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

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy 06/22

If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor’s name and the case 

number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

1. Debtor’s name

2. All other names debtor used

in the last 8 years

Include any assumed names,

trade names, and doing business

as names

3. Debtor’s federal Employer

Identification Number (EIN)

4. Debtor’s address

__________________________________________ 

Number Street

______________________________________________

______________________________________________ 

City State ZIP Code 

_______________________________________________

P.O. Box

_______________________________________________ 

City State ZIP Code

Location of principal assets, if different from 

principal place of business

_______________________________________________

Number Street

_______________________________________________

_______________________________________________ 

City State ZIP Code

5. Debtor’s website (URL) ____________________________________________________________________________________________________

 Fill in this information to identify the case:

 Check if this is an

amended filing

United States Bankruptcy Court for the:

____________________ District of _________________

(State) 

Case number (If known): _________________________ Chapter _____

Northern Texas

11

PM Management - Portfolio VIII NC LLC .

Principal place of busines 

Dallas TX 75254

_Dallas County________________ 

County 

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

2 7 -464 3 048

___ ___ – ___ ___ ___ ___ ___ ___ ___ 

Principal place of business

14841 Dallas Parkway, Suite 440

Mailing address, if different from 

principal place of business

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 1 of 14
Debtor Case number (if known)_____________________________________ 

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

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

 Partnership (excluding LLP)

 Other. Specify: __________________________________________________________________

7. Describe debtor’s business

A. Check one:

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

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

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

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

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

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

 None of the above

B. Check all that apply:

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

 Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C.

§ 80a-3)

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

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

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

___ ___ ___ ___

8. Under which chapter of the

Bankruptcy Code is the

debtor filing?

A debtor who is a “small business 

debtor” must check the first subbox. A debtor as defined in 

§ 1182(1) who elects to proceed

under subchapter V of chapter 11

(whether or not the debtor is a

“small business debtor”) must

check the second sub-box.

Check one:

 Chapter 7

 Chapter 9

 Chapter 11. Check all that apply:

 The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and its

aggregate noncontingent liquidated debts (excluding debts owed to insiders or

affiliates) are less than $3,024,725. If this sub-box is selected, attach the most

recent balance sheet, statement of operations, cash-flow statement, and federal

income tax return or if any of these documents do not exist, follow the procedure in

11 U.S.C. § 1116(1)(B).

 The debtor is a debtor as defined in 11 U.S.C. § 1182(1), its aggregate

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

less than $7,500,000, and it chooses to proceed under Subchapter V of

Chapter 11. If this sub-box is selected, attach the most recent balance sheet,

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

any of these documents do not exist, follow the procedure in 11 U.S.C.

§ 1116(1)(B).

 A plan is being filed with this petition.

 Acceptances of the plan were solicited prepetition from one or more classes of

creditors, in accordance with 11 U.S.C. § 1126(b).

 The debtor is required to file periodic reports (for example, 10K and 10Q) with the

Securities and Exchange Commission according to § 13 or 15(d) of the Securities

Exchange Act of 1934. File the Attachment to Voluntary Petition for Non-Individuals Filing

for Bankruptcy under Chapter 11 (Official Form 201A) with this form.

 The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule

12b-2.

 Chapter 12

6231

PM Management - Portfolio VIII NC LLC 

X 

X 

X 

X 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 2 of 14
Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

9. Were prior bankruptcy cases

filed by or against the debtor

within the last 8 years?

If more than 2 cases, attach a

separate list.

 No

 Yes. District _______________________ When _______________ Case number _________________________

MM / DD / YYYY

District _______________________ When _______________ Case number _________________________

MM / DD / YYYY

10. Are any bankruptcy cases

pending or being filed by a

business partner or an

affiliate of the debtor?

List all cases. If more than 1,

attach a separate list.

 No

 Yes. Debtor _____________________________________________ Relationship _________________________

District _____________________________________________ When __________________ 

MM / DD / YYYY 

Case number, if known ________________________________

11. Why is the case filed in this

district?

