Fill in this information to identify your case: Debtor 1 Henry Gonzalez

First Name Middle Name Last Name Debtor 2

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number 21-12885-RAM

(if known)  Check if this is an

amended filing

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................................................................................................ $ 392,499.00

1b. Copy line 62, Total personal property, from Schedule A/B..................................................................................... $ 5,433.03

1c. Copy line 63, Total of all property on Schedule A/B............................................................................................... $ 397,932.03

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... $ 551,970.00

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................................. $ 0.00

3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F............................ $ 11,200.00

Your total liabilities $ 563,170.00

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................................................................................ $ 1,200.00

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

Copy your monthly expenses from line 22c of Schedule J.......................................................................... $ 1,174.18

Part 4: Answer 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. Official Form 106Sum Summary of Your Assets and Liabilities and Certain Statistical Information page 1 of 2

Software Copyright (c) 2021 CINGroup - www.cincompass.com 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 1 of 7
Debtor 1 Gonzalez, Henry Case number (if known) 21-12885-RAM

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. $ 1,200.00

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.) $ 0.00

9b. Taxes and certain other debts you owe the government. (Copy line 6b.) $ 0.00

9c. Claims for death or personal injury while you were intoxicated. (Copy line 6c.) $ 0.00

9d. Student loans. (Copy line 6f.) $ 0.00

9e. Obligations arising out of a separation agreement or divorce that you did not report as priority claims. (Copy line 6g.) $ 0.00

9f. Debts to pension or profit-sharing plans, and other similar debts. (Copy line 6h.) +$ 0.00

9g. Total. Add lines 9a through 9f. $ 0.00

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

Software Copyright (c) 2021 CINGroup - www.cincompass.com 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 2 of 7
 Fill in this information to identify your case: Debtor 1 Henry Gonzalez

First Name Middle Name Last Name Debtor 2

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number 21-12885-RAM

(if known)  Check if this is an

amended filing

Official Form 106D

Schedule D: Creditors Who Have Claims Secured by Property 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, 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).

1. 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. Part 1: List All Secured Claims

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 A

Amount of claim

Do not deduct the

value of collateral.

Column B

Value of collateral

that supports this

claim

Column C

Unsecured

portion

If any

2.1 IndyMac Bank, F.S.B., Describe the property that secures the claim: $91,000.00 $392,499.00 $91,000.00

Creditor's Name 7805 SW 119th Rd, Miami, FL

33183-3812

Surrender 155 N Lake Ave

Pasadena, CA

91101-1849

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

 Contingent

Number, Street, City, State & Zip Code  Unliquidated

 Disputed

Who owes the debt? Check one. Nature of lien. Check all that apply.

 Debtor 1 only

 Debtor 2 only

 An agreement you made (such as mortgage or secured

car loan)

Debtor 1 and Debtor 2 only  Statutory lien (such as tax lien, mechanic's lien)

 At least one of the debtors and another  Judgment lien from a lawsuit

Check if this claim relates to a

community debt

 Other (including a right to offset) 2nd mortgage

Date debt was incurred Last 4 digits of account number 2840

Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 3

Software Copyright (c) 2021 CINGroup - www.cincompass.com 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 3 of 7
Debtor 1 Henry Gonzalez Case number (if known) 21-12885-RAM

First Name Middle Name Last Name

2.2 Miami-Dade Tax

Collector Describe the property that secures the claim: $0.00 $392,499.00 $0.00

Creditor's Name 7805 SW 119th Rd, Miami, FL

33183-3812

Surrender

200 NW 2nd Ave

Miami, FL 33128-1735

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

 Contingent

Number, Street, City, State & Zip Code  Unliquidated

 Disputed

Who owes the debt? Check one. Nature of lien. Check all that apply.

 Debtor 1 only

 Debtor 2 only

 An agreement you made (such as mortgage or secured

car loan)

Debtor 1 and Debtor 2 only  Statutory lien (such as tax lien, mechanic's lien)

 At least one of the debtors and another  Judgment lien from a lawsuit

Check if this claim relates to a

community debt

 Other (including a right to offset) Property Taxes

Date debt was incurred Last 4 digits of account number 0160

2.3 Phh Mortgage Services Describe the property that secures the claim: $460,970.00 $392,499.00 $68,471.00

Creditor's Name 7805 SW 119th Rd, Miami, FL

33183-3812

Surrender 1 Mortgage Way

Mount Laurel, NJ

08054-4637

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

 Contingent

Number, Street, City, State & Zip Code  Unliquidated

 Disputed

Who owes the debt? Check one. Nature of lien. Check all that apply.

