 Check if this is an

Fill in this information to identify your case:

United States Bankruptcy Court for the:

Case number (if known): Chapter you are filing under:









Chapter 7

Chapter 11

Chapter 12

Chapter 13 amended filing

Official Form 101

Voluntary Petition for Individuals Filing for Bankruptcy 04/20 

Part 1: Identify Yourself

1. Your full name

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

First Name

Middle Name

Last Name

Suffix (Sr., Jr., II, III)

First Name

Middle Name

Last Name

Suffix (Sr., Jr., II, III)

Clifford

Ryan

Morris

SOUTHERN DISTRICT OF FLORIDA

21-20416-MAM

The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case 

together--called a joint case--and in joint cases, these forms use you to ask for information from both debtors. For example, if 

a form asks, "Do you own a car," the answer would be yes if either debtor owns a car. When information is needed about the 

spouses separately, the form uses Debtor 1 and Debtor 2 to distinguish between them. In joint cases, one of the spouses 

must report information as Debtor 1 and the other as Debtor 2. The same person must be Debtor 1 in all of the forms.

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.

Write the name that is on your 

government-issued picture 

identification (for example, 

your driver's license or 

passport).

Bring your picture 

identification to your meeting 

with the trustee.

2. All other names you

First Name

Middle Name

Last Name

First Name

Middle Name

Last Name

have used in the last 8

years

Include your married or 

maiden names.

3.

xxx – xx –

9xx – xx –

OR

xxx – xx –

9xx – xx –

OR

0026

 

 

 

Only the last 4 digits of 

your Social Security 

number or federal 

Individual Taxpayer 

Identification number 

(ITIN)

4.  I have not used any business names or EINs.

Business name

Business name

 I have not used any business names or EINs.

Business name

Business name

Business name Business name

Any business names 

and Employer 

Identification Numbers 

(EIN) you have used in 

the last 8 years

Include trade names and 

doing business as names

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 1 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 1 of 8
Case number (if known) 21-20416-MAM

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

Debtor 1 Clifford Ryan Morris

–

–

–

–

EIN EIN

EIN EIN

 

 

 

 

5. Where you live

Number Street

City

County

If Debtor 2 lives at a different address:

State ZIP Code

Number

State ZIP Code

County

City

Street

If your mailing address is different from

the one above, fill it in here. Note that the

court will send any notices to you at this

mailing address.

If Debtor 2's mailing address is different

from yours, fill it in here. Note that the court

will send any notices to you at this mailing

address.

Number Street

City State ZIP Code

P.O. Box

Number Street

City State ZIP Code

P.O. Box

1228 Merlot Dr

Palm Beach Gardens FL 33410

Palm Beach

6.



Check one:





Check one:



Why you are choosing 

this district to file for 

bankruptcy Over the last 180 days before filing this 

petition, I have lived in this district longer 

than in any other district.

I have another reason. Explain.

(See 28 U.S.C. § 1408.)

Over the last 180 days before filing this 

petition, I have lived in this district longer 

than in any other district.

I have another reason. Explain.

(See 28 U.S.C. § 1408.)

Part 2: Tell the Court About Your Bankruptcy Case

7.



Check one:



(For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing

for Bankruptcy (Form 2010)). Also, go to the top of page 1 and check the appropriate box.

Chapter 7

Chapter 11

 Chapter 12

 Chapter 13

The chapter of the 

Bankruptcy Code you 

are choosing to file 

under

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 2 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 2 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

8. How you will pay the fee 





I will pay the entire fee when I file my petition.

I need to pay the fee in installments.

I request that my fee be waived

Please check with the clerk's office in your local

If you choose this option, sign and attach the Application for

Individuals to Pay The Filing Fee in Installments (Official Form 103A).

(You may request this option only if you are filing for Chapter 7.

court for more details about how you may pay. Typically, if you are paying the fee yourself, you may 

pay with cash, cashier's check, or money order. If your attorney is submitting your payment on your 

behalf, your attorney may pay with a credit card or check with a pre-printed address.

By law, a judge may, but is not required to, waive your fee, and may do so only if your income is less 

than 150% of the official poverty line that applies to your family size and you are unable to pay the 

fee in installments). If you choose this option, you must fill out the Application to Have the Chapter 7 

Filing Fee Waived (Official Form 103B) and file it with your petition.

9.  No

 Yes.

District When Case number

MM / DD / YYYY

District When Case number

MM / DD / YYYY

District When Case number

MM / DD / YYYY

Have you filed for 

bankruptcy within the 

last 8 years?

10.  No

 Yes.

Debtor

District

Relationship to you

MM / DD / YYYY

When Case number,

if known

Debtor

District

Relationship to you

MM / DD / YYYY

When Case number,

if known

Are any bankruptcy 

cases pending or being 

filed by a spouse who is 

not filing this case with 

you, or by a business 

partner, or by an 

affiliate?