Check all that apply:

 Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days

immediately preceding the date of this petition or for a longer part of such 180 days than in any other 

district.

 A bankruptcy case concerning debtor’s affiliate, general partner, or partnership is pending in this district.

12. Does the debtor own or have

possession of any real

property or personal property

that needs immediate

attention?

 No

 Yes. Answer below for each property that needs immediate attention. Attach additional sheets if needed.

Why does the property need immediate attention? (Check all that apply.)

 It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or safety.

What is the hazard? _____________________________________________________________________

 It needs to be physically secured or protected from the weather.

 It includes perishable goods or assets that could quickly deteriorate or lose value without

attention (for example, livestock, seasonal goods, meat, dairy, produce, or securities-related

assets or other options).

 Other _______________________________________________________________________________

Where is the property?_____________________________________________________________________

Number Street

____________________________________________________________________

_______________________________________ _______ ________________

City State ZIP Code 

Is the property insured?

 No

 Yes. Insurance agency ____________________________________________________________________

Contact name ____________________________________________________________________

Phone ________________________________ 

Statistical and administrative information

Northern District 

of Texas 01/28/2019 19-30252

See attached Schedule 1 

PM Management - Portfolio VIII NC LLC 

X 

X 

X 

X 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 3 of 14
Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

13. Debtor’s estimation of

available funds

Check one:

 Funds will be available for distribution to unsecured creditors.

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

14. Estimated number of

creditors

 1-49

 50-99

 100-199

 200-999

 1,000-5,000

 5,001-10,000

 10,001-25,000

 25,001-50,000

 50,001-100,000

 More than 100,000

15. Estimated assets

 $0-$50,000

 $50,001-$100,000

 $100,001-$500,000

 $500,001-$1 million

 $1,000,001-$10 million

 $10,000,001-$50 million

 $50,000,001-$100 million

 $100,000,001-$500 million

 $500,000,001-$1 billion

 $1,000,000,001-$10 billion

 $10,000,000,001-$50 billion

 More than $50 billion

16. Estimated liabilities

 $0-$50,000

 $50,001-$100,000

 $100,001-$500,000

 $500,001-$1 million

 $1,000,001-$10 million

 $10,000,001-$50 million

 $50,000,001-$100 million

 $100,000,001-$500 million

 $500,000,001-$1 billion

 $1,000,000,001-$10 billion

 $10,000,000,001-$50 billion

 More than $50 billion

Request for Relief, Declaration, and Signatures

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to 

$500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

17. Declaration and signature of

authorized representative of

debtor

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

petition.

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

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

correct.

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

Executed on _________________

MM / DD / YYYY

_____________________________________________ _______________________________________________

Signature of authorized representative of debtor Printed name

Title _________________________________________ 

01/29/2024

/s/ Kevin O'Halloran Kevin O'Halloran

Chief Restructuring Officer 

PM Management - Portfolio VIII NC LLC 

X 

X 

X 

X 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 4 of 14
Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

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

18. Signature of attorney _____________________________________________ Date _________________

Signature of attorney for debtor MM / DD / YYYY

_________________________________________________________________________________________________

Printed name

_________________________________________________________________________________________________

Firm name

_________________________________________________________________________________________________

Number Street

____________________________________________________ ____________ ______________________________

City State ZIP Code 

____________________________________ __________________________________________

Contact phone Email address

______________________________________________________ ____________

Bar number State

01/29/2024

Liz Boydston 

/s/Liz Boydston

Gutnicki LLP

10440 N. Central Expressway, Suite 800

Dallas TX 75231

(469) 895-4413 lboydston@gutnicki.com

24053684 TX

PM Management - Portfolio VIII NC LLC

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 5 of 14
UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTORS 

OF ABRI HEALTH SERVICES, LLC 

January 23, 2024 

Under the provisions of the LLC Agreement of Abri Health Services, LLC (the 

“Company”), a limited liability company duly organized and validly existing under the laws of 

the State of Delaware, and the Delaware Limited Liability Company Act, as amended, effective as 

of the date written above, the undersigned constituting all members of the Board of Directors (the 

“Board”) and the Board of each of the Company’s subsidiaries, hereby consent in writing that the 

following resolutions be adopted and direct that this consent be filed with the Company’s (and 

each of the Company’s subsidiaries’) official minutes, to have the same force and a unanimous 

vote of the Directors (and the directors of each of the Company’s subsidiaries) at a meeting duly 

held this date: 

A. Bankruptcy Filing

WHEREAS the Board has had the opportunity to consult with the Chief Restructuring

Officer (“CRO”), management, and the Company’s legal advisors and has fully considered 

presentations by each and each of the strategic alternatives available to the Company. 

