Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

First Name Middle Name 

Debtor 2 

(Spouse, if filing) Fie;t Name Middle Name 

United States Bankruptcy Court for the: Southern District of Florida 

Case number 21-17336-MAM 

Of known) 

Official Form 106Sum 

Last N-1mc 

Last Name 

D Check if this is an 

amended filing 

Summary of Your Assets and Liabilities and Certain Statistical Information 1211s 

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. 

if I Summarize Your Assets 

Your assets 

Value of what you own 

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

1a. Copy line 55, Total real estate, from Schedule AIB ... ............................................................................................... .. $0.00 

1 b. Copy line 62, Total personal property, from Schedule A/8 ........................................................................................... .. s 1,323,526.85 

1c. Copy line 63, Total of all property on Schedule AIB ...................................................................................................... I.__ $_1_,3_2_3_,_s_2_6_.8_

ijfj 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 EIF: 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 EIF ........................... .. 

3b. Copy the total claims from Part 2 {nonpriority unsecured claims) from line 6j of Schedule EIF ...................................... . 

Your total liabilities 

ifi Summarize Your Income and Expenses 

4. Schedule I: Your Income {Official Form 1061) 

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

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

Copy your monthly expenses from line 22c of Schedule J ................................................................................................ . 

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

Your liabilities 

Amount you owe 

s583,017.54 

so.oo 

+ s524.75 

$583,542.29 

$7,656.21 

$6,143.84 

page 1 of 2 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 1 of 33
Anisa Nazarova 21-17336-MAM 

Debtor 1 Case number (ii known) _____________ _ First Namo Middlo N:imo last Namo 

Answer These Questions for Administrative and Statistical Records 

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

El 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. 

D Yes 

7. What kind of debt do you have? 

D 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. 

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

this form to the court with your other schedules. 

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

Form 122A-1 line 11; OR, Form 122B Line 11; OR, Form 122C-1 line 14. $ _____ _ 

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

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

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

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

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

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

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

priority claims. (Copy line 69.) 

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

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

Total claim 

$ _______ _ 

$ ______ _ 

$ _______ _ 

$ _______ _ 

$ _______ _ 

+$ _______ _ 

$ _______ _ 

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

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 2 of 33
Fill in this information to identify your case and this filing: 

Debtor 1 Anisa Nazarova 

First Name M1dd!e Name Lnst Name 

Debtor 2 

(Spouse, if filing) F,.s, Name Middle Name Last Name 

United States Bankruptcy Court for the: Southern District of 

Florida 

Case number 21_17336_MAM 

(if know) 

Official Form 106A/B 

Schedule A/B: Property 

0 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 Buildin , 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? 

0 No. Go to Part 2 

0 Yes. Where is the property? 

1.1 d.10.kv.12 Matrosova Street 

Street address, if available, or other description 

Barda, Perm area 

618150 

City State ZIP Code 

1.2 2251 Buck Ridge Trail 

Street address, if available, or other description 

Loxahatchee FL 33470 

City State ZIP Code 

Palm Beach County 

Country 

What is the property? Check all that apply 

0 Single-family home 

0 Duplex or multi-unit building 

0 Condominium or cooperative 

0 Manufactured or mobile home 

0 Land 

0 Investment property 

0 Timeshare 

0 Other ______ _ 

Who has an interest in the property? Check 

one 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 

Do not deduct secured claims or exemptions. Put the 

amount of any secured claims on Schedule D: 

Creditors Who Have Claims Secured by Property: 

Current value of the 

entire property? 

$ Unknown 

current value of the 

portion you own? 

$ 0.00 

Describe the nature of your ownership 

interest (such as fee simple, tenancy by the 

entireties, or a life estate}, if known. 

Life estate 

0 Check if this is community property 

Other information you wish to add about this item, such as local 

property identification number: 

What is the property? Check all that apply 

0 Single-family home 

0 Duplex or multi-unit building 

0 Condominium or cooperative 

0 Manufactured or mobile home 

0 Land 

0 Investment property 

O Timeshare 

0 Otherfamily Farm 

Who has an interest in the property? Check 

one 

O Debtor 1 only 

O Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

Do not deduct secured claims or exemptions. Put the 

amount of any secured claims on Schedule D: 

creditors Who Have Claims Secured by Property: 

Current value of the Current value of the 

entire property? portion you own? 

$ 1,000,000.00 $ 0.00 

Describe the nature of your ownership 

interest (such as fee simple, tenancy by the 

entireties, or a life estate}, if known. 

Equitable interest 

O Check if this is community property 

Other information you wish to add about this item, such as local 

property identification number: 

page 1 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 3 of 33
Debtor 1 Anisa Nazarova Last Name Case number(if known) 21-17336-MAM F:rst Name 

This property is owned by Land Trust 072003, Your Florida Realty Services, LLC, 

trustee, with the Debtor holding a 50% beneficial interest. 

1.3 14701 NW 83rd Place 

Street address. if available. or other description 

What is the property? Check all that apply 

O Single-family home 

Do not deduct secured claims or exemptions. Put the 

amount of any secured claims on Schedule D: 

0 Duplex or multi-unit building 

0 Condominium or cooperative 

0 Manufactured or mobile home 

0 Land 

Creditors Who Have Claims Secured by Property: 

Morriston FL 32668 

City State ZIP Code 

Current value of the 

entire property? 

$ 100,000.00 

Current value of the 

portion you own? 

$ 0.00 

Marion County 

0 Investment property 

O Timeshare 

0 Other ______ _ 

Describe the nature of your ownership 

interest (such as fee simple, tenancy by the 

entireties, or a life estate), if known. 

Country Who has an interest in the property? Check 

one 

Equitable interest 

0 Debtor 1 only 

0 Debtor 2 only 

0 Check if this is community property 

O Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

Other information you wish to add about this item, such as local 

property identification number: 

4. 72 acres (part of 11 acre farm) This property is owned by Land Trust 0406, Lilia 

Belkova. trustee, with the Debtor holding a 50% beneficial interest. 

2. Add the dollar value of the portion you own for all of your entries from Part 1, including any entries for pages 

you have attached for Part 1. Write that number here ........................................................................................................................................... ► 

4iflfj Describe Your Vehicles 

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 

0No 

Yes 

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 

0No 

OYes 

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

5. you have attached for Part 2. Write that number here ........................................................................................................................................... ► 

Describe Your Personal and Household Items 

EJ 

EJ 

Do you own or have any legal or equitable interest in any of the following? Current value of the 

portion you own? 