 Debtor 1 only

 Debtor 2 only

 An agreement you made (such as mortgage or secured

car loan)

Debtor 1 and Debtor 2 only  Statutory lien (such as tax lien, mechanic's lien)

 At least one of the debtors and another  Judgment lien from a lawsuit

Check if this claim relates to a

community debt

 Other (including a right to offset)

Date debt was incurred 2006-10 Last 4 digits of account number 0920

Add the dollar value of your entries in Column A on this page. Write that number here: $551,970.00

If this is the last page of your form, add the dollar value totals from all pages.

Write that number here: $551,970.00

Part 2: List Others to Be Notified for a Debt That You Already Listed

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.

[ ] Name, Number, Street, City, State & Zip Code

GreenTree Mortgage

2 Eastwick Dr Ste 300

Gibbsboro, NJ 08026-1225

On which line in Part 1 did you enter the creditor? 2.1

Last 4 digits of account number 2840 

[ ] Name, Number, Street, City, State & Zip Code

IndyMac Federal Bank, FSB

888 E Walnut St

Pasadena, CA 91101-1895

On which line in Part 1 did you enter the creditor? 2.1

Last 4 digits of account number 2840 

Official Form 106D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page 2 of 3

Software Copyright (c) 2021 CINGroup - www.cincompass.com 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 4 of 7
Debtor 1 Henry Gonzalez Case number (if known) 21-12885-RAM

First Name Middle Name Last Name

[ ] Name, Number, Street, City, State & Zip Code

Ocwen Loan Servicing, LLC

1661 Worthington Rd Ste 100

West Palm Beach, FL 33409-6493

On which line in Part 1 did you enter the creditor? 2.3

Last 4 digits of account number 0920 

[ ] Name, Number, Street, City, State & Zip Code

OneWest Bank, F.S.B.

75 N Fair Oaks Ave

Pasadena, CA 91103-3651

On which line in Part 1 did you enter the creditor? 2.1

Last 4 digits of account number 2840 

[ ] Name, Number, Street, City, State & Zip Code

Van Ness Law Firm, PLC

1239 E Newport Center Dr Ste 110

Deerfield Beach, FL 33442-7711

On which line in Part 1 did you enter the creditor? 2.3

Last 4 digits of account number 0920 

[ ] Name, Number, Street, City, State & Zip Code

Wells Fargo Bank, N. A.

PO Box 10335

Des Moines, IA 50306-0335

On which line in Part 1 did you enter the creditor? 2.3

Last 4 digits of account number 0920 

Official Form 106D Additional Page of Schedule D: Creditors Who Have Claims Secured by Property page 3 of 3

Software Copyright (c) 2021 CINGroup - www.cincompass.com 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 5 of 7
Fill in this information to identify your case:

Debtor 1 Henry Gonzalez

First Name Middle Name Last Name Debtor 2

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

United States Bankruptcy Court for the: SOUTHERN DISTRICT OF FLORIDA, MIAMI DIVISION

Case number 21-12885-RAM

(if known)  Check if this is an

amended filing

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.

X /s/ Henry Gonzalez X

Henry Gonzalez Signature of Debtor 2

Signature of Debtor 1

Date December 13, 2021 Date

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 6 of 7
IndyMac Bank, F.S.B., 

155 North Lake Avenue 

Pasadena, CA 91101 

IndyMac Federal Bank, FSB

888 E Walnut St 

Pasadena, CA 91106 

OneWest Bank, F.S.B. 

75 North Fair Oaks Avenue 

Pasadena, CA 91103 

GreenTree Mortgage

2 Eastwick Dr #300 

Gibbsboro, NJ 08026 

Supplemental Creditors 

Case 21-12885-RAM Doc 26 Filed 12/13/21 Page 7 of 7