NOW IT IS THEREFORE RESOLVED that in the judgment of the Board, it is desirable 

and in the best interests of the Company, its creditors, and other parties in interest that the Company 

shall be and hereby is authorized to file or cause to be filed voluntary petitions for relief for the 

Company and or the Company’s subsidiaries in the proper jurisdiction (the “Bankruptcy Court”); 

and it is further 

RESOLVED that the CRO be and is hereby authorized, empowered, and directed to 

execute and file on behalf of the Company and or the Company’s subsidiaries all petitions, 

schedules, lists, and other motions, papers, or documents, and to take any and all action he deems 

necessary or proper to obtain such relief, including without limitation, any action necessary to 

maintain the ordinary court operations of the Company’s business; and it is further 

RESOLVED that the CRO is hereby authorized, empowered, and directed to certify the 

authenticity of these resolutions. 

B. Retention of Professionals

IT IS FURTHER RESOLVED that the CRO is hereby authorized, empowered, and

directed to employ the law firm of GUTNICKI LLP as general bankruptcy counsel to represent 

and assist the Company and its subsidiaries in carrying out its duties under the Bankruptcy Code 

and to take any and all actions to advance the Company’s and its subsidiaries’ rights and 

obligations; and the CRO is hereby authorized and directed to execute the appropriate retention 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 6 of 14
agreements, pay appropriate retainers, and to cause to be filed an appropriate application for 

authority tor retain the services of GUTNICKI LLP; and it is further 

RESOLVED that the CRO be and is hereby authorized, empowered, and directed to 

employ any other professionals to assist the Company and its subsidiaries in carrying out its duties 

under the Bankruptcy Code; and the CRO is hereby authorized, empowered, and directed to 

execute and file all necessary documents and agreements and to pay retainers necessary to employ 

and retain all assistance by legal counsel, accountants, financial advisors, and other professionals 

and to take and perform any and all further acts and deeds that the CRO deems necessary, proper, 

or desirable in connection with the bankruptcy cases, with a view toward successful prosecution 

of such cases; and it is further 

RESOLVED that all members of the Board have received sufficient notice of the actions 

and transactions relating to the matters contemplated by the forgoing resolutions, as may be 

required by the organizational documents of the Company, or hereby waive any right to have 

received such notice; and it is further 

RESOLVED that all acts, actions, and transactions relating to matters contemplated by the 

foregoing resolutions done in the name of and on behalf of the Company and its subsidiaries, which 

acts would have been approved by the foregoing resolutions except that such acts were taken 

before the adoption of these resolutions, are hereby in all respects approved and ratified as the true 

acts and deeds of the Company and its subsidiaries with the same force and effect as if each such 

act, transaction, agreement, certificate, or action has been specifically authorized in advance by 

resolution of the Board; ; and it is further 

RESOLVED that the CRO be and is hereby authorized and empowered to take all actions 

or not take any action in the name of the Company and its subsidiaries with respect to the 

transactions contemplated by these resolutions hereunder as the sole shareholder, partner, member, 

or managing member of each direct subsidiary of the Company, and in each case, as such CRO 

shall deem necessary or desirable in the CRO’s reasonable business judgment as may be necessary 

or appropriate to effective the purposes of the transactions contemplated herein. 

This Consent may be signed in one or more counterparts, each of which shall be 

deemed an original and all of which shall constitute one instrument. 

[Remainder of Page Intentionally Left Blank] 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 7 of 14
IN WITNESS WHEREOF, the undersigned have executed this Consent effective as of the date 

set forth above. 

