Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 1 of 2

Official Form 106Sum 

Summary of Your Assets and Liabilities and Certain Statistical Information 12/15

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. 

Part 1: Summarize Your Assets

Your assets

Value of what you own

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

1a. Copy line 55, Total real estate, from Schedule A/B........................................................................................................

$ ________________

1b. Copy line 62, Total personal property, from Schedule A/B............................................................................................. $ ________________

1c. Copy line 63, Total of all property on Schedule A/B ....................................................................................................... $ ________________

Part 2: Summarize Your Liabilities

Your liabilities

Amount you owe

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 E/F: 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 E/F ...........................................

$ ________________

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F....................................... + $ ________________

Your total liabilities $ ________________

Part 3: Summarize Your Income and Expenses

4. Schedule I: Your Income (Official Form 106I)

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

$ ________________

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

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

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________ District of __________

(State) 

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

 Check if this is an

amended filing

203,690.00

0.00

1,799.57

185,775.74

Southern District of Florida

2,707.00

3,058.65

12,195.74

173,580.00

Marcos Jaime Levy

205,489.57

20-20977

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 1 of 30
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

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

Part 4: Answ er These Questions for Administrative and Statistical Records

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

 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.

 Yes

7. What kind of debt do you have?

 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:

Total claim

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 6g.)

$_____________________

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

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

✔

0.00

0.00

0.00

0.00

0.00

Marcos Jaime Levy 20-20977

0.00

0.00

✔

5,216.01

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 2 of 30
12/15

3.

1.

Fill in this information to identify your case and this filing:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of

Florida

Case number

(if know)

Official Form 106A/B

Schedule A/B: Property

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.

Part 1: Describe Each Residence, Building, Land, or Other Real Estate You Own or Have an Interest In

Do you own or have any legal or equitable interest in any residence, building, land, or similar property?

 No. Go to Part 2

 Yes. Where is the property?

Value based on Broward Property Appraiser Market Value

Part 2:

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.

Cars, vans, trucks, tractors, sport utility vehicles, motorcycles

 No

 Yes

Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977

Check if this is an

amended filing

1.1

What is the property? Check all that apply

 Single-family home

 Duplex or multi-unit building

 Condominium or cooperative

 Manufactured or mobile home

 Land

 Investment property

 Timeshare

 Other

Who has an interest in the property? Check one

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 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?

$ 173,580.00

Current value of the

portion you own?

$ 173,580.00

Describe the nature of your ownership

interest (such as fee simple, tenancy by the

entireties, or a life estate), if known.

 Check if this is community property

16100 Golf Club Rd

101

Street address, if available, or other description

Weston

City

FL

State

33326-1874

ZIP Code

Broward County

Country

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

property identification number:

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...........................................................................................................................................➤ $ 173,580.00

Describe Your Vehicles

3.1 Make:Toyota

Model:Camry

Year: 2015

Approximate mileage: 95,000

Other information:

Who has an interest in the property? Check one

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

 Check if this is community property (see

instructions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims onSchedule D:

Creditors Who Have Claims Secured by Property:

Current value of the

entire property?

$ 0.00

Current value of the

portion you own?

Condition:Good; Debtor drives $ 0.00

pays and maintains vehicle under

son's name.;

page 1 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 3 of 30
4.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories

Examples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle accessories

 No

 Yes

Part 3:

Current value of the

portion you own?

Household goods and furnishings Do not deduct secured

claims or exemptions.

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

 No

 Yes. Describe...

1 twin bed, 2 single beds, 2 night tables, 2 lamps, 1 desk, 1 shelf, 1 side table, 1 dining table, 1 sofa, 1 couch, 1 book shelf, 1

wall mirror, 2 lamps, 2 side tables, miscellaneous kitchen appliances

Electronics

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

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

 No

 Yes. Describe...

1 Laptop, 1 computer, 1 cell phone

Collectibles of value

Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects;

stamp, coin, or baseball card collections; other collections, memorabilia, collectibles

 No

 Yes. Describe...

Equipment for sports and hobbies

Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; canoes

and kayaks; carpentry tools; musical instruments

 No

 Yes. Describe...

Firearms

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

 No

 Yes. Describe...