6. Household goods and furnishings 

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

QNo 

0 Yes. Describe ... 

Washing machine. dryer. refrigerator. stove. eating utensils. plates, drinking glasses. couch. end table, bookshelf. window 

treatments, kitchen table. chairs (3), bed (single), wardrobe. 

7. Electronics 

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

collections; electronic devices including cell phones. cameras, media players, games 

QNo 

0 Yes. Describe ... 

TV (Box-style. about 20"); cellular telephone (iPhone 6) 

Do not deduct secured 

claims or exemptions. 

$ 2QMQ_ 

$!l.Q..Q.Q_ 

page 2 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 4 of 33
Debtor 1 Anisa Nazarova 

First Name Mtdd!c Name Lasl Name 

Case number(ifknown) 21-17336-MAM 

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 

QNo . 

0 Yes. Describe ... 

I Family photos 

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 

0No 

0 Yes. Describe ... 

10. Firearms 

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

0No 

0 Yes. Describe ... 

11. Clothes 

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

QNo 

0 Yes. Describe ... 

IN□ value but to Debtor 

12. Jewelry 

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

gold, silver 

0No 

0 Yes. Describe ... 

13. Non-farm animals 

Examples: Dogs, cats, birds, horses 

0No 

O Yes. Describe ... 

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

0No 

0 Yes. Give specific information ... 

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

$.5...QQ_ 

you have attached for Part 3. Write that number here ........................................................................................................................................... ► 

$II Describe Your Financial Assets 

Do you own or have any legal or equitable interest in any of the following? 

16. Cash 

Examples: Money you have in your wallet, in your home, in a safe deposit box, and on hand when you file your petition 

QNo 

0Yes ............................................................. , .............................................................................. .. Cash .......................... 

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. 

QNo 

0Yes ................ .. Institution name: 

17.1. Checking account: Sber Bank (Russia} Checking Account 

Current value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

$ 6 242.00 

$~ 

page 3 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 5 of 33
Debtor 1 Anisa Nazarova 

First Namo Middle Namo Last N:tmc Case number(if known) 21-17336-MAM 

18. Bonds, mutual funds, or publicly traded stocks 

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

@No 

QYes ................. . 

19. Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in 

an LLC, partnership, and joint venture 

QNo 

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

Name of entity: 

Loxahatchee Horse Farm 

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. 

0No 

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

21. Retirement or pension accounts 

% of ownership: 

=50~ ___ % 

Examples: Interests in IRA, ERISA, Keogh, 40l{k), 403(b), thrift savings accounts, or other pension or profit-sharing plans 

0No 

0 Yes. List each account separately 

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 

0No 

QYes .................... . 

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

0No 

0Yes ..................... . 

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)(l), 529A(b), and 529(b)(l). 

0No 

0Yes ..................... . 

25. Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers 

exercisable for your benefit 

0 No 

O 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 

0No 

0 Yes. Give specific information about them ... 

27. Licenses, franchises, and other general intangibles 

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

0No 

0 Yes. Give specific information about them ... 

Money or property owed to you? 

28. Tax refunds owed to you 

0 No 

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

Federal: 

State: 

Local: 

$ Unknown 

Current value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

$Q,QQ__ 

$ Q,QQ__ 

$ Q,QQ__ 

page 4 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 6 of 33
Debtor 1 Anisa Nazarova 

F1rstNamr.- Middle Name lilSl Name 

Case number(if known) 21-17336-MAM 

29, Family support 

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

0 No 

O 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 

0No 

0 Yes. Give specific information .... 

31. Interests in insurance policies 

0 No 

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

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

0No 

0 Yes. Give specific information .... 

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

0No 

O Yes. Give specific information .... 

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

off claims 

QNo 

0 Yes. Give specific information .... 

Claims against PNC Bank, N.A. for various claims (offset, credit for payments made during successful Chapter 12 case, and 

other various damages, Claim against Mark Roher pre-petition and post-petition retainers paid and legal malpractice, Claims 

against Fidelity National Title Group related to overpayment of mortgage claims, Claims against Deer Run PoA related to 

alleged stay and injunction violations, Claim against Joel Aresty for return of retainer related to Rule 60 Motion to be filed (was 

not filed) 

35. Any financial assets you did not already list 

QNo 

0 Yes. Give specific information ... 

!Judgment Case No.: 38·2OO3-CA·OOO787 

36. Add the dollar value of the portion you own for all of your entries from Part 4. including any entries for pages 

$ 15,000.00 

$ 32.037,85 

you have attached for Part 4. Write that number here ........................................................................................................................................... ► 

Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1. 

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

0 No. Go to Part 6. 

0 Yes. Go to line 38. 

38. Accounts receivable or commissions you already earned 

0No 

0 Yes. Describe ... 

39. Office equipment, furnishings, and supplies 

Current value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

Examples: Business-related computers, software, modems, printers, copiers, fax machines, rugs, telephones, desks, chairs, electronic 

devices 

QNo 

0 Yes. Describe ... 

Computers (2 - 4yo and 7+yo); printers (3 • lyo, lyo and 4yo), dining table (used as desk), secretarial chairs (4), various 

tables, children's desks, folding table; massage tables (used as folding table), couch, paper, toner, general office supplies. 

40. Machinery, fixtures, equipment, supplies you use in business, and tools of your trade 

0No 

0 Yes. Describe ... 

$ l.OOQ.OQ 

page 5 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 7 of 33
Debtor 1 Anisa Nazarova Case number(if known) 21-17336-MAM FL-st Name 

41. Inventory 

0No 

O Yes. Describe ... 

Mitldrc Nc1mc Last Name 

42. Interests in partnerships or joint ventures 

0 No 

0 Yes. Describe ....... . 

43. Customer lists, mailing lists, or other compilations 

0No 

0 Yes.Do your lists include personally identifiable information (as defined in 11 U.S.C. § 101(41A))? 

44. Any business-related property you did not already list 

0No 

0 Yes. Give specific information .......... . 

Saddles (6 of various types), horse tack, farrier tools, veterinary equipment and related supplies. $ 1,500.00 

45. :~~ ~~~~~!~:~~;~u~o~f~~~ ~~~i~~ ~~~t ~~~~:ra~~~~.~~~~.~.~~.r'.~.~.~~~.~ .. ~~.~ .. ~'..~.~~~.~~·i·~:.~~.~.~~~.~i.~.5..~~~.~.~~~.5- ................... , ....... ► I $2,500.00 I 

Describe Any Farm- 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? 

