts to pension or profit-sharing plans, and other similar debts Gh. $ 0.00 

Gi. Other. Add all other nonpriority unsecured claims. Write that amount Gi. 

here. $ 25,944.00 

• • • ~ Gj. Total Nonprlority. Add lines Gf through Gi. Gj. • 

Official Form 1 OG E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of2 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 20 of 43
• 

Fill in this information to identify your case: 

Debtor 1 

Debtor 2 

(Spouse if, filing) 

Andy Devalcin First Name 

First Name 

United States Bankruptcy Court for the: 

Case number 

(ff known) 

Middle Name Last Name 

Middle Name Last Name 

SOUTHERN DISTRICT OF FLORIDA 

I 

I 

~---------~.----------------------------·--~' 

Official Form 106G 

D Check if this is an 

amended filing 

Schedule G: Executory Contracts and Unexpired Leases 12/15 

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

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

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

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

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

D Yes. Fill in all of the information below even if the contacts of leases are listed on Schedule AIB:Property (Official Form 106 NB). 

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

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

and unexpired leases. 

Person or compuy with whom you have the contract or ..... St.te what the contract or ..... Is for 

Name, Number, Street, Cily, Stale and ZIP Code 

2.1 

Name 

Number Street 

Ci State ZIP Code 

2.2 

Name 

Number Street 

, , 

Ci State ZIP Code 

2.3 

Name 

Number Street 

Ci State ZIP Code 

2.4 

Name 

Number Street 

City State ZIP Code 

2.5 

Name 

~------- -·---- Number Street 

City • State • ZIP Code,~------·- --------- • 

Official Form 106G Schedule G: Executory Contracts and Unexpired Leases 

Software Copyright (c} 1996-2019 Best Case, LLC • www.bestcase.com 

• 

Page 1of1 

Best Case Bankruptcy 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 21 of 43
, 

Fill in this 1nformat1on to identify your case: 

i Debtor 1 

'Debtor 2 

(Spouse if, filing) 

Andy Devalcin First Name 

First Name 

Middle Name Last Name 

Middle Name Last Name 

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

(W known) O Check if this is an 

amended filing 

Official Form 106H 

Schedule H: Your Codebtors 12/15 

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

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

fill it out, and number the entries In the boxes on the left. Attach the Additional Page to this page. On the top of any Additional Pages, write 

your name and case number (if known). Answer every question. 

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

•No 

0Yes 

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

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

• No. Go to line 3. 

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

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

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

Form 106D), Schedule Elf (Official Form 106E/F), or Schedule G (Official Form 106G). Use Schedule D, Schedule E/F, or Schedule G to fill 

out Column 2. 

Column 1: Your codebtor 

Name, Number, sn.t, City, Slate and ZIP Code 

f 3.1 I 

Name 

Number Street 

City State 

i3.2 I Name 

Number Street 

City State 

• • 

Official Form 106H 

Software Copyright (c} 1996-2019 Best Case, LLC -www.bestcase.com 

ZIPCode 

ZIP Code 

• 

Column 2: The creditor to whom you owe th• debt 

Check an schedules that apply: 

D Schedule D, line 

r D Schedule E/F, line 

D Schedule G, line 

D Schedule D, line 

D Schedule Elf, line 

D Schedule G, line 

• • 

Schedule H: Your Codebtors Page 1of1 Best Case Bankruptcy 

, 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 22 of 43
Debtor 1 

Debtor 2 

(Spouse, iffiling) 

Andy Devalcin 

United States Bankruptcy Court for the: 

Case number 

(If known) 

SOUTHERN DISTRICT OF FLORIDA 

Official Form 1061 

Schedule I: Your Income 

Check if this is: 

D An amended filing 

D A supplement showing postpetition chapter 

13 income as of the following date: 

MM/DD/YYYY 

12/15 

Be as complete and accurate as possible. If two married people are filing together (Debtor 1 and Debtor 2), both are equally responsible for 

supplying correct information. If you are married and not filing jointly, and your spouse is living with you, include information about your 

spouse. If you are separated and your spouse Is not filing with you, do not include Information about your spouse. If more space Is needed, 

attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question. 

1:m;1 Describe Employment 

1. Fill in your employment 

information. 

If you have more than one job, 

attach a separate page with 

information about additional 

employers. 

Employment status* 

Occupation 

Include part-time, seasonal, or 

self-employed work. Employer's name 

Occupation may include student Employer's address 

or homemaker, if it applies. 

Debtor1 

•Employed •Employed 

D Not employed D Not employed 

cleaner 

Patrick Cleaning System 

Fort Lauderdale Airport 

How long employed there? 17 years 

*See Attachment for Additional Employment Information 

Hliif Give Details About Monthly Income 

, . , , . , . . . , . Estimate monthly Income as of the date you file this form. If you have nothing to report for any line, wnte $0 in the space. Include your non-fihng 

spouse unless you are separated. 