Clothes

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

 No

 Yes. Describe...

Personal clothing and Shoes

Jewelry

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

gold, silver

 No

 Yes. Describe...

Non-farm animals

Examples: Dogs, cats, birds, horses

 No

 Yes. Describe...

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

 No

 Yes. Give specific information...

5.

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

you have attached for Part 2. Write that number here...........................................................................................................................................➤ $ 0.00

Describe Your Personal and Household Items

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

$ 1,370.00

Examples:

$ 600.00

Examples:

Examples:

$ 75.00

Examples:

Debtor 1 Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

page 2 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 4 of 30
15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

Part 4:

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

Cash

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

 No

 Yes.............................................................................................................................................. Cash ...........................

Deposits of money

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.

 No

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

17.1. Checking account: PNC Bank- Virtual Wallet With Performance Spend checking account ending in 3367

17.2. Checking account: TD Bank- Checking account ending in 0279

17.3. Savings account: PNC Bank - Virtual Wallet Reserve account ending in 3375

17.4. Savings account: PNC bank-Virtual Wallet Growth account ending in 3383

Bonds, mutual funds, or publicly traded stocks

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

 No

 Yes..................

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

LLC, partnership, and joint venture

 No

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

Name of entity: % of ownership:

OUT OF LIMITS BUSINESS STRATEGIES LLC 100 % $ 0.00

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.

 No

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

Retirement or pension accounts

Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sharing plans

 No

 Yes. List each account separately

Security deposits and prepayments

Your share of all unused deposits you have made so that you may continue service or use from a company

Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommunications

companies, or others

 No

 Yes.....................

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

 No

 Yes......................

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)(1), 529A(b), and 529(b)(1).

 No

 Yes......................

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

you have attached for Part 3. Write that number here...........................................................................................................................................➤ $ 2,045.00

Describe Your Financial Assets

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

$ 20.00

Examples:

$ 1,500.74

$ 4,000.00

$ 630.00

$ 0.00

Examples:

Debtor 1 Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

page 3 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 5 of 30
25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

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

for your benefit

 No

 Yes. Give specific information about them...

Patents, copyrights, trademarks, trade secrets, and other intellectual property

Examples: Internet domain names, websites, proceeds from royalties and licensing agreements

 No

 Yes. Give specific information about them...

Licenses, franchises, and other general intangibles

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

 No

 Yes. Give specific information about them...

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

Tax refunds owed to you

 No

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

Federal: $ 0.00

State: $ 0.00

Local: $ 0.00

Family support

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

 No

 Yes. Give specific information....

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

 No

 Yes. Give specific information....

Interests in insurance policies

 No

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

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

 No

 Yes. Give specific information....

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

 No

 Yes. Give specific information....

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

claims

 No

 Yes. Give specific information....

Any financial assets you did not already list

 No

 Yes. Give specific information...

Part 5: Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1.

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

 No. Go to Part 6.

 Yes. Go to line 38.

Money or property owed to you?

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

you have attached for Part 4. Write that number here...........................................................................................................................................➤ $ 6,150.74

Debtor 1 Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

page 4 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 6 of 30
38.

39.

40.

41.

42.

43.

44.

45.

46.

53.

54.

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

Accounts receivable or commissions you already earned

 No

 Yes. Describe...

Office equipment, furnishings, and supplies

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

devices

 No

 Yes. Describe...

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

 No

 Yes. Describe...

Inventory

 No

 Yes. Describe...

Interests in partnerships or joint ventures

 No

 Yes. Describe........

Customer lists, mailing lists, or other compilations

 No

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

Any business-related property you did not already list

 No

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

Suntrust Buisness Account ending in 5951 $ 4,000.00

Part 6:

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

 No. Go to Part 7.

 Yes. Go to line 47.

Part 7: Describe All Property You Own or Have an Interest in That You Did Not List Above

Do you have other property of any kind you did not already list?

