Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 20 of 69

Debtor 1 ALYSSA NICOLE MCCAIN

Case number (irknown
Frat name Widdie Nore TastName

48.Crops—either growing or harvested

OQ No poe .

O Yes. Give specific
information. 7

49, Farm and fishing equipment, implements, machinery, fixtures, and tools of trade
No
O Yes. So ~~ ——

O No
O ves.

51, Any farm- and commercial fishing-related property you did not already list
O No

O Yes. Give specific! ~ 7 —
information...... ls

52, Add the dollar value of all of your entries from Part 6, including any entries for pages you have attached $ 0.00
for Part 6. Write that number here >

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

53, Do you have other property of any kind you did not already list?
Examples: Season tickets, country club membership

© No ~ ~ 7 ~y

Q Yes. Give specific
information.

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

ror e: the Totals of Each Part of this Form

55, Part 1: Total real estate, line 2... > s 0.00

56.Part 2: Total vehicles, line &
57,Part 3: Total personal and household items, line 15 s 390.00
58,Part 4: Total financlal assets, line 36 $ 6,828.04

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

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

61.Part 7: Total other property not listed, line 54 +5 0,00

62.Total personal property. Add lines 56 through 61. . a 7,258.04 | copy personal property total > +S. 7,258.04

$ 7,258.04

Official Form 106A/B Schedule A/B: Property page 10

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



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Document Page 41 of 69

Debtor 1 ALYSSA NICOLE MCCAIN

Case number (known),
FratNome Wade Narva Tast Name

For Debtor 1 For Debtor 2 or
Copy line 4 here $3,290.00 $.

5. Indicate whether you have the payroll deductions below:

6, Add the payroll deductions, Add lines Sa + 5b + Sc-+ 5d+5e+5f+5g+5h. 6. § 608.00

5a, Tax, Medicare, and Social Security deductions 5a $
5b. Mandatory contributions for retirement plans sb. s 360.00 5
5c. Voluntary contributions for retirement plans 5c. §. 0.00  s
5d. Required repayments of retirement fund loans Sd. $. 0.00 $.
5e. Insurance 5e. 6.00 $.
5f, Domestic support obligations BS 0.00 5
§g. Union dues 5g. $___ 0.00 8
5h. Other deductions. Specify: 5h. +§. 0.00 +s

$

8

7. Calculate total monthly take-home pay. Subtract line 6 from line 4, 7. $2,682.00

8. List all other income regularly received:

8a. Net income from rental property and from operating a business, 8a. $. 0.00 8.
profession, or farm

‘Attach 2 statement for each property and business showing gross receipts, ordinary and
necessary business expenses, and the total monthly net income.

8b, Interest and dividends s___ 0,00 $

8c. Family support payments that you, a non-filing spouse, or a dependent $ 0.00 $
regularly receive
Include alimony, spousal support, child support, maintenance, divorce settlement, and

property settlement.
8d, Unemployment compensation $ 0.00 $
8e. Social Security s 0.00 $

8f. Other government assistance that you regularly receive

Include cash assistance and the value (it known) of any non-cash assistance that you
receive, such as food stamps or housing subsidies,

‘Specify (Debtor 1): ‘Specify (Debtor 2 or Non-Filing Spouse):
s___ 0.00 8.
8g. Pension or retirement income s 0.00 $
8h. Other monthly income.
Specty (Debtor spect (Deblor 2 oF Non-ng Spouse):
REFUND zoos s__0.00 5.
9. Add all other income, Add lines 8a + 8b + 8c + Gd + Se + BF 48g + Bh, s___0.00 ss
10. Calculate monthly Income. Add tine 7 + fine 9. [s 2,682.00 | + [s |=[s 2,682.00 |

‘Add the entries in fine 10 for Debtor 4 and Debtor 2 or non-ling spouse.

11. State all other regular contributions to the expenses that you list in Schedule J.
Inclide contributions from an unmarried partner, members of your household, your dependet roommates, and other fiends or
relatives. Do not include any emounts already included in lines 2-10 or amounts that are not to pay expenses listed in Schedule J.

Specify; THE INTERNET, RENTAL WASHER/DRYER, MY PHONE LINE, AND SENDS Wt $ 240.00

12, Add the amount in the last column of line 10 to the amount in line 11, The result is the combined monthly income. 12 2,922.00
Write that amount on the Summary of Your Assets and Liabilities and Certain Statistical Information, if it applies 7
43. Do you expect an Increase or decrease within the year after you file this form? comin income
No.
Q Yes. Explain:

Official Form 1061 Schedule |: Your Income page 2


Debtor 1

Case 24- -31768- swe7 Doc 1

Fratiame Widdle Name Taat Name

Ea Add the Amounts for Each Type of Unsecured Claim

Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
MEPAN Document Page 37 of%6Q number inom

6. 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.

Total claims 6a. Domestic support obligations 6a.
from Partt 6 Taxes and certain other debts you owe the
government 6b.
6c. Claims for death or personal injury while you were
intoxicated 6c.
6d. Other. Add all other priority unsecured claims.
Write that amount here. 6d.
6e. Total. Add lines 6a through 6d. 6e.
Total claims & Student loans 6f.
from Part2 64. obligations arising out of a separation agreement
or divorce that you did not report as priority
claims 6g.
6h. Debts to pension or profit-sharing plans, and other
similar debts 6h.
6i. Other. Add all other nonpriority unsecured claims.
Write that amount here. 6i.
6j. Total. Add lines 6f through 6i. Gj.

Official Form 106E/F

Total claim
$ 0.00
s 0.00
$ 0.00
ts; 0.00
s 0.00
Total claim
s 32,459.00
5 0.00
$ 0.00
+s 39,584.00
; 72,043.00

Schedule E/F: Creditors Who Have Unsecured Claims

page 14


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Document Page 46 of 69

Fill in this information to identify your case:

Debtort ALYSSA NICOLE MCCAIN
Frat hare wigee Name Tastee

Debtor 2 _ _ _ _

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

United States Bankruptcy Court for the: NORTHERN DISTRICT OF TEXAS

Case number -
(i known) Q Check if this is an

amended filing

Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy 04/22

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.

Give Details About Your Marital Status and Where You Lived Before

1. What is your current marital status?

QO Married
Not married

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

no
Q Yes. List all of the places you lived in the last 3 years. Do not include where you live now.

Debtor 1: Dates Debtor1 Debtor 2: Dates Debtor 2
lived there lived there
2 same as Debtor 1 O) same as Debtor 1
From — From
Number Street Number Street
To To
City State ZIP Code City State ZIP Code
O same as Debtor 1 O same as Debtor 1
_ ——= — From From
Number Street Number Street
To To
City State ZIP Code City "State ZIP Code:

3. 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.)

WD No

Q Yes. Make sure you fill out Schedule H: Your Codebtors (Official Form 106H).

Explain the Sources of Your Income

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


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Document Page 14 of 69

Debtor ALYSSA NICOLE MCCAIN
Frat Name Widdle Name Taal Name

Describe Your Personal and Household Items

Case number (renown).

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

Current value of the
portion you own?

Do not deduct seoured claims.

or exemptions.

6, Household goods and furnishings
Examples: Major appliances, furniture, linens, china, kitchenware

O No
Yes. Describe...

SOFA, BEDDING, MICROWAVE gs.

7. Electronics
Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners; music
collections; electronic devices including cell phones, cameras, media players, games
O No a eer = - a
Yes. Describe... “Tv, CELLPHONE $

re a ne ee eee |

8. Collectibles of value

Examples: 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

1 Yes. Describe...

9, Equipment for sports and hobbies

Examples: Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; canoes
and kayaks; carpentry tools; musical instruments.

J No ear ee ,
O Yes. Describe... \g

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

§ No ==

65.00

140.00

0.00

0.00

O Yes. Deseribe......) | $ 0.00
| ne ea on en ~ —

11, Clothes

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

~ — een
ls 150.00

12. Jewelry

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

gold, silver

Q No = i — — —

@ Yes. Describe... ‘sg 10.00
13,Non-farm animals

Examples: Dogs, cats, birds, horses

No a

@ Yes. Desctibe......1 CAT 8 5.00
14. Any other personal and household Items you did not already list, including any health aids you did not list

O No ee ee a .

1d Yes. Give specific | | 20.00

information, . | PRESCRIPTION Gl GLASSES _. / 8 :

15. Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached $ 390,00

for Part 3, Write that number here ..

Official Form 106A/B. Schedule A/B: Property

page 4



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Document Page 56 of 69

ALYSSA NICOLE MCCAIN

Debtor 1 Case number (irknown,

FratWane ‘widele Namie TastName

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

DNno
O Yes, Fill in the details.

‘Governmental unit Environmental law, if you know it Date of notice
Name of site Governmental unit
H
Number Street Number Street
City State ZIP Code

city State ZIP Code

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

no
QO Yes. Fill in the details.
Court or agency Nature of the case Status of the
case
Case title,
oa OQ] Pending
O onappeat
Number Street QO conetuded
Case number City State ZIP Code

Give Details About Your Business or Connections to Any Business

27. 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

2 A member of a limited liability company (LLC) or limited liability partnership (LLP)
OA partner in a partnership
O An officer, director, or managing executive of a corporation

C1 An owner of at least 5% of the voting or equity securities of a corporation
O] 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.
DOORDASH Describe the nature of the business

Business Name

DOORDASH INDEPENDENT ConTAACTOR,
| 1001 FULLER WISER ROAD _ DEPENDENT ©

Number Street
H Name of accountant or bookkeeper -
1

EULESS TX 76039
t City State ZIP Code

Describe the nature of the business

Business Name

Number Street
Name of accountant or bookkeeper

City State ZIP Code

Employer Identification number
Do not include Social Security number or ITIN.

Dates business existed
From 2020 To 2024

Employer Identification number
Do not include Social Security number or ITIN.

Dates business existed

From To

Official Form 107 ‘Statement of Financial Affairs for Individuals Filing for Bankruptcy page 11


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Document Page 54 of 69

ALYSSA NICOLE MCCAIN
FreNane idle Name TasiName

Debtor 1 Case number (irknown),

19.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
Q Yes. Fill in the details.

Description and value of the property transferred Date transfer
was made

Name of trust —— i

ica: List Certain Financl:

Accounts, Instruments, Safe Deposit Boxes, and Storage Units

| 20. Within 4 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?

i 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.

O Yes. Fill in the details.

Last 4 digits of account number —_Type of account or Date account was _Last balance before
instrument closed, sold, moved, closing or transfer
or transferred
Name of Financial inti
sme of Financial intitution WOOK O checking ee se |
O savings |

Number Street
O Money market

O Brokerage
City State ZIP Code a Other

XXXX—__ O checking $.

i Name of Financial Institution a
| Savings

Number Street UO] Money market
O Brokerage

| Qother__

| city State ZIP Code

21. 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? A
@ no

O Yes. Fill in the details.

Who else had access to it? Describe the contents Do you still
H have It?

O No |
| Name of Financial Institution Name O Yes |
| Number Street Number Street ~
| City State ZIP Code i

City State ZIP Code

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 9


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Document Page 60 of 69

Fill in this information to identify your case:

Form 122A-1Supp:

Check one box only as directed in this form and in

Debtor? _ALYSSA NICOLE MCCAIN
Firsiname Tie Name Tat Was a: ; ‘on of
Debtor 2 . There is no presumption of abuse.
(Spouse, iffing) FirstNeme Wide Name ast Name 0 2. The calculation to determine if @ presumption of
; _ NORTHERN DISTRICT OF TEXAS abuse applies will be made under Chapter 7
United States Bankruptcy Court for the: Means Test Calculation (Official Form 122A-2),
eae number Q 3. The Means Test does not apply now because of

qualified military service but it could apply later.

QO) Check if this is an amended filing

Official Form 122A—1
Chapter 7 Statement of Your Current Monthly Income 1

2/19

Be as complete and accurate as possible, If two married people are filing together, both are equally responsible for being accurate, If more
space is needed, attach a separate sheet to this form. Include the line number to which the additional information applies. On the top of any

additional pages, write your name and case number (if known). If you believe that you are exempted from a presumption of abuse because you
do not have primarily consumer debts or because of qualifying military service, complete and file Statement of Exemption from Presumption of

Abuse Under § 707(b)(2) (Official Form 122A-1Supp) with this form.

J Part 1: | Calculate Your Current Monthly Income

| 1, What is your marital and filing status? Check one only.
! Qi Not married. Fill out Column A, lines 2-11.
Q Married and your spouse Is filing with you. Fill out both Columns A and B, lines 2-11.

O Married and your spouse is NOT filing with you. You and your spouse are:
i Q Living in the same household and are not legally separated. Fill out both Columns A and B, lines 2-11.

2 Living separately or are legally separated. Fill out Column A, lines 2-11; do not fill out Column B. By checking this box, you declare
under penalty of perjury that you and your spouse are legally separated under nonbankruptcy law that applies or that you and your
‘spouse are living apart for reasons that do not include evading the Means Test requirements. 11 U.S.C. § 707(b)(7)(B).

Fill in the average monthly income that you received from all sources, derived during the 6 full months before you file this
bankruptcy case. 11 U.S.C. § 101(10A). For example, if you are filing on September 15, the 6-month period would be March 1 through
August 31. if the amount of your monthly income varied during the 6 months, add the income for all 6 months and divide the total by 6.
Fill in the result. Do not include any income amount more than once. For example, if both spouses own the same rental property, put the
income from that property in one column only. If you have nothing to report for any line, write $0 in the space.

Column A Column B
| Debtor 1 Debtor 2 or
non-iling spouse
' 2. Your gross wages, salary, tips, bonuses, overtime, and commissions 2,193.33
{before all payroll deductions). $_6:180.008 8.
' 3, Alimony and maintenance payments. Do not include payments from a spouse if 0.00
Column B is filled in. $_VAW 8.
4, All amounts from any source which are regularly paid for household expenses
of you or your dependents, including child support. Include regular contributions
{ from an unmarried partner, members of your household, your dependents, parents,
and roommates. Include regular contributions from a spouse only if Column B is not
| filled in, Do not include payments you listed on line 3. s_240.00 $__
| 5. Netincome from operating a business, profession, pastor 4 Debtor 2
Gross receipts (before all deductions) $118.33 g
Ordinary and necessary operating expenses -$0.00- 5.
| Net monthly income from a business, profession, or farm § 118.33 § Cory, 6118.33 0g.
6. Net income from rental and other real property Debtpr fy Debtor 2
Gross receipts (before all deductions) $0.00 s.
Ordinary and necessary operating expenses -30.00-
Net monthly income from rental or other real propery --g O.00 ¢ SPY, s 000 8

| 7. Interest, dividends, and royalties
]

Official Form 122A-1 Chapter 7 Statement of Your Current Monthly Income page 1


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Document Page 64 of 69

ALLY
P.O, BOX 380906
BLOOMINGTON, MN 55438

BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION
700 SCOTT & WHITE DRIVE
COLLEGE STATION, TX 77845

CAP ONE
PO BOX 71083
CHARLOTTE, NC 28272-1083

CARSON SMITHFIELD

225 WEST STATION SQUARE DRIVE
4TH FLOOR

PITTSBURGH, PA 15219

CHIMEF/STR
77 MAIDEN LANE
SAN FRANCISCO, CA 94108

CREDIT ONE BANK N.A.
6801 SOUTH CIMARRON ROAD
LAS VEGAS, NV 89113


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Document Page 52 of 69

Debtor1 ALYSSA NICOLE CCAM Case number (rinown,
FratNome Ti a Taian

14,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?