If you or your non-filing spouse have more than one employer, combine the information for all employers for that person on the lines below. If you need 

more space, attach a separate sheet to this form. 

2. 

3. 

4. 

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

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

Estimate and list monthly overtime pay. 

Calculate gross Income. Add line 2 + line 3. 

• • • 

2. $ 

3. +$ 

4. 

~ 

Official Form 1061 Schedule I: Your Income 

ForDeblor1 For Debtor 2 or 

................. 2,493.88 $ 0.00 

0.00 +$ 0.00 

2,49iii] I $ 0.00 I 

~ 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 23 of 43
Debtor1 Andy Devalcin Case number (if known) 

ForDebtor1 .For Deblor' 2 or 

................ Copy line 4 here 4. $ 2,493.88 $ 0.00 

5. List all payroll deductions: 

5a. Tax, Medicare, and Social Security deductions 5a. $ 435.89 $ 0.00 

5b. Mandatory contributions for retirement plans 5b. $ 0.00 $ 0.00 

5c. Voluntary contributions for retirement plans 5c. $ 0.00 $ 0.00 

5d. Required repayments of retirement fund loans 5d. $ 0.00 $ 0.00 

5e. Insurance 5e. $ 0.00 $ 0.00 

5f. Domestic support obligations 5f. $ 0.00 $ 0.00 

5g. Union dues 5g. $ 0.00 $ 0.00 

5h. Other deductions. Specify: SEU 5h.+ $ 37.42 + $ 0.00 

6. Add the payroll deductions. Add lines 5a+5b+5c+5d+5e+5f+5g+5h. 6. $ 473.31 $ 0.00 

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. $ 2,020.57 $ 0.00 

s. List all other Income regularly received: 

Sa. Net Income from rental property and from operating a business, 

profession, or farm 

Attach a statement for each property and business showing gross 

receipts, ordinary and necessary business expenses, and the total 

monthly net income. Sa. $ 0.00 $ 0.00 

Sb. Interest and dividends Sb. $ 0.00 $ 0.00 

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

regularly receive 

Include alimony, spousal support, child support, maintenance, divorce 

settlement, and property settlement. Sc. $ 0.00 $ 0.00 

Sd. Unemployment compensation Sd. $ 0.00 $ 0.00 

Se. Social Security Se. $ 0.00 $ 0.00 

Sf. Other government assistance that you regularly receive 

Include cash assistance and the value (if known) of any non-cash assistance 

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

Nutrition Assistance Program) or housing subsidies. 

Specify: Sf. $ 0.00 $ 0.00 

Sg. Pension or retirement income Sg. $ 0.00 $ 0.00 

Sh. Other monthly income. Specify: 2NDJOB; HMS Sh.+ $ 1,193.85 + $ 0.00 

,9. Add all other income. ldd lines Sa+Sb+Sc+Sd+Se+Sffg+Sh. 9,1$ 1,193.851 1$ • 0.00 1 

I 

10. I$ I I o.oo I =f 3,214.42 1 10. Calculate monthly income. Add line 7 + line 9. 3,214.421 + $ 

Add the entries in line 10 for Debtor 1 and Debtor 2 or non-filing spouse. 

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

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

other friends or relatives. 

Do not include any amounts already included in lines 2-10 or amounts that are not available to pay expenses listed in Schedule J. 

Specify: 11. +$ 0.00 

,----

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

Write that amount on the Summary of Schedules and Statistical Summary of Certain Liabilities and Related Data, if it 1 

applies 12. I $ __ 3_,2_1_4_.4_2~· 

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

• No. 

D Yes. Explain: C 

~--·~-------------

• • • 

Official Form 1061 Schedule I: Your Income 

• 

Combined 

monthly income 

____J 

• 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 24 of 43
Debtor 1 Andy Devalcin Case number (if known) 

Official Form B 61 

Attachment for Additional Employment Information 

Debtor 

Occupation pre-cook I 

Name of Employer Host International Inc 

How long employed 17 years 

Address of Employer Fort Lauderdale Airport 

• • • • • 

Official Form 1061 Schedule I: Your Income page3 

Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 25 of 43
Debtor 1 Andy Devalcin Check if this is: 

a An amended filing 

I

I DebkJr2 

(Spouse, if IUlg) 

0 A supplement showing poslpetilion chapter 

13 expenses as of the following date: 

I Ullited States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA MM/DD/YYYY 

1--- (lfknown) 

Official Form 106J 

Schedule J: Your Expenses 

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

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

number {If known). Answer every question. 

Describe Your Household 

1. Is this a joint case? 

• No. Go to line 2. 