0 No. Go to Part 7. 

0 Yes. Go to line 47. 

47. Farm animals 

Examples: Livestock, poultry, farm-raised fish 

0No 

0Yes ... 

I Eleven horses (Russian Trakehner) 

48. Crops-either growing or harvested 

@No 

0 Yes. Give specific information ... 

49. Farm and fishing equipment, implements, machinery. fixtures, and tools of trade 

0No 

OYes ... 

50. Farm and fishing supplies, chemicals, and feed 

QNo 

0Yes ... 

I Oats and Hay 

51. Any farm- and commercial fishing-related property you did not already list 

0No 

0 Yes. Give specific information ... 

TR3 Arena Rake; sprayer; seeder attachments; flat bed trailer; horse jumps 

Current value of the 

portion you own? 

Do not deduct secured 

claims or exemptions. 

$ unknown 

$ fil2Q,_QQ_ 

$ ~ 

52. Add the dollar value of the portion you own for all of your entries from Part 6, including any entries for pages 

you have attached for Part 6. Write that number here ........................................................................................................................................... ► 

Describe All Pro e 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 

0No 

0 Yes. Give specific 

information ... 

page 6 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 8 of 33
Debtor 1 Anisa Nazarova 

First Name M:ddlcNnmc Last Name 

Case number(if known) 21-17336-MAM 

Land Trust 072003, Land Trust 0406, Anissa Nazarova Living Trust dated September 5, 2000 

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

$1•1 List the Totals of Each Part of this Form 

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

56. Part 2: Total vehicles, line 5 

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

58. Part 4: Total financial assets, line 36 

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

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

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

62. Total personal property. Add lines 56 through 61 ................. .. 

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

$ 0.00 

$ 285.00 

$ 56,841.85 

$ 2,500.00 

$ 5,900.00 

+ $ 1,258,000.00 

$ 1,323,526.85 Copy personal property total► 

$1,25B,QD0,.O0 

$0.00 

+$ 

1,323,526.85 

$ 1,323,526.85 

page 7 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 9 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

First Nome Middle Namo 

Debtor 2 

(Spouse, if filing) First Nomo Middle Name 

United States Bankruptcy Court for the: Southern District of Florida 

Case number 

(If known) 

21-17336-MAM 

Official Form 106C 

Lnst Nnmc 

Lost Nnmc 

Schedule C: The Property You Claim as Exempt 

D Check if this is an 

amended filing 

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/8: Property (Official Form 106NB) 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. 

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. 

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

0 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. 

Brief description of the property and line on 

Schedule AJB that lists this property 

Household goods - Washing machine, dryer, 

Current value of the 

portion you own 

Copy the value from 

Schedule AIB 

Brief refrigerator, stove, eating utensils, plates, drinking $ 200.00 description: glasses, couch, end table, bookshelf, window 

treatments, kitchen table, chairs (3), bed (single), 

Line from wardrobe. 

Schedule AIB: 6 

Brief 

description: 

Line from 

Cash {dollars) (Cash On Hand) 

Schedule A/8: 16 

Brief 

description: 

Line from 

Cash (dollars) (Cash On Hand) 

Schedule AIB: 16 

$ 6,100.00 

$6,100.00 

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

Amount of the 

exemption you claim 

Check only one box 

for each exemption 

0s 200.00 

D 100% of fair market value, up to 

any applicable statutory limit 

0s 1,32s.oo 

0 100% of fair market value, up to 

any applicable statutory limit 

0s 4,ns.oo 

0 100% of fair market value, up to 

any applicable statutory limit 

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

0No 

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

0 No 

D Yes 

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

Specific laws that allow exemption 

11 U.S.C. § 522 (d)(5) 

11 USC§ 522(d)(5) 

11 U.S.C. § 522 (d)(5) 

page 1 of 1_ 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 10 of 33
Debtor Anisa Nazarova 

Ftrst Name Middle Name Last Namo 

•Mil Additional Page 

Brief description of the property and line 

on Schedule AIB that lists this property 

Brief 

description: 

Line from 

Sber Bank (Russia) Checking Account (Checking} 

ScheduleA/8: 17.1 

. f Judgment Case No.: 38-2003-CA-000787 (owed to 

Bne debtor} 

description: 

Line from 

Schedule AIB: 35 

Computers (2 - 4yo and ?+yo); printers (3 - 1yo, 1yo and 

Brief 4yo), dining table (used as desk), secretarial chairs (4), 

description: various tables, children's desks, folding table; massage 

tables (used as folding table), couch, paper, toner, 

Line from general office supplies. 

Schedule A/8: 39 

. Saddles (6 of various types), horse tack, farrier tools, 

Brief veterinary equipment and related supplies. 

description: 

Line from 

Schedule AIB: 44 

Brief 

description: 

Eleven horses (Russian Trakehner) 

Line from 

Schedule AIB: 47 

Brief 

description: 

Oats and Hay 

Line from 

Schedule AIB: 50 

Brief 

description: 

Line from 

Schedule A/8: 

Brief 

description: 

Line from 

Schedule AIB: 

Brief 

description: 

Line from 

Schedule A/8: 

Brief 

description: 

Line from 

Schedule A/8: 

Brief 

description: 

Line from 

Schedule AIB: 

Brief 

description: 

Line from 

Schedule AIB: 

Current value of the 

portion you own 

Copy the value from 

Schedule A/8 

$3,562.00 

$32,037.85 

$1,000.00 

$1,500.00 

$Unknown 

$900.00 

$ _______ _ 

$ ______ _ 

$ ______ _ 

$ ______ _ 

$ ______ _ 

$ _______ _ 

Case number (if known) 21-17336-MAM 

Amount of the 

exemption you claim 

Specific laws that allow exemption 

Check only one box 

for each exemption 

0$ 3,562.00 

D 100% of fair market value, up to 

any applicable statutory limit 

0$ 4,038.00 

0100% of fair market value, up to 

any applicable statutory limit 

0$ 1,000.00 

0 100% of fair market value, up to 

any applicable statutory limit 

0 $1,500.00 

0 100% of fair market value, up to 

any applicable statutory limit 

0 $ 13,400.00 

D 100% affair market value, up to 

any applicable statutory limit 

0$ 900.00 

0 100% of fair market value, up to 

any applicable statutory limit 

0$ ___ _ 

0 100% of fair market value, up to 

any applicable statutory limit 

0$ ___ _ 

D 100% of fair market value, up to 

any applicable statutory limit 

0$ ------ 0 100% of fair market value, up to 

any applicable statutory limit 

0$ ------ 0 100% of fair market value, up to 

any applicable statutory limit 

0$ __ _ 

D 100% of fair market value, up to 

any applicable statutory limit 

0$ ___ _ 

D 100% of fair market value, up to 

any applicable statutory limit 

11 U.S.C. § 522 (d)(5) 

11 U.S.C. § 522 (d)(5) 

11 USC § 522(d)(6) 

11 USC § 522(d)(6) 

11 USC § 522(d)(3) 

11 USC § 522(d)(3) 

Official Form 106C Schedule C: The Property You Claim as Exempt pageg_of 2 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 11 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

F1r,;tName M1dtl!e Nn1110 Last Nnme 

Debtor 2 

(Spouse, If filing) Firc.r N,m, Mldd'.c Name Lusl Name 

United States Bankruptcy Court for the: Southern District of Florida 

Case number 21-17336-MAM 

(if know) 

Official Form 106D 

Schedule D: Creditors Who Have Claims Secured by Property 

0 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 additional pages, write 

your name and case number (if known). 

