A All Financial Services Inc.

1251 N Skokie Highway

Lake Bluff, IL 60044

A All Financial Services Inc.

1251 N Skokie Highway

Lake Bluff, IL 6004

AT&T Mobility

P.O. Box 6428

Carol Stream, IL 60197

Blatt, Hasenmiller, Leibsker & Moore LLC

125 South Wacker Dr

Suite 400

Chicago, IL 60606-4440

Blatt, Hasenmiller, Leibsker & Moore LLC

125 S Wacker Drive, Suite 400

Chicago, IL 60606-4440

Blatt, Hasenmiller, Leibsker & Moore LLC

125 S Wacker Drive, Suite 400

Chicago, IL 60606

Bureau of Collection Recovery LLC

P.O. Box 9001

Minnetonka, MN 55345-9001

Capital One Bank

P.O. Box 71083

Charlotte, NC 28272-1083

Cash Banc

29L Atlantic Avenue Ste. 324

Ocean View, DE 19970

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CashNetUSA

200 W Jackson, Ste. 1400

Chicago, IL 60606-6941

Chase Bank USA

800 Brooksedge Blvd

Westerville, OH 43081

Citibank NA

701 E 60th St N

Sioux Falls, SD 57104

Citibank Sears Premier Card

P.O. Box 6189

Sioux Falls, SD 57117

Citifinancial Auto

2208 Highway 121 Ste. 100

Bedford, TX 76021

Citifinancial Auto

2208 Highway 121 Ste 100

Bedford, TX 76021

Citimortgage

P.O. Box 9438

Gaithersburg, MD 20898

Dell Computer/Web Bank

12234 N IH 35 SB Bldg B

Austin, TX 78753

Elmhurst Emergency Med Services

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

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Encore Receivable Management

400 N Rogers Road

Olathe, KS 66062

FBCS Services

2200 Byberry Rd Ste 120

Hatboro, PA 19040-3738

Fingerhut

P.O. Box 166

Newark, NJ 07101

First Consumers Financial

14580 Florida Blvd

Baton Rouge, LA 70819

Focus Receivables Management

1130 Northcase Pkwy

Ste. 150

Marietta, GA 30067

GEMB/JC Penney

P.O. Box 981131

El Paso, TX 79998

Guaranty Bank/Best Bank

c/o Professional Placement S

316 N Milwaukee St

Suite 410

Milwaukee, WI 53202

HFC

P.O. Box 8873

Virginia Beach, VA 23450-8873

Home Depot Credit Services

P.O. Box 689100

Des Moines, IA 50368-9100

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HSBC

P.O. Box 5891

Carol Stream, IL 60197-5891

HSBC Bank

P.O. Box 81622

Salina, CA 93912

LVNV Funding, LLC

P.O. Box 10497

Greenville, SC 29603

National Credit Adjusters

P.O. Box 3023

327 W 4th St

Hutchinson, KS 67504-3023

Northland Group Inc.

7831 Glenroy Road Ste. 250

Edina, MN 55439

Partners Financial Services

403 Axminster Dr

Fenton, MO 63026

Peoples Energy

130 E Randolph Dr

Chicago, IL 60601

SCH Pathology Consultants

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

St. Elizabeth Hospital

c/o Illinois Collection Service

P.O. Box 1010

Tinley Park, IL 60477

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Student Loan Consol Cnt

2401 International Ln

Madison, WI 53704

The Childrens Place/Citibank

P.O. Box 6497

Sioux Falls, SD 57117

United Consumer Financial

865 Bassett Road

Westlake, OH 44145

Wells Fargo Financial Cards

3201 N 4th Ave

Sioux Falls, SD 57104

Wells Fargo Financial Cards

3201 N 4t Ave

Sioux Falls, SD 57104

WFNNB - Newport News

P.O. Box 659705

San Antonio, TX 78265-9705

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UNITED STATES BANKRUPTCY COURT

NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

In Re: Bankruptcy Case Number:

Brett Jay Holloway

Ramona S Holloway

VERIFICATION OF CREDITOR MATRIX

Number of Creditors:

The above named Debtor(s) hereby verifies that the list of creditors is true and correct to the best of my (our) 

knowledge.

s/ Brett Jay Holloway

Brett Jay Holloway

Dated: 

Debtor

1/14/2010

s/ Ramona S Holloway

Joint Debtor

Ramona S Holloway

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 Document Page 6 of 57
B 1 (Official Form 1) (1/08)

Holloway, Brett, Jay

Name of Debtor (if individual, enter Last, First, Middle): Name of Joint Debtor (Spouse) (Last, First, Middle):

Holloway, Ramona, S

Voluntary Petition

Eastern Division

Northern District of Illinois United States Bankruptcy Court

All Other Names used by the Debtor in the last 8 years All Other Names used by the Joint Debtor in the last 8 years

(include married, maiden, and trade names): (include married, maiden, and trade names):

Last four digits of Soc. Sec. or Indvidual-Taxpayer I.D. (ITIN) No./Complete EIN(if 

more than one, state all): 7857 9447

Last four digits of Soc. Sec. or Indvidual-Taxpayer I.D. (ITIN) No./Complete EIN(if more 

than one, state all):

Street Address of Debtor (No. & Street, City, and State):

2218 24th Street

North Chicago, IL 

2218 24th Street

North Chicago, IL 

Street Address of Joint Debtor (No. & Street, City, and State):

ZIP CODE 60064 60064 ZIP CODE

County of Residence or of the Principal Place of Business: County of Residence or of the Principal Place of Business:

Lake Lake

Mailing Address of Debtor (if different from street address): Mailing Address of Joint Debtor (if different from street address):

 

ZIP CODE ZIP CODE

Location of Principal Assets of Business Debtor (if different from street address above):

ZIP CODE





Chapter 13

Chapter 12

Chapter 9

Chapter 11

Chapter 7

Chapter 15 Petition for 

Recognition of a Foreign 

Nonmain Proceeding

Chapter 15 Petition for

Recognition of a Foreign 

Main Proceeding

Chapter of Bankruptcy Code Under Which

the Petition is Filed (Check one box)

Nature of Business

(Check one box)













Other

Health Care Business

Single Asset Real Estate as defined in 11 

U.S.C. § 101(51B)

Clearing Bank

Commodity Broker

Stockbroker

Railroad



Type of Debtor









See Exhibit D on page 2 of this form.

Other (If debtor is not one of the above entities, 

check this box and state type of entity below.) 

_____________________ 

Partnership

Corporation (includes LLC and LLP)

 Individual (includes Joint Debtors) 

(Check one box.)

(Form of Organization)











Nature of Debts

(Check one box)



Tax-Exempt Entity

(Check box, if applicable)

Debts are primarily 

business debts.

 Debts are primarily consumer

debts, defined in 11 U.S.C.

§ 101(8) as “incurred by an

individual primarily for a

personal, family, or household purpose.”

Debtor is a tax-exempt organization 

under Title 26 of the United States 

Code (the Internal Revenue Code.)

 













Filing Fee (Check one box)

Full Filing Fee attached

Filing Fee to be paid in installments (applicable to individuals only). Must attach

signed application for the court's consideration certifying that the debtor is

unable to pay fee except in installments. Rule 1006(b) See Official Form 3A.

Debtor is a small business debtor as defined in 11 U.S.C. § 101(51D).

Debtor is not a small business debtor as defined in 11 U.S.C. § 101(51D).

Check one box:

Check if:

Debtor's aggregate noncontingent liquidated debts (excluding debts owed to

insiders or affiliates) are less than $2,190,000.

Filing Fee waiver requested (applicable to chapter 7 individuals only). Must 

attach signed application for the court's consideration. See Official Form 3B.

Chapter 11 Debtors

Check all applicable boxes

A plan is being filed with this petition

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

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





Statistical/Administrative Information 



Debtor estimates that funds will be available for distribution to unsecured creditors.

Debtor estimates that, after any exempt property is excluded and administrative 

 THIS SPACE IS FOR 

COURT USE ONLY

expenses paid, there will be no funds available for distribution to unsecured creditors.