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

DNo 

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

2. Do you have dependents? D No 

Do not list Debtor 1 and 

Debtor2. •Yes. Fill out this information for 

each dependent... .......... . 

Do not state the 

dependents names. 

, 

3. Do your expenses Include 

expenses of people other than 

yourself and your dependents? 

•No 

DYes 

Estimate Your Ongoing Monthly Expenses 

Dependent's relationship to 

Debtor 1 or Debtor 2 

Daughter 

Dependent's 

age 

Does dependent 

live with you? 

DNo 

•Yes 

DNo 

DYes 

DNo 

DYes 

DNo 

DYes 

12115 

Estimate your expenses as of your bankruptcy filing date unless you are using this form as a supplement in a Chapter 13 case to report 

expenses as of a date after the bankruptcy is filed. If this is a supplemental Schedule J, check the box at the top of the form and fill in the 

applicable date. 

Include expenses paid for with non-cash government assistance if you know 

the value of such assistance and have Included It on Schedule I: Your Income 

(Official Form 1061.) 

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

payments and any rent for the ground or lot. 

If not included in line 4: 

4a. Real estate taxes 

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

4c. • Home maintenance, repair, lid upkeep expenses • 

4d. Homeowner's association or condominium dues 

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

Official Form 106J Schedule J: Your Expenses 

Your expenses 

4. $ 1,000.00 

4a. $ 0.00 

4b. $ 0.00 

4c. t' - sl.oo 

4d. $ ---------0-.0-0 

5. $ 0.00 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 26 of 43
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Debtor 1 Andy Devalcin Case number (if known) 

G. Utilities: 

Ga. Electricity, heat, natural gas Ga. $ 210.00 

Gb. Water, sewer, garbage collection Gb. $ 40.00 

Ge. Telephone, cell phone, Internet, satellite, and cable services Ge. $ 100.00 

Gd. Other. Specify: Gd. $ 0.00 

7. Food and housekeeping supplies 7. $ 550.00 

8. Childcare and children's education costs 8. $ 0.00 

9. Clothing, laundry, and dry cleaning 9. $ 90.00 

10. Personal care products and services 10. $ 25.00 

11. Medical and dental expenses 11. $ 0.00 

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

Do not include car payments. 12. $ 300.00 

13. Entertainment, clubs, recreation, newspapers, magazines, and books 13. $ 90.00 

14. Charitable contributions and religious donations 14. $ 100.00 

15. Insurance. 

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

15a. Life insurance 15a. $ 0.00 

15b. Health insurance 15b. $ 116.00 

15c. Vehicle insurance 15c. $ 0.00 

15d. Other insurance. Specify: 15d. $ 0.00 

1G. Taxes. Do not include taxes deducted from your pay or included in lines 4 or 20. 

Specify: 1G. $ 0.00 

17. Installment or lease payments: 

17a. Car payments for Vehicle 1 17a. $ 0.00 

17b. Car payments for Vehicle 2 17b. $ 0.00 

17c. Other. Specify: 17c. $ 0.00 

17d. Other. Specify: 17d. $ 0.00 

18. Your payments of alimony, maintenance, and support that you did not report as 0.00 deducted from your pay on line 5, Schedule I, Your Income (Official Form 1061). 18. $ 

19. Other payments you make to support others who do not live with you. $ 400.00 

Specify: FAMILY INTERNATIONAL 19. 

20. Other real property expenses not Included In lines 4 or 5 of this form or on Schedule I: Your Income. 

20a. Mortgages on other property 20a. $ 0.00 

20b. Real estate taxes 20b. $ 0.00 

20c. Property, homeowners, or renter's insurance 20c. $ 0.00 

20d. Maintenance, repair, and upkeep expenses 20d. $ 0.00 

20e. Homeowner's association or condominium dues 20e. $ 0.00 

21. Other: Specify: 21. +$ 0.00 

22. Calculate your lonthly expenses , , , I 

22a. Add lines 4 through 21. $ 3,081.00 

I 22b. Copy line 22 (monthly expenses for Debtor 2), if any, from Official Form 1 OGJ-2 $ 

22c. Add line 22a and 22b. The result is your monthly expenses. I $ 3,081.00 ~ I 

23. Calculate your monthly net income. 

23a. Copy line 12 (your combined monthly income) from Schedule I. 23a. $ 3,214.42 

23b. Copy your monthly expenses from line 22c above. 23b. -$ 3,081.00 

23c. Subtract your monthly expenses from your monthly income. I 133.42 The result is your monthly net income. 23c. I$ 

24. Do you expect an increase or decrease in your expenses within the year after you file this form? 

For example, do you expect to finish paying for your car loan within the year or do you expect your mortgage payment to increase or decrease because of a 

modification to the terms of your mortgage? 

•No. 