Examples: Season tickets, country club membership

 No

 Yes. Give specific

Part 8: List the Totals of Each Part of this Form List the Totals of Each Part of this Form

56. Part 2: Total vehicles, line 5 $ 0.00

57. Part 3: Total personal and household items, line 15 $ 2,045.00

58. Part 4: Total financial assets, line 36 $ 6,150.74

59. Part 5: Total business-related property, line 45 $ 4,000.00

60. Part 6: Total farm- and fishing-related property, line 52 $ 0.00

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

Add the dollar value of the portion you own for all of your entries from Part 5, including any entries for pages

you have attached for Part 5. Write that number here...........................................................................................................................................➤ $ 4,000.00

Describe Any Farm- and Commercial Fishing-Related Property You Own or Have an Interest In. erty You Own or Have an Interest In.

If you own or have an interest in farmland, list it in Part 1.

information...

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

$ 0.00

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

$ 173,580.00

+ $ 0.00

Debtor 1 Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

page 5 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 7 of 30
62. Total personal property. Add lines 56 through 61 ................... $ 12,195.74 Copy personal property total➤ + $

12,195.74

63. Total of all property on Schedule A/B. Add line 55 + line 62 $ 185,775.74

Debtor 1 Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

page 6 of 6

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 8 of 30
Official Form 106C Schedule C: The Property You Claim as Exempt page 1 of __

Official Form 106C 

Schedule C: T he Property You Claim as Exempt 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/B: Property (Official Form 106A/B) 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. 

Part 1: 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.

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

 You are claiming federal exemptions. 11 U.S.C. § 522(b)(2)

2. For any property you list on Schedule A/B that you claim as exempt, fill in the information below.

Brief description of the property and line on 

Schedule A/B that lists this property

Current value of the 

portion you own

Copy the value from 

Schedule A/B

Brief 

description:

Line from 

Schedule A/B:

$________________  $ ____________

Brief 

description:

Line from 

Schedule A/B:

$________________  $ ____________

Brief 

description: $________________  $ ____________

Line from 

Schedule A/B:

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

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

 No

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

 No

 Yes 

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________ District of __________

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

 Check if this is an

amended filing

Specific laws that allow exemption

 100% of fair market value, up to

any applicable statutory limit 

 100% of fair market value, up to

any applicable statutory limit 

 100% of fair market value, up to

any applicable statutory limit 

Amount of the 

exemption you claim 

Check only one box 

for each exemption

Household goods - 1 twin bed, 2 single beds, 2 night

tables, 2 lamps, 1 desk, 1 shelf, 1 side table, 1

dining table, 1 sofa, 1 couch, 1 book shelf, 1 wall

mirror, 2 lamps, 2 side tables, miscellaneous kitchen

appliances

1,370.00

16100 Golf Club Rd

173,580.00

✔

Southern District of Florida

✔

✔

✔

1.1

6

In re Hawkins, 51 B.R. 348 (S.D. Fla.

1985) Fla. Const. Art.10, § 4(a) (2)

Fla. Const. Art. 10, sec. 4(a)(1)

Marcos Jaime Levy

173,580.00

1,000.00

20-20977

1

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 9 of 30
12/15

Fill in this information to identify your case:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of Florida

Case number

(if know)

Official Form 106D

Schedule D: Creditors Who Have Claims Secured by Prope Schedule D: Creditors Who Have Claims Secured by Property

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).

Part 1: List All Secured Claims

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977 Check if this is an

amended filing

Do any creditors have claims secured by your property?

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

 Yes. Fill in all of the information below.

1.

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.

Column B

Value of collateral

that supports this

claim

Column C

Unsecured

portion If any

Column A

Amount of claim

Do not deduct the

value of collateral.

2.1 Describe the property that secures the claim: $ 13,000.00 $ 0.00 $ 13,000.00

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Date debt was incurred 

- $0.00

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

apply.

 Contingent

 Unliquidated

 Disputed

Nature of lien. Check all that apply.

An agreement you made (such as mortgage or

secured car loan)

Statutory lien (such as tax lien, mechanic’s lien)

 Judgment lien from a lawsuit

 Other (including a right to offset) 

Building Four of Country Club Apts at Bonav

Creditor’s Name

c/o Bryant Law

101 NE 3rd Ave, Suite 1500

Number Street

Fort Lauderdale

City

FL

State

33301

ZIP Code

Last 4 digits of account number 3562

2.2 Describe the property that secures the claim: $ 190,690.00 $ 173,580.00 $ 17,110.00

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Date debt was incurred 

16100 Golf Club Rd 101, Weston, FL 33326-1874 - $173,580.00

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

apply.