Ano

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

Gifts or contributions to charities Describe what you contributed Date you Value
that total more than $600 contributed
§.
Charity’s Name
$.
Number Street
City Slate ZIP Code

rant: | List Certain Losses

18. Within 4 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

O Yes. Fill in the details.

Describe the property you lost and Describe any insurance coverage for the loss Date of your Value of property
lost

how the loss occurred 7
Include the amount that insurance has paid. List pending insurance

claims on line 33 of Schedule A/B: Property.

List Certain Payments or Transfers

16. 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, bankruptey petition preparers, or credit counseling agencies for services required in your bankruptcy.
no
| Q1 Yes. Fill in the details.

Description and value of any property transferred Date payment or Amount of payment
transfer was
Berson Who Was Pakd made
| Number Street = $
| $.

Giy Siale ZIP Code

Email or website addres

Person Who Made the Payment, Not You

Official Form 107, ‘Statement of Financial Affairs for Individuals Filing for Bankruptcy page 7


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 24 of 69

Fill in this information to identify your case:

TastName

Debior1 ALYSSA NICOLE
Frat Name Wide Name
Debtor 2
(Spouse, if fing) Fre Name Middle Name
United States Bankruptey Court for the; NORTHERN DISTRICT OF TEXAS
Case number
{if known)

O Check if this is an

Official Form 106D

Schedule D: Creditors Who Have Claims Secured by Property

amended filing

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).

4. Do any creditors have claims secured by your property?
1 No. Check this box and submit this form to the court with your other schedules. You have nothing else to report on this form,

G Yes. Fillin all of the information below.

List All Secured Claims

Column A ‘Column B Column C
2, List all:secured.claims. If 4 creditor has more than one secured claim, list the creditor separately amount of claim Value of collateral Unsecured
for each claim, If more than one creditor has a particular claim, list the other creditors in Part2. he not deduct the _that supports this
As much as possible, list the claims in alphabetical order according to the creditor's name. value of collateral, claim tfany

FLAGSHIP CREDIT ACCEPTAN Describe the property that secures the claim:

314,735.00 s_ 5,118.00 s 9,617.00

Creditors Name
530 WEST ALLEGAN STREET
Number Sweat—SSSOsC—~—~—~S
LANSING mi 48929
City State ZIP Code
Who owes the debt? Check one.
@ Debtor 1 only

Q debtor 2 only
Q Debtor 1 and Debtor 2 only
Atleast one of the debtors and another

Q Check if this claim relates toa
community debt

| Date debt was incurred 7/8/28

AUTOMOBILE ESCAPE TITANIUM FORD

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

2 Unliquidated

O] Disputed

Nature of lien. Check all that apply.

© An agreement you made (such as mortgage or secured
car loan)

D2 Statutory tien (such as tax lien, mechanic's lien)

2 Judgment lien from a lawsuit

1 other (including a right to offset)

Last 4 digits of account number 1001

2.2) CHIMEF/STR Describe the property that secures the claim: 8 168.00 s 0.00 s_168.00
| Creditor's Name f ~ ~ ]
' 77 MAIDEN LANE
} Number ‘Street _ i
{ As of the date you file, the claim is: Check all that apply.
0 Contingent
SAN FRANCISCO CA 94108 O unliquidated
city ‘Stale ZIP Code Q bisputed
Who owes the debt? Check one. Nature of lien. Check all that apply.
© Debtor 1 only © An agreement you made (such as mortgage or secured
O21 Debtor 2 only car loan)
OQ Debtor 1 and Debtor 2 only Statutory lien (such as tax lien, mechanic's lien)
Q Atleast one of the debtors and another Judgment lien from a lawsuit
2 other (including a right to offset)
O Check if this claim relates to a
i community debt
| Date debtwas incurred 2020 Last 4 digits of account number 5229
Add the dollar value of your entries in Column A on this page. Write that number here: 14,903.00 _
page 1

Official Form 106D

Schedule D: Creditors Who Have Claims Secured by Property


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 42 of 69

Fill in this information to identify your case:

ALYSSA NICOLE MCCAIN sete i
Debtor 1 aan aR TER sarName Check if this is:

Debtor 2 ”
(Spouse, i fing) FratName rrr ane O An amended filing

O A supplement showing postpetition chapter 13
, NORTHERN DISTRICT OF TEXAS
United States Bankruptoy Court for the: expenses as of the following date:

Case number MM 7 DD7 YYYY
(if known)

Official Form 106J
Schedule J: Your Expenses 1215

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.

TEEEIIE) 2-+<rive vour Househo

1. Is this a joint case?

© No. Gotoline 2.
Q Yes. Does Debtor 2 live in a separate household?
QO No
2 Yes. Debtor 2 must file Official Form 106J-2, Expenses for Separate Household of Debtor 2.

2. Do you have dependents? W No
Dependent’s relationship to Dependent’s Does dependent live
Do not list Debtor 1 and Q] Yes. Fill out this information for Debtor 1 or Debtor 2 age with you?
Debtor 2. each dependent

Do not state the dependents’ 5 No
names. Yes
Q No
O Yes

QO No
Q Yes

QO No
O Yes

OD No
O ves

3. Do your expenses include Uno
expenses of people other than Q
yourself and your dependents? Yes

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 1061.) Your expenses

4, The rental or home ownership expenses for your residence. Include first mortgage payments and 5 1,200.00
any rent for the ground or lot. 4 _——SSSSS
If not included In line 4:
4a. Realestate 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. $.

Official Form 106J Schedule J: Your Expenses page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

The law requires that you
receive a briefing about credit
counseling before you file for
bankruptcy. You must
truthfully check one of the
following choices. If you
cannot do so, you are not
eligible to file.

If you file anyway, the court
can dismiss your case, you
will lose whatever filing fee
you paid, and your creditors
can begin collection activities
again.

Official Form 101

counseling agency within the 180 days before |
filed this bankruptcy petition, and | received a
certificate of completion.

Attach a copy of the cerlificate and the payment
plan, if any, that you developed with the agency.

O I received a briefing from an approved credit
counseling agency within the 180 days before |
filed bankruptcy petition, but | do not have a

certificate of completion.

Within 14 days after you file this bankruptcy petition,
you MUST file a copy of the certificate and payment
plan, if any.

Q I certify that | asked for credit counseling
services from an approved agency, but was.
unable to obtain those services during the 7
days after | made my request, and exigent
circumstances merit a 30-day temporary waiver
of the requirement.

To ask for a 30-day temporary waiver of the
requirement, attach a separate sheet explaining
what efforts you made to obtain the briefing, why
you were unable to obtain it before you filed for
bankruptcy, and what exigent circumstances
required you to file this case.

Your case may be dismissed if the court is
dissatisfied with your reasons for not receiving a
briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must
still receive a briefing within 30 days after you file.
You must file a certificate from the approved
agency, along with a copy of the payment plan you
developed, if any. If you do not do so, your case
may be dismissed.

‘Any extension of the 30-day deadiine is granted
only for cause and is limited to a maximum of 15
days.

2 1am not required to receive a briefing about
credit counseling because of:

Q Incapacity. | have a mental illness or a mental
deficiency that makes me
incapable of realizing or making
rational decisions about finances.

My physical disability causes me
to be unable to participate in a
briefing in person, by phone, or
through the internet, even after
reasonably tried to do so.

O Active duty. | am currently on active military
duty in a military combat zone.

If you believe you are not required to receive a
briefing about credit counseling, you must file a
motion for waiver of credit counseling with the court.

Q Disability.

Voluntary Petition for Individuals Filing for Bankruptcy

Document Page 5 of 69
Debtor 1 puyees Load MCCAIN Case number (iknow)
Frei Name Midi Wave Tosi Wame
iF taaaa Explain Your Efforts to Receive a Briefing About Credit Counseling
ADOMEDSEIOg 1 About Debtor 2 (Spouse Only in a Joint Case):

15. Tell the court whether

you have received a You must check one: You must check one:

briefing about credit

counseling. @ I received a briefing from an approved credit O I received a briefing from an approved credit

counseling agency within the 180 days before |
filed this bankruptcy petition, and | received a
certificate of completion.

Attach a copy of the certificate and the payment
plan, if any, that you developed with the agency.

QO Ireceived a briefing from an approved credit
counseling agency within the 180 days before |
filed this bankruptcy petition, but | do not have a
certificate of completion.

Within 14 days after you file this bankruptcy petition,
you MUST file a copy of the certificate and payment
plan, if any.

O Icertify that | asked for credit counseling
services from an approved agency, but was
unable to obtain those services during the 7
days after | made my request, and exigent
circumstances merit a 30-day temporary waiver
of the requirement.

To ask for a 30-day temporary waiver of the
requirement, attach a separate sheet explaining
what efforts you made to obtain the briefing, why
you were unable to obtain it before you filed for
bankruptcy, and what exigent circumstances
required you to file this case,

Your case may be dismissed if the court is
dissatisfied with your reasons for not receiving a
briefing before you filed for bankruptcy.

If the court is satisfied with your reasons, you must
still receive a briefing within 30 days after you file.
You must file a certificate from the approved
agency, along with a copy of the payment plan you
developed, if any. If you do not do so, your case
may be dismissed.

Any extension of the 30-day deadline is granted
only for cause and is limited to a maximum of 15
days.

Q 1am not required to receive a briefing about
credit counseling because of:

Q Incapacity. | have a mental illness or a mental
deficiency that makes me
incapable of realizing or making
rational decisions about finances,

My physical disability causes me
to be unable to participate in a
briefing in person, by phone, or
through the internet, even after |
reasonably tried to do so.

O Active duty. | am currently on active military
duty in a military combat zone.

QO Disability,

If you believe you are not required to receive a
briefing about credit counseling, you must file a
motion for waiver of credit counseling with the court.

page 5


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 35 of 69

Lidell Case number (rinown,
Tana

ALYSSA NICOLE
FratNane

Debtor 1

Wie Name

| Pare 3: | List Others to Be Notified About a Debt That You Already Listed

5. Use this page only if you have others to be notified about your bankruptcy, for a debt that ready listed in Parts 1 or 2. For

Official Form 106E/F

example, if a collection agency is trying to collect from you for a debt you owe to someone

, 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.

LVNV FUNDING
Name

55 BEATTIE PLACE

Number Street
GREENVILLE SC 29601
City State ZIP Code
DEBT CO LLC

Name

9417 EAST 63RD STREET

Number Strest

RAYTOWN MO___ 64133
ciy State ZIP Code

MIDLAND CREDIT MANAGEMENT

Name

350 CAMINO DE LA REINA

Number Street
SAN DIEGO. CA 92108
Ciy State ZIP Code
CARSON SMITHFIELD

Name

225 WEST STATION SQUARE DRIVE.

Number Street

4TH FLOOR
PITTSBURGH PA 15219
Ciy State ZIP Code

PROFESSIONAL ACCOUNT MANAGEMENT

Name

325 DANIEL ZENKER DRIVE

On which entry in Part 1 or Part 2 did you list the original creditor?

Line 4__of (Check one): Part 1: Creditors with Priority Unsecured Claims
@ Part 2: Creditors with Nonpriority Unsecured Claims

Last 4 digits of account number 7512

On which entry in Part 1 or Part 2 did you list the original creditor?

Line 5 of (Check one): O Part 1: Creditors with Priority Unsecured Claims

@ Part 2: Creditors with Nonpriority Unsecured

Claims:

Last 4 digits of account number 3491

On which entry in Part 1 or Part 2 did you list the original creditor?

Line_7 of (Check one): O Part 1: Creditors with Priority Unsecured Claims
@ Part 2: Creditors with Nonpriority Unsecured

Claims

Last 4 digits of account number 9595

On which entry in Part 4 or Part 2 did you list the original creditor?

Line _Q of (Check one): Q Part 1: Creditors with Priority Unsecured Claims
@ Part 2: Creditors with Nonpriority Unsecured

Claims

Last 4 digits of account number 0822

On which entry in Part 1 or Part 2 did you list the original creditor?

Line 21 __ of (Check one): Q Part 4: Creditors with Priority Unsecured Claims

Number ‘Street @ Part 2: Creditors with Nonpriority Unsecured
Claims

HORSEHEADS NY 14845 Last 4 digits of account number 7512

Clty” State ZIP Code

HALSTED FINANCIAL SERVICES On which entry in Part 1 or Part 2 did you list the original creditor?

Name

PO BOX 828 Line 23 _ of (Check one): ) Part 1: Creditors with Priority Unsecured Claims

Number ‘Street @ Part 2: Creditors with Nonpriority Unsecured
Claims

SKOKIE IL 60076 Last 4 digits of account number 7512

ciy — Stato ZIP Code -

NATIONAL CREDIT ADJUSTERS On which entry in Part 4 or Part 2 did you list the original creditor?

lame

327 WEST 4TH AVENUE Line 23 of (Check one): ) Part 1: Creditors with Priority Unsecured Claims

Number Street @ Part 2: Creditors with Nonpriority Unsecured
Claims

BUTCHINSON KS __ 67501 Last 4 digits of account number 7512

Schedule E/F: Creditors Who Have Unsecured Claims

page 13


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 21 of 69

Fill in this information to identify your case:

Debtor 4 ALYSSA
Fest Name

Debtor 2
(Spouse, i fling) FirstName Middle Nao LastName

United States Bankruptoy Court for the: NORTHERN DISTRICT OF TEXAS.

Case number QO Cheek if this is an
(it known) a
amended filing

Official Form 106C
Schedule C: The Property You Claim as Exempt o4i22

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/8) 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 alds, 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 Jaw 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.

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.
Q 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 lineon Current value ofthe = Amount of the exemption you claim Specific laws that allow exemption

Schedule A/B that Ilsts this property portlon you own
Copy the value from Check only one box for each exemption.
Schedule A/B
Brief 11 U.S.C. § 522(4)(2)
description: AUTOMOBILE, POOR CONDITION = 000 Ag 0.00
Line from 0) 100% of fair market value, up to

Schedule A/B: 31 any applicable statutory limit

Brief

description: HOUSEHOLD, SOFA $. 4000 Ws 40.00

Line from 6 O 100% of fair market value, up to

Schedule A/B: ———— any applicable statutory limit

Brief 11 USC. §522(0)(3)
description: HOUSEHOLD, BEDDING $ 20 Ds 20.00

Line from D2 100% of fair market value, up to

Schedule A/B: & any applicable statutory limit

3. Are you claiming a homestead exemption of more than $189,050?
(Subject to adjustment on 4/01/25 and every 3 years after that for cases filed on or after the date of adjustment.)