11.  No.

 Yes.

Go to line 12.

 No. Go to line 12.



Do you rent your 

residence? Has your landlord obtained an eviction judgment against you?

Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) 

and file it as part of this bankruptcy petition.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 3 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 3 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

Part 3: Report About Any Businesses You Own as a Sole Proprietor

12.  No. Go to Part 4.

 Yes. Name and location of business

Name of business, if any

Number Street

City State ZIP Code

Check the appropriate box to describe your business:

 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))

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

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

 None of the above

Are you a sole proprietor 

of any full- or part-time 

business?

A sole proprietorship is a 

business you operate as an 

individual, and is not a 

separate legal entity such as 

a corporation, partnership, or 

LLC.

If you have more than one 

sole proprietorship, use a 

separate sheet and attach it 

to this petition.

13. If you are filing under Chapter 11, the court must know whether you are a small business debtor or a debtor

choosing to proceed under Subchapter V so that it can set appropriate deadlines. If you indicate that you

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).

 No.

 No.

 Yes.

I am not filing under Chapter 11.

I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in

the Bankruptcy Code.

I am filing under Chapter 11, I am a small business debtor according to the definition in the

Bankruptcy Code, and I do not choose to proceed under Subchapter V of Chapter 11.

are you a small business

debtor

 Yes. I am filing under Chapter 11, I am a debtor according to the definition in § 1182(1) of the

Bankruptcy Code, and I choose to proceed under Subchapter V of Chapter 11.

or a debtor as

defined by 11 U.S.C.

§ 1182(1)?

are a small business debtor or you are choosing to proceed under Subchapter V, you must attach your

Are you filing under 

Chapter 11 of the 

Bankruptcy Code, and

For a definition of small 

business debtor, see 

11 U.S.C. § 101(51D).

Part 4: Report If You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention

14.  No

 Yes. What is the hazard?

If immediate attention is needed, why is it needed?

Where is the property?

Number Street

City State ZIP Code

Do you own or have any 

property that poses or is 

alleged to pose a threat of 

imminent and identifiable 

hazard to public health or 

safety? Or do you own 

any property that needs 

immediate attention?

For example, do you own 

perishable goods, or 

livestock that must be fed, or 

a building that needs urgent 

repairs?

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 4 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 4 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

Part 5: Explain Your Efforts to Receive a Briefing About Credit Counseling

15. About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):

You must check one:









 Incapacity.

 Disability.

 Active duty.









 Incapacity.

 Disability.

 Active duty.

You must check one:

Tell the court 

whether you 

have received a 

briefing about 

credit 

counseling.

The law requires 

that you receive a 

briefing about credit 

counseling before 

you file for 

bankruptcy. You 

must truthfully 

check one of the 

following choices. 

If you cannot do so, 

you are not eligible 

to file.

If you file anyway, 

the court can 

dismiss your case, 

you will lose 

whatever filing fee 

you paid, and your 

creditors can begin 

collection activities 

again.

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, and I received a 

certificate of completion.

Attach a copy of the certificate and the payment 

plan, if any, that you developed with the agency.

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, but I do not have 

a certificate of completion.

Within 14 days after you file this bankruptcy petition, 

you MUST file a copy of the certificate and payment 

plan, if any.

I certify that I asked for credit counseling 

services from an approved agency, but was 

unable to obtain those services during the 7 

days after I made my request, and exigent 

circumstances merit a 30-day temporary 

waiver of the requirement.

To ask for a 30-day temporary waiver of the 

requirement, attach a separate sheet explaining what 

efforts you made to obtain the briefing, why you 

were unable to obtain it before you filed for 

bankruptcy, and what exigent circumstances 

required you to file this case.

Your case may be dismissed if the court is 

dissatisfied with your reasons for not receiving a 

briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must 

still receive a briefing within 30 days after you file. 

You must file a certificate from the approved agency, 

along with a copy of the payment plan you 

developed, if any. If you do not do so, your case 

may be dismissed.

Any extension of the 30-day deadline is granted only 

for cause and is limited to a maximum of 15 days.

I am not required to receive a briefing about 

credit counseling because of:

I have a mental illness or a mental 

deficiency that makes me 

incapable of realizing or making 

rational decisions about finances.

My physical disability causes me 

to be unable to participate in a 

briefing in person, by phone, or 

through the internet, even after I 

reasonably tried to do so.

I am currently on active military 

duty in a military combat zone.

If you believe you are not required to receive a 

briefing about credit counseling, you must file a 

motion for waiver of credit counseling with the court.

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, and I received a 

certificate of completion.

Attach a copy of the certificate and the payment 

plan, if any, that you developed with the agency.

I received a briefing from an approved credit 

counseling agency within the 180 days before I 

filed this bankruptcy petition, but I do not have 

a certificate of completion.

Within 14 days after you file this bankruptcy petition, 

you MUST file a copy of the certificate and payment 

plan, if any.