$50,001 to 

$100,000

$0 to

$50,000

  

$100,001 to 

$500,000



$500,001 to

$1

million



$1,000,001 

to $10 

million 

  

$10,000,001 

to $50 

million 

$50,000,001 

to $100 

million 

$100,000,001 

to $500 

million 

$500,000,001 

to $1 billion 

More than $1 

billion 

Estimated Liabilities



$50,001 to 

$100,000

$50,000,001 

to $100 

million 

$100,000,001 

to $500 

million 

$0 to

$50,000

Estimated Assets

        

         

Over

100,000

50,001-

100,000

25,001-

50,000

10,001-

25,000

5,001-

10,000

1,000-

5,000

200-

999

100-

199

50-

99

1-

49

$100,001 to 

$500,000

$1,000,001 

to $10 

million 

$500,001 to

$1

million

$10,000,001 

to $50 

million 

$500,000,001 

to $1 billion 

More than $1 

billion 

Estimated Number of Creditors

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 7 of 57
B 1 (Official Form 1) (1/08) FORM B1, Page 2

Voluntary Petition Name of Debtor(s):

(This page must be completed and filed in every case) Brett Jay Holloway, Ramona S Holloway

NONE

All Prior Bankruptcy Cases Filed Within Last 8 Years (If more than two, attach additional sheet.)

Location Case Number: Date Filed:

Where Filed:

Location

Where Filed:

Case Number: Date Filed:

NONE

Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor (If more than one, attach additional sheet)

Judge:

Name of Debtor: Case Number: Date Filed:

District: Relationship:



Exhibit A

Exhibit A is attached and made a part of this petition.

(To be completed if debtor is required to file periodic reports (e.g., forms 10K and

10Q) with the Securities and Exchange Commission pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934 and is requesting relief under chapter 11.)

Ronald E. Griesheimer

have informed the petitioner that [he or she] may proceed under chapter 7, 11,

I, the attorney for the petitioner named in the foregoing petition, declare that I

whose debts are primarily consumer debts)

(To be completed if debtor is an individual

Exhibit B

1/14/2010

available under each such chapter. I further certify that I have delivered to the

12, or 13 of title 11, United States Code, and have explained the relief

X

debtor the notice required by 11 U.S.C. § 342(b).

Signature of Attorney for Debtor(s) Date

Ronald E. Griesheimer 01057774



Yes, and Exhibit C is attached and made a part of this petition.

No





Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to public health or safety?

Exhibit C

Exhibit D

(To be completed by every individual debtor. If a joint petition is filed, each spouse must complete and attach a separate Exhibit D.)

Exhibit D completed and signed by the debtor is attached and made a part of this petition.

If this is a joint petition:

Exhibit D also completed and signed by the joint debtor is attached and made a part of this petition.















Landlord has a judgment against the debtor for possession of debtor's residence. (If box checked, complete the following).

Certification by a Debtor Who Resides as a Tenant of Residential Property 

(Check all applicable boxes.) 

Debtor is a debtor in a foreign proceeding and has its principal place of business or principal assets in the United States in this District. or 

has no principal place of business or assets in the United States but is a defendant in an action or proceeding [in a federal or state court] in 

this District, or the interests of the parties will be served in regard to the relief sought in this District.

There is a bankruptcy case concerning debtor's affiliate. general partner, or partnership pending in this District.

Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this District for 180 days immediately 

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

(Check any applicable box)

Information Regarding the Debtor - Venue

(Name of landlord that obtained judgment)

Debtor has included in this petition the deposit with the court of any rent that would become due during the 30-day period after the 

filing of the petition.

Debtor claims that under applicable nonbankruptcy law, there are circumstances under which the debtor would be permitted to cure the 

entire monetary default that gave rise to the judgment for possession, after the judgment for possession was entered, and

(Address of landlord)





 Debtor certifies that he/she has served the Landlord with this certification. (11 U.S.C. § 362(l)). 

