Fill in this information to identify your case:

United States Bankruptcy Court for the:

SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known) Chapter 11

 Check if this an amended

filing

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy 04/20

If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor's name and the case number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

1. Debtor's name 7701 SW 120th Street LLC

2. All other names debtor used in the last 8 years

Include any assumed

names, trade names and

doing business as names

3. Debtor's federal Employer

Identification Number

(EIN)

83-1556010

4. Debtor's address Principal place of business Mailing address, if different from principal place of

business

9620 NE 2nd Ave

Ste 203

Miami Shores, FL 33138-2749

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

Miami-Dade Location of principal assets, if different from principal

County place of business

9620 NE 2nd Ave Ste 203 Miami Shores, FL

33138-2749

Number, Street, City, State & ZIP Code

5. Debtor's website (URL)

6. Type of debtor  Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP))

 Partnership (excluding LLP)

 Other. Specify:

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 1 of 26
Debtor 7701 SW 120th Street LLC Case number (if known) Name

7. Describe debtor's business A. Check one:

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

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

 Railroad (as defined in 11 U.S.C. § 101(44))

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

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

 Clearing Bank (as defined in 11 U.S.C. § 781(3))

None of the above

B. Check all that apply

Tax-exempt entity (as described in 26 U.S.C. §501)

 Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C. §80a-3)

 Investment advisor (as defined in 15 U.S.C. §80b-2(a)(11))

C. NAICS (North American Industry Classification System) 4-digit code that best describes debtor.

 See http://www.uscourts.gov/four-digit-national-association-naics-codes.

8. Under which chapter of the Bankruptcy Code is the debtor filing?

A debtor who is a “small

business debtor” must check

the first sub-box. A debtor as defined in § 1182(1) who

elects to proceed under subchapter V of chapter 11

(whether or not the debtor is a “small business debtor”) must check the second sub-box.

Check one:

 Chapter 7

 Chapter 9

 Chapter 11. Check all that apply:  The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and its aggregate

noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than

$2,725,625. If this sub-box is selected, attach the 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).  The debtor is a debtor as defined in 11 U.S.C. § 1182(1), its aggregate noncontingent liquidated debts

(excluding debts owed to insiders or affiliates) are less than $7,500,000, and it chooses to proceed

under Subchapter V of Chapter 11. If this sub-box is selected, attach the 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).  A plan is being filed with this petition.

 Acceptances of the plan were solicited prepetition from one or more classes of creditors, in

accordance with 11 U.S.C. § 1126(b).  The debtor is required to file periodic reports (for example, 10K and 10Q) with the Securities and

Exchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File the

attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11 (Official

Form 201A) with this form.  The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule 12b-2.

 Chapter 12

9. Were prior bankruptcy

cases filed by or against the debtor within the last 8

years?

 No.

Yes.

If more than 2 cases, attach a

separate list. District When Case number

District When Case number

10. Are any bankruptcy cases pending or being filed by a business partner or an

affiliate of the debtor?

 No

Yes.

List all cases. If more than 1, attach a separate list Debtor Relationship

District When Case number, if known

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 2

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 2 of 26
Debtor 7701 SW 120th Street LLC Case number (if known) Name

11. Why is the case filed in

this district?

Check all that apply:  Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days immediately

preceding the date of this petition or for a longer part of such 180 days than in any other district.  A bankruptcy case concerning debtor's affiliate, general partner, or partnership is pending in this district.

12. Does the debtor own or have possession of any

real property or personal

property that needs

immediate attention?

 No

Yes. Answer below for each property that needs immediate attention. Attach additional sheets if needed. Why does the property need immediate attention? (Check all that apply.)

It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or safety. What is the hazard?

It needs to be physically secured or protected from the weather. It includes perishable goods or assets that could quickly deteriorate or lose value without attention (for example,

livestock, seasonal goods, meat, dairy, produce, or securities-related assets or other options).  Other

Where is the property?

Number, Street, City, State & ZIP Code

Is the property insured?

 No

Yes.

Insurance agency

Contact name

Phone

Statistical and administrative information

13. Debtor's estimation of available funds. Check one:

Funds will be available for distribution to unsecured creditors. After any administrative expenses are paid, no funds will be available to unsecured creditors.