DYes. 1 Explain here: - ------------ ---------------------

• • • • • 

Official Form 1 OGJ Schedule J: Your Expenses page2 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 27 of 43
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Fill in this 1nformat1011 to 1dent1fy your case. 

Debtor 1 

Debtor 2 

(Spouse if, filing) 

Andy Devalcin First Name 

First Name 

Middle Name Last Name 

Middle Name Last Name 

;,::: B-an_k_ru_p-tc_y_C_o_u_rt __ i_or_th_e_: __ S_O_U_T_H_E_R_N DISTRICT OF FLOR-ID_A _________ _ 

Official Form 106Dec 

Declaration About an Individual Debtor's Schedules 

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

I 

I 

D Check if this is an 

amended filing 

12115 

You must file this form whenever you file bankruptcy schedules or amended schedules. Making a false statement, concealing property, or 

obtaining money or property by fraud In connection with a bankruptcy case can result In fines up to $250,000, or imprisonment for up to 20 

years, or both.18 U.S.C. §§ 152, 1341, 1519, and 3571. 

Sign Below 

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

D No 

• Yes. Name of person Fabiola Bouchette Attach Bankruptcy Petition Preparer's Notice, ----------------------- Declaration, and Signature (Official Form 119) 

Under penalty of perjury, I declare that I have read the summary and schedules flied with this declaration and 

that they are true and correct. 

X Isl And Devficin 

Andy Devalcin 

Signature of Debtor 1 

Date June 12, 2019 

• 

Official Form 106Dec 

x 

Signature of Debtor 2 

Date 

• • 

Declaration About an Individual Debtor's Schedules 

Software Copyright (c) 1996-2019 Best Case, LLC -www.bestcase.com 

• • 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 28 of 43
, 

Fill in this 1nformat1on to identify your case: 

. Debtor 1 Andy Devalcin 

Debtor 2 

(Spouse if, filing) 

First Name 

First Name 

Middle Name Last Name 

Middle Name Last Name 

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

(if known) 