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 Document Page 8 of 57
B 1 (Official Form 1) (1/08) FORM B1, Page 3

Voluntary Petition Name of Debtor(s):

Brett Jay Holloway, Ramona S Holloway (This page must be completed and filed in every case)





X Not Applicable

Pursuant to 11 U.S.C. § 1511, I request relief in accordance with the 

Chapter of title 11 specified in the petition. A certified copy of the 

order granting recognition of the foreign main proceeding is attached.

(Check only one box.)

I request relief in accordance with chapter 15 of Title 11, United States Code.

Certified Copies of the documents required by § 1515 of title 11 are attached. [If no attorney represents me and no bankruptcy petition preparer signs the petition] I

have obtained and read the notice required by 11 U.S.C. § 342(b).

X s/ Brett Jay Holloway

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

in this petition.

[If petitioner is an individual whose debts are primarily consumer debts and has

chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12

or 13 of title 11, United States Code, understand the relief available under each such

chapter, and choose to proceed under chapter 7.

I declare under penalty of perjury that the information provided in this petition is true

and correct.

Signature(s) of Debtor(s) (Individual/Joint)

Signatures

Signature of a Foreign Representative

I declare under penalty of perjury that the information provided in this petition is true

and correct, that I am the foreign representative of a debtor in a foreign proceeding, 

and that I am authorized to file this petition. 

X s/ Ramona S Holloway

Signature of Debtor (Signature of Foreign Representative) Brett Jay Holloway

Signature of Joint Debtor Ramona S Holloway (Printed Name of Foreign Representative)

Telephone Number (If not represented by attorney)

Date

1/14/2010 Date

Ronald E. Griesheimer

Attorney at Law 321 Grand Avenue

Ronald E. Griesheimer Bar No. 01057774 

I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined 

in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the 

debtor with a copy of this document and the notices and information required under 11 

U.S.C. §§ 110(b), 110(h), and 342(b); and, (3) if rules or guidelines have been 

promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable 

by bankruptcy petition preparers, I have given the debtor notice of the maximum amount 

before preparing any document for filing for a debtor or accepting any fee from the debtor, 

as required in that section. Official Form 19 is attached. 

Signature of Non-Attorney Petition Preparer

Firm Name

Printed Name of Attorney for Debtor(s) / Bar No.

Signature of Attorney for Debtor(s)

X

Signature of Attorney

Ronald E. Griesheimer

847-244-3131 847-244-0766

1/14/2010

Telephone Number

 Waukegan, IL 60085 Printed Name and title, if any, of Bankruptcy Petition Preparer

Address Not Applicable

Social-Security number (If the bankruptcy petition preparer is not an individual, state 

the Social-Security number of the officer, principal, responsible person or partner of 

the bankruptcy petition preparer.) (Required by 11 U.S.C. § 110.) 

*In a case in which § 707(b)(4)(D) applies, this signature also constitutes a 

certification that the attorney has no knowledge after an inquiry that the 

information in the schedules is incorrect. 

Date 

Address

I declare under penalty of perjury that the information provided in this petition is true

and correct, and that I have been authorized to file this petition on behalf of the

debtor.

Signature of Debtor (Corporation/Partnership) X Not Applicable

If more than one person prepared this document, attach to the appropriate official form 

for each person. 

Not Applicable

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

Code, specified in this petition.

X

Signature of Authorized Individual

Printed Name of Authorized Individual

Title of Authorized Individual

Date

Names and Social-Security numbers of all other individuals who prepared or assisted 

in preparing this document unless the bankruptcy petition preparer is not an 

individual. 

A bankruptcy petition preparer’s failure to comply with the provisions of title 11 and 

the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or 

both. 11 U.S.C. § 110; 18 U.S.C. § 156. 

Date

Signature of bankruptcy petition preparer or officer, principal, responsible person, or 

partner whose Social-Security number is provided above. 

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 Document Page 9 of 57
B 1D (Official Form 1, Exhibit D) (12/09)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Eastern Division

In re Brett Jay Holloway Ramona S Holloway Case No. 