14. Estimated number of creditors  1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than100,000

15. Estimated Assets  $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

16. Estimated liabilities  $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 3

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 3 of 26
Debtor 7701 SW 120th Street LLC Case number (if known) Name

Request for Relief, Declaration, and Signatures WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment

for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

17. Declaration and signature of authorized

representative of debtor The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this petition.

I have been authorized to file this petition on behalf of the debtor.

I have examined the information in this petition and have a reasonable belief that the information is true and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on June 15, 2020

MM / DD / YYYY

X /s/ John Aaron John Aaron

Signature of authorized representative of debtor Printed name

Title Manager

18. Signature of attorney X /s/ Chad Van Horn Date June 15, 2020

Signature of attorney for debtor MM / DD / YYYY

Chad Van Horn

Printed name

Van Horn Law Group, P.A.

Firm name

330 N Andrews Ave Ste 450

Fort Lauderdale, FL 33301-1012

Number, Street, City, State & ZIP Code

Contact phone (954) 765-3166 Email address chad@cvhlawgroup.com

64500

Bar number and State

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 4

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 4 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206A/B

Schedule A/B: Assets - Real and Personal Property 12/15

Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest. Include

all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts or unexpired

leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).

Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.

For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form. Part 1: Cash and cash equivalents

1. Does the debtor have any cash or cash equivalents?

 No. Go to Part 2.

Yes Fill in the information below. All cash or cash equivalents owned or controlled by the debtor Current value of

debtor's interest

3. Checking, savings, money market, or financial brokerage accounts (Identify all)

Name of institution (bank or brokerage firm) Type of account Last 4 digits of account

number

3.1. Regions Bank Business Checking checking 1446 $-10.00

4. Other cash equivalents (Identify all)

5. Total of Part 1. $-10.00

Add lines 2 through 4 (including amounts on any additional sheets). Copy the total to line 80.

Part 2: Deposits and Prepayments

6. Does the debtor have any deposits or prepayments?

 No. Go to Part 3.

Yes Fill in the information below.

Part 3: Accounts receivable

10. Does the debtor have any accounts receivable?

 No. Go to Part 4.

Yes Fill in the information below.

Part 4: Investments

13. Does the debtor own any investments?

 No. Go to Part 5.

Yes Fill in the information below. Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 1

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 5 of 26
Debtor 7701 SW 120th Street LLC Case number (If known)

Name

Part 5: Inventory, excluding agriculture assets

18. Does the debtor own any inventory (excluding agriculture assets)?

 No. Go to Part 6.

Yes Fill in the information below.

Part 6: Farming and fishing-related assets (other than titled motor vehicles and land)

27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?

 No. Go to Part 7.

Yes Fill in the information below.

Part 7: Office furniture, fixtures, and equipment; and collectibles

38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?

 No. Go to Part 8.

Yes Fill in the information below.

Part 8: Machinery, equipment, and vehicles

46. Does the debtor own or lease any machinery, equipment, or vehicles?

 No. Go to Part 9.

Yes Fill in the information below.

Part 9: Real property

54. Does the debtor own or lease any real property?

 No. Go to Part 10.

Yes Fill in the information below.

55. Any building, other improved real estate, or land which the debtor owns or in which the debtor has an interest

Description and location of

property

Include street address or other description such as Assessor Parcel Number (APN), and type of

property (for example, acreage,

factory, warehouse, apartment or office building, if available.

Nature and extent of debtor's

interest in

property

Net book value of

debtor's interest

(Where available)

Valuation method used

for current value Current value ofdebtor's interest

55.1. 7701 SW 120th St,

Pinecrest, FL

33156-5238

SUNILAND ESTS 1ST

ADD PB 50-58

LOT 3 BLK 4 F/A/U

30-5010-002-0030

OR 20087-4518

122001 4

COC 24546-2761 12

2001 5

Investment

Property $430,127.00 Miami-Dade Prope $430,127.00

56. Total of Part 9. $430,127.00

Add the current value on lines 55.1 through 55.6 and entries from any additional sheets. Copy the total to line 88.

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 2

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 6 of 26
Debtor 7701 SW 120th Street LLC Case number (If known)

Name

57. Is a depreciation schedule available for any of the property listed in Part 9?

 No

Yes

58. Has any of the property listed in Part 9 been appraised by a professional within the last year?

 No

Yes

Part 10: Intangibles and intellectual property

59. Does the debtor have any interests in intangibles or intellectual property?

 No. Go to Part 11.