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

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

0 Yes. Fill in all of the information below. 

•¥•+ List All Secured Claims 

2. List all secured claims. If a creditor has more than one secured claim, list the creditor 

separately for each claim. If more than one creditor has a particular claim, list the other creditors in 

Part 2. As much as possible, list the claims in alphabetical order according to the creditor's name. 

Deer Run Property Owners' Association 

Creditor's Name 

c/o Steven R. Braten 

Describe the property that secures the claim: 

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

"'2-'-50.c.....cS..co..cu""th_A'-"'-u-'-st"-ra"'lc.cia""n-'-A-'-v'--'ec.c.______ that apply. 

Number Street 0 Contingent 

_S_u_ite_50_0 ____________ O Unliquidated 

West Palm Beach FL 33401 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Disputed 

Nature of lien. Check all that apply. 

O An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

Column A 

Amount of 

claim Do not 

deduct the value 

of collateral. 

$ 90,000.00 

O Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 0 Other {including a right to offset) ______ _ 

0 Check if this claim relates to a 

community debt 

Last 4 digits of account number 

Date debt was incurred __ 

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

Column a 

Value of 

collateral that 

supports this 

claim 

$ 0.00 

ColumnC 

Unsecured 

portion If any 

$ 90,000.00 

page 1 of 4 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 12 of 33
Debtor Anisa Nazarova 

FirslNmm: M1dd!c N;1mc L.O.SI Name 

Deer Run Property Owners Association, 

Creditor's Name 

Inc c/o Rosenbaum PLLC 

250 Australian Avenue South 

Number Street 

5th Floor 

West Palm Beach FL 33401 

City Slate ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 Al least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

Enterprise Funding Solutions LLC 

Creditor's Name 

4600 N Flagler 

Number Street 

West Palm Beach FL 33407 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

Fidelity National Title Group; 

Creditor's Name 

Commonwealth Land Title Insurance 

Company 

2533 N 117th Ave 

Number Street 

Omaha NE 68164 

City Slate ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

Official Farm 106D 

Case number(if known) 21-17336-MAM 

Describe the property that secures the claim: $ 8,816.07 

2251 Buck Ridge Trail, Loxahatchee, FL 33470 - $1,000,000.00 

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

that apply. 

0 Contingent 

0 Unliquidated 

0 Disputed 

Nature of lien. Check all that apply. 

0 An agreement you made (such as mortgage or 

secured car lo,m) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Describe the property that secures the claim: $ 115,900.00 

2251 Buck Ridge Trail, Loxahatchee, FL 33470 - $1,000,000.00 

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

that apply. 

0 Contingent 

0 Unliquidated 

0 Disputed 

Nature of lien. Check all that apply. 

0 An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Describe the property that secures the claim: $ 30,000.00 

14701 NW 83rd Place, Morriston, FL 32668 - $100,000.00 

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

that apply. 

0 Contingent 

0 Unliquidated 

0 Disputed 

Nature of lien. Check all that apply. 

0 An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Schedule D: Creditors Who Have Claims Secured by Property 

$ 1,000,000.00 $ 0.00 

$ 1,000,000.00 $ 0.00 

$ 100,000.00 $ 0.00 

page 2 of 4 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 13 of 33
Debtor Anisa Nazarova Case number(if known) 21-17336-MAM Firs1 Namr. Middle Name last Name 

Marion County Tax Collector 

Creditor'~ Name 

503 SE 25th Ave 

Number Street 

Ocala FL 34471 

City S1a1e ZIP Corle 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

Palm Beach County Tax Collector c/o 

Creditor's Name 

Hampton Peterson Esq. 

Describe the property that secures the claim: $ _47_._o.c.o __ _ 

14701 NW 83rd Place, Morriston, FL 32668 - $100,000.00 

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

that apply. 

0 Contingent 

0 Unliquidated 

0 Disputed 

Nature of lien. Check all that apply. 

O An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Describe the property that secures the claim: $ 17,600.00 

2251 Buck Ridge Trail, Loxahatchee, FL 33470 - $1,000,000.00 

POB 

3715 As of the date you file, the claim is: Check all 

that apply. 

Number Street 0 Contingent 

..:..W:..:e:.:s..:..t .:....P.::a::..:lm..:....:::B.::e::::ac:::_h.:_.!_F::_L _ _:3:::,3::.:4c:::0:=:2____ O Un liquidated 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

PNC Bank Retail Lending 

Creditor's Name 

P.O. Box 94982 

Number Street 

Cleveland OH 44101 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

0 Check if this claim relates to a 

community debt 

Date debt was incurred __ 

Oflicial Form 106D 

0 Disputed 

Nature of lien. Check all that apply. 

0 An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Describe the property that secures the claim: $ 317,654.47 

2251 Buck Ridge Trail, Loxahatchee, FL 33470 - $1,000,000.00 

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

that apply. 

0 Contingent 

0 Unliquidated 

0 Disputed 

Nature of lien. Check all that apply. 

0 An agreement you made (such as mortgage or 

secured car loan) 

0 Statutory lien (such as tax lien, mechanic's lien) 

0 Judgment lien from a lawsuit 

0 Other (including a right to offset) ______ _ 

Last 4 digits of account number 

Schedule D: Creditors Who Have Claims Secured by Property 

$ 100,000.00 $ 0.00 

$ 1,000,000.00 $ 0.00 

$ 1,000,000.00 $ 0.00 

page 3 or 4 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 14 of 33
Debtor Anisa Nazarova 

FirstN.i.mc Midd!c Name Last Nf\"1C 

Case number(if known) 21-17336-MAM 

Describe the property that secures the claim: $ 3,000.00 

Shawna Hurdin~ c/o Alexander Domb, 

Creditor's Name 

2251 Buck Ridge Trail, Loxahatchee, FL 33470 - $1,000,000.00 

P.A. 