No
1 Yes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case?

Q No
Q Yes

Official Form 106C. Schedule C: The Property You Claim as Exempt page 1 of __


Debtor 1

44

Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 27 of 69
Pail NICOLE MCCAIN Case number (it known),
ron 2 NONPRIORITY Unsecured Claims — Continuation Page
After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth. Total claim
CREDIT ONE BANK NLA, Last 4 digits of account number 7512 __ s 965.00:

45

Official Form 106E/F

Nonpriorty Creditor’s Name
6801 SOUTH CIMARRON ROAD

Number ‘Street
LAS VEGAS NV

89113

oiy ‘Sate

Who incurred the debt? Check one,

42 Debtor 1 only

©) pebtor 2 only

Q Debtor 1 and Debtor 2 only

0 Atleast one of the debtors and another

O Cheek if this claim is for a community debt

Is the claim subject to offset?

DZ no
OQ Yes

DECLARATION ENERGY LLC DBA ENE

ZIP Code

Nonpriority Creditors Name
PO BOX 2209

Number Street
BELLAIRE TM*

77402

City ‘Siate

Who incurred the debt? Check one.

44 Debtor 4 only

Q Debtor 2 only

© Debtor 4 and Debtor 2 only

C1 Atleast one of the debtors and another

Oi Check if this claim is for a community debt

Is the claim subject to offset?

ino
QO Yes

DISCOVER

ZiP Code

Nonpriorty Creditor's Name
PO BOX 51908

Number Street
LOS ANGELES cA

90051-8208

Giy State

Who incurred the debt? Check one.

Debtor 4 only

1 debtor 2 only

Q Debtor 1 and Debtor 2 only

O At least one of the debtors and another

O Check if this claim is for a community debt

Is the claim subject to offset?

Gi no
O ves

“ZIP Code

Schedule E/F: Creditors Who Have Unsecured Claims

When was the debt incurred? 12/16/22

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

Q Contingent
D2 unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

O21 Student ioans

2 Obligations arising out of a separation agreement or divorce that
you did not report as priority ciaims

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

{2 other. Specify CREDIT CARD

Last 4 digits of account number 3491

/9/2:

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

$205.00

‘When was the debt incurred?

O Contingent
O unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

OQ Student loans

Q Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

© other. Specify UTILITIES

3834.00

Last 4 digits of account number 3221
4/1/21

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

‘When was the debt incurred?

O Contingent
O unliquidated
O Disputed

Type of NONPRIORITY unsecured claim:

OQ Student loans

2 obligations arising out of a separation agreement or divorce that
‘you did not report as priority claims

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

[A other. Specity CREDIT CARD

page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 23 of 69
Debtor ALYSSA NICOLE MCCAIN case number iim
Fraivome Tide Nave TaatNare
Additional Page
Brief description of the property and line Current value ofthe © Amount of the exemption you claim Specific laws that allow exemption
on Schedule A/B that Iists this property portion you own
Copy the value from Check only one box for each exemption
Schedule AB
Secerpton: OTHER FINANCIAL ACCOUNT, CASH /g oor Ws 0.01 TUS. §522(0)(6)
i ; 2 100% of fair market value, up to
Line from 17 ae
Schedule AB: any applicable statutory limit
oe ion; OTHERLEINANGIAL ACCOUNT, VEN oo WS 001 Huss ssuan
Line ‘rom ; Q 100% of fair market value, up to
Schedule as; 12 — any applicable statutory limit
Briel ot PENSION PLAN, FORT WORTH EMPL(g 571500 Ag 6,718.00 " use. : ame
lescription: tuse.
Line from 24 O 100% of fair market value, up to
Schedule A/B: ~~ any applicable statutory limit
ee INSURANCE PLAN, SEGURIAN FINAN: ¢ 000 Wg 0.00 118.6. § 522(aK7)
les Hi
0 100% of fair market value, up to
Line from 31.4 1 r
Schedule AB: any applicable statutory limit
Briel ‘ot OFFICE EQUIPMENT, FOOD DELIVER g 00 Ws 40.00 11 US.C. § 522(0)(5)
lescription:
Line from 2 100% of fair market value, up to
Schedule ae; 39 any applicable statutory limit
Brief
: $. Qs
description:
Line on 2 100% of fair market value, up to
Schedule A/B:. ———— any applicable statutory limit
Brief
iption: 8. Qs
description:
Line oe 2 100% of fair market value, up to
Schedule A/B: any applicable statutory limit
Brief
iption: $ Os
description:
Line foe D 100% of fair market value, up to
Schedule A/B:. —— any applicable statutory limit
Brief
ion: $ Qs
description:
Line ‘on 2 100% of fair market value, up to
Schedule A/B:. ——— any applicable statutory limit
Brief
ipti 8. Os
description:
Line ‘on 2 100% of fair market value, up to
Schedule A/B: any applicable statutory limit
Brief
iption: 8 Os
description:
Line ‘oe 2 100% of fair market value, up to
. limit
Schedule A/B:. ——— any applicable statutory limi
Brief
iption: $ Qs
description:
Line ‘om 1 100% of fair market value, up to
/ ‘in
Schedule A/B;. any applicable statutory limit

Official Form 106C

Schedule C: The Property You Claim as Exempt

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 36 of 69

Debtor 4 ALYSSA NICOLE

MCCAIN

Case number (irknowe),

FirstName "wide Name

Taat Name

| Part 3: | List Others to Be Notified About a Debt That You Already Listed

_ 5. 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.

HORACIO LOPEZ

On which entry in Part 1 or Part 2 did you list the original creditor?

Name
2332 LONGHORN STREET Line 26 of (Check one): Q Part 1: Creditors with Priority Unsecured Claims
Number Street & Part 2: Creditors with Nonpriority Unsecured Claims
4 6098
DALLAS 1X 75228 Last 4 digits of account number 6098
City State ZIP Code
On which entry in Part 1 or Part 2 did you list the original creditor?
Name
Line____of (Check one): O) Part 1: Creditors with Priority Unsecured Claims
Number Street O Part 2: Creditors with Nonpriority Unsecured
Claims
Last 4 digits of account number
City State ZIP Code
On which entry in Part 1 or Part 2 did you list the original creditor?
Name
Line ‘of (Check one): O Part 1: Creditors with Priority Unsecured Claims
Number Steet O Part 2: Creditors with Nonpriority Unsecured
Claims
Last 4 digits of account number
City ‘State ZIP Code
On which entry in Part 1 or Part 2 did you list the original creditor?
Name
Line of (Check one): O Part 4: Creditors with Priority Unsecured Claims
Number Street Q Part 2: Creditors with Nonpriority Unsecured
Claims
Last 4 digits of account number
Gay Slate ZIP Code
On which entry in Part 1 or Part 2 did you list the original creditor?
Name
Line ____ of (Check one): Q Part 1: Creditors with Priority Unsecured Claims
Number Street Q Part 2: Creditors with Nonpriority Unsecured
Claims
Last 4 digits of account number
City, State ZP Code
On which entry In Part 4 or Part 2 did you list the original creditor?
Name
Line ‘of (Check one): O Part 4: Creditors with Priority Unsecured Claims
Number Street Q Part 2: Creditors with Nonpriority Unsecured
Claims
Last 4 digits of account number
ty State ZIP Code = =
7 On which entry in Part 1 or Part 2 did you list the original creditor?
lame
Line of (Check one): Q Part 4: Creditors with Priority Unsecured Claims
Number Street O Part 2: Creditors with Nonpriority Unsecured
Claims
ow Sa ae Cae Last 4 digits of account number
Official Form 106E/F Schedule E/F: Creditors Who Have Unsecured Claims page 13


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 18 of 69

ALYSSA NICOLE MCCAIN
Fratnane Widcie Narre Tani Name

Debtor 1 Case number (known),

31, Interests in insurance policies
Examples: Health, disability, or life insurance;health savings account (HSA);credit, homeowner's, or renter’s insurance

OQ No

Yes. Name the insurance company

Cor : ficiary: ‘Surrender or refund value:
Sreach policy and lst ts value, . ComPany name Beneficiary: Surrender or refund value:
SECURIAN FINANCIAL, TERM INSU TAMEKA LASHAWN Mctil\s 0.00
$.
$.
32. Any interest in property that is due you from someone who has died
If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receive
property because someone has died,
No . . oe
1 Yes. Give specific information... ls 0.00
| ene — a i
33. Claims against third parties, whether or not you have filed a lawsuit or made a demand for payment
Examples: Accidents, employment disputes, insurance claims, or rights to sue
{2 No
— ~ ——— = 4
. Descri im.
O Yes. Describe each claim. le 0.00
34, Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights
to set off claims
4 No
O) Yes. Describe each claim. : |. 0.00
35. Any financial assets you did not already list
No r — ~ i
O Yes. Give specific information....nc | is 0.00
36. Add the dollar value of all of your entries from Part 4, including any entries for pages you have attached
for Part 4, Write that number here > Is 6,828.04

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

37.Do you own or have any legal or equitable interest In any business-related property?
O No. Go to Part 6.
1d Yes. Go to line 38.

Current value of the
portion you own?
Do not deduct secured claims
or exemptions.
38, Accounts receivable or commissions you already earned
No r ———e ee et ert aa nena —_ ——————————
ibe..../ |
CO Yes. Describe... \ 0.00
39, Office equipment, furnishings, and supplies
Examples: Business-related computers, software, modems, printers, copiers, fax machines, rugs, telephones, desks, chairs, electronic devices
Qa No or er nee ne et ntti eet ~
Yes. Describe... FOOD DELIVERY BAG (~$20) AND DRINK CARRIER ($20). s 40.00
Official Form 106A/B Schedule A/B: Property page B



Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 62 of 69

ALYSSA NICOLE MCCAIN
Fratname ‘Wace Name Tost Nara

| Part 3: | Sign Below

Debtor 1 Case number (irknown),

By signing here, | declare under penalty of perjury that the information on this statement and in any attachments is true and correct.

x Mh x

Signature Of Debtor 4 Signature of Debtor 2
i
| vee Ob fio / 2024 bate
j MM7 DD TYYYY MM? DD TYYYY

If you checked line 14a, do NOT fill out or file Form 122A-2.
If you checked line 14b, fill out Form 122A~2 and file it with this form.

Official Form 122A-1 Chapter 7 Statement of Your Current Monthly Income page 3


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 10 of 69

ALYSSA NICOLE MCCAIN
FiatNane Waele Nae Toathame

Debtor 1

| Part 4: | Answer These Questions for Administrative and Statistical Records

Case number (7known),

8. Are you filing for bankruptcy under Chapters 7, 11, or 137

Ono.
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.

Q 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:

From Part 4 on Schedule E/F, copy the following:

a. Domestic support obligations (Copy line 62.)

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.

$___ 2,551.67
Total claim
s 0.00
s 0.00
s 0.00
s 32,459.00
sO.
+s 0.00
s 32,459.00
page 2

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



Debtor 1

FirstName Twidate Name

Test Name

Page 33 of Bgrumber wincwn,

Case. 24-31768-swe7 Rog. Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document

rar Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

4.22

4.23

Official Form 106E/F

‘SPEEDY CASH

Nonpriorty Greditor’s Name
PO BOX 780408

Number Street
WICHITA KS

67278

City Siale

Who incurred the debt? Check one.

(A Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

. Atleast one of the debtors and another

U Check if this claim is for a community debt

Is the claim subject to offset?

no
Q Yes

STATE FARM PAT WHITE.

ZIP Code

Nonpriority Creditors Name
500 GRAPEVINE HWY STE 110

Number Street
HURST TM

Giy State

Who incurred the debt? Check one.

YA Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt

Is the claim subject to offset?

Zi No
O Yes

TAMU

ZIP Code

Nonpriority Creditors Name
6001 TAMU

Number Strest
COLLEGE STATION 1x

77843

City State

Who incurred the debt? Check one.

@ debtor 1 only

Q bebtor 2 only

Q Debtor 1 and Debtor 2 only

O1 Atleast one of the debtors and another

OQ) Check if this claim is for a community debt
Is the claim subject to offset?

no
O Yes

ZIP Code

Schedule E/F: Creditors Who Have Unsecured Claims

Last 4 digits of accountnumber 7512
3/1/23

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

When was the debt incurred?

Q Contingent
2 unliquidated
Disputed

Type of NONPRIORITY unsecured claim:

O student loans

2 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

2 Debts to pension or profit-sharing plans, and other similar debts
@ other. Specity. PAYDAY LOAN

Last 4 digits of account number 4408

1/15/23

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

When was the debt incurred?

Q Contingent
Q unliquidated
OQ. Disputed

Type of NONPRIORITY unsecured claim:

Student loans

2 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

© otter. speciy CAR INSURANCE

Last 4 digits of account number 0322_ a
3/1/22 _

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

When was the debt incurred?

Q Contingent
QO Unliquidated
QO bisputed

Type of NONPRIORITY unsecured claim:

@ student toans

Q. 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
C2 other. Specify,

Total claim

$2,388.00

3406.00

52,177.00

page 4


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 69 of 69

GPSOLVE

Clerk of Court
U.S. Bankruptcy Court

NORTHERN DISTRICT OF TEXAS.

In re: ALYSSA NICOLE MCCAIN
Dear Clerk of Court,

lam the Managing Attorney of Upsolve.org. Upsolve is a nonprofit
self-service web application funded by the Legal Services Corporation
and leading philanthropic foundations. Our web application helps
low-income debtors who cannot afford counsel generate their
bankruptcy forms on their own.

We are writing to notify the Court that the Upsolve web application has
assisted the above-captioned debtor in preparing their Chapter 7 forms.
Upsolve does not provide legal advice and Upsolve is not the debtor's
attorney. And because we have provided our services at no cost, Upsolve
is not a petition preparer under section 110 of the Bankruptcy Code. As a
result, Official Form 119 is not required of the debtor and has not been
provided.

If you have any additional questions, please do not hesitate to contact
me at tina@upsolve.org. Please docket this letter.

Respectfully Submitted,

Tina Tran


Debtor 1

Case,g4-31768:swe7 Qog,d Filed 06/17/
D At

FratName Wide Name

Tact Name

24 Entered 06/17/24 15:07:28 Desc Main
Page 30 of 9 rUmer «iow,

Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

418

aaa

Official Form 106E/F

MODPED

Nonpriority Creditors Name
PO BOX 730283

Number Street
ST.LOUIS MO

63179

City Stale

Who incurred the debt? Check one.