Yes Fill in the information below.

Part 11: All other assets

70. Does the debtor own any other assets that have not yet been reported on this form?

Include all interests in executory contracts and unexpired leases not previously reported on this form.  No. Go to Part 12.

Yes Fill in the information below.

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 3

Software Copyright (c) 2020 CINGroup - www.cincompass.com 

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 7 of 26
Debtor 7701 SW 120th Street LLC Case number (If known)

Name

Part 12: Summary

In Part 12 copy all of the totals from the earlier parts of the form

Type of property Current value of

personal property

Current value of real

property

80. Cash, cash equivalents, and financial assets. Copy line 5, Part 1 $-10.00

81. Deposits and prepayments. Copy line 9, Part 2. $0.00

82. Accounts receivable. Copy line 12, Part 3. $0.00

83. Investments. Copy line 17, Part 4. $0.00

84. Inventory. Copy line 23, Part 5. $0.00

85. Farming and fishing-related assets. Copy line 33, Part 6. $0.00

86. Office furniture, fixtures, and equipment; and collectibles. Copy line 43, Part 7. $0.00

87. Machinery, equipment, and vehicles. Copy line 51, Part 8. $0.00

88. Real property. Copy line 56, Part 9.........................................................................................> $430,127.00

89. Intangibles and intellectual property. Copy line 66, Part 10. $0.00

90. All other assets. Copy line 78, Part 11. + $0.00

91. Total. Add lines 80 through 90 for each column $-10.00 + 91b. $430,127.00

92. Total of all property on Schedule A/B. Add lines 91a+91b=92 $430,117.00

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 4

Software Copyright (c) 2020 CINGroup - www.cincompass.com 

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 8 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206D

Schedule D: Creditors Who Have Claims Secured by Property 12/15

Be as complete and accurate as possible.

1. Do any creditors have claims secured by debtor's property?

No. Check this box and submit page 1 of this form to the court with debtor's other schedules. Debtor has nothing else to report on this form. Yes. Fill in all of the information below. Part 1: List Creditors Who Have Secured Claims

2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one secured

claim, list the creditor separately for each claim.

Column A

Amount of claim

Do not deduct the value

of collateral.

Column B

Value of collateral

that supports this

claim

2.1 Forethought Life Insurance

Company Describe debtor's property that is subject to a lien $680,000.00 $430,127.00

Creditor's Name 7701 SW 120th St, Pinecrest, FL 33156-5238

SUNILAND ESTS 1ST ADD PB 50-58 LOT 3

BLK 4 F/A/U 30-5010-002-0030 OR

20087-4518 122001 4 COC 24546-2761 12

2001 5

Robert Michael Arena Jr.,

President

10 W Market St Ste 2300

Indianapolis, IN

46204-2954

Creditor's mailing address Describe the lien

Is the creditor an insider or related party?

 No

Creditor's email address, if known Yes

Is anyone else liable on this claim?

Date debt was incurred  No

 Yes. Fill out Schedule H: Codebtors (Official Form 206H)

Last 4 digits of account number

Do multiple creditors have an

interest in the same property?

As of the petition filing date, the claim is:

Check all that apply

 No  Contingent

 Unliquidated

 Disputed

 Yes. Specify each creditor,

including this creditor and its relative

priority.

3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional Page, if any. $680,000.00

Part 2: List Others to Be Notified for a Debt Already Listed in Part 1

List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection agencies,

assignees of claims listed above, and attorneys for secured creditors.

If no others need to notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page.

Name and address On which line in Part 1 did you

enter the related creditor?

Last 4 digits of

account number for

this entity

CT Corporation, Registered Agent

for Forethought Life Insurance Co.

1200 S Pine Island Rd

Plantation, FL 33324-4413

Line 2.1

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 2

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 9 of 26
Debtor 7701 SW 120th Street LLC Case number (if known) Name Thomas Crowder, Esq.

Kahane & Associates PA

8201 Peters Rd Ste 3000

Plantation, FL 33324-3292

Line 2.1

Official Form 206D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page 2 of 2

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 10 of 26
Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206E/F

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

Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured 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: Assets - Real and

Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and 2

in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1: List All Creditors with PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507).  No. Go to Part 2.