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

.;;;;.11;;;.;1;;..;9-'-9_P.....;o __ lo--C_lu_b_R_d _______ that apply. 

NumhP.r Strem 0 contingent 

Suite 1 0 Unliquidated 

West Palm Beach FL 33414 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

0 Disputed 

Nature of lien. Check all that apply. 

O An agreement you made (such as mortgage or 

secured car loan) 

O Slatutury lien (such as tax lien, mechanic's lien) 

O Judgment lien from a lawsuit O Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 

O Other (including a right to offset) ______ _ 

O Check if this claim relates to a 

community debt 

Last 4 digits of account number 

Date debt was incurred __ 

Add the dollar value of your entries in Column A on this page. Write that number here: $ 583,017.54 

List Others to Be Notified for a Debt That You Already Listed 

$ 1,000,000.00 $ 0.00 

Use this page only if you have others to be notified about your bankruptcy tor a debt that you already listed in Part 1. For example, if a collection 

agency is trying to collect from you for a debt you owe to someone else, list the creditor in Part 1, and then list the collection agency here. 

Similarly, if you have more than one creditor for any of the debts that you listed in Part 1, list the additional creditors here. If you do not have 

additional persons to be notified for any debts in Part 1, do not fill out or submit this page. 

McGlinchey Stafford On which line in Part 1 did you enter the creditor? 

Creditor's Name Last 4 digits of account number ______ _ 

ATTN: Kimberly Held Israel 

Number Street 

10407 Centurion Pkwy N., Ste 200 

Jacksonville FL 32256 

City State ZIP Code 

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 4 of 4 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 15 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

Middle Ni'lm@ La~t Nnme 

Debtor 2 

(Spouse, if filing) First Name Middle Nam!:! 

United States Bankruptcy Court for the: Southern District of Florida 

Case number 21-17336-MAM 

(if know) 

Official Form 106E/F 

Schedule E/F: Creditors Who Have Unsecured Claims 

0 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. On the top of any additional pages, write 

your name and case number (if known). 

List All of Your PRIORITY Unsecured Claims 

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

0 No. Go to Part 2. 

Yes. 

List All of Your NONPRIORITY Unsecured Claims 

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

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

0 Yes. Fill in all of the information below. 

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

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

included in Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.lf you have more than three nonpriority unsecured 

claims fill out the Continuation Page of Part 2. 

Florida Power and Light 

Nonpriority Creditor's Name 

General Mail Facility 

Number Street 

Miami FL 33188-0001 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

O Debtor 1 and Debtor 2 only 

0 At least one of the debtors and another 

O Check if this claim relates to a community 

debt 

Is the claim subject to offset? 

@No 

0Yes 

Official Form 106E/F 

Last 4 digits of account number 7265 

When was the debt incurred? ____ _ 

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

0 Contingent 

0 Unliquidated 

0 Disputed 

Type of NONPRIORITY unsecured claim: 

QStudent loans 

O Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims 

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

debts 

0 Other. Specify 

Schedule E/F: Creditors Who Have Unsecured Claims 

Total claim 

$ 56.00 

page 1 of 3 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 16 of 33
Debtor Anisa Nazarova 

F1rs1Narnc M1dd!c Name Last Name Case number(if known) 21-17336-MAM 

Florida Power and Light 

Nunμriurity Cretlitur's Name 

General Mail Facility 

Numher Street 

Miami FL 33188-0001 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

O Debtor 2 only 

O Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 

O Check if this claim relates to a community 

debt 

Is the claim subject to offset? 

0No 

Yes 

Florida Power and Light 

Nonpriority Creditor's Name 

General Mail Facility 

Number Street 

Miami FL 33188-0001 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

O Debtor 2 only 

0 Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 

O Check if this claim relates to a community 

debt 

Is the claim subject to offset? 

0No 

@Yes 

Sumter Electric Cooperative Inc 

Nonpriority Creditor's Name 

330 S US Highway 301 

Number Street 

Sumterville FL 33585 

City State ZIP Code 

Who owes the debt? Check one. 

0 Debtor 1 only 

0 Debtor 2 only 

O Debtor 1 and Debtor 2 only 

O At least one of the debtors and another 

O Check if this claim relates to a community 

debt 

Is the claim subject to offset? 

0No 

0Yes 

Last 4 digits of account number 7265 

When was the debt incurred? _____ _ 

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

0 Contingent 

0 Unliquidated 

O Disputed 

Type of NONPRIORITY unsecured claim: 

Ostudent loans 

0 Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims 

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

debts 

0 Other. Specify Utility Services 

Last 4 digits of account number 6569 

When was the debt incurred? _____ _ 

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

0 Contingent 

0 Unliquidated 

0 Disputed 

Type of NONPRIORITY unsecured claim: 

0Student loans 

O Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims 

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

debts 

0 Other. Specify Utility Services 

Last 4 digits of account number 

When was the debt incurred? _____ _ 

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

0 Contingent 

0 Unliquidated 

0 Disputed 

Type of NONPRIORITY unsecured claim: 

0Student loans 

0 Obligations arising out of a separation agreement or divorce 

that you did not report as priority claims 

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

debts 

0 Other. Specify 

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

$ 123,16 

$ 45.59 

$ 300.00 

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. 

Add the Amounts for Each Type of Unsecured Claim 

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

Add the amounts for each type of unsecured claim. 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 2 of 3 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 17 of 33
Debtor Anisa Nazarova 

First Name M:dtltc Name Last NanicCase number(if known) 21-17336-MAM 

Total claim 

Total claims 6a. Domestic support obligations 6a. $ 0.00 

from Part 1 

6b. Ta>ces and certain other debts you owe the 6b. $ 0.00 

government 

6c. Claims for death or personal injury while you were Ge. $ 0.00 

intoxicated 

6d. Other. Add all other priority unsecured claims. Write that 6d. $ 0.00 

amount here. 

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

$ 0.00 

Total claim 

Total claims 61. Student loans 61. $ 0.00 

from Part2 

6g. Obligations arising out of a separation agreement or 6g. $ 0.00 

divorce that you did not report as priority claims 

6h. Debts to pension or profit-sharing plans, and other 6h. $ 0.00 

similar debts 

6i. Other. Add all other nonpriority unsecured claims. Write that 6i. $ 524.75 

amount here. 