(A Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?

Gi no
O Yes

MODPED

ZIP Code

Nonpriority Creditors Name
PO BOX 790283

Number ‘Street
ST.LOUIS MO

63179

City State

Who incurred the debt? Check one.

(i Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

Q] Atleast one of the debtors and another

Q) Check if this claim is for a community debt

Is the claim subject to offset?
no

O Yes

MODPED

ZIP Code

Nonpriority Creditors Name
PO BOX 780283

Number Sireet
ST. LOUIS Mo

63179

City State

Who incurred the debt? Check one.

{A Debtor 1 only

Q bebtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?

Gino
O Yes

ZIP Code

Schedule E/F: Creditors Who Have Unsecured Claims

Total claim

Last 4 digits of account number 0005 ___ s 2,137.00

When was the debt incurred? 8/1 ‘1 8

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

Q Contingent
Q. unliquidated
Q bisputed

Type of NONPRIORITY unsecured claim:

@ student loans

Q2 obligations arising out of a separation agreement or divorce that
you did not report as priority claims

Q2 Detis to pension or profit-sharing pians, and other similar debts

Q other. Specify

Last 4 digits of accountnumber 0001

8/1/17

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

3,500.00

When was the debt incurred?

Q Contingent
C1 untiquidatea
Q Disputed

Type of NONPRIORITY unsecured claim:

© student loans

Q2 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

C2 other. Specify

4,000.
Last 4 digits of account number 0010_ —_— & 0.00

8/1/21

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

When was the debt incurred?

Q Contingent
Q) unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

© student loans

O21 obligations arising out of a separation agreement or divorce that
you did not report as priority claims

O Debts to pension or profit-sharing plans, and other similar debts
QO) other. Specify

page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 7 of 69

vebtrt — Alussa__Wiegle McCain Case number (too
Fee Maas ee
Sign Below
| have examined this petition, and | declare under penalty of perjury that the information provided is true and
For you correct.

For your attorney, if you are
represented by one

If you are not represented
by an attorney, you do not
need to file this page.

Official Form 101

If | have chosen to file under Chapter 7, | am aware that | may proceed, if eligible, 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.

If no attorney represents me and | did not pay or agree to pay someone who is not an attorney to help me fill out
this document, | have obtained and read the notice required by 11 U.S.C. § 342(b).

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

| understand making a false statement, concealing property, or obtaining money or property by fraud in connection
with @ 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.

x Wh x

Signature of Debtor 1 Signature of Debtor 2
executedon 06 / IL | 2024 Executed on
MM 7 DD /YYYY MMT DD /YYYY

|, the attorney for the debtor(s) named in this petition, declare that | have informed the debtor(s) about eligibility
to proceed under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief
available under each chapter for which the person is eligible. | also certify that | have delivered to the debtor(s)
the notice required by 11 U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, certify that | have no
knowledge after an inquiry that the information in the schedules filed with the petition is incorrect.

x Date
Signature of Attorney for Debtor MM 7 DD /YYYY
Printed name
Firm name
Number Street
City State ZIP Code
Contact phone Email address
Bar number State

Voluntary Petition for Individuals Filing for Bankruptcy page 7


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Debtor 4 ALYSSA NICOLE

Document Page 6 of 69

MCCAIN Case number (itinown),

FreName Widaie Name

Tat Name

| Part 6: | Answer These Questions for Reporting Purposes

16. What kind of debts do
you have?

17, Are you filing under
Chapter 7?

Do you estimate that
after any exempt
property is excluded and
administrative expenses.
are paid that funds will
be available for
distribution to
unsecured creditors?

48. How many creditors do
you estimate that you
owe?

49. How much do you
estimate your assets to
be worth?

20. How much do you
estimate your
liabilities to be?

Official Form 101

16a. Are your debts 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.”
O No. Go to line 16b.
© Yes. Goto line 17.

16b. Are your debts primarily business debts? Business debts are debts that you incurred to obtain
money for a business or investment or through the operation of the business or investment.

O No. Goto line 160,
O Yes. Go to line 17.

16c. State the type of debts you owe that are not consumer debts or business debts.

I No. 1am not filing under Chapter 7. Go to line 18.

@ Yes. | am filing under Chapter 7. Do you estimate that after any exempt property is excluded and
administrative expenses are paid that funds will be available to distribute to unsecured creditors?

No
QO Yes

@ 149

O 50-99
QO 100-199
Q 200-999

© $0-$50,000

Q $50,001-$100,000
Q $100,001-$500,000
O $500,001-$1 million

Q $0-$50,000

© $50,001-100,000
Q $100,001-500,000
OQ $500,001-81 million

OQ 1,000-5,000
O21 5,001-10,000
OQ 10,001-25,000

O $1,000,001-$10 milion

OQ $10,000,001-$50 million
2 $50,000,001-$100 million
O $100,000,001-8500 million

Q $1,000,001-$10 million

Q $10,000,001-$50 million
Q2 $50,000,001-§100 million
Q $100,000,001-$500 million

Voluntary Petition for Individuals Filing for Bankruptey

O 25,001-50,000
QO 50,001-100,000
O] More than 100,000

2 $500,000,001-$1 billion

Q $1,000,000,001-$10 billion
O $10,000,000,001-850 billion
Q) More than $50 billion

Q $500,000,001-81 billion

Q $1,000,000,001-810 billion
OQ $10,000,000,001-850 billion
O More than $50 billion

page 6


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 19 of 69

Debtor? ALYSSA NICOLE MCCAIN

Case number (known),
Fir Name Widdie Ware Taat Namo

40.Machinery, fixtures, equlpment, supplies you use in business, and tools of your trade

Y no eee Co

QO Yes. Desc n $ 0.00
41. Inventory

W@ No F E _— =— _ oe a :

O Yes, Describe... ’ 0.00

42.Interests in partnerships or joint ventures
W No

Q Yes, Describe....... Name of entity: % of ownership:

% $
%
% $.

an

43.Customer lists, mailing lists, or other compilations
W No
2 Yes. Do your lists include personally identifiable information (as defined in 11 U.S.C. § 101(41A))?
O No
Q Yes. Describe.

| ls 0.00

44, Any business-related property you did not already list
Wt No

Q Yes. Give specific
information

45, Add the dollar value of all of your entries from Part 5, including any entries for pages you have attached $ 40,00
for Part 5. Write that number here |

Describe Any Farm- and Commercial Fishing-Related Property You Own or Have an Interest In.
If you own or have an interest in farmland, list it in Part 1.

46,Do you own or have any legal or equitable interest in any farm- or commercial fishing-related property?

@ No. Go to Part 7.
O21 Yes. Go to line 47.

Current value of the
portion you own?
Do not deduct secured claims
or exemptions,
47. Farm animals
Examples: Livestock, poultry, farm-raised fish
OQ No
Q yes... a — — ~ a |
| i
| $

Official Form 1064/8 Schedule AJB: Property page 9



Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 9 of 69

Fill in this information to identify your case:

Debtor _ ALYSSA NICOLE
First Name Midale Name

Debtor 2
(Spouse, if fing) First Name idole Name Last Name

United States Bankruptcy Court for the: NORTHERN DISTRICT OF TEXAS

Case number 1 Check if this is an
Le amended filing

Official Form 106Sum
Summary of Your Assets and Liabilities and Certain Statistical Information 1215

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.

EEEEED summarize Your Assets

Your assets
Value of what you own.

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

1a. Copy line 55, Total real estate, from Schedule A/B.... sO
1b. Copy line 62, Total personal property, from Schedule VB... $ 7,258.04
1c. Copy line 63, Total of all property on Schedule A/B ......... $ 7,258.04

EEE sommarize 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............ $ ___14,903.00_

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 0.0... s__0.00

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

+s 72,043.00

Your total liabilities s___ 86,946.00

summarize Your Income and Exponaes

4. Schedule |: Your Income (Official Form 1061)

Copy your combined monthly income from line 12 of Schedule !. s 2,922.00
5. Schedule J: Your Expenses (Official Form 106J)
Copy your monthly expenses from line 22c of Schedule J $ 2,980.00

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 25 of 69

Fill in this information to identify your case:

Debtor ALYSSA NICOLE MCCAIN
FirstName Wie Name Taam

Debtor 2

(Spouse, if fling) Fiat Name Wale Name TaatNare

United States Bankruptcy Cour for the: NORTHERN DISTRICT OF TEXAS
O Cheek if this is an

Case number

(if known) amended filing
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims 41215

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 108G). Do not include any
creditors with partially secured claims that are listed in Schedule D: Creditors Who Have Claims Secured by Property. lf 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).

List All of Your PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims against you?
Wd No. Go to Part 2.
O ves.

2. List all of your priority unsecured claims. If a creditor has more than one priority unsecured claim, list the creditor separately for each claim. For
each claim listed, identify what type of claim it is. If a claim has both priority and nonpriority amounts, list that claim here and show both priority and

nonpriority amounts. As much as possible, list the claims in alphabetical order according to the creditor's name. If you have more than two priority
unsecured claims, fill out the Continuation Page of Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.

(For an explanation of each type of claim, see the instructions for this form in the instruction booklet.)
Total claim Priority Nonpriority

amount amount
24
Last 4 digits of accountnumber = S. 8 8.
Priority Craditor's Name
When was the debt incurred?
Number ‘Street
As of the date you file, the claim is: Check all that apply.
City State ZIP Code a Contingent
D8 Unliquidated
Who incurred the debt? Check one, DD bisputed
1 Debtor 1 only
1D Debtor 2 only ‘Type of PRIORITY unsecured claim:
a Debtor 1 and Debtor 2 only 1 Domestic support obligations
At least one of the debtors and another Taxes and certain other debts you owe the government
0 Check if this claim is for a community debt) cigims for death or personal injury while you were
Is the claim subject to offset? Intoxicated
QO No Q other. specify
O Yes
Last 4 digits of account number = $ $
Priority Creditor's Name
When was the debt incurred?
Number ‘Street
' As of the date you file, the claim is: Check all that apply.
O Contingent
Cy Slate ZIP Code QO Unliquidated
Who incurred the debt? Check one. 1 Dispute
O bebtor 1 only ‘Type of PRIORITY unsecured claim:
OQ] Debtor 2 only

Q Domestic support obligations
O Taxes and certain other debts you owe the government
O2 Claims for death or personal injury while you were

Debtor 1 and Debtor 2 only
O Atleast one of the debtors and another

O Check if this claim Is for a community debt

intoxicated
Is the claim subject to offset? C1 other. Specify
Ono

O ves,

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 1 of 69

Fill in this information to identify your case:

United States Bankruptcy Court for the:

| ' FILED “|
| NORTHERN DISTRICT OF TEXAS: i

(sa) JUN 17 2024

Case number (irknowny: gener you are filing under. |
| Chapter 7 LERK, U.S. BANKRUPTCY co! Qa if this i
| URT Check if this is an
i O Chapter 11 RTHERN DISTRICT OF TEXAS i"
Q Chapter 12 amended filing
' OQ Chapter 13

Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy 12122

The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a
Joint case—and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,”
the answer would be yes if either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 7 and
Debtor 2 to distinguish between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The
‘same person must be Debtor 7 in all of the forms.

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct

information. If more space Is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number
(if known). Answer every question.

Identify Yourself

About Debtor 1: About Debtor 2 (Spouse Only in a Joint Case):
1. Your full name ALYSSA
Write the name fea piel nYOUr Fist name First name
government-issu ju
identification (for example, NICOLE
your driver's license or Middle name Middle name
Passport). MCCAIN
A , Last name Tastname
Bring your picture
identification to your meeting
| with the trustee. Suffix (Sr, Jr, Ml) Suffix Sr, Jr, Mi ily
2. All other names you A
have used inthe lasts Firstname test name
, years
H Middle name Middle name i
| Include your married or |
i maiden names and any ‘
| assumed, trade names and ‘Lastname Last name I
' doing business as names.
Do NOT list the name of any First name. First name

separate legal entity such as
a corporation, partnership, or Hidde name.

le
© LLC that is not filing this Middle name
| petition.
Tast name Lastname
l Business name (if applicable) Business name (if applicable)
| Business name (ff applicable) Business name (i applicable)
|
3. Only the last 4 digits of |
your Social Security yx xx 7 5 1 2 WK XK |
number or federal OR OR i
Individual Taxpayer 9 9
| Identification number SS XX = XK
(TIN)

Official Form 104 Voluntary Petition for Individuals Filing for Bankruptcy page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 48 of 69

ALYSSA NICOLE MCCAIN
FraiNare ‘widcle Nave TastName

Debtor 1 Case number (iknow

J Part 3: Certain Payments You Made Before You Filed for Bankruptcy

6. Are elther Debtor 1’s or Debtor 2's debts primarily consumer debts?
O 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 $7,575* or more?

OQ No. Goto line 7.

QO Yes. List below each creditor to whom you paid a total of $7,575* 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 4/01/25 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.
Q 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.

Datesof Total amount paid Amount you still owe Was this payment for...
payment
$ $
Grediors Name O Mortgage
O car
Number Steet O credit cara
OD Loan repayment
Q suppliers or vendors.
iy t—~<“—*é‘C we IP Code O other
= 8 $ O Mortgage
Creditors Name
O car
Number Street O) credit card
O Loan repayment
O suppliers or vendors
Gy Sle ZIP oe D other _
_ = § 8 O Mortgage
Greditors Name
O car
Number Street Q credit card
Q Loan repayment
O suppliers or vendors
cy Sat 2 on OQ other

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Do not deduct secured claims or exemptions. Put

Document Page 12 of 69
Debtor? ALYSSA NICOLE MCCAIN Case number (escown)
FraName Miedo Name TastName
What is the property? Check all that apply.
413. O. Single-family home

Street address, if available, or other description

Giy State ZIP Code

County

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. ...

EEE] veserite Your Vehicles

2 Duplex or multi-unit building

Q) Condominium or cooperative
Q Manufactured or mobile home
Q Land

Cl investment property

O Timeshare

O other

Who has an interest in the property? Check one.
Q Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

1 Atleast one of the debtors and another

the amount of any seoured claims on Schedule D:
Creditors Who Have Claims Secured by Property.

Current value of the Current value of the
entire property? portion you own?

$ $.

Describe the nature of your ownership
interest (such as fee simple, tenancy by
the entireties, or a life estate), if known.

O Cheek if this is community property
(see instructions)

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

property identification number:

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.

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

OQ No

@ Yes

3.1, Make: FORD
Model ESCAPE TITANIUN
Year: 2013

Approximate mileage: °°00°

Other informati
|P00R GONDITION

If you own or have more than one, describe here:

3.2, Make:
Model:
Year:
Approximate mileage:

Official Form 106A/B

Who has an interest in the property? Check one,
Debtor 1 only

O Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this is community property (see
instructions)

Who has an interest in the property? Check one.