 Contingent

 Unliquidated

 Disputed

Nature of lien. Check all that apply.

An agreement you made (such as mortgage or

secured car loan)

Statutory lien (such as tax lien, mechanic’s lien)

 Judgment lien from a lawsuit

 Other (including a right to offset) 

US Bank Trust National Association

Creditor’s Name

425 Walnut Street

Number Street

Cincinnati

City

OH

State

45202-3923

ZIP Code

Last 4 digits of account number 3562

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 2

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 10 of 30
Part 2: List Others to Be Notified for a Debt That You Already Listed

Add the dollar value of your entries in Column A on this page. Write that number here: $ 203,690.00

Use this page only if you have others to be notified about your bankruptcy for 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.

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 2 of 2

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 11 of 30
12/15

Fill in this information to identify your case:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of Florida

Case number

(if know)

Official Form 106E/F

Schedule E/F: Creditors Who Have Unsecured Claims

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).

Part 1: List All of Your PRIORITY Unsecured Claims

Part 2: List All of Your NONPRIORITY Unsecured Claims

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977 Check if this is an

amended filing

Do any creditors have priority unsecured claims against you?

 No. Go to Part 2.

 Yes.

1.

3. 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.If you have more than three nonpriority unsecured claims fill out the Continuation Page of Part 2.

Total claim

Do any creditors have nonpriority unsecured claims against you?

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

 Yes. Fill in all of the information below.

2.

3.1 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

BSI Financial Services

Nonpriority Creditor's Name

1425 Greenway Dr. #400

Number Street

Irving

City

TX

State

75038-2480

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 12 of 30
3.2 $ 1,799.57

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Capital One Bank (USA)

Nonpriority Creditor's Name

by American InfoSource as agent

PO Box 71083

Number Street

Charlotte

City

NC

State

28272-1083

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

3.3 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Chase Mortgage

Nonpriority Creditor's Name

POBox 24696

Number Street

Columbus

City

OH

State

43224-0696

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

3.4 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Country Club Village Association

Nonpriority Creditor's Name

16300 Golf Club Rd

Number Street

Weston

City

FL

State

33326

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 2 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 13 of 30
3.5 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Discover Card

Nonpriority Creditor's Name

PO Box 30943

Number Street

Salt Lake City

City

UT

State

84130-0943

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

3.6 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Elite Management Associates

Nonpriority Creditor's Name

9600 Griffin Rd

Number Street

Cooper City

City

FL

State

33328-3417

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

3.7 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

SN Servicing Corporation

Nonpriority Creditor's Name

323 Fifth Street

Number Street

Eureka

City

CA

State

95501

ZIP Code

Last 4 digits of account number 4721

When was the debt incurred? 

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 3 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 14 of 30
Part 3: List Others to Be Notified About a Debt That You Already Listed

Part 4: Add the Amounts for Each Type of Unsecured Claim

3.8 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

Stephen H. Butler P.A.

Nonpriority Creditor's Name

Turnberry Plaza

2875 NE 191 Street #702

Number Street

Aventura

City

FL

State

33180-2834

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

3.9 $ Unknown

Who owes the debt? Check one.

 Debtor 1 only

 Debtor 2 only

 Debtor 1 and Debtor 2 only

 At least one of the debtors and another

Check if this claim relates to a community

debt

Is the claim subject to offset?

 No

 Yes

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

 Contingent

 Unliquidated

 Disputed

Type of NONPRIORITY unsecured claim:

Student loans

Obligations arising out of a separation agreement or divorce

that you did not report as priority claims

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

debts

 Other. Specify 

US National Bank

Nonpriority Creditor's Name

c/o Ghidotti/Berger

1031 North Miami Beach Blvd

Number Street

Miami

City

FL

State

33162

ZIP Code

Last 4 digits of account number 3562

When was the debt incurred? 

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.

5.

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.

6.

Total claim

6a. Domestic support obligations 6a. $ 0.00

6b. Taxes and certain other debts you owe the government 6b. $ 0.00

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

intoxicated

6c. $ 0.00

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

amount here.