Official Form 107 

I 

~~~~~-~~~~·_J D Check if this is an 

amended filing 

Statement of Financial Affairs for Individuals Filing for Bankruptcy 4/19 

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. 

ipmlM Give Details About Your Marital Status and Where You Lived Before 

1. What is your current marital status? 

D Married 

• Not married 

2. During the last 3 years, have you lived anywhere other than where you live now? 

• No 

D Yes. List all of the places you lived in the last 3 years. Do not include where you live now. 

Debtor 1 Prior Address: Datu Debtor 1 

llved there 

Debtor 2 Prior Address: Dates Debtor 2 

lived there 

3. Within the last 8 years, did you ever live with a spouse or legal equivalent in a community property state or territory? (Community property 

states and territories include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington and Wisconsin.) 

• No , , , , , 

D Yes. Make sure you fill out Schedule H: Your Codebtors (Official Form 106H). 

Explain the Sources of Your Income 

4. Did you have any income from employment or from operating a business during this year or the two previous calendar years? 

Fill in the total amount of income you received from all jobs and all businesses, including part-time activities. 

If you are filing a joint case and you have income that you receive together, list it only once under Debtor 1. 

D No 

• Yes. Fill in the details. 

From January 1 of current year until 

the date you filed for bankruptcy: 

• 

Debtor1 

Sources of income 

Check all that apply. 

• Wages, commissions, 

bonuses, tips 

D'operating a business 

Gross income 

(before deductions and 

exclusions) 

$18,501.00 

• 

Debtor2 

Sources of income 

Check all that apply. 

D Wages, commissions, 

bonuses, tips 

D Oplrating a business 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy 

Software Copyright (c) 1996-2019 Best Case. LLC - www.bestcase.com 

Gross income 

(before deductions 

and exclusions) 

• 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 29 of 43
Debtor 1 Andy Devalcin 

For last calendar year: 

(January 1 to December 31, 2018 ) 

For the calendar year before that: 

(January 1 to December 31, 2017) 

Debtor 1 

Sources of income 

Check all that apply. 

• Wages, commissions, 

bonuses, tips 

D Operating a business 

• Wages, commissions, 

bonuses, tips 

D Operating a business 

Case number (if known) 

Debtor 2 

Gross income Sources of income 

(before deductions and Check all that apply. 

exdusions) 

$39,577.00 D Wages, commissions, 

bonuses, tips 

D Operating a business 

$24,034.00 D Wages, commissions, 

bonuses, tips 

D Operating a business 

5. Did you receive any other income during this year or the two previous calendar years? 

Gross income 

(before deductions 

and exdusions) 

Include income regardless of whether that income is taxable. Examples of other income are alimony; child support; Social Security, unemployment, 

and other public benefit payments; pensions; rental income; interest; dividends; money collected from lawsuits; royalties; and gambling and lottery 

winnings. If you are filing a joint case and you have income that you received together, list it only once under Debtor 1. 

List each source and the gross income from each source separately. Do not include income that you listed in line 4. 

• No 

D Yes. Fill in the details. 

Debtor1 

Sources of income 

Describe below. 

Gross income from 

each source 

(before deductions and 

exclusions) 

HMM List Certain Payments You Made Before You Flied for Bankruptcy 

6. Are either Debtor 1 's or Debtor 2's debts primarily consumer debts? 

Debtor 2 

Sources of Income 

Describe below. 

Gross Income 

(before deductions 

and exclusions) 

D No. Neither Debtor 1 nor Debtor 2 has 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." 

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $6,825* or more? 

D No. Go to line 7. 

D,.ves List below each credit'f'to whom you paid a total of $~25* or more in one or more ¥.ments and the total amount "11! 

paid that creditor. Do not include payments for domestrc support obligations, such as child support and alimony. Also, do 

not include payments to an attorney for this bankruptcy case. 

* Subject to adjustment on 4/01/22 and every 3 years after that for cases filed on or after the date of adjustment. 

• Yes. Debtor 1 or Debtor 2 or both have primarily consumer debts. 

During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $600 or more? 

•No. 

D Yes 

Go to line 7. 

List below each creditor to whom you paid a total of $600 or more and the total amount you paid that creditor. Do not 

include payments for domestic support obligations, such as child support and alimony. Also, do not include payments to an 

attorney for this bankruptcy case. 

Creditor's Name and Address Dates of payment Total amount 

paid 

Amount you 

still owe 

Was this payment for ••• 

• • • • • 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com Best Case Bankruptcy 

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Debtor 1 Andy Devalcin Case number (if known) 

7. Within 1 year before you filed for bankruptcy, did you make a payment on a debt you owed anyone who was an insider? 

Insiders include your relatives; any general partners; relatives of any general partners; partnerships of which you are a general partner; corporations 

of which you are an officer, director, person in control, or owner of 20% or more of their voting securities; and any managing agent, including one for 

a business you operate as a sole proprietor. 11 U.S.C. § 101. Include payments for domestic support obligations, such as child support and 

alimony. 

• No 

D Yes. List all payments to an insider. 

Insider's Name and Address Dates of payment Total amount 

paid 

Amount you 

still owe 

Reason for this payment 

8. Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account of a debt that benefited an 

insider? 

Include payments on debts guaranteed or cosigned by an insider. 

• No 

D Yes. List all payments to an insider 

Insider's Name and Address Dates of payment 

lqtDtM Identify Legal Actions, Repossessions, and Foreclosures 

Total amount 

paid 

Amount you 

still owe 

Reason for this payment 

Include creditor's name 