Q Debtor 4 only

O Debtor 2 only

Q Debtor 4 and Debtor 2 only

O atleast one of the debtors and another

O cheek if this is community property (see
instructions)

Schedule A/B: Property

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 Current value of the
entire property? portion you own?

$ 5,118.00 ¢ 0.00

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 Current value of the
entire property? portion you own?

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 11 of 69

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

Debtor! ALYSSA NICOLE MCCAIN
Frat Name Wicd Ware Tat Namie

Debtor 2

(Spouse, if filing) First Name Wicale Name Lest Name.

United States Bankruptcy Court for the: NORTHERN DISTRICT OF TEXAS

‘Case number

1 Check if this is an
amended filing

Official Form 106A/B
Schedule A/B: Property 12115

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.

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

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

@ No. Go to Part 2.
C1 Yes. Where is the property?
What is the property? Check all that apply. Do not deduct secured claims or exemptions. Put

QO single-family home the amount of any secured claims on Schedule D:
Creditors Who Have Clalms Secured by Property.

1. unit build
Street address, i avallable, or other description O Duplex oF muitrunit butaing

Q Condominium or cooperative Current value of the Current value of the
2) Manufactured or mobile home entire property? portion you own?
Q Land $ $
Q. investment property
O Timeshare Describe the nature of your ownership
City State ZIP Code a : interest (such as fee simple, tenancy by
Other the entireties, or a life estate), if known.
Who has an interest in the property? Check one.
Q Debtor 1 only
County Q Debtor 2 only
OQ Debtor 4 and Debtor 2 only QO check if this Is community property

CO atteast one of the debtors and another {see instructions)

Other information you wish to add about this Item, such as local
property identification number:

If you own or have more than one, list here:

What Is the property? Check all that apply. Do not deduct seoured claims or exemptions. Put
O Single-family home the amount of any secured claims on Schedule D:

1.2. a ae FL cle Creditors Who Have Claims Secured by Property.
Street address, if available, or other description O Duplex or multi-unit building
Q Condominium or cooperative Current value of the Current value of the
2 Manufactured or mobile home entire property? Portion you own?
D Land 8 $
OQ investment property ae of hl
scribe the nature of your ownership
iy Sate Ze Code © Timeshare interest (such as fee simple, tenancy by
O other the entireties, or a life estate), if known.
Who has an interest In the property? Check one.
C1 Debtor 1 only
County ————— 0 debtor 2 only
Q Debtor 1 and Debtor 2 only Q Check if this Is community property
(1 Atleast one of the debtors and another (see instructions)

Other information you wish to add about this item, such as local
property identification number:

Official Form 106A/B Schedule A/B: Property page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 61 of 69

Debtor 1 ALYSSA NICOLE MEGAN Case number (snow),
FraiName Vie Nae Taste
Column A Column B
Debtor 4 Debtor 2 or
| non-filing spouse
8. Unemployment compensation s_ 0.00. $
i

Do not enter the amount if you contend that the amount received was a benefit
| under the Social Security Act. Instead, list it here: . v

For you ...
For your spouse ...

| 9. Pension or retirement income. Do not include any amount received that was a
benefit under the Social Security Act. Also, except as stated in the next sentence, do
| not include any compensation, pension, pay, annuity, or allowance paid by the
| United States Government in connection with a disability, combat-related injury or
disability, or death of a member of the uniformed services. If you received any retired
| pay paid under chapter 61 of title 10, then include that pay only to the extent that it
{ does not exceed the amount of retired pay to which you would otherwise be entitled if $ 0.00

retired under any provision of title 10 other than chapter 61 of that title. $.
10. Income from all other sources not listed above. Specify the source and amount.
Do not include any benefits received under the Social Security Act; payments received
as a victim of a war crime, a crime against humanity, or international or domestic
j terrorism; or compensation, pension, pay, annuity, or allowance paid by the United
States Government in connection with a disability, combat-related injury or disability, or
death of a member of the uniformed services. If necessary, list other sources on a
separate page and put the total below.
i s__0.00 $.
$ $
Total amounts from separate pages, if any. +3 +$
41. Calculate your total current monthly income. Add lines 2 through 10 for each i l=
column. Then add the total for Column A to the total for Column B. | $.2.551 6 7 S$. $2,551.67]
Total current
‘monthly Income

| Part 2: | Determine Whether the Means Test Applies to You

12. Calculate your current monthly income for the year. Follow these steps;
12a. Copy your total current monthly income from line 11.

| Multiply by 12 (the number of months in a year).
12b. The result is your annual income for this part of the form.

13, Calculate the median family income that applies to you. Follow these steps:

Fill in the state in which you live. TM

Fill in the number of people in your household. 1

Fill in the median family income for your state and size of household.

To find a list of applicable median income amounts, go online using the link specified in the separate
instructions for this form. This list may also be available at the bankruptcy clerk's office.

14, How do the lines compare?

44a. (Z Line 12b is less than or equal to line 13. On the top of page 1, check box 1, There is no presumption of abuse.
| Go to Part 3. Do NOT fill out or file Official Form 1224-2

opy line 11 heres | s 2,551.67 |

x 12
1a. | $30,620.00 |

$61,460.00

14b, Line 12b is more than line 13. On the top of page 1, check box 2, The presumption of abuse is determined by Form 122A-2.

i] Go to Part 3 and fill out Form 122A-2.

Official Form 122A-1 Chapter 7 Statement of Your Current Monthly Income

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 44 of 69

Debtor 4 ALYSSA NICOLE MCCAIN
FistName idle Name Tat Name

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
2c, Add line 22a and 22b, The result is your monthly expenses.

23. Calculate your monthly net income.
23a. Copy line 12 (your combined monthly income) from Schedule |.

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

23c. Subtract your monthly expenses from your monthly income.
The result is your monthly net income.

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.
O Yes. + Explain here:

Official Form 106J Schedule J: Your Expenses.

Case number (rinown),

21.

22a,

22c,

23a,

230,

+s i000
| $ 2,980.00
| $. 0.00
|

$ 2,922.00
-s 2,980.00
$ -58.00

page 3



CARR 31768-swe7 Qac,i Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Debtor 1 Decumern:

iat Nane Wile War Taito Document

Page 32 of BgTMUmPe "rm.

Ea Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth. Total claim
4.19
NORTH TEXAS TOLLWAY AUTHORITY Last 4 digits of accountnumber 1543 s 121.00
Nonpriority Creditors Name.
mo pox scozaa When was the debt incurred? 12/17/23
Number Street As of the date you file, the claim is: Check all that apply.
DALLAS TM 76039
tity State ZIP Code Q Contingent
QO Unliquidated
Who incurred the debt? Check one. O pisputed
Y Debtor 1 only
Q Debtor 2 only Type of NONPRIORITY unsecured claim:
1 Debtor 1 and Debtor 2 only 2 student loans
O1 Atleast one of the debtors and another O obligations arising out of a separation agreement or divorce that
it this claim i you did not report as priority claims
OI Check if this elaim is for a community debt QO Debts to pension or profit-sharing plans, and other similar debts
Is the claim subject to offset? A other. specity NTTA ZIPCASH TOLL BILL
Di no
O Yes
4.20
NORTH TEXAS TOLLWAY AUTHORITY Last 4 digits of account number 7512 $. 376.00
Nonpriority Creditor’s Name
When was the debt incurred? 1 1/3/2.
P.O. 660224
Number ‘Street
Daas x e088 As of the date you file, the claim is: Check all that apply.
ty State ZIP Code Q Contingent

Who incurred the debt? Check one.

A Debtor + onty

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

Qi Check if this claim is for a community debt

Is the claim subject to offset?
no

O Yes

NORTH TEXAS TOLLWAY AUTHORITY

Nonpriority Creditors Name
P.O. BOX 65024

Number ‘Street

DALLAS TM 75266
Ciy State ZIP Code

Who incurred the debt? Check one.

i Debtor 1 only

Q Debtor 2 only

1 Debtor 1 and Debtor 2 only

C1 Atleast one of the debtors and another

Q Check if this claim is for a community debt
Is the claim subject to offset?

Gino
Q Yes

Official Form 106E/F

Q unliquidated
O Disputed

Type of NONPRIORITY unsecured claim:

O Student toans

2 Obiigations arising out of a separation agreement or divorce that
you did not report as priority claims

Q2 Debts to pension or profit-sharing plans, and other similar debts

© other. specity NTTA ZIPCASH TOLL BILL

s 447.00

Last 4 digits of account number 4664
When was the debt incurred? 5/18/24 8/24

As of the date you

the claim is: Check all that apply.

O Contingent
OQ unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

O Student loans

2 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

Q Debts to pension or profit-sharing plans, and other similar debts
{A other. specity NTTA ZIPCASH TOLL BILL

Schedule E/F: Creditors Who Have Unsecured Claims page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 49 of 69

Debtor ALYSSA NICOLE MCCAIN

Case number ¢tinown),
FirstName ‘Wide Name TastName

7. 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.

O No

ra] Yes. List all payments to an insider.

Dates of Total amount Amount you still Reason for this payment
payment paid owe

KRISTEN BACCHUS 10/18/23 g 600 5 0

Insider's Name

12412 HIGH MEADOW DRIVE 9/26/23

Number Street

8/30/23

DALLAS TX 75244

City ‘State ZIP Code
$. $.

Insiders Name

Number Street

Ciy Slate ZIP Code

8. 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

Qi Yes. List all payments that benefited an insider.

Dates of Totalamount Amount you still Reason for this payment
Payment Paid owe Include creditor's name

$. $.
Insiders Name

Number Street

City State ZIP Code

insiders Name

Number Street

iy Slate ZIP Code’

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


Debtor 1

rst Name Widale Name

Tasthame

Page 31 of GgnUmber einer,

CARR aH 31768-swe7 Dog,i Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Decument

Uke NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

4.16

Official Form 106E/F

MODPED

Nonprioty Creditors Name
PO BOX 790283

Number Street
ST. LOUIS MO.

63179

Ciy State

Who incurred the debt? Check one.

A Debtor 1 only

O Debtor 2 only

2 Debtor 1 and Debtor 2 only

O. Atleast one of the debtors and another

QO Check if this claim is for a community debt

Is the claim subject to offset?

Zi no
O Yes

MODPED

ZIP Code

Nonpriority Greditor’s Name
PO BOX 790233

Number Street
ST. LOUIS ive}

63179

Giy State

Who incurred the debt? Check one.

Debtor 1 only

2 Debtor 2 only

2 Debior 1 and Debtor 2 only

1 Atleast one of the debtors and another

O Check if this claim is for a community debt

Is the claim subject to offset?

No
Q Yes

MODPED

ZIP Code

Nonpriority Creditors Name
PO BOX 790283

Number Street
ST. LOUIS Mo

63179

Ciy State

Who incurred the debt? Check one.

{4 Debtor 1 only

Q Debtor 2 only

Q] Debtor 1 and Debtor 2 only

1 Atleast one of the debtors and another

QO Check if this claim is for a community debt
Is the claim subject to offset?

no

O Yes

ZIP Code

Schedule E/F: Creditors Who Have Unsecured Claims

Last 4 digits of account number 0006
8/1/19

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

When was the debt incurred?

O) Contingent
O Unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

@ student ioans

Q] Obligations arising out of 2 separation agreement or divorce that
you did not report as priority claims

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

OQ) other. Specify

Last 4 digits of accountnumber 0004

8/1/18

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

When was the debt incurred?

QO Contingent
2) Unliquidated
O) Disputed

Type of NONPRIORITY unsecured claim:

a ‘Student loans

Q Obligations arising out of a separation agreement or divorce that
you did not report as priority ciaims

2 Debts to pension or profit-sharing plans, and other similar debts
O2 other. Specify

Last 4 digits of account number 0008
8/1/20

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

When was the debt incurred?

Q Contingent
2) unliquidated
Q) bDisputed

Type of NONPRIORITY unsecured claim:

@ student loans

2 obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

2) other. Specify

Total claim

3 4,500.00

+4,500.00

35,500.00

page 4


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 68 of 69

TA&M U
6001 TAMU
COLLEGE STATION, TX 77843

WITHERITE LAW GROUP

10440 NORTH CENTRAL EXPRESSWAY
SUITE 400

DALLAS, TX 75231


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 8 of 69

Debtor1 ALYSSA NICOLE MCCAIN Case number (know,
FratName ‘wise Nome Tost Name
For you if you are filing this ‘The law allows you, as an individual, to represent yourself in bankruptcy court, but you
bankruptcy without an should understand that many people find it extremely difficult to represent
attorney themselves successfully, Because bankruptcy has long-term financial and legal

consequences, you are strongly urged to hire a qualified attorney.
If you are represented by
an attorney, you do not To be successful, you must correctly file and handle your bankruptcy case. The rules are very

need to file this page. technical, and a mistake or inaction may affect your rights. For example, your case may be
dismissed because you did not file a required document, pay a fee on time, attend a meeting or
hearing, or cooperate with the court, case trustee, U.S. trustee, bankruptcy administrator, or audit
firm if your case is selected for audit. If that happens, you could lose your right to file another
case, or you may lose protections, including the benefit of the automatic stay.

You must list all your property and debts in the schedules that you are required to file with the
court, Even if you plan to pay a particular debt outside of your bankruptcy, you must list that debt
in your schedules. If you do not list a debt, the debt may not be discharged. If you do not list
property or properly claim it as exempt, you may not be able to keep the property. The judge can
also deny you a discharge of all your debts if you do something dishonest in your bankruptcy
case, such as destroying or hiding property, falsifying records, or lying. Individual bankruptcy
cases are randomly audited to determine if debtors have been accurate, truthful, and complete.
Bankruptcy fraud is a serious crime; you could be fined and imprisoned.

If you decide to file without an attorney, the court expects you to follow the rules as if you had
hired an attorney. The court will not treat you differently because you are filing for yourself. To be
successful, you musi be familiar with the United States Bankruptcy Code, the Federal Rules of
Bankruptcy Procedure, and the local rules of the court in which your case is filed. You must also
be familiar with any state exemption laws that apply.

Are you aware that filing for bankruptcy is a serious action with long-term financial and legal
consequences?

O No

12 Yes

Are you aware that bankruptcy fraud is a serious crime and that if your bankruptcy forms are
inaccurate or incomplete, you could be fined or imprisoned?

O No

U Yes

Did you pay or agree to pay someone who is not an attorney to help you fill out your bankruptcy forms?
No

Q Yes. Name of Person .
Attach Bankruptcy Petition Preparer's Notice, Declaration, and Signature (Official Form 119).

By signing here, | acknowledge that | understand the risks involved in filing without an attorney. |
have read and understood this notice, and | am aware that filing a bankruptcy case without an
attorney may cause me to lose my rights or property if | do not properly handle the case.