 Yes. Go to line 2.

2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than 3 creditors with

priority unsecured claims, fill out and attach the Additional Page of Part 1.

Total claim Priority amount

2.1 Priority creditor's name and mailing address As of the petition filing date, the claim is: $0.00 $0.00

Florida Department of Revenue

PO Box 6668

Tallahassee, FL 32314-6668

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (8)

Is the claim subject to offset?

 No

Yes

2.2 Priority creditor's name and mailing address As of the petition filing date, the claim is: $0.00 $0.00

Internal Revenue Services

PO Box 7346

Philadelphia, PA 19101-7346

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (8)

Is the claim subject to offset?

 No

Yes

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of 2

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 11 of 26
Debtor 7701 SW 120th Street LLC Case number (if known) Name

2.3 Priority creditor's name and mailing address As of the petition filing date, the claim is: $11,621.26 $0.00

Miami-Dade Tax Collector

140 W Flagler St Ste 1403

Miami, FL 33130-1561

Check all that apply.

 Contingent

 Unliquidated

 Disputed

Date or dates debt was incurred Basis for the claim:

Last 4 digits of account number

Specify Code subsection of PRIORITY

unsecured claim: 11 U.S.C. § 507(a) (8)

Is the claim subject to offset?

 No

Yes

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill

out and attach the Additional Page of Part 2.

Amount of claim

3.1 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $50,000.00

John Aaron

9620 NE 2nd Ave Ste 203

Miami Shores, FL 33138-2749

Date(s) debt was incurred 

Last 4 digits of account number 

 Contingent

 Unliquidated

 Disputed

Basis for the claim: 

Is the claim subject to offset? No Yes

Part 3: List Others to Be Notified About Unsecured Claims

4. List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies, assignees

of claims listed above, and attorneys for unsecured creditors.

If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page.

Name and mailing address On which line in Part1 or Part 2 is the

related creditor (if any) listed?

Last 4 digits of

account number, if

any

4.1 Florida Department of Revenue

8175 NW 12th St Ste 119

Doral, FL 33126-1828

Line 2.1 

 Not listed. Explain 

4.2 Internal Revenue Service

7850 SW 6th Ct # 5730

Plantation, FL 33324-3202

Line 2.2 

 Not listed. Explain 

Part 4: Total Amounts of the Priority and Nonpriority Unsecured Claims

5. Add the amounts of priority and nonpriority unsecured claims.

Total of claim amounts

5a. Total claims from Part 1 5a. $ 11,621.26

5b. Total claims from Part 2 5b. + $ 50,000.00

5c. Total of Parts 1 and 2

Lines 5a + 5b = 5c. 5c. $ 61,621.26

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 2

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 12 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206G

Schedule G: Executory Contracts and Unexpired Leases 12/15

Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, number the entries consecutively.

1. Does the debtor have any executory contracts or unexpired leases?

No. Check this box and file this form with the debtor's other schedules. There is nothing else to report on this form. Yes. Fill in all of the information below even if the contacts of leases are listed on Schedule A/B: Assets - Real and Personal Property (Official

Form 206A/B).

2. List all contracts and unexpired leases State the name and mailing address for all other parties with

whom the debtor has an executory contract or unexpired

lease

2.1 State what the contract or

lease is for and the nature

of the debtor's interest

State the term remaining

List the contract number of

any government contract

2.2 State what the contract or

lease is for and the nature

of the debtor's interest

State the term remaining

List the contract number of

any government contract

2.3 State what the contract or

lease is for and the nature

of the debtor's interest

State the term remaining

List the contract number of

any government contract

2.4 State what the contract or

lease is for and the nature

of the debtor's interest

State the term remaining

List the contract number of

any government contract

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 1 of 1

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 13 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206H

Schedule H: Your Codebtors 12/15

Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach the Additional Page to this page.

1. Do you have any codebtors?

 No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form.

Yes

2. In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule on which the

creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.

Column 1: Codebtor Column 2: Creditor

Name Mailing Address Name Check all schedules

that apply:

2.1 John Aaron 9620 NE 2nd Ave Ste 203

Miami Shores, FL 33138-2749

Forethought Life

Insurance Company

 D 2.1

E/F

G

Official Form 206H Schedule H: Your Codebtors Page 1 of 1

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 14 of 26
Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 202

Declaration Under Penalty of Perjury for Non-Individual Debtors 12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this form

for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any

amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document, and

the date. Bankruptcy Rules 1008 and 9011. WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

Declaration and signature

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or another individual serving as a representative of the debtor in this case.