__________________________________ 

Name: Barry Dershowitz 

Title: Board Member 

__________________________________ 

Name: Ephraim Diamond 

Title: Board Member 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 8 of 14
4878-1942-8255, v. 1

SCHEDULE 1 

On the date hereof, each of the affiliated entities listed below, including the debtor in this 

chapter 11 (subchapter V) case (collectively, the “Debtors”), filed a petition in the United States 

Bankruptcy Court for the Northern District of Texas for relief under chapter 11-subchapter V of 

the Bankruptcy Code. Contemporaneously with the filing of their petitions, the Debtors filed a 

motion requesting that the subchapter V of chapter 11 cases of the entities listed below be 

consolidated for procedural purposes only and jointly administered pursuant to Rule 1015(b) of 

the Federal Rules of Bankruptcy Procedure. 

Entity Name EIN 

PM Management – Killeen I NC LLC 27-4643105

PM Management – Killeen II NC LLC 27-4643179

PM Management – Killeen III NC LLC 27-4643245

PM Management – Portfolio VIII NC LLC 27-4643048

The following two affiliates filed petitions for relief under subchapter V of chapter 11 in 

2021. The cases are jointly administered under case no. 21-30700, which cases are postconfirmation but still open. 

Entity Name EIN 

Abri Health Services, LLC 84-3903319

Senior Care Centers, LLC 26-3788550

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 9 of 14
4864-0359-1327, v. 1

Liz Boydston (SBN 24053684) 

Alexandria Rahn (SBN 24110246) 

GUTNICKI LLP 

10440 N. Central Expressway, Suite 800 

Dallas, Texas 75231 

Telephone: (465) 895-4413 

Facsimile: (465) 895-4413 

lboydston@gutnicki.com 

arahn@gutnicki.com 

Proposed Counsel to the Debtors 

Max Schlan (pro hac vice pending) 

GUTNICKI LLP 

45 Rockefeller Plaza, Suite 2000 

New York, NY 10111 

Telephone: (646) 825-2330 

Facsimile: (646) 825-2330 

mschlan@gutnicki.com 

IN THE UNITED STATES BANKRUPTCY COURT 

FOR THE NORTHERN DISTRICT OF TEXAS 

DALLAS DIVISION 

In re: § Chapter 11

§

PM Management - Killeen I NC LLC, et al., § Case No. 24-____ (sgj) 

§ 

Debtors.1 § (Joint Administration Requested)

CONSOLIDATED CORPORATE OWNERSHIP STATEMENT PURSUANT TO 

FEDERAL RULES OF BANKRUPTCY PROCEDURE 1007 AND 7007.1

Pursuant to Rule 1007(a)(1) and 7007.1 of the Federal Rules of Bankruptcy Procedure, the 

above-captioned debtors and debtors-in-possession (collectively, the “Debtors”) respectfully 

represent that on the Petition Date, the Debtors’ books and records reflect the following entities 

direct or indirectly own 10% or more of any class of Debtors’ equity interests. 

Entity Ownership Ownership of Senior Care 

Centers, LLC

PM Management – Killeen I NC LLC Senior Care Centers, 

LLC (100%)

Abri Health Services, LLC 

(100%) 

PM Management – Killeen II NC LLC Senior Care Centers, 

LLC (100%)

Abri Health Services, LLC 

(100%)

PM Management – Killeen III NC LLC Senior Care Centers, 

LLC (100%)

Abri Health Services, LLC 

(100%)

PM Management – Portfolio VIII NC 

LLC

Senior Care Centers, 

LLC (100%)

Abri Health Services, LLC 

(100%)

1 The Debtors in these subchapter V of chapter 11 cases, along with the last four digits of each Debtor’s EIN are PM 

Management - Killeen I NC LLC (3105), PM Management - Killeen II NC LLC (3179), PM Management - Killeen 

III NC LLC (3245), and PM Management – Portfolio VIII NC LLC (3048) 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 10 of 14
Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 1

Official Form 204 

Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest 

Unsecured Claims and Are Not Insiders 12/15

A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor 

disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by 

secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20 

largest unsecured claims. 