6d. $ 0.00

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

$ 0.00

Total claims

from Part 1

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 4 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 15 of 30
Total claim

6f. Student loans 6f. $ 0.00

6g. Obligations arising out of a separation agreement or

divorce that you did not report as priority claims

6g. $ 0.00

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

debts

6h. $ 0.00

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

amount here.

6i. $ 1,799.57

6j. Total. Add lines 6f through 6i. 6j. 

$ 1,799.57

Total claims

from Part 2

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 5 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 16 of 30
12/15

Fill in this information to identify your case:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of Florida

Case number

(if know)

Official Form 106G

Schedule G: Executory Contracts and Unexpired Leases

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).

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977 Check if this is an

amended filing

Do you have any executory contracts or unexpired leases?

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

 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).

1.

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.

2.

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 1 of 1

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 17 of 30
12/15

Fill in this information to identify your case:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of Florida

Case number

(if know)

Official Form 106H

Schedule H: Your Codebtors

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.

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977 Check if this is an

amended filing

Do you have any codebtors? (If you are filing a joint case, do not list either spouse as a codebtor.)

 No

 Yes

1.

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.)

 No. Go to line 3.

 Yes. Did your spouse, former spouse, or legal equivalent live with you at the time?

2.

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.

3.

Column 1: Your codebtor Column 2: The creditor to whom you owe the debt

Check all schedules that apply:

Official Form 106H Schedule H: Your Codebtors page 1 of 1

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 18 of 30
Official Form 106I Schedule I: Your Income page 1

Official Form 106I 

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.

Part 1: 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.

Debtor 1 Debtor 2 or non-filing spouse

Employment status  Employed

 Not employed

 Employed

 Not employed

Occupation __________________________________ __________________________________

Employer’s name __________________________________ __________________________________

Employer’s address _______________________________________

Number Street

_______________________________________ 

_______________________________________ 

_______________________________________ 

City State ZIP Code

________________________________________

Number Street

________________________________________ 

________________________________________ 

________________________________________ 

City State ZIP Code

Part 2: Give Details About Monthly Income

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.

For Debtor 1 For Debtor 2 or 

non-filing spouse

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

deductions). If not paid monthly, calculate what the monthly wage would be. 2. $___________ $____________

3. Estimate and list monthly overtime pay. 3. +$___________ + $____________

4. Calculate gross income. Add line 2 + line 3. 4. $__________ $____________

Debtor 1 ____________________________________________________________________

First Name Middle Name Last Name

Debtor 2 ____________________________________________________________________ 

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

United States Bankruptcy Court for the: ______________________ District 

tate) 

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

Check if this is: 

 An amended filing

 A supplement showing postpetition chapter 13

income as of the following date:

________________

MM / DD / YYYY

How long employed there?________________________ ________________________

Southern District of Florida

20-20977

1,385.00

0.00

1,385.00

Cincinnati, OH 45242

1 Financial Way Cincinnati

Insurance Agent

✔

Marcos Jaime Levy

4

Ohio National

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 19 of 30
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

Official Form 106I Schedule I: Your Income page 2

For Debtor 1 For Debtor 2 or 

non-filing spouse

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. $____________ $_____________

+ $_____________

6.

5h. Other deductions. Specify: __________________________________ 5h. + $____________

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

8. List all other income regularly received:

8a. 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. 8a.

$____________ $_____________

8b. Interest and dividends 8b. $____________ $_____________

8c. 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. 8c.

$____________ $_____________

8d. Unemployment compensation 8d. $____________ $_____________

8e. Social Security 8e. $____________ $_____________

8f. 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: ___________________________________________________ 8f. $____________ $_____________

8g. Pension or retirement income 8g. $____________ $_____________

8h. Other monthly income. Specify: _______________________________ 8h. + $____________ + $_____________

9. Add all other income. Add lines 8a + 8b + 8c + 8d + 8e + 8f +8g + 8h. 9. $____________ $_____________

10. Calculate monthly income. Add line 7 + line 9.

Add the entries in line 10 for Debtor 1 and Debtor 2 or non-filing spouse. 10.

