Fill in this information to identify your case:

United States Bankruptcy Court for the:

SOUTHERN DISTRICT OF FLORIDA, FORT LAUDERDALE DIVISION

Case number (if known) Chapter 11

 Check if this an amended

filing

Official Form 201

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

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

1. Debtor's name United Dispenser Services, Inc.

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

Include any assumed

names, trade names and

doing business as names

3. Debtor's federal Employer

Identification Number

(EIN)

59-3721030

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

business

6500 NW 16th St

Ste 2

Plantation, FL 33313-4522

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

Broward Location of principal assets, if different from principal

County place of business

6500 NW 16th St Ste 2 Plantation, FL 33313-4522

Number, Street, City, State & ZIP Code

5. Debtor's website (URL) www.uniteddispenser.com

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

 Partnership (excluding LLP)

 Other. Specify:

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

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 1 of 8
Debtor United Dispenser Services, Inc. Case number (if known) Name

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

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

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

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

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

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

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

None of the above

B. Check all that apply

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

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

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

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

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

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

A debtor who is a “small

business debtor” must check

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

elects to proceed under subchapter V of chapter 11

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

Check one:

 Chapter 7

 Chapter 9

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

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

$2,725,625. If this sub-box is selected, attach the most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return or if any of these documents do not exist, follow the

procedure in 11 U.S.C. § 1116(1)(B).  The debtor is a debtor as defined in 11 U.S.C. § 1182(1), its aggregate noncontingent liquidated debts

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

under Subchapter V of Chapter 11. If this sub-box is selected, attach the most recent balance

sheet, statement of operations, cash-flow statement, and federal income tax return, or if any of these

documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B).  A plan is being filed with this petition.

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

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

Exchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File the Attachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11 (Official

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

 Chapter 12

9. Were prior bankruptcy

cases filed by or against the debtor within the last 8

years?

 No.

Yes.

If more than 2 cases, attach a

separate list. District When Case number

District When Case number

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

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 2 of 8
Debtor United Dispenser Services, Inc. Case number (if known) Name

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

affiliate of the debtor?

 No

Yes.

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

District When Case number, if known

11. Why is the case filed in

this district?

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

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

12. Does the debtor own or have possession of any

real property or personal

property that needs

immediate attention?

 No

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

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

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

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

Where is the property?

Number, Street, City, State & ZIP Code

Is the property insured?

 No

Yes.

Insurance agency

Contact name

Phone

Statistical and administrative information

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

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

14. Estimated number of creditors  1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than100,000

15. Estimated Assets  $0 - $50,000

 $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $1,000,001 - $10 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $500,000,001 - $1 billion

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

16. Estimated liabilities  $0 - $50,000  $1,000,001 - $10 million  $500,000,001 - $1 billion

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

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 3 of 8
Debtor United Dispenser Services, Inc. Case number (if known) Name  $50,001 - $100,000

 $100,001 - $500,000

 $500,001 - $1 million

 $10,000,001 - $50 million

 $50,000,001 - $100 million

 $100,000,001 - $500 million

 $1,000,000,001 - $10 billion

 $10,000,000,001 - $50 billion

 More than $50 billion

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

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 4 of 8
Debtor United Dispenser Services, Inc. Case number (if known) Name

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

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

17. Declaration and signature of authorized

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

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

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

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

Executed on October 28, 2021

MM / DD / YYYY

X /s/ David Fay David Fay

Signature of authorized representative of debtor Printed name

Title President

18. Signature of attorney X /s/ Chad Van Horn Date October 28, 2021

Signature of attorney for debtor MM / DD / YYYY

Chad Van Horn

Printed name

Van Horn Law Group, P.A.

Firm name

330 N Andrews Ave Ste 450

Fort Lauderdale, FL 33301-1012

Number, Street, City, State & ZIP Code

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

64500

Bar number and State

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 5

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 5 of 8
Software Copyright (c) 2021 CINGroup - www.cincompass.com

United States Bankruptcy Court

IN RE: Case No. 

Debtor(s)

Chapter 

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

Date: Signature: 

Debtor

Date: Signature: 

Joint Debtor, if any

Southern District of Florida, Fort Lauderdale Division

VERIFICATION OF CREDITOR MATRIX

United Dispenser Services, Inc. 11

October 28, 2021 /s/ David Fay

David Fay, President

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 6 of 8
C T CORPORATION SYSTEM, AS REP

330 N Brand Blvd Ste 700

Glendale, CA 91203-2336

C T CORPORATION SYSTEM, AS REPRESENTATIV

330 N Brand Blvd Ste Attn

Glendale, CA 91203-2308

Corporation Service Company as Rep.

PO Box 2576

Springfield, IL 62708-2576

CORPORATION SERVICE COMPANY, AS REP

PO Box 2576

Springfield, IL 62708-2576

CT Lien Solutions

PO Box 29071

Glendale, CA 91209-9071

David A. Fay

6500 NW 16th St Ste 2

Plantation, FL 33313-4522

First National Financial

6433 Topanga Canyon Blvd # 442

Canoga Park, CA 91303-2621

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 7 of 8
Internal Revenue Services

PO Box 7346

Philadelphia, PA 19101-7346

Law Offices of Gable & Heidt

4000 Hollywood Blvd Ste 735

Hollywood, FL 33021-1213

Shelter Developers of America

5009 N Hiatus Rd

City of Sunrise, FL 33351-8018

U.S. SMALL BUSINESS ADMINISTRATION

2 NORTH ST STE 320

Birmingham, AL 35201

US Attorney for Southern District of Fla

99 NE 4th St

Miami, FL 33132-2131

Wellen Capital, LLC

600 W Jackson Blvd Ste 750

Chicago, IL 60661-5683

Case 21-20340-PDR Doc 1 Filed 10/28/21 Page 8 of 8