Wy
x Mi, hb x
Signature éf Debfor 1 7 7 — ‘Signature of Debtor 2

Date pb / 20a4 Date

MM7DD /YYYY MM?DD /YYYY —
Contact phone +18177860253 Contact phone
Cell phone 8177660253 Cell phone
Email address AGGIEMONDAYS@GMAIL.COM Email address

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 22 of 69
Debtor1 ALYSSA NICOLE MCCAIN Case number (tanown,
Frame Wida Nam Ta Nome
vont 2: Additional Page
Brief description of the property and line Current value of the © Amount of the exemption you claim Specific laws that allow exemption
on Schedule A/B that lists this property portion you own
Copy the value from Check only one box for each exemption
Schedule A/B
Seetrotion: HOUSEHOLD, MICROWAVE $ 500 Ws 5.00 11 USC, § 522(0)(3)
i O 100% of fair market value, up to
Line from 6
Schedule A/B: _ any applicable statutory limit
Briel iption ELECTRONICS, TV $ 80.00 $ 80.00 TH USE. § 522(0)(3)
lescription:
Line from Q2 100% of fair market value, up to
Schedule A/a: _—— any applicable statutory limit
Briel it ELECTRONICS, CELLPHONE $ 50.00 As 60.00 11US.C. § 522(0)(5)
scription:
1D 100% of fair market value, up to
Line from 7 P Fi
Schedule 4/8: ——— any applicable statutory limit
Secs CLOTHES $ 19000 As 180.00 11S. § 522(6)(3)
tion:
. 2 100% of fair market value, up to
Line from 14 7
‘Schedule A/B: any applicable statutory limit
Briel ‘pt JEWELRY, WATCH $ 1000 Wg 10.00 11 USC. § 522(0)(4)
lescription:
it OD 100% of fair market value, up to
Line from 1
Schedule A/a; 22— any applicable statutory limit
hein i PERSONAL ANIMALS, CAT $ 50 Ws 5.00 11 USC. § 522(0)(3)
lescription:
Line from 13 O 100% of fair market value, up to
‘Schedule A/B:. —— any applicable statutory limit
Bret it HEALTHAID, PRESCRIPTION GLASSES g 20.00 As 2000 11 US.C. § 522(6)9)
iescription:
100% of fair market value, up to
Line from 14 Q ,
‘Schedule A/B: ~ any applicable statutory limit
Briel ot CASH $ 200 As 20.00 11 USC. § 522(d)(5)
ription:
Line from O 100% of fair market value, up to
Schedule Ae; 18 — any applicable statutory limit
are inti CHECKING ACCOUNT, CHIME FINANC g 58.00 Ag 58.00 11 US. § 522(0)5)
lescription:
. O 100% of fair market value, up to
Line from ‘ ®, U
Schedule A/B: iz any applicable statutory limit
erie ‘i CHECKING ACCOUNT, AXOS BANK —g 10.00 As 40/00 MUSE. §522(6)(5)
lescription:
Line from 17 1 100% of fair market value, up to
Schedule /B: ~~ - any applicable statutory limit 7
Biel of SAVINGS ACCOUNT, FORT WORTH Cig 20 As 25.00 11 USC. § 522(6)(5)
jescription:
Line from 2 100% of fair market value, up to
Schedule A/a; 12— any applicable statutory limit
Briel ‘i SAVINGS ACCOUNT, CHIME FINANCH oor As 0.02 11 USC. § 522(0)8)
jescription:
Line from 47 OQ 100% of fair market value, up to
Schedule AB: —— any applicable statutory limit

Official Form 106C

Schedule C: The Property You Claim as Exempt

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Debtor + ALYSSA NICOLE

Document Page 59 of 69

MCCAIN Case number (iF known),

Fratwane Miele Name

Tastee

J Part 2: | List Your Unexpired Personal Property Leases

For any unexpired personal property lease that you listed in Schedule G: Executory Contracts and Unexpired Leases (Official Form 1066),

fill in the information below. Do not list real estate leases. Unexpired leases are leases that are still in effect; the lease period has not yet
ended. You may assume an unexpired personal property lease if the trustee does not assume it. 11 U.S.C. § 365(p)(2).

Describe your unexpired personal property leases

Lessor's name:

Description of leased
property:

Lessor's name:

Description of leased
property:
Lessor's name:

Description of leased
property:

Lessor’s name:

Description of leased
property:

Lessor's name:

Description of leased
property:

Lessor's name:

Description of leased
Property:

Lessor's name:

Description of leased
property:

Sign Below

Will the lease be assumed?

ONo
O ves

ONo
O ves

ONo
QO ves

ONo
O Yes

Oves

Under penalty of perjury, | declare that I have indicated my intention about any property of my estate that secures a debt and any
personal property that is subject to.an unexpired lease.

x

* Mie
Signature4t Debior 1 7

meee

Official Form 108

Signature of Debtor 2

Date
MMT DDT YYW

Statement of Intention for Individuals Filing Under Chapter 7

page 2


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 66 of 69

HORACIO LOPEZ
2332 LONGHORN STREET
DALLAS, TX 75228

LVNV FUNDING
55 BEATTIE PLACE
GREENVILLE, SC 29601

MERRICK
10705 S JORDAN GTWY STE
SOUTH JORDAN, UT 84095

MIDLAND CREDIT MANAGEMENT
350 CAMINO DE LA REINA
SAN DIEGO, CA 92108

MODPED
PO BOX 790233
ST. LOUIS, MO 63179

NATIONAL CREDIT ADJUSTERS
327 WEST 4TH AVENUE
HUTCHINSON, KS 67501


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 39 of 69
Fill in this information to identify your case:

Debtor 1 ALYSSA
Fi

Name

Debtor 2
(Spouse, If fling) Frst Name ‘widale Name

Tat Name

United States Bankruptcy Court for the; NORTHERN DISTRICT OF TEXAS

Case number
{IF known)

O Check if this is an
amended filing

Official Form 106H
Schedule H: Your Codebtors 12115

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.

1. Do you have any codebtors? (If you are filing a joint case, do not list either spouse as a codebtor.)
No

O Yes

2. Within the last 8 years, have you lived In a community property state or territory? (Community property states and terntories include
Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, and Wisconsin.)
O No. Go to line 3.

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

O Yes. In which community state or territory did you live? . Fill in the name and current address of that person.

Name of your spouse, former spouse, o legal equivalent

Number ‘Street

Gy Sate ZiP Code

3. In Column 4, 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.

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

Check all schedules that apply:
3.4
Q Schedule D, line
Name
Q Schedule E/F, line
Number Slrest Q) Schedule G, line
ty ‘State ~_2iP Code
3.2
Q Schedule D, line
Name —_—
Q Schedule E/F, line
Number Street Q Schedule G, line
Ciy- State ZIP Code
3.3
Q Schedule D, line
Name
QO) Schedule E/F, line
Number ‘Sireet CO Schedule G, line
City State, ZIP Code

Official Form 106H Schedule H: Your Codebtors page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document

Fill in this information to identify your case:

Debtor 1 ALYSSA

NICOLE

Page 40 of 69

MCCAIN

Frathame
Debtor 2

TWisie Name

TastName

(Spouse, if filing) FirstName
United States Bankruptcy Court for the:

Case number

TWicdle Name

LastName

NORTHERN DISTRICT OF TEXAS:

(if known)

Official Form 1061

Schedule I: Your Income

Check if this is:
Q An amended filing
O A supplement showing postpetition chapter 13

income as of the following date:

MM 7 DDT YYYY

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

4, Fillin 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.

Employment status

Occupation

Employer's name

Employer's address

Debtor 1

Debtor 2 or nonfiling spouse

BZ Employed
(2) Not employed

CUSTOMER SERVICE REP II

1 Employed
O Not employed

CITY OF FORT WORTH

200 TEXAS STREET

Number Street Number Street

FORT WORTH TX 76102

City State ZIP Code City State ZIP Code

How long employed there? 6 MONTHS

| 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.

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.

4, Calculate gross income. Add line 2 + line 3.

Official Form 1061

For Debtor 4 For Debtor 2 or
non-filing spouse
$3,290.00 $
3. +s 0.00 +5
4. | $3,290.00 $

Schedule |: Your Income

page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 55 of 69

ALYSSA NICOLE MCCAIN
FratNane ‘idee Namie Cast Name

Debtor 1 Case number (itinewn),

| 22,Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy?
A No
O Yes, Fill in the details.

: Who else has or had access to it? Describe the contents Do you still
have it?
i
‘ QNo
| Name of Storage Faciity Name Oyes
Number Street Number Street

CityState ZIP Code

City State ZIP Code

Identify Property You Hold or Control for Someone Else

, 23, 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,
Zno
' 2 Yes. Fill in the details.
j ‘Where is the property? Describe the property Value

‘Owner's Name 8.

i — amber Streat
Number Street “=

ci State ZIP Code
State ZIP Code "

| Ci
| rare 0: | Give Detalls About Environmental Information

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

TM 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.

TM 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.

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

GZ no

Q Yes. Fill in the details.

Governmental unit Environmental law, if you know it Date of notice
Name of site Governmental unit
Number Street Number Street

City State ZIP Code

iy State ZIP Code

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 10


Debtor 1

FirstName Wide Name

Cage,24-31768-swe7 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
aa (5 TOS Document— Page 28 of 69 rurber arom,

ror: Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

47

43

Official Form 106E/F

FIRST BANK AND TRUST

Nonpriority Creditors Name
PO BOX 84064

Number Strest
COLUMBUS GA 31908

Giy State ZIP Code

Who incurred the debt? Check one.

(A Debtor 1 only

Q Debtor 2 only

Q) Debtor 4 and Debtor 2 only

O Atleast one of the debtors and another

CO) Check if this claim is for a community debt
Is the claim subject to offset?

G no
O Yes

MERRICK

Nonpriority Creditors Name
10705 S JORDAN GTWY STE

Number ‘Street
SOUTH JORDAN uT 84095

Ciy State ZIP Code

Who incurred the debt? Check one.

@ Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?

Gi no
O Yes

MODPED

Nonpriority Creditor's Name:
PO BOX 790233

Number Street
ST. LOUIS Mo 63179

City State ZIP Code

Who incurred the debt? Check one.

i Debtor 1 only

1 Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

Q Check if this claim is for a community debt
Is the claim subject to offset?

Gi no
O Yes

Schedule E/F: Creditors Who Have Unsecured Claims

Last 4 digits of account number 9595
When was the debt incurred? 8/1/20

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

QO) Contingent
2 unliquidated
QO) Disputed

Type of NONPRIORITY unsecured claim:

student loans

2 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

C1 Debts to pension or profit-sharing plans, and other similar debts

@ other. specity CREDIT CARD

Last 4 digits of account number 0822
2/1/22

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

When was the debt incurred?

QO Contingent
QO Unliquigatea
Q Disputed

Type of NONPRIORITY unsecured claim:

Q Student loans

Q 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

Qa
© other. specify CREDIT CARD

Last 4 digits of account number 0003
2018

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

When was the debt incurred?

Q Contingent
QO Unliquidated
2 disputed

Type of NONPRIORITY unsecured claim:

@ student loans

Q obligations arising out of a separation agreement or divorce that
you did not report as priority claims

Q Debts to pension or profit-sharing pians, and other similar debts

O other. Specify

Total claim

31,246.00

31,223.00

51,000.00

page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 58 of 69

Fill in this information to identify your case

Debtor1 ALYSSA
FraName

Debtor 2
(Spouse, i filing) Fist Name Widdie Name Laat Nome

United States Bankruptcy Court for the: NORTHERN DISTRICT OF TEXAS

Case number O Check if this is an
(it known) amended filing

Official Form 108
Statement of Intention for Individuals Filing Under Chapter 7 tas

If you are an individual filing under chapter 7, you must fill out this form if:

= creditors have claims secured by your property, or

you have leased personal property and the lease has not expired.

You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors,
whichever is earlier, unless the court extends the time for cause. You must also send copies to the creditors and lessors you list on the form.

If two married people are filing together in a joint case, both are equally responsible for supplying correct Information.
Both debtors must sign and date the form.

Be as complete and accurate as possible. 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),

List Your Creditors Who Have Secured Claims

1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the
information below.

Identify the creditor and the property that is collateral What do you intend to do with the property that Did you claim the property
secures a debt? as exempt on Schedule C?
Creditor’s
Crediors EL AGSHIP CREDIT ACCEPTANCE O Surrender the property. ONo
7 C. Retain the property and redeem it. OW ves
Description of AUTOMOBILE POOR CONDITION Ci retain the property and enter into a
securing debt: Reaffirmation Agreement.

@ Retain the property and [explain]:
CONTINUE MAKING PAYMENTS

Creditors O surrender the property. ONo
a O Retain the property and redeem it. Oves

powty of C Retain the property and enter into a

securing debt; Reaffirmation Agreement.

(Retain the property and {explain}:

Creditor's O Surrender the property. ONo

oe ; O Retain the property and redeem it, Oves
pony of O Retain the property and enter into a
securing debt: Reaffirmation Agreement.
QO Retain the property and [explain]:

Creditors (2 surrender the property. ONo

° O Retain the property and redeem it, Oves
coal taal of i Retain the property and enter into a
securing debt: Reaffirmation Agreement.

O. Retain the property and [explain]:

Official Form 108: Statement of intention for Individuals Filing Under Chapter 7 page 1


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 67 of 69

NORTH TEXAS TOLLWAY AUTHORITY
P.O, 660224
DALLAS, TX 75266

NORTH TEXAS TOLLWAY AUTHORITY
P.O, BOX 660244
DALLAS, TX 76039

NORTH TEXAS TOLLWAY AUTHORITY
P.O. BOX 66024
DALLAS, TX 75266

PROFESSIONAL ACCOUNT MANAGEMENT
325 DANIEL ZENKER DRIVE
HORSEHEADS, NY 14845

SPEEDY CASH
PO BOX 780408
WICHITA, KS 67278

STATE FARM PAT WHITE
500 GRAPEVINE HWY STE 110
HURST, TX 76054


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 4 of 69

Debtor 1 ALYSSA NICOLE MCCAIN

Case number tirknown),
Firetname ‘Widele Name Tost Name

Report About Any Businesses You Own as a Sole Proprietor

12. Are you a sole proprietor {Q No. Go to Part 4.
of any full- or part-time
business? Yes, Name and location of business

A sole proprietorship is a
business you operate as an
individual, and is not a
‘separate legal entity such as

a corporation, ip,
fen tion, partnership, or Number Street

Name of business, if any

If you have more than one
‘sole proprietorship, use a
‘separate sheet and attach it
to this petition,

City State ZIP Code

Check the appropriate box to describe your business:

O Health Care Business (as defined in 11 U.S.C. § 101(27A))
2 Single Asset Real Estate (as defined in 11 U.S.C, § 101(51B))
C1 Stockbroker (as defined in 11 U.S.C. § 101(53A))

O Commodity Broker (as defined in 11 U.S.C. § 101(8))

C1 None of the above

13. Are you filing under if you are filing under Chapter 11, the court must know whether you are a small business debtor or a debtor
Chapter 11 of the choosing to proceed under Subchapter V so that it can set appropriate deadlines. If you indicate that you are
Bankruptcy Code, and a small business debtor or you are choosing to proceed under Subchapter V, you must attach your most.
are you a small business 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).

debtor or a debtor as

defined by 11 U.S.C. §

1182(1)2 @ No. 1am not filing under Chapter 11.