Debtor(s) (if known)

EXHIBIT D - INDIVIDUAL DEBTOR'S STATEMENT OF COMPLIANCE WITH

CREDIT COUNSELING REQUIREMENT

 Warning: You must be able to check truthfully one of the five statements regarding credit 

counseling listed below. If you cannot do so, you are not eligible to file a bankruptcy case, and the court can 

dismiss any case you do file. If that happens, you will lose whatever filing fee you paid, and your creditors 

will be able to resume collection activities against you. If your case is dismissed and you file another 

bankruptcy case later, you may be required to pay a second filing fee and you may have to take extra steps 

to stop creditors' collection activities.

 Every individual debtor must file this Exhibit D. If a joint petition is filed, each spouse must complete and file 

a separate Exhibit D. Check one of the five statements below and attach any documents as directed.

 1. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit 

counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities 

for available credit counseling and assisted me in performing a related budget analysis, and I have a certificate 

from the agency describing the services provided to me. Attach a copy of the certificate and a copy of any debt 

repayment plan developed through the agency.



 2. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit 

counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities 

for available credit counseling and assisted me in performing a related budget analysis, but I do not have a 

certificate from the agency describing the services provided to me. You must file a copy of a certificate from the 

agency describing the services provided to you and a copy of any debt repayment plan developed through the 

agency no later than 14 days after your bankruptcy case is filed.



 3. I certify that I requested credit counseling services from an approved agency but was unable to 

obtain the services during the seven days from the time I made my request, and the following exigent 

circumstances merit a temporary waiver of the credit counseling requirement so I can file my bankruptcy case now. 

[Summarize exigent circumstances here.]



 If your certification is satisfactory to the court, you must still obtain the credit counseling briefing 

within the first 30 days after you file your bankruptcy petition and promptly file a certificate from the 

agency that provided the counseling, together with a copy of any debt management plan developed 

through the agency. Failure to fulfill these requirements may result in dismissal of your case. Any 

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

Your case may also be dismissed if the court is not satisfied with your reasons for filing your bankruptcy 

case without first receiving a credit counseling briefing.

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 Document Page 10 of 57
B 1D (Official Form 1, Exh. D) (12/09) – Cont.





 Incapacity. (Defined in 11 U.S.C. § 109(h)(4) as impaired by reason of mental illness or 

mental deficiency so as to be incapable of realizing and making rational decisions with respect to financial 

responsibilities.);

 4. I am not required to receive a credit counseling briefing because of: [Check the applicable 

statement.] [Must be accompanied by a motion for determination by the court.]

 Disability. (Defined in 11 U.S.C. § 109(h)(4) as physically impaired to the extent of being 

unable, after reasonable effort, to participate in a credit counseling briefing in person, by telephone, or 

through the Internet.);

 Active military duty in a military combat zone.





 5. The United States trustee or bankruptcy administrator has determined that the credit counseling 

requirement of 11 U.S.C. ' 109(h) does not apply in this district.



 I certify under penalty of perjury that the information provided above is true and correct.

Signature of Debtor:

Brett Jay Holloway

s/ Brett Jay Holloway

Date: 1/14/2010

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 Document Page 11 of 57
B 1D (Official Form 1, Exhibit D) (12/09)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Eastern Division

In re Brett Jay Holloway Ramona S Holloway Case No. 

Debtor(s) (if known)

EXHIBIT D - INDIVIDUAL DEBTOR'S STATEMENT OF COMPLIANCE WITH

CREDIT COUNSELING REQUIREMENT

 Warning: You must be able to check truthfully one of the five statements regarding credit 

counseling listed below. If you cannot do so, you are not eligible to file a bankruptcy case, and the court can 

dismiss any case you do file. If that happens, you will lose whatever filing fee you paid, and your creditors 

will be able to resume collection activities against you. If your case is dismissed and you file another 

bankruptcy case later, you may be required to pay a second filing fee and you may have to take extra steps 

to stop creditors' collection activities.

 Every individual debtor must file this Exhibit D. If a joint petition is filed, each spouse must complete and file 

a separate Exhibit D. Check one of the five statements below and attach any documents as directed.

 1. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit 

counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities 

for available credit counseling and assisted me in performing a related budget analysis, and I have a certificate 

from the agency describing the services provided to me. Attach a copy of the certificate and a copy of any debt 

repayment plan developed through the agency.