$___________ + $_____________ = $_____________

11. State all other regular contributions to the expenses that you list in Schedule J.

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: _______________________________________________________________________________ 11. + $_____________

12. $_____________

Combined 

monthly income

12. Add the amount in the last column of line 10 to 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 it applies

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

 No.

 Yes. Explain: 

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

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

$____________

$____________

$____________

6. $____________

$____________

$____________

$____________

$____________

$____________

0.00

103.19

0.00

0.00

20-20977

103.19

1,281.81

1,776.84

0.00

0.00

3,058.65

0.00

0.00

0.00

0.00

0.00

0.00

3,058.65

0.00

0.00

0.00

1,776.84

3,058.65

1,385.00

✔

0.00

Marcos Jaime Levy Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 20 of 30
Official Form 106I Schedule I: Your Income

Debtor 1 _ Case number (if known) 

First Name Middle Name Last Name

Continuation Sheet for Official Form 106I 

1. Describe Employment:

Debtor: Marcos Jaime Levy

Occupation:

Name of Employer: Atlanta Regional Census Center

Employer's Address: 285 Peachtree Ctr Ave NE Marquis II, 11th Floor, Atlanta,

GA 30303

Length of Employment: Temporary

-------

Debtor: Marcos Jaime Levy

Occupation: Insurance Sales

Name of Employer: Marco Levy

Employer's Address: 16100 Golf Club Rd Unit 101, Weston, FL 33326

Length of Employment:

-------

Marcos Jaime Levy 20-20977

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 21 of 30
Official Form 106J Schedule J: Your Expenses page 1

Official Form 106J 

Schedule J: Your Expenses 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. 

Part 1: Describe Your Household

1. Is this a joint case?

 No. Go to line 2.

 Yes. Does Debtor 2 live in a separate household?

 No

 Yes. 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.

 No

 Yes. Fill out this information for

each dependent.......................... 

Dependent’s relationship to 

Debtor 1 or Debtor 2

Dependent’s

age

Does dependent live 

with you?

_________________________ ________

 No

 Yes

_________________________ ________  No

 Yes

_________________________ ________  No

 Yes

_________________________ ________  No

 Yes

_________________________ ________  No

 Yes

3. Do your expenses include

expenses of people other than

yourself and your dependents?

 No

 Yes

Part 2: Estimate Your Ongoing Monthly Expenses

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 106I.) Your expenses

4. The rental or home ownership expenses for your residence. Include first mortgage payments and

any rent for the ground or lot. 4. $_____________________

If not included in line 4:

4a. Real estate taxes 4a. $_____________________

4b. Property, homeowner’s, or renter’s insurance 4b. $_____________________

4c. Home maintenance, repair, and upkeep expenses 4c. $_____________________

4d. Homeowner’s association or condominium dues 4d. $_____________________

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________ District of __________

(State) 

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

Check if this is: 

 An amended filing

 A supplement showing postpetition chapter 13

expenses as of the following date:

________________

MM / DD / YYYY

Southern District of Florida

1,000.00

0.00

0.00

0.00

378.00

20-20977

✔

✔

✔

Marcos Jaime Levy

Mother 86

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 22 of 30
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

Official Form 106J Schedule J: Your Expenses page 2

Your expenses

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

6. Utilities:

6a. Electricity, heat, natural gas 6a. $_____________________

6b. Water, sewer, garbage collection 6b. $_____________________

6c. Telephone, cell phone, Internet, satellite, and cable services 6c. $_____________________

6d. Other. Specify: _______________________________________________ 6d. $_____________________

7. Food and housekeeping supplies 7. $_____________________

8. Childcare and children’s education costs 8. $_____________________

9. Clothing, laundry, and dry cleaning 9. $_____________________

10. Personal care products and services 10. $_____________________

11. Medical and dental expenses 11. $_____________________

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

Do not include car payments. 12.

$_____________________

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

14. Charitable contributions and religious donations 14. $_____________________

15. Insurance.

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

1

15a. Life insurance 15a. $_____________________

15b. Health insurance 15b. $_____________________

15c. Vehicle insurance 15c. $_____________________

15d. Other insurance. Specify:_______________________________________ 15d. $_____________________

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

Specify: ________________________________________________________ 16. $_____________________

17. Installment or lease payments:

17a. Car payments for Vehicle 1 17a. $_____________________

17b. Car payments for Vehicle 2 17b. $_____________________

17c. Other. Specify:_______________________________________________ 17c. $_____________________

17d. Other. Specify:_______________________________________________ 17d. $_____________________

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 106I). 18.

