Fill in this information to identify your case:

Debtor 1 Altagracia Tavarez

First Name Middle Name Last Name

Debtor 2

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

United States Bankruptcy Court for the: FT. LAUDERDALE DIVISION

Case number 21-15049-PDR

(if known)  Check if this is an

amended filing

Official Form 108

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

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

 creditors have claims secured by your property, or

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

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

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

on the form

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

sign and date the form.

Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,

write your name and case number (if known).

Part 1: List Your Creditors Who Have Secured Claims

1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the

information below.

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

secures a debt?

Did you claim the property

as exempt on Schedule C?

Creditor's Select Portfolio Servicing, Inc  Surrender the property.  No

 Yes

name:  Retain the property and redeem it.

 Retain the property and enter into a

Reaffirmation Agreement. Description of 7825 Alhambra Boulevard

Miramar, FL 33023-5821

Broward County

Parcel Identification Number:

5141 27 09 0170

Legal Description: MIRAMAR

PARK FIRST ADD 59-20 B LOT

12 BLK 2

Valuation is based Zillow

property  Retain the property and [explain]:

securing debt:

Part 2: List Your Unexpired Personal Property Leases

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

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

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

Describe your unexpired personal property leases Will the lease be assumed?

Lessor's name:  No

 Yes

Description of leased

Property:

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

Software Copyright (c) 1996-2021 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 21-15049-PDR Doc 17 Filed 06/21/21 Page 1 of 2
Debtor 1 Altagracia Tavarez Case number (if known) 21-15049-PDR

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Lessor's name:  No

 Yes

Description of leased

Property:

Part 3: Sign Below

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

property that is subject to an unexpired lease.

X /s/ Altagracia Tavarez X

Altagracia Tavarez Signature of Debtor 2

Signature of Debtor 1

Date June 21, 2021 Date

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

Software Copyright (c) 1996-2021 Best Case, LLC - www.bestcase.com Best Case Bankruptcy

Case 21-15049-PDR Doc 17 Filed 06/21/21 Page 2 of 2