6j. Total. Add lines 61 through 6i. 6j. $ 524.75 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 3 of 3 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 18 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

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 21-17336-MAM 

(if know) 

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? 

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

0 Yes. Fill in all of the information below even if the contracts or leases are listed on Schedule A/B: Property (Official Form 106A/B). 

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 company with whom you have the contract or lease State what the contract or lease is for 

Official Form 106G Schedule G: Executory Contracts and Unexpired Leases page l of l 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 19 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

Fir~t Name M1c1dle Nllmf! L05t N.ll11C 

Debtor 2 

(Spouse, if filing) First Nnmc MlddlcN.i.mc Last NRme 

United States Bankruptcy Court for the: Southern District of Florida 

Case number 21-17336-MAM 

(if know) 

Official Form 106H 

Schedule H: Your Codebtors 

0 Check if this is 

an amended 

filing 

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 

OYes 

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.) 

0 No. Go to line 3. 

0 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 E/F (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 

Otticial Form 106H 

Column 2: The creditor to whom you owe the debt 

Check all schedules that apply: 

Schedule H: Your Codebtors page 1 of 1 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 20 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

First Name 

Debtor 2 

(Spouse, if filing) Firsl Name Middle Name 

United States Bankruptcy Court for the: _ Southern District of Florida 

Case number 

(If known) 

21-17336-MAM 

Lu:;INmm.· 

Last Name 

Check if this is: 

D An amended filing 

DA supplement showing postpetition chapter 13 

income as of the following date: 

Official Form 1061 MM/ DD/ YYYY 

Schedule I: Your Income 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. 

@•+ Describe Employment 

1. Fill in your employment 

information. 

If you have more than one job, 

attach a separate page with 

information about additional 

employers. 

Include part-time, seasonal, or 

self-employed work. 

Occupation may include student 

or homemaker, if it applies. 

Employment status 

Occupation 

Employer"s name 

Employer's address 

Debtor 1 

~Employed 

D Not employed 

Horse farmer 

Loxahatchee Horse Farm 

2251 Buck Ridge Trail 

Number Street 

Loxahatchee, FL 33470 

City State ZIP Code 

How long employed there?_2_1~y_e_a_r_s ________ _ 

if◄ Give Details About Monthly Income 

Debtor 2 or non-filing spouse 

Employed D Not employed 

Number Street 

City State ZIP Code 

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

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

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

3. Estimate and list monthly overtime pay. 

4. Calculate gross income. Add line 2 + line 3. 

2. 

3. 

4. 

Official Form 1061 Schedule I: Your Income 

$ 

+$ 

$ 

For Debtor 1 For Debtor 2 or 

non-filing spouse 

0.00 $ 

0.00 + $ 

o.oo I $ 

page 1 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 21 of 33
Debtor 1 Anisa Nazarova 

Firsl Name Middle Name Last Name 

Copy line 4 here .................................................. ···········•······•·····•················-+ 4. 

5. List all payroll deductions: 

5a. Tax, Medicare, and Social Security deductions 5a. 

5b. Mandatory contributions for retirement plans 5b. 

5c. Voluntary contributions for retirement plans 5c. 

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

5e. Insurance 5e. 

5f. Domestic support obligations 5f. 

5g. Union dues 5g. 

5h. Other deductions. Specify: 5h. 

6. Add the payroll deductions. Add lines 5a + 5b + 5c + 5d + 5e +5f + 5g + Sh. 6. 

7. Calculate total monthly take-home pay. Subtract line 6 from line 4. 7. 

B. List all other income regularly received: 

Ba. 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. Ba. 

Bb. Interest and dividends Bb. 

Be. 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. Be. 

Bd. Unemployment compensation Bd. 

Be. Social Security Be. 

Bf. 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:_____________________ Bf. 

Bg. Pension or retirement income Bg. 

Bh. Other monthly income. Specify: ____________ _ Bh. 

9. Add all other income. Add lines Ba + Bb + Be+ Bd +Be+ Bf +Bg + Bh. 9. I 

10• I 1 o. Calculate monthly income. Add line 7 + line 9. 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. 

Case number cu known) 21-17336-MAM 

For Debtor 1 For Debtor 2 or 

non-filing spouse 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

+$ 0.00 + $ 

$ $ 

$ $ 

$ $ 

$ 0.00 $ 

$ 0.00 $ 

$ 5,316.37 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 $ 

$ 0.00 ----- $ 

$ 357.00 $ 

+$ 0.00 +$ 

$ 5,673.37 I I $ 

$ 5,673.37 l+I $ 

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: Contributions from dauQhter, Lilia Belkova Russo 11. 

12. Add the amount in the last column of line 1 Oto the amount in line 11. The result is the combined monthly income. 

Write that amount on the Summary of Your Assets and Liabilities and Certain Statistical Information, if ii applies 12. 

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

I 

I= 1$ 

5,673.37 

+ $ 1,982.84 

1$ 7,656.21 

Combined 

monthly income 

D No. Farming operations are expected to return to pre-COVID levels within 12 to 18 months, which will translate 

~Yes. Explain: into a gradual but substantial increase in monthly income. 

Official Form 1061 Schedule I: Your Income page 2 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 22 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

First NRmB M~dclla N;une LH:il NHmL' Check if this is: 

Debtor 2 

(Spouse, if filing) First Nome MidCIIC Name Ln~t N.imo OAn amended filing 

DA supplement showing postpetition chapter 13 

expenses as of the following date: United states Bankruptcy court for the: Southern District of Florida 

Case number 

(If known) 

21-17336-MAM 

Official Form 106J 

Schedule J: Your Expenses 

(State} 

MM/ DD/ YYYY 

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, 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? 

No Oves. Debtor 2 must file Official Form 106J-2, Expenses for Separate Household of Debtor 2. 

2. Do you have dependents? 

Do not list Debtor 1 and 

Debtor 2. 

Do not state the dependents' 

names. 

3. Do your expenses include 

expenses of people other than 

yourself and your dependents? 

~No 

D Yes. Fill out this information for 

Dependent's relationship to 

Debtor 1 or Debtor 2 

each dependent... ....................... ------------

□ No 

Elves 

Estimate Your Ongoing Monthly Expenses 

Dependent's 

age 

Does dependent live 

with you? 

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, and upkeep expenses 

4d. Homeowner's association or condominium dues 

Official Form 106J Schedule J: Your Expenses 

Your expenses 

$ 0.00 

4. 