For a definition of small ONo. 1am filing under Chapter 11, but | am NOT a small business debtor according to the definition in the
business debtor, see Bankruptcy Code.

11 U.S.C. § 101(61D).
O Yes. 1am filing under Chapter 11, | am a small business debtor according to the definition in the
Bankruptcy Code, and | do not choose to proceed under Subchapter V of Chapter 11.

O Yes. | am filing under Chapter 11, | am a debtor according to the definition in § 1182(1) of the Bankruptoy
Code, and | choose to proceed under Subchapter V of Chapter 11.

| Part 4 | Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention

14.Do you ownorhaveany No
property that poses or is

alleged to pose a threat O ves. Whatis the hazard?

of imminent and
identifiable hazard to

public health or safety?
Or do you own any

property that needs If immediate attention is needed, why is it needed?

immediate attention?
For example, do you own

perishable goods, or livestock
that must be fed, or a building
that needs urgent repairs?

Where is the property?

Number Street

City” State ZIP Code

Official Form 104 Voluntary Petition for Individuals Filing for Bankruptcy page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document

ALYSSA NICOLE MCCAIN
FrstName Wadia Narie Tastame

Debtor 1

Page 47 of 69

Case number (it known)

4. 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,
{f you are filing a joint case and you have income that you receive together, list it only once under Debtor 1

Q No
@ Yes. Fill in the details.

Debtor 1
Sources of Income

Check all that apply.

From January 1 of current year until a frases. commissions,
the date you filed for bankruptcy: onuses, tips
Operating a business

© wages, commissions,
bonuses, tips
(January 1 to December 31, 2023) @ Operating a business

For last calendar year:

© wages, commissions,
bonuses, tips
(January 1 to December 31, a ) © operating a business

For the calendar year before that:

Gross income

(before deductions and
exclusions)

$ 13236

$ 45643

20897

6. 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 lawsults; 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.

Debtor 2

Sources of income
Check alt that apply.

QO wages, commissions,
bonuses, tips

Q operating a business

QO. wages, commissions,
bonuses, tips

Q operating a business

O wages, commissions,
bonuses, tips
C1 operating a business

List each source and the gross income from each source separately, Do not include income that you listed in line 4.

OQ No
G@ Yes. Fill in the details.

Debtor 4

Sources of Income
Describe below.

From January 1 of current year until -AMILY
the date you filed for bankruptcy: TAX AEEUNO

For last calendar year:

Gross Income from
each source

(before deductions and
exclusions)

$ 1,200.00

HAVA]

Debtor 2

‘Sources of Income
Describe below.

(January 1 to December 31, 2023 ) TAX REFUND

For the calendar year before that; FAMILY

(January 1 to December 31, 2022) Ay AEFUNDD
Wy

8
8

FAMILY 8 1,320.00
$ 1,695.00
8
$11,760.00
$ 76.00
$.

Official Form 107 ‘Statement of Financial Affairs for Individuals Filing for Bankruptcy

Gross income

(before deductions and
exclusions)

Gross income from
each source

(before deductions and
exclusions)

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 45 of 69

Fill in this information to identify your case:

Debtor 1 ALYSSA NICOLE MCCAIN
Fanaa is Toms Tato
Debtor 2
(Spouse, if filing) First Neme ‘Middle Name Last Name
United States Bankruptcy Court for the; NORTHERN DISTRICT OF TEXAS
Case number
(lfknown)
O 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.

ee Stan Below

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

No
C2 Yes, Name of person . Attach Bankruptcy Petition Preparer's Notice, Declaration, and
Signature (Official Form 119).

Under penalty of perjury, | declare that | have read the summary and schedules filed with this declaration and
that they are true and correct.

x Ws x

Signature of Debtor 1 Signature of Debtor 2
vate Mb| b [2004 Date
wa DD 7 YYYY MMT DDT WWW

Official Form 106Dec Declaration About an Individual Debtor's Schedules


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 15 of 69

Debtor 1 ALYSSA NICOLE = Case number ¢rinown
FraiNore Wie Name Taat Name
Ea Describe Your Financial Assets
Do you own or have any legal or equitable interest in any of the following? Current value of the
portion you own?
Do not deduct secured claims
or exemptions.
16.Cash
Examples: Money you have in your wallet, in your home, ina safe deposit box, and on hand when you file your petition
O No
G ves.. $ 20.00
17.Deposits of money
Examples: 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.
Q No
ves. Institution name:
17.1. Checking account: CHIME FINANCIAL, $ 58.00
47.2, Checking account: AXOS BANK, 3 10.00
17.3, Savings account: FORT WORTH CITY CREDIT UNION, 5 25.00
17.4, Savings account: CHIME FINANCIAL, $ 0.02
17.5, Certificates of deposit: $
47.6. Other financial account: CASH APP $ 0.01
17.7. Other financial account: ~VENMO. $ 0.01
17.8. Other financial account: $
17.9. Other financial account: $
18.Bonds, mutual funds, or publicly traded stocks
Examples: Bond funds, investment accounts with brokerage firms, money market accounts
D no
O ves. Institution or issuer name:
%.
$.
$.
49, Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest In
an LLC, partnershlp, and Joint venture
no Name of entity: % of ownership:
Q Yes. Give specific % 8
information about
them. = = — §.
% 8.

Official Form 106A/B Schedule A/B: Property page 5


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 57 of 69

Debtor1 ALYSSA NICOLE MCCAIN Case number (ricown
FaatNome aa ae Taste

Employer Identification number
Do not include Social Security number or ITIN.

} Describe the nature of the business

Business Name

| EIN oe
' Number Street Name of accountant or bookkeeper Dates business existed
i From To

City ‘State ZIP Code

28, 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.

A no

O Yes. Fill in the details below.

Date Issued

Name MM 70D WYY

Number Street

City State ZIP Code

rae 2 Stan Belew

Ihave read the answers on this Statement of Financial Affairs and any attachments, and | declare under penalty of perjury that the
answers are true and correct. | 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.

x Ml x

i Signature’f Debtor 1 Signature of Debtor 2

| pate Mb /I(2024 Date

nal pages to Your Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107)?

Did you pay or agree to pay someone who is not an attorney to help you fill out bankruptcy forms?
No

O Yes. Name of person . Attach the Bankruptcy Petition Preparer's Notice,
i Declaration, and Signature (Official Form 119).

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 12


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 63 of 69

IN THE UNITED STATES BANKRUPTCY COURT FOR THE
NORTHERN DISTRICT OF TEXAS

IN RE:

ALYSSA NICOLE MCCAIN
Debtor.

)
)
) Case No.
)
)

Chapter 7
VERIFICATION OF MATRIX

The above named debtor hereby verifies that the attached List of Creditors is true
and correct to the best of his/her/their knowledge.

Date: ib 14024 Wyle

Debtor Signature



Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 17 of 69

Debtor 1 ALYSSA NICOLE MCCAIN
FeatNams Wile Name TastWame

Case number (irtnown)

24. Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tultion program.
26 U.S.C. §§ 530(b)(1), 529A(b), and 529(b)(1).

No
O Yes Institution name and description. Separately file the records of any interests.11 U.S.C. § 521(c):
$.
$.
$.
25. Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers
exercisable for your benefit
Uno -
O Yes. Give specific
information about them... 8 0.00
i
26. Patents, copyrights, trademarks, trade secrets, and other intellectual property
Examples: Internet domain names, websites, proceeds from royalties and licensing agreements
Uno
O Yes. Give specific |
information about them. Ig 0.00
27, Licenses, franchises, and other general intangibles
Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses, professional licenses
B no — - a
Q Yes. Give specific 3
information about them..../ $ 0.00
Money or property owed to you? Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
28. Tax refunds owed to you
no
O Yes. Give specific information
7 Federal:
about them, including whether | Federal 8
you already filed the returns | Slate:
and the tax years. Local: $
29. Family support
Examples: Past due or lump sum alimony, spousal support, child support, maintenance, divorce settlement, property settlement
No 7 — .
Q Yes. Give specific information. | i
| Alimony: $.
H | Maintenance: $
‘ i
i | Support: $.
| Divorce settlement: 8.
i | Property settiement, 5S.
30. 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
Uno
Q Yes. Give specific information.. ; 0.00

Official Form 1064/B Schedule A/B: Property page 7


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 3 of 69

Debtor 1 policed NICOLE ber Case number (#n0w,
Fret Name Nidal Name Tat Name
Part 2: f Tell the Court About Your Bankruptcy Case
7. The chapter of the Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing

Bankruptcy Code you for Bankruptcy (Form 2010)). Also, go to the top of page 1 and check the appropriate box.
are choosing to file @ Chapter 7

under
QO Chapter 11
Q Chapter 12
O Chapter 13

8. How you will pay the fee (4 | will pay the entire fee when I file my petition. Please check with the clerk's office in your
local court for more details about how you may pay. Typically, if you are paying the fee
yourself, you may pay with cash, cashier's check, or money order. If your attorney is
submitting your payment on your behalf, your attorney may pay with a credit card or check
with a pre-printed address.

O I need to pay the fee in installments. If you choose this option, sign and attach the
Application for Individuals to Pay The Filing Fee in Installments (Official Form 103A).

O I request that my fee be waived (You may request this option only if you are filing for Chapter 7.
By law, a judge may, but is not required to, waive your fee, and may do so only if your income is
less than 150% of the official poverty line that applies to your family size and you are unable to
pay the fee in installments). If you choose this option, you must fill out the Application to Have the
Chapter 7 Filing Fee Waived (Official Form 103B) and file it with your petition.

9. Have you filed for Wd No
bankruptcy within the
last 8 years? Q Yes. district When mire Case number
District When Case number
MM DDIYYYY
District When Case number
MM DD /YYYY
40, Are any bankruptcy ZW no
cases pending or being a
filed by a spouse who is Yes. Debtor Relationship to you
not filing this case with District When Case number, if known
you, or by a business MM/DD /YYYY
partner, or by an
affiliate?
Debtor Relationship to you
District When Case number, if known,
MM/DD/YYYY

1

Do you rent your No. Go toline 12.
residence? Wes. Has your landlord obtained an eviction judgment against you?
@ No. Goto line 12.

O Yes. Fill out initial Statement About an Eviction Judgment Against You (Form 101A) and file it as
part of this bankruptcy petition.

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 38 of 69

Fill in this information to identify your case:

Debtor ALYSSA NICOLE MCCAIN
Fiat Name ie Name TastNeme

Debtor 2
(Spouse If fling) First Name Middle Name Tost Name

NORTHERN DISTRICT OF TEXAS

United States Bankruptcy Court for the:

Cc 1b:
Case number O Check if this is an

amended filing

Official Form 106G
Schedule G: Executory Contracts and Unexpired Leases 1245
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).

1, Do you have any executory contracts or unexpired leases?
4 No. Check this box and file this form with the court with your other schedules. You have nothing else to report on this form.
O 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).

2. 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.

Person or company with whom you have the contract or lease State what the contract or lease is for

24

Name

Number Street

city State ZIP Code

2.2

Name

Number Street

City State ZIP Code
23

Name

Sumber Wreet

City State ZIP Code

2.4

Name

Number treet

City State ZIP Code

Official Form 106G Schedule G: Executory Contracts and Unexpired Leases page 1


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 26 of 69

ALYSSA NICOLE MCCAIN Case number (ittnown

FirstName ‘Widele Nowe TostNare

Debtor 1

| Part 2: | List All of Your NONPRIORITY Unsecured Claims

3. Do any creditors have nonpriority unsecured claims against you?

O No. You have nothing to report in this part, Submit this form to the court with your other schedules,
Yes

4, 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
fe] awe igi 4872
Last 4 digits of account number 4872
Nonpririy Grediors Name s_7.266.00
es When was the debt incurred? 12/1/2
Number Street
BLOOMINGTON uN 85438
oy Sale ZIP Code As of the date you file, the claim Is: Check all that apply.
QO Contingent
Who incurred the debt? Check one, O unliquidated
{i Debtor 1 only O Disputed
Q Debtor 2 only
CO Debtor 1 and Debtor 2 only Type of NONPRIORITY unsecured claim:
C. Atleast one of the debtors and another D student loans
QO. Obligations arising out of a separation agreement or divorce
vim I ige ing a sepé ag! or
O Check if this claim is for a community debt Tero cil net Epon on prot clans
Is the claim subject to offset? 2 Debts to pension or profit-sharing plans, and other similar debts
© No @ other. Specify AUTOMOBILE
QO Yes
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION Last 4 digits of account number 0072 _ s___ 250.00
Nonpriorty Gredifors Name When was the debt Incurred?
700 SCOTT & WHITE DRIVE
Number Street
COLLEGE STATION *x 77845 As of the date you file, the claim is: Check all that apply.
ty State 2 Code Q Contingent
‘Who incurred the debt? Check one. O unliquidated
© debtor 1 only O disputes
Q Debtor 2 only
O debtor + and Debtor 2 only ‘Type of NONPRIORITY unsecured claim:
O Atleast one of the debtors and another Q student loans
- . Q  obiigations arising out of a separation agreement or divorce
Q Check if this claim is for a community debt that you did not report as priority claims
Is the claim subject to offset? 2 bebts to pension or profit-sharing plans, and other similar debts
© No © other. Specity MEDICAL
O Yes
[S| CaP ONE Last 4 digits of account number 0813. __ __ 3,857.00
i Creditor’s
Nonprony Greiiors Name When was the debt incurred? {1/21
PO BOK 71088,
Number Siveat
CHARLOTTE NC 28272-1083, 7 .
a sae ata As of the date you file, the claim is: Check ail that apply.
O contingent
‘Who incurred the debt? Check ono. OD Uniquidates
@ Debtor 4 only 1D pisputea
C1 Debtor 2 only
O Debior 1 and Debtor 2 only ‘Type of NONPRIORITY unsecured claim:

O atleast one of the debtors and another
Q Student loans

O Check if this claim is for a community debt 2 Obligations arising out of a separation agreement or divorce
fh ome that you did not report as priority claims

a 2 clalm subject to o 1 Debts to pension or profit-sharing plans, and other similar debts
No

Oy W@ other. Speciy_ CREDIT CARD
es

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


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document Page 2 of 69
Debtor 1 ALYSSA NICOLE MCCAIN
Fratane Wide arse Tas Narre
About Debtor 1:

4, Your Employer
Identification Number
(EIN), if any.