I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:  Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)

 Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

 Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

 Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)

 Schedule H: Codebtors (Official Form 206H)

 Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)

 Amended Schedule  Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)

 Other document that requires a declaration

I declare under penalty of perjury that the foregoing is true and correct.

Executed on June 15, 2020 X /s/ John Aaron

Signature of individual signing on behalf of debtor

John Aaron

Printed name

Manager

Position or relationship to debtor

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 15 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 206Sum

Summary of Assets and Liabilities for Non-Individuals 12/15

Part 1: Summary of Assets

1. Schedule A/B: Assets-Real and Personal Property (Official Form 206A/B)

1a. Real property:

 Copy line 88 from Schedule A/B............................................................................................................................. $ 430,127.00

1b. Total personal property:

 Copy line 91A from Schedule A/B......................................................................................................................... $ -10.00

1c. Total of all property:

 Copy line 92 from Schedule A/B........................................................................................................................... $ 430,117.00

Part 2: Summary of Liabilities

2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D.................................... $ 680,000.00

3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

3a. Total claim amounts of priority unsecured claims:

 Copy the total claims from Part 1 from line 5a of Schedule E/F.......................................................................... $ 11,621.26

3b. Total amount of claims of nonpriority amount of unsecured claims:

 Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F................................................ +$ 50,000.00

4. Total liabilities ....................................................................................................................................................... Lines 2 + 3a + 3b $ 741,621.26

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals page 1

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 16 of 26
 Fill in this information to identify the case: Debtor name 7701 SW 120th Street LLC

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number (if known)

 Check if this is an

amended filing

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy 04/19

The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write

the debtor’s name and case number (if known).

Part 1: Income

1. Gross revenue from business  None.

Identify the beginning and ending dates of the debtor’s fiscal year, which may be a calendar year Sources of revenue Check all that applyGross revenue

(before deductions and

exclusions)

From the beginning of the fiscal year to filing date:

From 1/01/2020 to Filing Date

 Operating a business $0.00

 Other

2. Non-business revenue

Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits, and

royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.  None.

Description of sources of revenue Gross revenue from

each source

(before deductions and

exclusions)

For prior year: From 1/01/2019 to 12/31/2019 Loan from manager $50,000.00

Part 2: List Certain Transfers Made Before Filing for Bankruptcy

3. Certain payments or transfers to creditors within 90 days before filing this case

List payments or transfers--including expense reimbursements--to any creditor, other than regular employee compensation, within 90 days before filing this

case unless the aggregate value of all property transferred to that creditor is less than $6,825. (This amount may be adjusted on 4/01/22 and every 3 years after that with respect to cases filed on or after the date of adjustment.)

 None.

Creditor's Name and Address Dates Total amount of value Reasons for payment or transfer Check all that apply

4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than $6,825. (This amount may be

adjusted on 4/01/22 and every 3 years after that with respect to cases filed on or after the date of adjustment.) Do not include any payments listed in line 3.

Insiders include officers, directors, and anyone in control of a corporate debtor and their relatives; general partners of a partnership debtor and their

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 1

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 17 of 26
Debtor 7701 SW 120th Street LLC Case number (if known)

relatives; affiliates of the debtor and insiders of such affiliates; and any managing agent of the debtor. 11 U.S.C. § 101(31).  None.

Insider's name and address Relationship to debtor Dates Total amount of value Reasons for payment or transfer

5. Repossessions, foreclosures, and returns

List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor, sold at a

foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6.  None

Creditor's name and address Describe of the Property Date Value of property

6. Setoffs

List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account of the

debtor without permission or refused to make a payment at the debtor’s direction from an account of the debtor because the debtor owed a debt.  None

Creditor's name and address Description of the action creditor took Date action was

taken Amount

Part 3: Legal Actions or Assignments

7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits

List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor was involved in any

capacity—within 1 year before filing this case.  None.