Name of creditor and complete 

mailing address, including zip code 

Name, telephone number, and 

email address of creditor 

contact 

Nature of the claim 

(for example, trade 

debts, bank loans, 

professional 

services, and 

government 

contracts)

Indicate if 

claim is 

contingent, 

unliquidated, 

or disputed 

Amount of unsecured claim 

If the claim is fully unsecured, fill in only unsecured 

claim amount. If claim is partially secured, fill in 

total claim amount and deduction for value of 

collateral or setoff to calculate unsecured claim. 

Total claim, if 

partially 

secured 

Deduction for 

value of 

collateral or 

setoff 

Unsecured 

claim 

1 

2 

3 

4 

5 

6 

7 

8 

 Check if this is an

amended filing

Debtor name __________________________________________________________________ 

United States Bankruptcy Court for the: ______________________ District of _________

(State)

Case number (If known): _________________________ 

 Fill in this information to identify the case: 

Pharmscript of Texas LLC 

PO Box 6042 

Somerset, NJ 08875

Gordon Food Service

Attn: Curt 

Wyoming, MI 49509

Kare Technologies, LLC 

Po Box 4738 

Houston, TX 77210-4738

Medline Industries Inc

PO BOX 121080 

Dallas, TX 75312-1080

VICTARE

1020 RAMBLING OAKS LN 

WEATHERFORD, TX 76088

MasVida Health Care Solutions, 

LLC

133 Nursery Ln 

Fort Worth, TX 76114

Skyline Development 

2656 S Loop W 

Houston, TX 77054

Direct Supply, DSSI

Box 88201 

Milwaukee, WI 53288-0201

$211,646.29

$179,526.87

$126,839.10

$123,108.08

$101,545.58

$100,583.52

$74,602.38

$73,949.21

Northern Texas

PM Management - Killeen I NC LLC, et al.

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 11 of 14
Debtor _______________________________________________________ Case number (if known)_____________________________________ Name

Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 2 

Name of creditor and complete 

mailing address, including zip code 

Name, telephone number, and 

email address of creditor 

contact 

Nature of the claim 

(for example, trade 

debts, bank loans, 

professional 

services, and 

government 

contracts)

Indicate if 

claim is 

contingent, 

unliquidated, 

or disputed 

Amount of unsecured claim 

If the claim is fully unsecured, fill in only unsecured 

claim amount. If claim is partially secured, fill in 

total claim amount and deduction for value of 

collateral or setoff to calculate unsecured claim. 

Total claim, if 

partially 

secured 

Deduction for 

value of 

collateral or 

setoff 

Unsecured 

claim 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

SHIFTKEY LLC

PO Box 735913 

DALLAS, TX 75373-5913

Direct Supply

Box 88201 

Milwaukee, WI 53288-0201

QUALITY REHAB 

MANAGEMENT LLC

5057 Keller Springs Rd 

Addison, TX 75001

ACADIAN AMBULANCE 

SERVICES,INC.

P.O. BOX 92970 

LAFAYETTE, LA 70509

Imperial PFS Corporation

PO BOX 100391 

Pasadena, CA 91189-0391

Curana Health Medical Group, 

LLC

PO BOX 122020 

Dallas, TX 75312-2020

HOME DEPOT PRO - 

SUPPLYWORKS

PO BOX 844727 

DALLAS, TX 75284-4727

Principle Laboratory

16840 Buccaneer Ln, Suite 261 

Houston, TX 77058

Constellation NewEnergy, Inc.

PO Box 4640 

Carol Stream, IL 60197-4640

Safely You, Inc. 

Po Box 103323 

PASADENA, CA 91189-3323

Sage Telehealth Services, LLC

7500 Rialto Blvd. Bldg 1, Suite 250 

Austin, TX 78735

Starfire Sprinkler Services 

10829 HillPoint 

San Antonio, TX 78217

$69,834.28

$36,295.42

$32,800.00

$21,707.14

$18,617.79

$18,000.00

$17,934.23

$17,152.19

$16,929.76

$16,480.00

$15,600.00

$12,477.99

PM Management - Portfolio VIII NC LLC et al.