$_____________________

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

Specify:_______________________________________________________ 19. $_____________________

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 20a. $_____________________

20b. Real estate taxes 20b. $_____________________

20c. Property, homeowner’s, or renter’s insurance 20c. $_____________________

20d. Maintenance, repair, and upkeep expenses 20d. $_____________________

20e. Homeowner’s association or condominium dues 20e. $_____________________

0.00

500.00

0.00

120.00

126.00

0.00

0.00

0.00

20-20977

0.00

20.00

0.00

0.00

50.00

125.00

0.00

38.00

0.00

350.00

Marcos Jaime Levy

0.00

E&O Insurance

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 23 of 30
Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ 

First Name Middle Name Last Name

Official Form 106J Schedule J: Your Expenses page 3

21. +$_____________________

22a.

22b.

21. Other. Specify:______________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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. 22c.

$_____________________

$_____________________

$_____________________

23. Calculate your monthly net income.

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

$_____________________

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

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

The result is your monthly net income. 23c.

$_____________________

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?

 No.

 Yes. Explain here: 

 +$_____________________

 +$_____________________

0.00

✔

20-20977

2,707.00

2,707.00

Marcos Jaime Levy

2,707.00

3,058.65

351.65

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 24 of 30
4/19

Fill in this information to identify your case:

Debtor 1 Marcos Jaime Levy

Debtor 2

(Spouse, if filing)

United States Bankruptcy Court for the: Southern District of Florida

Case number

(if know)

Official Form 107

Statement of Financial Affairs for Individuals Filing fo Statement of Financial Affairs for Individuals Filing for Bankruptcy r Bankruptcy

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.

Part 1: Give Details About Your Marital Status and Where You Lived Before

Part 2: Give Details About Your Marital Status and Where You Lived Before

First Name Middle Name Last Name

First Name Middle Name Last Name

20-20977 Check if this is an

amended filing

What is your current marital status?

 Married

 Not married

1.

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

 No

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

2.

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.)

 No

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

3.

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.

 No

 Yes. Fill in the details.

Debtor 1

Sources of income

Check all that apply

Gross income

(before deductions and

exclusions)

Debtor 2

Sources of income

Check all that apply

Gross income

(before deductions and

exclusions)

4.

From January 1 of current year until the date you filed

for bankruptcy: Wages, commissions,

bonuses, tips

Operating a business

$ 14,138.66 Wages, commissions,

bonuses, tips

 Operating a business

$ 

For last calendar year:

(January 1 to December 31, 2019

Wages, commissions,

bonuses, tips

Operating a business

$ 14,788.00 Wages, commissions,

bonuses, tips

 Operating a business

$ 

For last calendar year:

(January 1 to December 31, 2018

Wages, commissions,

bonuses, tips

Operating a business

$ 10,843.00 Wages, commissions,

bonuses, tips

 Operating a business

$ 

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 that 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

 Yes. Fill in the details.

5.

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 1 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 25 of 30
Part 3: List Certain Payments You Made Before You Filed for Bankruptcy

Part 4: Identify Legal Actions, Repossessions, and Foreclosures

Debtor 1 Debtor 2

Sources of income

Describe below.

Gross income from each

source

(before deductions and

exclusions)

Sources of income

Describe below.

Gross income from each

source

(before deductions and

exclusions)

From January 1 of current

year until the date you filed

for bankruptcy:

Unemployment Benefits $ 12,325.00

For last calendar year:

(January 1 to December 31, 

2019

For the calendar year before

that:

(January 1 to December 31, 

2018

Are either Debtor 1’s or Debtor 2’s debts primarily consumer debts?

 No. Neither Debtor 1 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?

 No. Go to line 7.

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.

 Yes. Debtor 1 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?

 No. Go to line 7.

 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.

6.

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.

 No.

 Yes. List all payments to an insider.

7.

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.

 No.