5. Where you live

6. Why you are choosing
this district to file for
i bankruptcy

Official Form 101

EIN

EIN

1001 FULLER WISER RD

Case number (it known),

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

If Debtor 2 lives at a different address:

Number Street Number Street
APT 213
EULESS TX__76039
City State ZIP Code City State ZIP Code
TARRANT
County County

If your mailing address is different from the one
above, fill it in here. Note that the court will send
any notices to you at this mailing address.

If Debtor 2's mailing address is different from
yours, fill it in here. Note that the court will send
any notices to this mailing address.

Number Street

Number Street

P.O. Box P.O. Box
City State ZIP Code City State ZIP Code
Check one: Check one:

id Over the last 180 days before filing this petition,
| have lived in this district longer than in any
other district.

O Ihave another reason. Explain.
(See 28 U.S.C. § 1408.)

CO) Over the last 180 days before filing this petition,
I have lived in this district longer than in any
other district.

O Ihave another reason. Explain.
(See 28 U.S.C. § 1408.)

Voluntary Petition for Individuals Filing for Bankruptcy

page 2


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 50 of 69
‘ALYSSA NICOLE MCCAIN

Debtor 4 Case number (rknown),
FiatName Wide Name Tas Name

Identify Legal Actions, Repossessions, and Foreclosures

9. 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

Q) Yes. Fill in the details.

Nature of the case Court or agency Status of the case
Case title Cour Name O Pending
Q onappeal
Number Street O) Concluded
Case number
City State ZIP Code
Casetile. TaniNene Q Pending
O on appeal
Number Street QO) concluded
Case number
City State ‘ZIP Code

10. 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.

O No. Goto line 11.
@ Yes. Fill in the information below.

Describe the property Date Value of the property
VOLUNTARILY SURRENDERED 2017
HYUNDAI ACCENT, VEHICLE WAS 9/5/23 og 10995
Creditors Name SOLD AT AUCTION BY ALLY.
P.O. BOX 380906
Number Street Explain what happened

w Property was repossessed.
QO. Property was foreclosed.

BLOOMINGTON MN _ 55438 Property was garnished.
City State ZIP Code Property was attached, seized, or levied.

Describe the property Date Value of the property

Creditors Name

Number Street
Explain what happened

Property was repossessed.

Property was foreclosed.

Property was garnished.

Property was attached, seized, or levied.

City Stale ZIP Code

oooo

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


Debtor 1

Fratname Wide Name

Test name

Page 34 of Ggumber wrirown

Case.24-31/(68-swe7 Doc.l Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Document

Ee Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

4.25

Official Form 106E/F

WITHERITE LAW GROUP

Nonpriorty Crediter’s Name
10440 NORTH CENTRAL EXPRESSWAY

Number ‘Street
DALLAS TM

75231

Ciy Stale

Who incurred the debt? Check one.

( Debtor 1 only

O Debtor 2 only

QO Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

Ci Check if this claim is for a community debt
Is the claim subject to offset?

no
O Yes

ZIP Code

Nonpriority Creditors Name

Number ‘Street

City State

Who incurred the debt? Check one.

Q Debtor 1 only

Q) Debtor 2 only

Qi Debtor 1 and Debtor 2 only

C1 Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?

O No
O Yes

ZIP Code

Nonpriorty Creditors Name

Number Street

City Siate

Who incurred the debt? Check one.

O21 Debtor 4 only

1 Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?
O No

O Yes

ZIP Code

Schedule E/F: Creditors Who Have Unsecured Claims.

Last 4 digits of account number 6098
5/29/24

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

When was the debt incurred?

Q Contingent
QO unliquidated
Q Disputed

Type of NONPRIORITY unsecured claim:

OQ Student loans

QO Objigations arising out of a separation agreement or divorce that
you did not report as priority claims

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

@ other. specify AUTO ACCIDENT PERSONAL |

Last 4 digits of account number

When was the debt incurred?

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

CQ Contingent
O Unliquidates
QO disputed

Type of NONPRIORITY unsecured claim:

1 Student toans

Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

QO other. specify

Last 4 digits of account number

When was the debt incurred?

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

O Contingent
2 Unliquidated
O) Disputed

Type of NONPRIORITY unsecured claim:

Q Student loans

Q. Obligations arising out of a separation agreement or divorce that
you did not report as priority claims.

2 Debts to pension or profit-sharing plans, and other similar debts
Q other. Specify

Total claim

20,000.00

page 4


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 43 of 69

Debtor 4 ALYSSA NICOLE MCCAIN

Fralname eda ae TaetName
5, Additional mortgage payments for your residence, such as home equity loans
6. Utilities:

6a. Electricity, heat, natural gas

6b. Water, sewer, garbage collection

6c. Telephone, cell phone, Internet, satellite, and cable services
6d. Other. Specify:

. Food and housekeeping supplies
. Childcare and children’s education costs
. Clothing, laundry, and dry cleaning

. Personal care products and services

. Medical and dental expenses

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

Do not include car payments.

Entertainment, clubs, recreation, newspapers, magazines, and books

. Charitable contributions and religious donations

. Insurance.

Do not include insurance deducted from your pay or included in lines 4 or 20.
16a, Life insurance

15b, Health insurance

18c. Vehicle insurance

16d. Other insurance. Specify:

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

Installment or lease payments:
17a. Car payments for Vehicle 1
47. Car payments for Vehicle 2
17, Other. Specify:
174, Other. Specify:

your pay on line 5, Schedule |, Your Income (Official Form 1061).

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

Specify:

20a. Mortgages on other property
20b. Real estate taxes

20c. Property, homeowner's, or renter’s insurance
20d. Maintenance, repair, and upkeep expenses

20e, Homeowner's association or condominium dues

Official Form 106J Schedule J: Your Expenses

Case number (known),

. Your payments of alimony, maintenance, and support that you did not report as deducted from

. Other real property expenses not included in lines 4 or § of this form or on Schedule f: Your Income.

10.
1.

12,
13.
14,

16a.
15b.

15d.

16.

17a.
17b.
Ie.

170,

18,

Your expenses

8. 0.00

&.

8.

8. 120.00
s. 0.00
8. 200.00
s_ 0.00
$, 100.00
8, 100.00
$. 20.00
s___ 170.00.
$ 150.00
$. 0.01
$ 0.00
$ 0.00
$ 400.00
$ 0.00
5 0.00
$ 400.00
$.

$

$.

$ 0.00
$ 0.00

AAA A #



Debtor 1

Casg24-31768-swe7 Qacid Filed

First Name

Wide Name Tattame POCUF

06/17/24 Entered 06/17/24 15:07:28 Desc Main

Page 29 of Bg" “in

Ea Your NONPRIORITY Unsecured Claims — Continuation Page

After listing any entries on this page, number them beginning with 4.4, followed by 4.5, and so forth.

4.10

Official Form 106E/F

MODPED

Nonprionty Greditor’s Name
PO BOX 790283

Number ‘Street
ST.LOUIS Mo 63179

Ciy State ZIP Code

Who incurred the debt? Check one.

(A Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O. Atleast one of the debtors and another

QO Check if this clair

is for a community debt
Is the claim subject to offset?

GD no
O ves

MODPED

Nonprionity Creditor’s Name
PO BOX 790233

Number ‘Sirest
ST. LOUIS 1x 63179

iy State ZIP Code

Who incurred the debt? Check one.

{A Debtor 1 only

Q Debtor 2 only

Q Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt

Is the claim subject to offset?

no
Q Yes

MODPED

Nonprionity Creditors Name
PO BOX 790233

Number Street
ST.LOUIS Mo 63179

City State ZIP Code

Who incurred the debt? Check one.

{Mi Debtor 1 only

Q Debtor 2 only

QO Debtor 1 and Debtor 2 only

O Atleast one of the debtors and another

O Check if this claim is for a community debt
Is the claim subject to offset?

© No
O Yes

Schedule E/F: Creditors Who Have Unsecured Claims

Last 4 digits of accountnumber OO02
When was the debt incurrea? 8/1/17.

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

O Contingent
2 unliquidated
CO) Disputed

Type of NONPRIORITY unsecured claim:

@ ‘Student loans

Q Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

O) other. specity

Last 4 digits of account number 0009

8/1/20

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

When was the debt incurred?

Q Contingent
QO untiquidated
O Disputed

Type of NONPRIORITY unsecured claim:

wg ‘Student loans.

(1 Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

QO other. specify,

Last 4 digits of account number OOO7
8/1/19

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

When was the debt incurred?

1 Contingent
1 unliquidated
O Disputed

Type of NONPRIORITY unsecured claim:

@ student loans

O. Obligations arising out of a separation agreement or divorce that
you did not report as priority claims

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

other. specify,

Total claim

31,113.00

2,000.00

s 2,032.00

page 4


Case 24-31768-swe7

Doc 1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main

Do not deduct secured claims or exemptions, Put
‘the amount of any secured claims on Schedule D:
Creditors Who Have Claims Secured by Property.

Document Page 13 of 69
Debtor 1 ALYSSA —— = Case number tiknonn).
Frain Te Wa Tas Nae
33, Make: Who has an interest in the property? Check one.
Model: O Debtor 1 only
Q Debtor 2
Year: Debtor 2 only

Approximate mileage:
Other information:

SS |
3.4. Make:
Model:
Year:
Approximate mileage:
Other information:
__

Q Debtor 1 and Debtor 2 only
O Atleast one of the debtors and another

O check if this is community property (see
instructions)

Who has an interest in the property? Check ons.

Q Debtor 1 only

O Debtor 2 only

() Debtor 1 and Debtor 2 only

(1 Atleast one of the debtors and another

O Check if this is community property (see
instructions)

Current value ofthe Current value of the
entire property? —_portion you own?

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 Current value of the
entire property? portion you own?

4, Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories
Examples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle accessories

D no
O Yes

4.1, Make:
Model:
Year:

Other information:

If you own or have more than one, list here:

4.2, Make:
Model:
Year:

Who has an interest in the property? Check one.
Q Debtor 4 only

O Debtor 2 onty

O. Debtor 1 and Debtor 2 only

CO Atleast one of the debtors and another

O Check if this is community property (see
instructions)

Who has an interest in the property? Check one.
O bebtor + only

Q Debtor 2 only
Q Debtor 1 and Debtor 2 only

Do not deduct secured ciaims 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?

Current value of the
portion you own?

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 ofthe Current value of the

Other Information: Dateast one of the debtors and another entire prop portion you own?
|
CO check if this is community property (see © 5.
| instructions)
5, Add the dollar value of the portion you own for all of your entries from Part 2, including any entrles for pages ly 0.00
you have attached for Part 2. Write that number here .
Official Form 1064/8 ‘Schedule A/B: Property page 3


Case 24-31768-swe7 Doci1_ Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 65 of 69

DEBT CO LLC
9417 EAST 63RD STREET
RAYTOWN, MO 64133

DECLARATION ENERGY LLC DBA ENE
PO BOX 2209
BELLAIRE, TX 77402

DISCOVER
PO BOX 51908
LOS ANGELES, CA 90051-6208

FIRST BANK AND TRUST
PO BOX 84064
COLUMBUS, GA 31908

FLAGSHIP CREDIT ACCEPTANCE
530 WEST ALLEGAN STREET
LANSING, MI 48929

HALSTED FINANCIAL SERVICES
PO BOX 828
SKOKIE, IL 60076


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 51 of 69

Debtor 1 ALYSSA NICOLE MCCAIN

Case number (known,
FratName Tia Name Tost Name

11. 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?

Z no
Q Yes. Fill in the details.

Describe the action the creditor took Date action Amount
was taken
Creditors Name
Number Street _ ——_ *____
City State ZIP Code Last 4 digits of account number: XXXX-__

12. Within 4 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
O Yes

| Part 5: | List Certain Gifts and Contributions

13,Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person?
no
Q Yes. Fill in the details for each gift.

Gifts with a total value of more than $600 Describe the gifts Dates you gave Value
per person the gifts

$.

Person to Whom You Gave the Gift

$.
Number Street
Gy State ZIP Code
Person's relationship to you
Gifts with a total value of more than $600 Describe the gifts Dates yougave —-Value
per person the gifts
a $
Berson to Whom You Gave the Git

$.
Nonber Sweat
City State ZIP Code

Person's relationship to you

Official Form 107 Statement of Financlal Affairs for Individuals Filing for Bankruptcy page 6


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 53 of 69

Debtor1 ALYSSA COLE MCCAIN Case number (Fino)
Fratnene aa Ware TaeTRame
Description and value of any property transferred Date payment or Amount of

transfer was made payment

Person Who Was Paid

' Number Street

City State ZIP Code

Email or website address
Person Who Made the Payment, Not You

47. Within 4 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
O Yes. Fill in the details.

Description and value of any property transferred Date payment or — Amount of payment
transfer was:
made
Parson Who Was Paid
| Number Street 8
|
| s

iy Sisie__ZIP Code

18. 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
OQ Yes. Fill in the details.

Description and value of property Describe any property or payments received —_Date transfer
transferred or debts paid in exchange was made
Person Who Received Transfer

Number Street

City State ZIP Code
Person's relationship to you
Parson Who Received Transfer

Number Street

ty State_—_ZIP Code

Person's relationship to you

Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 8


Case 24-31768-swe7 Doc1 Filed 06/17/24 Entered 06/17/24 15:07:28 Desc Main
Document Page 16 of 69

Debtor? ALYSSA NICOLE MCCAIN Case number ¢trown)
FratName Widdle Name Tost Name

20. 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
O Yes. Give specific Issuer name:
information about

them. 8
$.
$.

21, Retirement or pension accounts
Examples: Interests in IRA, ERISA, Keogh, 401k), 403(b), thrift savings accounts, or other pension or profit-sharing plans
O No
& ves. List each

account separately. Type of account: Institution name:

401(k) or similar plan: $.
Pension plan: FORT WORTH EMPLOYEES RETIREMENT FUND, $s 6,715.00
IRA: 8.
Retirement account: 8.
Keogh: $.
Additional account: 8.
Adgitional account: $
22, Security deposits and prepayments
Your share of all unused deposits you have made so that you may continue service or use from a company
Examples: Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommunications
companies, or others
Wd No
OQ Yes. Institution name or individual:
Electric: 8.
Gas: $
Heating oil: $
‘Security deposit on rental unit: $
Prepaid rent: $
Telephone: $
Water: $
Rented furniture: $
Other: $
23. Annuities (A contract for a periodic payment of money to you, either for life or for a number of years)
Uno
Q Yes. Issuer name and description:
$.
8.
$.

Official Form 106A/B ‘Schedule A/B: Property page 6