9. Within 1 year before you filed for bankruptcy, were you a party in any lawsuit, court action, or administrative proceeding? 

List all such matters, including personal injury cases, small claims actions, divorces, collection suits, paternity actions, support or custody 

modifications, and contract disputes. 

D No 

• Yes. Fill in the details. 

Case title Nature of the case Court or agency Status of the case 

Case number 

mi Midland Funding LLC vs Andy 

Devalcin 

2019-003722-SP-25 

Civil Miami Dade Clerk of Court 

73 West Flagler 

Miami, FL 33130 

• Pending 

D On appeal 

D Concluded 

10. Within 1 year before you filed for bankruptcy, was any of your property repossessed, foreclosed, garnished, attached, seized, or levied? 

Check all that apply and fill in the details below. 

D No. Go t<Kine 11. 

• Yes. Fill in the information below. 

Creditor Name and Address 

Capital One Auto Finance 

7933 Preston Rd 

Plano, TX 75024 

Describe the Property 

Explain what happened 

2015 toyota Tacoma 

• Property was repossessed. 

D Property was foreclosed. 

D Property was garnished. 

D Property was attached, seized or levied. 

Date Value of the 

property 

$24,631.00 

11. Within 90 days before you filed for bankruptcy, did any creditor, Including a bank or financial Institution, set off any amounts from your 

accounts or refuse to make a payment because you owed a debt? 

• No 

D Yes. Fill in the details. 

C.ditor Name and Address e Describe the ac'if:>n the creditor took • 

Official Form 107 Statement of Financial Affairs for Individuals Fiiing for Bankruptcy 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 

Date action was 

taken • Amount 

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Debtor 1 Andy Devalcin Case number (if known) 

12. Within 1 year before you filed for bankruptcy, was any of your property in the possession of an assignee for the benefit of creditors, a 

court-appointed receiver, a custodian, or another official? 

• No 

D Yes 

l@fW List Certain Gifts and Contributions 

13. Within 2 years before you flied for bankruptcy, did you give any gifts with a total value of more than $600 per person? 

• No 

D Yes. Fill in the details for each gift. 

Gifts with a total value of more than $600 

per person 

Person to Whom You Gave the Gift and 

Address: 

Describe the gifts Dates you gave 

the gifts 

Value 

14. Within 2 years before you flied for bankruptcy, did you give any gifts or contributions with a total value of more than $600 to any charity? 

• No 

D Yes. Fill in the details for each gift or contribution. 

Gifts or contributions to charities that total Describe what you contributed 

more than $600 

Charity's Name 

Address (Number, Street, City, State and ZIP Code) 

ipi!i!IM List Certain Losses 

Dates you 

contributed 

Value 

15. Within 1 year before you filed for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, fire, other disaster, 

or gambling? 

• No 

D Yes. Fill in the details. 

Describe the property you lost and 

how the loss occurred 

ipi!i!IM List Certain Payments or Transfers 

Describe any insurance coverage for the loss 

Include the amount that insurance has paid. List pending 

insurance claims on line 33 of Schedule AIB: Property. 

Date of your 

loss 

Value of property 

lost 

16. Within 1 year before you flied for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you 

consulted abce seeking bankruptcy or prefltring a bankruptcy petition• ' ' 

Include any attorneys, bankruptcy petition preparers, or credit counseling agencies for services required in your bankruptcy. 

0 No 

• Yes. Fill in the details. 

Person Who Was Paid 

Address 

Email or website address 

Person Who Made the Payment, if Not You 

123 Credit Counselors Inc 

6161 Blue Lagoon Drive 

Suite 255A 

Miami, FL 33126 

Fabiola Bouchette 

1561 NE 167th Street 

Miami, FL 33162 

Description and value of any property 

transferred 

bankruptcy class 

bankruptcy preparatu=ion 

---··------·-------

• • • • 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy 

Software Copyright (c) 1996-2019 Best Case. LLC - www.bestcase.com 

Date payment 

or transfer was 

made 

Amount of 

payment 

$30.00 

---------··---------

06/2019 $495.00 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 32 of 43
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Debtor 1 Andy Devalcin Case number (if known) 

17. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone who 

promised to help you deal with your creditors or to make payments to your creditors? 

Do not include any payment or transfer that you listed on line 16. 

• No 

D Yes. Fill in the details. 

Person Who Was Paid 

Address 

Description and value of any property 

transferred 

Date payment 

or transfer was 

made 

Amount of 

payment 

18. Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property 

transferred in the ordinary course of your business or financial affairs? 

Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property). Do not 

include gifts and transfers that you have already listed on this statement. 

• No 

D Yes. Fill in the details. 

Person Who Received Transfer 

Address 

Person's relationship to you 

Desc:ripllon and value of 

property transt8rred 

Describe any property or 

payments recelV'ed or debts 

paid In exchange 

Date transfer was 

made 

19. Within 1 O years before you filed for bankruptcy, did you transfer any property to a self-settled trust or similar device of which you are a 

beneficiary? (These are often called asset-protection devices.) 

• No 

D Yes. Fill in the details. 

Name of trust Description and value of the property transferred 

l@l:W List of Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units 

Date Transfer was 

made 

20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed, 

sold, moved, or transferred? 

Include checking, savings, money market, or other financial accounts; certificates of deposit; shares in banks, credit unions, brokerage 

houses, pension funds, cooperatives, associations, and other financial institutions • 

• No 

D Yes. Fill in the details. 

Name of Financial Institution and 

Address (Number, Streat, City, State and ZIP 

Code) 

Last 4 digits of 

account number 

Type of account or 

instrument 