Case title Case number Nature of case Court or agency's name and

address Status of case

7.1. Forethought Life Insurance

Company v. 7701 SW 120th

Street LLC and John Aaron

2019-03142-CA-01

Foreclosure Miami-Dade 11th Judicial

Circuit

 Pending

 On appeal

 Concluded

8. Assignments and receivership

List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the hands of a

receiver, custodian, or other court-appointed officer within 1 year before filing this case.  None

Part 4: Certain Gifts and Charitable Contributions

9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of the gifts to that recipient is less than $1,000

 None

Recipient's name and address Description of the gifts or contributions Dates given Value

Part 5: Certain Losses

10. All losses from fire, theft, or other casualty within 1 year before filing this case.  None

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 2

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Debtor 7701 SW 120th Street LLC Case number (if known)

Description of the property lost and how

the loss occurred

Amount of payments received for the loss

If you have received payments to cover the loss, for example, from insurance, government compensation, or

tort liability, list the total received.

List unpaid claims on Official Form 106A/B (Schedule

A/B: Assets – Real and Personal Property).

Dates of loss Value of property

lost

Part 6: Certain Payments or Transfers

11. Payments related to bankruptcy

List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing of this

case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy relief, or filing

a bankruptcy case.  None.

Who was paid or who received the

transfer?

Address

If not money, describe any property transferred Dates Total amount or value

11.1. Van Horn Law Group, P.A.

330 N Andrews Ave Ste 450

Fort Lauderdale, FL

33301-1012

Attorney fee: $5,000.00; Filing Fee:

$1,717.00

Total received: $6,717.00 6/15/2020 $6,717.00

Email or website address

Who made the payment, if not debtor?

John Aaron

12. Self-settled trusts of which the debtor is a beneficiary

List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case to a

self-settled trust or similar device. Do not include transfers already listed on this statement.  None.

Name of trust or device Describe any property transferred Dates transfers were made Total amount or value

13. Transfers not already listed on this statement

List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within 2

years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include both

outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.  None.

Who received transfer?

Address Description of property transferred or payments received or debts paid in exchange Date transfer was made Total amount or value

Part 7: Previous Locations

14. Previous addresses

List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.  Does not apply

Address Dates of occupancy

From-To

Part 8: Health Care Bankruptcies

15. Health Care bankruptcies

Is the debtor primarily engaged in offering services and facilities for: Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 3

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 19 of 26
Debtor 7701 SW 120th Street LLC Case number (if known)

- diagnosing or treating injury, deformity, or disease, or

- providing any surgical, psychiatric, drug treatment, or obstetric care?

 No. Go to Part 9.

 Yes. Fill in the information below.

Facility name and address Nature of the business operation, including type of services the debtor providesIf debtor provides meals

and housing, number of

patients in debtor’s care

Part 9: Personally Identifiable Information

16. Does the debtor collect and retain personally identifiable information of customers?

 No.

 Yes. State the nature of the information collected and retained.

17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other pension or profit-sharing plan made available by the debtor as an employee benefit?

 No. Go to Part 10.

 Yes. Does the debtor serve as plan administrator?

Part 10: Certain Financial Accounts, Safe Deposit Boxes, and Storage Units

18. Closed financial accounts Within 1 year before filing this case, were any financial accounts or instruments held in the debtor’s name, or for the debtor’s benefit, closed, sold, moved, or transferred?

Include checking, savings, money market, or other financial accounts; certificates of deposit; and shares in banks, credit unions, brokerage houses, cooperatives, associations, and other financial institutions.  None

Financial Institution name and

Address Last 4 digits of account number Type of account orinstrument

Date account was

closed, sold, moved, or

transferred

Last balance before

closing or transfer

19. Safe deposit boxes

List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this case.  None

Depository institution name and address Names of anyone with access

to it

Address

Description of the contents Do you still

have it?

20. Off-premises storage

List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in which

the debtor does business.  None

Facility name and address Names of anyone with access

to it

Description of the contents Do you still

have it?

Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own

21. Property held for another List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do not list

leased or rented property.  None

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 4

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 20 of 26
Debtor 7701 SW 120th Street LLC Case number (if known)

Part 12: Details About Environment Information

For the purpose of Part 12, the following definitions apply: Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the medium

affected (air, land, water, or any other medium).

Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly owned, operated, or utilized.

Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a similarly

harmful substance.

Report all notices, releases, and proceedings known, regardless of when they occurred.