800.00 

4a. $ 

4b. $ 330.00 

4c. $ 0.00 

4d. $ 130.00 

page 1 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 23 of 33
Anisa Nazarova Debtor 1 Case number (ii known) 21-17336-MAM -------------- Fusi Name MHJdlc Norm: LO$l Nome 

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

6. Utilities: 

Ba. Electricity, heat, natural gas 

6b. Water, sewer, garbage collection 

Be. Telephone, cell phone, Internet, satellite, and cable services 

6d. Other. Specify: 

7. Food and housekeeping supplies 

8. Childcare and children's education costs 

9. Clothing, laundry, and dry cleaning 

10. Personal care products and services 

11. Medical and dental expenses 

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

Do not include car payments. 

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

14. Charitable contributions and religious donations 

15. Insurance, 

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

15a. Life insurance 

15b. Health insurance 

15c. Vehicle insurance 

15d. Other insurance. Specify: ________________ _ 

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

Specify: ______________________ _ 

17. Installment or lease payments: 

17a. Car payments for Vehicle 1 

17b. Car payments for Vehicle 2 

17c. other. Specify: Mortgage on 4.32 acre Marion County property 

17d. Other. Specify: ___________________ _ 

18. Your payments of alimony, maintenance, and support that you did not report as deducted from 

your pay on line 5, Schedule I, Your Income (Official Form 1061). 

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

Specify: _______________________ _ 

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 

20b. Real estate taxes 

20c. Property, homeowner's, or renter's insurance 

20d. Maintenance, repair, and upkeep expenses 

2oe. Homeowner's association or condominium dues 

Official Form 106J Schedule J: Your Expenses 

Your expenses 

5. $ 

6a. $ 

6b. $ 

6c. $ 

6d. $ 

7. $ 

8. $ 

9. $ 

10. $ 

11. $ 

12. $ 

13. $ 

14. $ 

15a. $ 

15b. $ 

15c. $ 

15d. $ 

16. $ 

17a. $ 

17b. $ 

17c. $ 

17d. $ 

18. $ 

19. $ 

20a. $ 

20b. $ 

20c. $ 

20d. $ 

20e. $ 

0.00 

3QQ.QQ 

o oo 

6Q.QQ 

0.00 

120.00 

0 00 

15 OQ 

jQ OQ 

0,QQ 

200.00 

15.00 

0.00 

0.00 

0.00 

100,QO 

0 QO 

0.00 

0.00 

0.00 

161.00 

0.00 

0.00 

0.00 

0.00 

0.00 

0.0Q 

a oo 

0.00 

page 2 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 24 of 33
Debtor 1 Anisa Nazarova Case number (ii k11own) 

21-17336-MAM 

First Namo Middle Namo --------------

21. Other. Specify: Horse feed and oats 

Farrier 

L.ist Name 

50% of disputed mortgage payment on Buck Ridge Trail property 

22. Calculate your monthly expenses. 

22a. Add lines 4 through 21. 

22b. Copy line 22 (monthly expenses for Debtor 2). if any, from Official Form 106J-2 22c. Add line 22a 

and 22b. The result is your monthly expenses. 

23. Calculate your monthly net income. 

23a. Copy line 12 (your combined monthly income) from Schedule I. 

23b. Copy your monthly expenses from line 22c above. 

23c. Subtract your monthly expenses from your monthly income. 

The result is your monthly net income. 

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? 

21 +$ 1 ,800.00 

• -----1-2-0-.0-0-

22a. 

22b. 

22c 

23a. 

23b. 

23c. 

+$ ________ _ 

+$ 1,982_84 ---------

:----6_, 1_43_._84_j 

$ 6,143.84 ---------

$ ____ 7_,_65_6_.2_1_ 

-$ ____ 6_, 1_4_3_.8_4_ 

$ 1,512.37 ---------

□ No. 

~Yes. Explain here: Most expenses herein are related to the business. Living expenses in Russia are nominal. 

Business expenses are expected to rise along with increased operations over the next 18 

months. 

Official Fonm 106J Schedule J: Your Expenses page 3 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 25 of 33
Fill in this information to identify your case: l 

Debtor 1 Anisa Nazarova 

Fl~tNamo Middte Name 

Debtor 2 

(Spouse, if filing) First Namo M1ddlo Name 

United States Bankruptcy Court for the Southern District of Florida 

Case number 21-17336-MAM 

(If known) 

Official Form 106Dec 

Last Name 

La~t Name 

Declaration About an Individual Debtor's Schedules 

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

D Check if this is an 

amended filing 

12/15 

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? 

0 No 

0 Yes. Name of person ___________________ . Attach Bankruptcy Petition Preparers Notice, Declaration, and 

Signature (Official Form 119). 

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

that they are true and correct. 

X /s/ Anisa Nazarova 

Signature of Debtor" 1 

Date 09/22/2021 

MM/ DD I YYYY 

Official Form 106Dec 

Signature of Debtor 2 

Date _____ _ 

MM/ DD I YYYY 

Declaration About an Individual Debtor's Schedules 

Doc ID: f5cf94c14a1f16096c1dd7d9fe47ce5f1 b062c6b 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 26 of 33
Fill in this information to identify your case: 

Debtor 1 Anisa Nazarova 

Mic.Idle Name Lnst Name 

Debtor 2 

(Spouse, if filing) First Nome Middle Ntl.mo LO.SI Name 

United States Bankruptcy Court tor the: Southern District of Florida 

Case number 21_17336-MAM 

(if know) 

Official Form 107 

0 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. 

Give Details About Your Marital Status and Where You Lived Before 

1. What is your current marital status? 

O Married 

0 Not married 

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

0No 

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

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.) 

0No 

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

¥fl 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. 

QNo 

0 Yes. Fill in the details. 

Debtor 1 Debtor 2 

Sources of income 

Check all that apply 

Gross income 

(before deductions 

and exclusions) 

Sources of income 

Check all that apply 

Gross income 

(before deductions 

and exclusions) 

From January 1 of current year until the date 

you filed for bankruptcy: 

For last calendar year: 

(January 1 to December 31, 2020 

For the calendar year before that: 

(January 1 to December 31, 2019 

0 Wages, 

r commissions, $ 45,668.22 

bonuses, tips 

0 Operating a business 

0 Wages, 

r commissions, $ 98,736.00 

bonuses, tips 

0 Operating a business 

0 Wages, 

r commissions, $ 82,800.00 

bonuses, tips 

0 Operating a business 

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

0 Wages, 

r commissions, 

$ __ 

bonuses, tips 

0 Operating a business 

0 Wages, 

r commissions, 

$ __ 

bonuses, tips 

0 Operating a business 

0 Wages, 

' commissions, 

$ __ 

bonuses, tips 

0 Operating a business 

page l of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 27 of 33
Debtor Anisa Nazarova 

First Name M.dlllc Name Last Name Case number(if known) 21-17336-MAM 

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

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 U1at 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 

0 Yes. Fill in the details. 

Debtor 1 Debtor 2 

Sources of income 

Describe below. 