Date account was 

closed, sold, 

moved,~ 

transfer ... d 

Last balance 

before closing or 

tr,, fer 

21. Do you now have, or did you have within 1 year before you filed for bankruptcy, any safe deposit box or other depository for securities, 

cash, or other valuables? 

• No 

C Yes. Fill in the details. 

Name of Financial Institution 

Address (Number, Street, City, State and ZIP Code) 

Who else had access to it? 

Address (Number, Street, City, 

S- and ZIP Code) 

Describe the contents 

22. Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy? 

• No 

C Yes. Fill in the details. 

Name of Storage Facility 

Address (Number, Street, City, State and ZIP Code) 

• • 

Who else has or had access 

to it? 

Address (Number, Street, City, 

State and ZIP Code) 

• 

Describe the contents 

• 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy 

Software Copyright (c) 1996-2019 Best Case. LLC • www.bestcase.com 

Do you still 

have it? 

Do you still 

have it? 

• 

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, 

Debtor 1 Andy Devalcin Case number (it known) 

Hl!iM Identify Property You Hold or Control for Someone Else 

23. Do you hold or control any property that someone else owns? Include any property you borrowed from, are storing for, or hold in trust 

for someone • 

• No 

C Yes. Fill in the details. 

Owner's Name 

Address (Number, Street, City, s- and ZIP Code) 

Where is the property? 

(Number, Street, City, State and ZIP 

Code) 

lillfill1M Give Details About Environmental Information 

For the purpose of Part 10, the following definitions apply: 

Describe the property Value 

• Environmental law means any federal, state, or local statute or regulation concerning pollution, contamination, releases of hazardous or 

toxic substances, wastes, or material Into the air, land, soll, surface water, groundwater, or other medium, Including statutes or 

regulations controlling the cleanup of these substances, wastes, or material. 

• Site means any location, facility, or property as defined under any environmental law, whether you now own, operate, or utilize it or used 

to own, operate, or utlllze it, including disposal sites. 

• Hazardous material means anything an environmental law defines as a hazardous waste, hazardous substance, toxic substance, 

hazardous material, pollutant, contaminant, or similar term. 

Report all notices, releases, and proceedings that you know about, regardless of when they occurred. 

24. Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental law? 

• No 

C Yes. Fill in the details. 

Name of site 

Address (Number, Street, City, Steta and ZIP Code) 

Governmental unit 

Address (Number, Street, City, State and 

ZIP Code) 

25. Have you notified any governmental unit of any release of hazardous material? 

• No 

C Yes. Fill in the details. 

Name of site 

Address (Number, Streat, City, Steta and ZIP Code) 

" 

Governmental unit 

Address (Number, Streat, City, State and 

.Code) " 

Environmental law, if you 

know It 

Environmental law, if you 

know it 

" 

Date of notice 

Date of notice 

26. Have you been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders • 

• No 

C Yes. Fill in the details. 

Case Title 

Case Number 

Court or agency 

Name 

Address (Number, Streat, City, 

State and ZIP Code) 

lillfillM Give Details About Your Business or Connections to Any Business 

Nature of the case Status of the 

case 

27. Within 4 years before you filed for bankruptcy, did you own a business or have any of the following connections to any business? 

C A sole proprietor or self-employed In a trade, profession, or other activity, either full-time or part-time 

C A member of a limited liability company (LLC) or limited liability partnership (LLP) 

C A partner in a partnership 

C An officer, director, or managing executive of a corporation 

C • • • • An owner of at least 5% of the voting or equity securities of a corporation • 

, 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page6 

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Debtor 1 Andy Devalcin Case number (if known) 

• No. None of the above applies. Go to Part 12. 

D Yes. Check all that apply above and fill in the details below for each business. 

Business Name Describe the nature of the business Employer Identification number 

Address Do not Include Social Security number or ITIN. 

(Number, Street, City, Stmte •nd ZIP Code) Name of accountant or bookkeeper 

Dates business existed 

28. Within 2 years before you filed for bankruptcy, did you give a financial statement to anyone about your business? Include all financial 

institutions, creditors, or other parties . 

• No 

D Yes. Fill in the details below. 

Name 

Address 

(Number, Street, City, S- and ZIP Codm) 

l:tMltM Sign Below 

Date Issued 

I have read the answers on this Statement of Financial Affairs and any attachments, and I declare under penalty of perjury that the answers 

are true and correct. I understand that 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. -1------~ 

Signature of Debtor 2 

Date June 12, 2019 Date 

Did you attach additional pages to Your Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107)? 

•No 

DYes 

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

DNo 

• Yes. Name of Person Fabiola Bouchette . Attach the Bankruptcy Petition Preparers Notice, Declaration, and Signature (Official Form 119). 

, 

• • • • • 

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Fill in this information to identify your case: 

Debtor 1 

Debtor 2 

(Spouse if, filing} 

Andy Devalcin First Name 

First Name 

Middle Name Last Name 

Middle Name Last Name 

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA 

Case number 

(~known) 

Official Form 108 

Statement of Intention for Individuals Filing Under Chapter 7 

If you are an individual filing under chapter 7, you must fill out this form if: 

• creditors have clalms secured by your property, or 

• you have leased personal property and the lease has not expired. 

D Check if this is an 

amended filing 

12/15 

You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors, 

whichever is earlier, unless the court extends the time for cause. You must also send copies to the creditors and lessors you list 

on theform 