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

unliquidated

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 12 of 14
Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors

Official Form 202 

Declaration Under Penalty of Perjury for Non-Individual Debtors 12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit 

this form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, 

and any amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the 

document, and the date. Bankruptcy Rules 1008 and 9011. 

WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 

1519, and 3571. 

Declaration and signature

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or 

another individual serving as a representative of the debtor in this case.

I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:

 Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)

 Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)

 Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

 Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)

 Schedule H: Codebtors (Official Form 206H)

 Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)

 Amended Schedule ____

 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)

 Other document that requires a declaration__________________________________________________________________________________

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

Executed on ______________ _________________________________________________________________________

MM / DD / YYYY Signature of individual signing on behalf of debtor

________________________________________________________________________

Printed name

______________________________________ 

Position or relationship to debtor

Debtor Name __________________________________________________________________ 

United States Bankruptcy Court for the: ______________________ District of __________

(State) 

Case number (If known): _________________________ 

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

PM Management - Killeen I NC LLC, et al. 

Northern Texas

Consolidated Corporate Ownership Statement 

01/23/2024 /s/ Kevin O'Halloran

Kevin O'Halloran 

Chief Restructuring Officer

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

Document Page 13 of 14
IN THE UNITED STATES BANKRUPTCY COURT 

FOR THE NORTHERN DISTRICT OF TEXAS

IN RE: §

PM Management - Killeen I NC LLC, et al.

§

§ Case No. 

§

Debtor(s) § Chapter 11 (subchapter V)

DECLARATION FOR ELECTRONIC FILING OF 

BANKRUPTCY PETITION AND MASTER MAILING LIST (MATRIX)

PART I: DECLARATION OF PETITIONER:

As an individual debtor in this case, or as the individual authorized to act on behalf of the corporation, 

partnership, or limited liability company seeking bankruptcy relief in this case, I hereby request relief as, or on 

behalf of, the debtor in accordance with the chapter of title 11, United States Code, specified in the petition to be 

filed electronically in this case. I have read the information provided in the petition and in the lists of creditors to 

be filed electronically in this case and I hereby declare under penalty of perjury that the information provided 

therein, as well as the social security information disclosed in this document, is true and correct. I understand that 

this Declaration is to be filed with the Bankruptcy Court within seven (7) business days after the petition and lists of 

creditors have been filed electronically. I understand that a failure to file the signed original of this Declaration will 

result in the dismissal of my case.

□ [Only include for Chapter 7 individual petitioners whose debts are primarily consumer debts] –

I am an individual whose debts are primarily consumer debts and who has chosen to file under chapter 7. I

am aware that I may proceed under chapter 7, 11, 12, or 13 of title 11, United States Code, understand the

relief available under each chapter, and choose to proceed under chapter 7.

 [Only include if petitioner is a corporation, partnership or limited liability company] –

I hereby further declare under penalty of perjury that I have been authorized to file the petition and lists of

creditors on behalf of the debtor in this case.

Date: 01/29/2024 . /s/ Kevin O’Halloran 

Kevin O’Halloran, Chief Restructuring Officer 

PART II: DECLARATION OF ATTORNEY:

I declare under penalty of perjury that: (1) I will give the debtor(s) a copy of all documents referenced by 

Part I herein which are filed with the United States Bankruptcy Court; and (2) I have informed the debtor(s), if an 

individual with primarily consumer debts, that he or she may proceed under chapter 7, 11, 12, or 13 of title 11, 

United States Code, and have explained the relief available under each such chapter.

Date: 01/29/2024 . /s/ Liz Boydston 

Liz Boydston, GUTNICKI LLP

10440 N. Central Expressway, Suite 800 

Dallas, Texas 75231 

(469) 895-4413

B T X N 1 7 0 

Case 24-30247-sgj11 Doc 1 Filed 01/29/24 Entered 01/29/24 16:32:33 Desc Main

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