 Yes. List all payments that benefited an insider.

8.

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

 Yes. Fill in the details.

9.

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 26 of 30
Part 5: List Certain Gifts and Contributions

Part 6: List Certain Losses

Part 7: List Certain Payments or Transfers

Nature of the case Court or agency Status of the case

 Pending

 On appeal

 Concluded

Case title: 

US Bank Trust National Association

vs. Marcos Levy

Case number: CACE17-17401

Circuit Court 17th Judicial Circuit

Court Name

Number Street

Broward

City

FL

State

.

ZIP Code

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 fill in the details below.

 No. Go to line 11.

 Yes. Fill in the information below.

10.

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?

 No

 Yes. Fill in the details

11.

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?

 No

 Yes

12.

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

 No

 Yes. Fill in the details for each gift.

13.

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?

 No

 Yes. Fill in the details for each gift or contribution.

14.

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?

 No

 Yes. Fill in the details.

15.

Description and value of any property transferred Date payment or

transfer was made

Amount of

payment

Bankruptcy Chapter 13 10/7/2020 $ 4,340.00

$ 

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.

 No

 Yes. Fill in the details.

16.

Law Offices of Daryl Jones, P.A.

Person Who Was Paid

14707 S Dixie Hwy

Ste 101

Number Street

Miami

City

FL

State

33176-7949

ZIP Code

amelich@dljoneslaw.com

Email or website address

Person Who Made the Payment, if Not You

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 3 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 27 of 30
Part 8: List Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units

Part 9: Identify Property You Hold or Control for Someone Else

Part 10: Give Details About Environmental Information

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.

 No

 Yes. Fill in the details.

17.

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.

 No

 Yes. Fill in the details.

18.

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.)

 No

 Yes. Fill in the details.

19.

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.

 No

 Yes. Fill in the details.

20.

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?

 No

 Yes. Fill in the details.

21.

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

 No

 Yes. Fill in the details.

22.

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.

 No

 Yes. Fill in the details.

23.

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

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.

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.

Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental law?

 No

 Yes. Fill in the details.

24.

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

 No

 Yes. Fill in the details.

25.

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

 No

 Yes. Fill in the details.

26.

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 4 of 5

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 28 of 30
Part 11: Give Details About Your Business or Connections to Any Business

Part 12: Sign Below

Describe the nature of the business

Financial Services and Business Development, new

business only asset is bank account

Name of accountant or bookkeeper

Employer Identification number

Do not include Social Security number or ITIN.

EIN: –

Dates business existed

From 07/24/2020 To Current

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

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

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

 A partner in a partnership

 An officer, director, or managing executive of a corporation

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

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

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

27.

OUT OF LIMITS BUSINESS STRATEGIES LLC

Business Name

16100 Golf Club Rd

Unit 101

Number Street

Weston

City

FL

State

33326

ZIP Code

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.

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

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

28.

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.

Date 10/19/2020

/s/ Marcos Jaime Levy

Signature of Debtor 1

Date 

Signature of Debtor 2

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

 No

 Yes. Name of person Attach the Bankruptcy Petition Preparer’s Notice, 

Declaration, and Signature (Official Form 119).

Debtor Case number(if known) 20-20977 Marcos Jaime Levy

First Name Middle Name Last Name

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

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 29 of 30
Official Form 106Dec Declaration About an Individual Debtor’s Schedules 

Official Form 106Dec

Declaration About an Individual Debtor’s Schedules 12/15

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

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? 

 No

 Yes. Name of person__________________________________________________. Attach Bankruptcy Petition Preparer’s 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.

______________________________________________  _____________________________

Signature of Debtor 1 Signature of Debtor 2

Date _________________ Date _________________

MM / DD / YYYY MM / DD / YYYY

Debtor 1 __________________________________________________________________ 

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

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

United States Bankruptcy Court for the: ______________________ District of __________

(State) 

Case number ___________________________________________

(If known)

 Fill in this information to identify your case:

 Check if this is an

amended filing

Southern District of Florida

10/19/2020

✔

20-20977

Marcos Jaime Levy

/s/ Marcos Jaime Levy

Case 20-20977-PDR Doc 9 Filed 10/19/20 Page 30 of 30