 2. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit 

counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities 

for available credit counseling and assisted me in performing a related budget analysis, but I do not have a 

certificate from the agency describing the services provided to me. You must file a copy of a certificate from the 

agency describing the services provided to you and a copy of any debt repayment plan developed through the 

agency no later than 14 days after your bankruptcy case is filed.



 3. I certify that I requested credit counseling services from an approved agency but was unable to 

obtain the services during the seven days from the time I made my request, and the following exigent 

circumstances merit a temporary waiver of the credit counseling requirement so I can file my bankruptcy case now. 

[Summarize exigent circumstances here.]



 If your certification is satisfactory to the court, you must still obtain the credit counseling briefing 

within the first 30 days after you file your bankruptcy petition and promptly file a certificate from the 

agency that provided the counseling, together with a copy of any debt management plan developed 

through the agency. Failure to fulfill these requirements may result in dismissal of your case. Any 

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

Your case may also be dismissed if the court is not satisfied with your reasons for filing your bankruptcy 

case without first receiving a credit counseling briefing.

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 Document Page 12 of 57
B 1D (Official Form 1, Exh. D) (12/09) – Cont.





 Incapacity. (Defined in 11 U.S.C. § 109(h)(4) as impaired by reason of mental illness or 

mental deficiency so as to be incapable of realizing and making rational decisions with respect to financial 

responsibilities.);

 4. I am not required to receive a credit counseling briefing because of: [Check the applicable 

statement.] [Must be accompanied by a motion for determination by the court.]

 Disability. (Defined in 11 U.S.C. § 109(h)(4) as physically impaired to the extent of being 

unable, after reasonable effort, to participate in a credit counseling briefing in person, by telephone, or 

through the Internet.);

 Active military duty in a military combat zone.





 5. The United States trustee or bankruptcy administrator has determined that the credit counseling 

requirement of 11 U.S.C. ' 109(h) does not apply in this district.



 I certify under penalty of perjury that the information provided above is true and correct.

Signature of Debtor: s/ Ramona S Holloway

Ramona S Holloway

Date: 1/14/2010

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 Document Page 13 of 57
B6A (Official Form 6A) (12/07)

, In re: Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE A - REAL PROPERTY

DESCRIPTION AND

LOCATION OF

PROPERTY

NATURE OF DEBTOR'S

INTEREST IN PROPERTY

AMOUNT OF

SECURED

CLAIM

CURRENT VALUE

OF DEBTOR'S

INTEREST IN

PROPERTY, WITHOUT

DEDUCTING ANY

SECURED CLAIM 

 OR EXEMPTION

HUSBAND, WIFE, JOINT

OR COMMUNITY

single family home J

2218 24th Street

North Chicago, IL 60064

Co-Owner $ 98,505.00 $ 149,464.00

Total  $ 98,505.00

(Report also on Summary of Schedules.)

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 Document Page 14 of 57
B6B (Official Form 6B) (12/07)

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE B - PERSONAL PROPERTY

TYPE OF PROPERTY

CURRENT VALUE OF

DEBTOR'S INTEREST

IN PROPERTY, WITHOUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

DESCRIPTION AND LOCATION

NONE

OF PROPERTY

HUSBAND, WIFE, JOINT

OR COMMUNITY

1. Cash on hand cash on hand J 25.00

Checking, savings or other financial 

accounts, certificates of deposit, or 

shares in banks, savings and loan, thrift, 

building and loan, and homestead 

associations, or credit unions, brokerage 

houses, or cooperatives.

2. Chase checking J 25.00

Checking, savings or other financial 

accounts, certificates of deposit, or 

shares in banks, savings and loan, thrift, 

building and loan, and homestead 

associations, or credit unions, brokerage 

houses, or cooperatives.

Chase savings J 25.00

Checking, savings or other financial 

accounts, certificates of deposit, or 

shares in banks, savings and loan, thrift, 

building and loan, and homestead 

associations, or credit unions, brokerage 

houses, or cooperatives.

