Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 1 

Official Form 204 

Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest 

Unsecured Claims and Are Not Insiders 12/15

A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor 

disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by 

secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20 

largest unsecured claims. 

Name of creditor and complete 

mailing address, including zip code

Name, telephone number, 

and email address of 

creditor contact 

Nature of the claim 

(for example, trade

debts, bank loans, 

professional 

services, and 

government 

contracts)

Indicate if 

claim is 

contingent, 

unliquidated, 

or disputed 

Amount of unsecured claim

If the claim is fully unsecured, fill in only unsecured 

claim amount. If claim is partially secured, fill in 

total claim amount and deduction for value of 

collateral or setoff to calculate unsecured claim. 

Total claim, if 

partially 

secured

Deduction for 

value of 

collateral or 

setoff

Unsecured 

claim

1

2

3

4

5

6

7

8

 Check if this is an

amended filing

Debtor name __________________________________________________________________ 

United States Bankruptcy Court for the:_______________________________ 

Case number (If known): _________________________ 

Fill in this information to identify the case:

340 Biscayne Owner LLC

Paycheck Protection

Program

Utility Services

Hotel Operator

989,219.00

0.00

Unknown

0.00

Disputed

Unliquidated

Contingent

0.00

Unknown

Unknown

Unknown

Southern District of Florida

Aimbridge Hospitality Holdings LLC

5851 Legacy Circle

Suite 400

Planto, TX, 75024

Florida Power & Light Company

700 Universe Boulevard

North Palm Beach, FL, 33408

Miami Dade Tax Collector

200 NW 2nd Avenu

Miami, FL, 33128

Florida Department of Revenue

Mail Stop 3-2000

5050 W. Tennessee Street

Tallahassee, FL, 32399-0112

Internal Revenue Service

P.O. Box 7346

Philadelphia, PA, 19101

Holiday Hospitality Franchising, LLC

Three Ravinia Drive

Suite 100

Atlanta, GA, 30346

Bilzin Sumberg

1450 Brickell Avenue, 23rd Floor

Miami, FL, 33131

First Bank Puerto Rico

D/B/A First Bank Florida

9795 South Dixie Highway

Miami, FL, 33156

21-17203

Case 21-17203-LMI Doc 5 Filed 07/26/21 Page 1 of 2
Debtor _______________________________________________________ Case number (if known)_____________________________________ 

Name

Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 2 

Name of creditor and complete 

mailing address, including zip code

Name, telephone number, 

and email address of 

creditor contact 

Nature of the claim 

(for example, trade

debts, bank loans, 

professional 

services, and 

government 

contracts)

Indicate if 

claim is 

contingent, 

unliquidated, 

or disputed 

Amount of unsecured claim

If the claim is fully unsecured, fill in only unsecured 

claim amount. If claim is partially secured, fill in 

total claim amount and deduction for value of 

collateral or setoff to calculate unsecured claim. 

Total claim, if 

partially 

secured

Deduction for 

value of 

collateral or 

setoff

Unsecured 

claim

9

10

11

12

13

14

15

16

17

18

19

20

340 Biscayne Owner LLC

Lease Financing

Obligation (Monthly)

Disputed

Unliquidated

Contingent 0.00

KAWA 340 Biscayne LLC

21500 Biscayne Blvd

Suite 700

Miami, FL, 33180

Case 21-17203-LMI Doc 5 Filed 07/26/21 Page 2 of 2