12/26/19 11:20AM

Fill in this information to identify your case:

Debtor 1 Mariann M Davis

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA

Case number 19-26168

(if known)  Check if this is an

amended filing

Official Form 108

Statement of Intention for Individuals Filing Under Chapter 7 12/15

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

 creditors have claims secured by your property, or

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

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 the form

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).

Part 1: 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 106D), fill in the

information below.

Identify the creditor and the property that is collateral What do you intend to do with the property that

secures a debt?

Did you claim the property

as exempt on Schedule C?

Creditor's Pnc Mortgage  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 5719 Place Lake Dr Fort Pierce, Reaffirmation Agreement.

FL 34951 Saint Lucie County

Lot 277, Portofino Shores,

Phase three, according to the

map of plat thereof, as recorded

in Plat book 43, page 40, of the

public records of St. Lucie

County, Florida

property  Retain the property and [explain]:

securing debt:

 Negotiate Repayment Terms with Lender

Creditor's Portofino Shores Property Owners

Assoc.

 Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 5719 Place Lake Dr Fort Pierce, Reaffirmation Agreement.

FL 34951 Saint Lucie County

Lot 277, Portofino Shores,

Phase three, according to the

map of plat thereof, as recorded

in Plat book 43, page 40, of the

Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 page 1

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

Case 19-26168-MAM Doc 23 Filed 12/26/19 Page 1 of 2
12/26/19 11:20AM

Debtor 1 Mariann M Davis Case number (if known) 19-26168

public records of St. Lucie

County, Florida

property  Retain the property and [explain]:

securing debt: Negotiate Repayment Terms with Lender

Creditor's Santander Consumer USA  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Description of 2016 Nissan Altima Reaffirmation Agreement.

1N4AL3AP3GC248394 1

OWNER

property  Retain the property and [explain]:

securing debt: Negotiate Repayment Terms with Lender

Part 2: List Your Unexpired Personal Property Leases

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 personal property leases Will the lease be assumed?

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Part 3: Sign Below

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/ Mariann M Davis X

Mariann M Davis Signature of Debtor 2

Signature of Debtor 1

Date December 26, 2019 Date

Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 page 2

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

Case 19-26168-MAM Doc 23 Filed 12/26/19 Page 2 of 2