If two married people are filing together in a joint case, both are equally responsible for supplying correct information. Both debtors must 

sign and date the form. 

Be as complete and accurate as possible. 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). 

ipiM List Your Creditors Who Have Secured Claims 

1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 1060), fill in the 

information below. 

~ .............. ,...."' ..... Cl .... nil r 

Creditor's 

name: 

Description of , 

property 

securing debt: 

Creditor's 

name: 

Description of 

property 

securing debt: 

Creditor's 

name: 

Description of 

property 

securing debt: 

Creditor's 

What do you Intend to do with the property that 

secures a debt? 

D Surrender the property. 

D Retain the property and redeem it. 

D Retain the property an;.enter into a 

Reaffirmation Agreement. 

D Retain the property and [explain): 

D Surrender the property. 

D Retain the property and redeem it. 

D Retain the property and enter into a 

Reaffirmation Agreement. 

D Retain the property and [explain): 

D Surrender the property. 

D Retain the property and redeem it. 

D Retain the property and enter into a 

Reaffirmation Agreement. 

D Retain the property and (explain]: 

D Surrender the property. 

Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 

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Did you claim the property 

as exempt on Schedule C? 

DNo 

DYes 

DNo 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 36 of 43
Debtor 1 Andy Devalcin 

name: 

Description of 

property 

securing debt: 

IMtM List Your Unexpired Personal Property Leases 

Case number (if known) 

D Retain the property and redeem it. 

D Retain the property and enter into a 

Reaffirmation Agreement. 

D Retain the property and [explain]: 

DYes 

For any unexpired personal property lease that you listed in Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G), fill 

in the information below. Do not list real estate leases. Unexpired leases are leases that are still in effect; the lease period has not yet ended. 

You may assume an unexpired personal property lease If the trustee does not assume it. 11 U.S.C. § 365(p)(2). 

Describe your unexpired pertonal property leases 

Lessor's name: 

Description of leased 

Property: 

Lessor's name: 

Description of leased 

Property: 

Lessor's name: 

Description of leased 

Property: 

Lessor's name: 

Description of leased 

Property: 

Lessor's name: 

Description of leased 

Property: 

Lessor's name: 

Description of leased 

, Property: 

Lessor's name: 

Description of leased 

Property: 

IMM Sign Below 

, 

Will the lease be assumed? 

D No 

D Yes 

D No 

D Yes 

D No 

D Yes 

D No 

D Yes 

D No 

D Yes 

D No 

, D Yr 

D No 

D Yes 

Under penalty of perjury, I declare that I have indicated my intention about any property of my estate that secures a debt and any personal 

property that is subject to an unexpired lease. 

X /s/ Andy Devalcin 

Andy Devalcin 

Signature of Debtor 1 

Date June 12, 2019 

• • 

x 

Signature of Debtor 2 

Date 

• • 

Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 

Software Copyright (c) 1996-2019 Best Case. LLC -www.bestcase.com 

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

Individuals Filing for Bankruptcy (Form 201 O) 

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 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) 

Software Copyright (c) 1996-2019 Best Case, LLC - www.bestcase.com 

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 

fbe responsible to pay: r r 

most taxes; 

most student loans; 

domestic support and property settlement 

obligations; 

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Case 19-18137-LMI Doc 1 Filed 06/19/19 Page 38 of 43
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 ~bove the median for you~ state, you 

must file a seconft' form -the Chapter 7 Mbans 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 

• • • 

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

Software Copyright (c) 1996-2019 Best Case. LLC • www.bestcase.com 

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 admi.fistrative fee , 

$1,717 totalfee 

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

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

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. I 

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

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 

$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) 

Software Copyright (c) 1996-2019 Best Case. LLC - www.bestcase.com 

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 ojligations, 

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. 

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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 Bankrup~y (Official Form 101 ). Tj>ensure 

that you receive i~ormation 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) 

Software Copyright (c) 1996-2019 Best Case, LLC -www.bestcase.com 

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/usUeo/hapcpa/ccde/cc approved.html 

In Alabama and North Carolina, go to: 

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

BankruptcyResources/ApprovedCredit 

AndDebtCounselors.aspx. 

If ~ou do not have access ~ a computer, the clerk of 

t~ bankruptcy court may 1'e able to help you obtairf 

the list. 

• • 

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In re Andy Devalcin 

United States Bankruptcy Court 

Southern District of Florida 

Debtor(s) 

Case No. 

Chapter _7 ________ _ 

VERIFICATION OF CREDITOR MATRIX 

The above-named Debtor hereby verifies that the attached list of creditors is true and correct to the best of his/her knowledge. 

Date: June 12, 2019 

, , 

• • 

Software Copyright (c) 1996-2019 Best Case. LLC - www.bestcase.com 

Isl Andy Devalcin 

Andy Devalcin 

Signature of Debtor 

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• • 

Capital One Auto Finance 

Po Box 259407 

Plano, TX 75025 

Capital One Auto Finance 

7933 Preston Rd 

Plano, TX 75024 

Midland Funding LLC 

8875 Aero Drive 

Suite 200 

San Diego, CA 92123 

Molly Fitzpatrick, Esq 

Po Box 2 90335 

Tampa, FL 33687 

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