22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.  No.

 Yes. Provide details below.

Case title Case number Court or agency name and

address Nature of the case Status of case

23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an

environmental law?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address Environmental law, if known Date of notice

24. Has the debtor notified any governmental unit of any release of hazardous material?

 No.

 Yes. Provide details below.

Site name and address Governmental unit name and

address Environmental law, if known Date of notice

Part 13: Details About the Debtor's Business or Connections to Any Business

25. Other businesses in which the debtor has or has had an interest

List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.

Include this information even if already listed in the Schedules.

 None

Business name address Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN.

Dates business existed

26. Books, records, and financial statements

26a. List all accountants and bookkeepers who maintained the debtor’s books and records within 2 years before filing this case.  None

Name and address Date of service From-To

26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of account and records or prepared a financial statement within 2

years before filing this case.  None

26c. List all firms or individuals who were in possession of the debtor’s books of account and records when this case is filed.

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 5

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 21 of 26
Debtor 7701 SW 120th Street LLC Case number (if known)

 None

Name and address If any books of account and records are unavailable, explain why

26c.1. John Aaron

26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial statement within 2 years before filing this case.  None

Name and address

26d.1. Forethought Life Insurance Company

27. Inventories Have any inventories of the debtor’s property been taken within 2 years before filing this case?

 No

 Yes. Give the details about the two most recent inventories.

Name of the person who supervised the taking of the

inventory

Date of inventory The dollar amount and basis (cost, market, or other basis) of each inventory

28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other people in

control of the debtor at the time of the filing of this case.

Name Address Position and nature of any interest % of interest, if

any

John Aaron Managing Member 100%

29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in control of the debtor, or shareholders in control of the debtor who no longer hold these positions?

 No

 Yes. Identify below.

30. Payments, distributions, or withdrawals credited or given to insiders Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses, loans, credits on loans, stock redemptions, and options exercised?

 No

 Yes. Identify below.

Name and address of recipient Amount of money or description and value of

property

Dates Reason for providing

the value

31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?

 No

 Yes. Identify below.

Name of the parent corporation Employer Identification number of the parent corporation

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 6

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Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 22 of 26
Debtor 7701 SW 120th Street LLC Case number (if known)

32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?

 No

 Yes. Identify below.

Name of the pension fund Employer Identification number of the parent corporation

Part 14: Signature and Declaration WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information is true and

correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on June 15, 2020

/s/ John Aaron John Aaron

Signature of individual signing on behalf of the debtor Printed name

Position or relationship to debtor Manager

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?

 No

Yes

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 7

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© 2020 CINgroup 1.866.218.1003 – CINcompass (www.cincompass.com)

United States Bankruptcy Court

IN RE: Case No. 

Debtor(s)

Chapter 

The above named debtor(s) hereby verify(ies) that the attached matrix listing creditorsistrue to the best of my(our) knowledge.

Date: Signature: 

Debtor

Date: Signature: 

Joint Debtor, if any

Southern District of Florida, Miami Division

VERIFICATION OF CREDITOR MATRIX

7701 SW 120th Street LLC 11

June 15, 2020 /s/ John Aaron

John Aaron, Manager

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 24 of 26
CT Corporation, Registered Agent

for Forethought Life Insurance Co.

1200 S Pine Island Rd

Plantation, FL 33324-4413

Florida Department of Revenue

PO Box 6668

Tallahassee, FL 32314-6668

Florida Department of Revenue

8175 NW 12th St Ste 119

Doral, FL 33126-1828

Forethought Life Insurance Company

Robert Michael Arena Jr., President

10 W Market St Ste 2300

Indianapolis, IN 46204-2954

Internal Revenue Service

7850 SW 6th Ct # 5730

Plantation, FL 33324-3202

Internal Revenue Services

PO Box 7346

Philadelphia, PA 19101-7346

John Aaron

9620 NE 2nd Ave Ste 203

Miami Shores, FL 33138-2749

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 25 of 26
Miami-Dade Tax Collector

140 W Flagler St Ste 1403

Miami, FL 33130-1561

Thomas Crowder, Esq.

Kahane & Associates PA

8201 Peters Rd Ste 3000

Plantation, FL 33324-3292

Case 20-16512-AJC Doc 1 Filed 06/15/20 Page 26 of 26