ING Direct J 40.00

Security deposits with public utilities, 

telephone companies, landlords, and 

others.

3. X

Household goods and furnishings, 

including audio, video, and computer 

equipment.

4. Misc. household goods and furnishings J 1,000.00

Books, pictures and other art objects, 

antiques, stamp, coin, record, tape, 

compact disc, and other collections or 

collectibles.

5. X

6. Wearing apparel. Wearing apparel - all clothing, coats, etc. for 5 

people

J 0.00

7. Furs and jewelry. X

Firearms and sports, photographic, and 

other hobby equipment.

8. X

Interests in insurance policies. Name 

insurance company of each policy and 

itemize surrender or refund value of 

each.

9. X

Annuities. Itemize and name each 

issuer.

10. X

Interests in an education IRA as defined 

in 26 U.S.C. § 530(b)(1) or under a 

qualified State tuition plan as defined in 

26 U.S.C. § 529(b)(1). Give particulars. 

(File separately the record(s) of any such 

interest(s). 11 U.S.C. § 521(c).)

11. X

Interests in IRA, ERISA, Keogh, or other 

pension or profit sharing plans. Give 

particulars.

12. X

Stock and interests in incorporated and 

unincorporated businesses. Itemize.

13. X

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 15 of 57
B6B (Official Form 6B) (12/07) -- Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

(Continuation Sheet)

SCHEDULE B - PERSONAL PROPERTY

TYPE OF PROPERTY

CURRENT VALUE OF

DEBTOR'S INTEREST

IN PROPERTY, WITHOUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

DESCRIPTION AND LOCATION

NONE

OF PROPERTY

HUSBAND, WIFE, JOINT

OR COMMUNITY

Interests in partnerships or joint 

ventures. Itemize.

14. X

Government and corporate bonds and 

other negotiable and nonnegotiable 

instruments.

15. X

16. Accounts receivable. X

Alimony, maintenance, support, and 

property settlements to which the debtor 

is or may be entitled. Give particulars.

17. X

Other liquidated debts owed to debtor 

including tax refunds. Give particulars.

18. X

Equitable or future interests, life estates, 

and rights or powers exercisable for the 

benefit of the debtor other than those 

listed in Schedule A - Real Property.

19. X

Contingent and noncontingent interests 

in estate of a decedent, death benefit 

plan, life insurance policy, or trust.

20. X

Other contingent and unliquidated 

claims of every nature, including tax 

refunds, counterclaims of the debtor, 

and rights to setoff claims. Give 

estimated value of each.

21. X

Patents, copyrights, and other 

intellectual property. Give particulars.

22. X

Licenses, franchises, and other general 

intangibles. Give particulars.

23. X

24.Customer lists or other compilations X

containing personally identifiable 

information (as defined in 11 U.S.C. § 

101(41A)) provided to the debtor by 

individuals in connection with obtaining a 

product or service from the debtor primarily 

for personal, family, or household 

purposes.

Automobiles, trucks, trailers, and other 

vehicles and accessories.

25. 2000 Dodge Caravan, 107,000 miles J 650.00

Automobiles, trucks, trailers, and other 

vehicles and accessories. 2003 Chrysler Voyager, 75,000 miles J 2,350.00

26. Boats, motors, and accessories. X

27. Aircraft and accessories. X

Office equipment, furnishings, and 

supplies.

28. X

Machinery, fixtures, equipment and 

supplies used in business.

29. X

30. Inventory. X

31. Animals. Welsh Corgi (dog) and gray tabby cat J 0.00

Crops - growing or harvested. Give 

particulars.

32. X

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 16 of 57
B6B (Official Form 6B) (12/07) -- Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

(Continuation Sheet)

SCHEDULE B - PERSONAL PROPERTY

TYPE OF PROPERTY

CURRENT VALUE OF

DEBTOR'S INTEREST

IN PROPERTY, WITHOUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

DESCRIPTION AND LOCATION

NONE

OF PROPERTY

HUSBAND, WIFE, JOINT

OR COMMUNITY

33. Farming equipment and implements. X

34. Farm supplies, chemicals, and feed. X

Other personal property of any kind not 

already listed. Itemize.