I certify that I asked for credit counseling 

services from an approved agency, but was 

unable to obtain those services during the 7 

days after I made my request, and exigent 

circumstances merit a 30-day temporary 

waiver of the requirement.

To ask for a 30-day temporary waiver of the 

requirement, attach a separate sheet explaining what 

efforts you made to obtain the briefing, why you 

were unable to obtain it before you filed for 

bankruptcy, and what exigent circumstances 

required you to file this case.

Your case may be dismissed if the court is 

dissatisfied with your reasons for not receiving a 

briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must 

still receive a briefing within 30 days after you file. 

You must file a certificate from the approved agency, 

along with a copy of the payment plan you 

developed, if any. If you do not do so, your case 

may be dismissed.

Any extension of the 30-day deadline is granted only 

for cause and is limited to a maximum of 15 days.

I am not required to receive a briefing about 

credit counseling because of:

I have a mental illness or a mental 

deficiency that makes me 

incapable of realizing or making 

rational decisions about finances.

My physical disability causes me 

to be unable to participate in a 

briefing in person, by phone, or 

through the internet, even after I 

reasonably tried to do so.

I am currently on active military 

duty in a military combat zone.

If you believe you are not required to receive a 

briefing about credit counseling, you must file a 

motion for waiver of credit counseling with the court.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 5 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 5 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

Part 6: Answer These Questions for Reporting Purposes

16. 16a.

16b.

16c.

Are your debts primarily consumer debts?

Are your debts primarily business debts?

State the type of debts you owe that are not consumer or business debts.

Consumer debts

Business debts

are defined in 11 U.S.C. § 101(8)

as "incurred by an individual primarily for a personal, family, or household purpose."

are debts that you incurred to obtain

money for a business or investment or through the operation of the business or investment.





No. Go to line 16b.

Yes. Go to line 17.





No. Go to line 16c.

Yes. Go to line 17.

What kind of debts do you 

have?

17.

 No.

 Yes.

I am not filing under Chapter 7. Go to line 18.

I am filing under Chapter 7. Do you estimate that after any exempt property is excluded and

administrative expenses are paid that funds will be available to distribute to unsecured creditors?





No

Yes

Are you filing under 

Chapter 7?

Do you estimate that after 

any exempt property is 

excluded and 

administrative expenses 

are paid that funds will be 

available for distribution 

to unsecured creditors?

18.  1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5,001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than 100,000

How many creditors do 

you estimate that you 

owe?

19.  $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

 $500,000,001-$1 billion

 $1,000,000,001-$10 billion

 $10,000,000,001-$50 billion

 $100,000,001-$500 million  More than $50 billion

How much do you 

estimate your assets to 

be worth?

20.  $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

 $500,000,001-$1 billion

 $1,000,000,001-$10 billion

 $10,000,000,001-$50 billion

 $100,000,001-$500 million  More than $50 billion

How much do you 

estimate your liabilities to 

be?

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 6 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 6 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

Part 7: Sign Below

X /s/ Clifford Ryan Morris X

Clifford Ryan Morris, Debtor 1 Signature of Debtor 2

Executed on

MM / DD / YYYY

Executed on

MM / DD / YYYY

12/11/2021

For you I have examined this petition, and I declare under penalty of perjury that the information provided is true 

and correct.

If I have chosen to file under Chapter 7, I am aware that I may proceed, if eligible, under Chapter 7, 11, 12, 

or 13 of title 11, United States Code. I understand the relief available under each chapter, and I choose to 

proceed under Chapter 7.

If no attorney represents me and I did not pay or agree to pay someone who is not an attorney to help me 

fill out this document, I have obtained and read the notice required by 11 U.S.C. § 342(b).

I request relief in accordance with the chapter of title 11, United States Code, specified in this petition.

I understand 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.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 7 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 7 of 8
Debtor 1 Clifford Ryan Morris Case number (if known) 21-20416-MAM

X /s/ Kenneth Ray Noble III, Esq

Signature of Attorney for Debtor

Date

MM / DD / YYYY

Printed name

Firm Name

Number Street

City State ZIP Code

Contact phone Email address

Bar number State

12/11/2021

Kenneth Ray Noble III, Esq

Noble Law Firm, PA

6199 N Federal Highway

Boca Raton FL 33487

(561) 353-9300

859451 FL

For your attorney, if you are 

represented by one

If you are not represented by 

an attorney, you do not need 

to file this page.

I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about 

eligibility to proceed under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the 

relief available under each chapter for which the person is eligible. I also certify that I have delivered to 

the debtor(s) the notice required by 11 U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, 

certify that I have no knowledge after an inquiry that the information in the schedules filed with the petition 

is incorrect.

Official Form 101 Voluntary Petition for Individuals Filing for Bankruptcy page 8 

Case 21-20416-MAM Doc 19 Filed 12/11/21 Page 8 of 8