Gross income from each 

source 

Sources of income 

Describe below. 

Gross income from each 

source 

(before deductions and 

exclusions) 

(before deductions and 

exclusions) 

From January 1 of 

current year until the 

date you filed for 

bankruptcy: 

For last calendar year: 

(January 1 to December 

31, 2020 

For the calendar year 

before that: 

(January 1 to December 

31, 2019 

Pension $2,499.00 

Pension $4,055.00 

Pension $2,909.00 

List Certain Payments You Made Before You Filed for Bankruptcy 

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

0 No. Neither Debtor l 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? 

0 No. Go to line 7. 

O Yes. List below each creditor to whom you paid a total of $6,825* or more in one or more payments 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. 

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

O Yes. Debtor l 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? 

O No. Go to line 7. 

0 Yes. 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. 

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. 

0No. 

O Yes. List all payments to an insider. 

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. 

0No. 

O Yes. list all payments that benefited an insider. 

Olflcial Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 28 of 33
Debtor Anisa Nazarova Case number(if known) 21-17336-MAM F1rs1 Nam!:! Midd'.cNanic Last NamL' 

Identify Legal Actions, Repossessions, and Foreclosures 

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. 

No 

0 Yes. Fill in the details. 

Case title: 

Belkova v PNC Bank, N.A. 

Case number: 

5:20-cv-143-BJD 

Case title: 

Belkova v. PNC Bank, N.A. 

Case number: 21-10117-DD 

Nature of the case 

Appeal: Date filed: 04/07/2020 

Appeal: Date filed: 11/10/2020 

Court or agency 

USDC - MDFL Jacksonville 

Court Name 

300 N Hogan Street 

Number Street 

Jacksonville FL 32202 

City State ZIP Code 

11th Circuit Court of Appeals Atlanta 

Court Name 

56 Forsyth Street, N.W. 

Number Street 

Atlanta GA 30303 

City State ZIP Code 

Status of the 

case 

0 Pending 

0 On appeal 

0 Concluded 

0 Pending 

0 On appeal 

0 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 till in the details below. 

0 No. Go to line 11. 

O Yes. Fill in the information below. 

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? 

0No 

O Yes. Fill in the details 

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? 

0No 

QYes 

@f W List Certain Gifts and Contributions 

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

0No 

0 Yes. Fill in the details tor each gift. 

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

0No 

O Yes. Fill in the details tor each gift or contribution. 

§•M List Certain Losses 

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? 

0No 

0 Yes. Fill in the details. 

§W List Certain Payments or Transfers 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 3 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 29 of 33
Debtor Anisa Nazarova Case number(if known) 21-17336-MAM First Name Mrddlr? Name Last Naml! 

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

anyone you consulted about seeking bankruptcy or preparing a bankruptcy petition? 

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

QNo 

0 Yes. Fill in the details. 

The Associates 

Person Who was Paid 

2401 PGA Boulevard 

Number Street 

280M 

West Palm Beach FL 33410 

City Stale ZIP Cocle 

dlm@theassociates.com 

Email or website address 

Living Trust of Nazarova 

Person Who Made the Payment, if Not You 

Mark Roher 

Person Who Was Paid 

1806 N Flamingo Road, Suite 300 

Number Street 

Pembroke Pines FL 33028 

Cily State ZIP Code 

Email or website address 

Person Who Made the Payment, if Not You 

Description and value of any property transferred 

$6,000 fees, $1,500 costs. 

Description and value of any property transferred 

Pre- and post petition retainers paid. 

Date payment 

or transfer was 

made 

09/2021 

Date payment 

or transfer was 

made 

07/2021 

08/2021 

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. 

0No 

O Yes. Fill in the details. 

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. 

0No 

0 Yes. Fill in the details. 

19.Within 10 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.} 

0 No 

O Yes. Fill in the details. 

List Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units 

Amount of 

payment 

$ 7,500.00 

$ __ 

Amount of 

payment 

$ 14,500.00 

$ 2,000.00 

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. 

0No 

0 Yes. Fill in the details. 

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 4 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 30 of 33
Debtor Anisa Nazarova 

First NAmc Las1 N.imc Case number(if known) 21-17336-MAM 

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? 

0 No 

O Yes. Fill in the details. 

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

0No 

O Yes. Fill in the details. 

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. 

0No 

O Yes. Fill in the details. 

Give Details About Environmental Information 

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

0 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, soil, surface water, groundwater, or other medium, 

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

0 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 utilize 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? 

0No 

O Yes. Fill in the details. 

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

0No 

O Yes. Fill in the details. 

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

0No 

0 Yes. Fill in the details. 

Give Details About Your Business or Connections to Any Business 

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

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

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

O A partner in a partnership 

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

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

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

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

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 5 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 31 of 33
Debtor Anisa Nazarova 

Firs1 Name Mlddl(' Name 

Loxahatchee Horse Farms 

Business Name 

2251 Buck Ridge Trail 

Nl1mber Street 

Loxahatchee FL 33470 

City State ZIP Code 

Last Name 

Describe the nature of the business 

Horse Farm (50% owner) 

Name of accountant or bookkeeper 

Lilia Belvoka 

Case number(if known) 21-17336-MAM 

Employer Identification number 

Do not include Social Security number or 

ITIN. 

EIN: 9 3 - L 7 4 4 8 1 5 

Dates business existed 

From 06/01/1995 To current 

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. 

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

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

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 6 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 32 of 33
Debtor Anisa Nazarova 

Fir~, mc Middle Name LU.SI Name Case number(if known) 21-17336-MAM 

ijlfj Sign Below 

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. 

X /s/ Anisa Nazarova 

Signature of Debtor 1 

Date 09/22/2021 

X 

:::S'.""ig-na-,t-u,-e-o..,.f :::-De-:b...,.to-r-:2,----------------

Date __ 

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

0No 

O Yes. Name of person 

Official Form 107 

Attach the Bankruptcy Petition Preparer's Notice, 

Declaration. and Signature (Official Form 119). 

Statement of Financial Affairs for Individuals Filing for Bankruptcy page 7 of 7 

Case 21-17336-MAM Doc 44 Filed 09/22/21 Page 33 of 33