35. X

Total  $ 4,115.00

(Include amounts from any continuation sheets 

attached. Report total also on Summary of 

Schedules.)

2 continuation sheets attached

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 17 of 57
, In re Case No.

Debtors (If known)

Brett Jay Holloway Ramona S Holloway

B6C (Official Form 6C) (12/07)

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

11 U.S.C. § 522(b)(2) 

(Check one box)

Debtor claims the exemptions to which debtor is entitled under:

11 U.S.C. § 522(b)(3) 

Check if debtor claims a homestead exemption that exceeds

$136,875

 





DESCRIPTION OF PROPERTY

SPECIFY LAW

PROVIDING EACH

EXEMPTION

VALUE OF

CLAIMED

EXEMPTION

CURRENT

VALUE OF PROPERTY

WITHOUT DEDUCTING

EXEMPTION

2000 Dodge Caravan, 107,000 

miles

735 ILCS 5/12-1001(c) 650.00 650.00

2003 Chrysler Voyager, 75,000 

miles

735 ILCS 5/12-1001(c) 2,350.00 2,350.00

cash on hand 735 ILCS 5/12-1001(b) 25.00 25.00

Chase checking 735 ILCS 5/12-1001(b) 25.00 25.00

Chase savings 735 ILCS 5/12-1001(b) 25.00 25.00

ING Direct 735 ILCS 5/12-1001(b) 40.00 40.00

Misc. household goods and 

furnishings

735 ILCS 5/12-1001(b) 1,000.00 1,000.00

Wearing apparel - all clothing, 

coats, etc. for 5 people

735 ILCS 5/12-1001(a),(e) 0.00 0.00

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 18 of 57
B6D (Official Form 6D) (12/07)

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

 Check this box if debtor has no creditors holding secured claims to report on this Schedule D.CONTINGENT

DATE CLAIM WAS

INCURRED, NATURE

OF LIEN, AND

DESCRIPTION AND 

VALUE OF PROPERTY

SUBJECT TO LIEN

AMOUNT OF 

CLAIM WITHOUT

DEDUCTING

VALUE OF

COLLATERAL

UNSECURED

PORTION, IF

ANY

DISPUTED

UNLIQUIDATED

HUSBAND, WIFE, JOINT

OR COMMUNITY

CREDITOR'S NAME AND

MAILING ADDRESS

INCLUDING ZIP CODE AND

AN ACCOUNT NUMBER

(See Instructions, Above.)

CODEBTOR

ACCOUNT NO. 439432**** J 07/01/2006 2,737.00 Security Agreement

2000 Dodge Caravan, 107,000 

miles

__________________________

VALUE $650.00

Citifinancial Auto

2208 Highway 121 Ste 100

Bedford, TX 76021

2,087.00

ACCOUNT NO. 438504**** J 01/01/2006 4,179.00 Security Agreement

2003 Chrysler Voyager, 75,000 

miles

__________________________

VALUE $2,350.00

Citifinancial Auto

2208 Highway 121 Ste. 100

Bedford, TX 76021

1,829.00

ACCOUNT NO. 2005216408 J 04/01/2008 149,464.00 First Lien on Residence

single family home

2218 24th Street

North Chicago, IL 60064

__________________________

VALUE $98,505.00

Citimortgage

P.O. Box 9438

Gaithersburg, MD 20898

50,959.00

0

attached

continuation sheets

$ $ 54,875.00 (Total of this page)

Subtotal  156,380.00

$ 54,875.00 $

(Use only on last page)

Total  156,380.00

(If applicable, report 

also on Statistical 

Summary of Certain 

Liabilities and 

Related Data.)

(Report also on Summary of 

Schedules)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 19 of 57
B6E (Official Form 6E) (12/07)

, Case No. In re

(If known) Debtors

Brett Jay Holloway Ramona S Holloway

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

 Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.

TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets.)

 Claims for domestic support that are owed to or recoverable by a spouse, former spouse, or child of the debtor, or the parent, legal guardian, or

responsible relative of such a child, or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in

11 U.S.C. § 507(a)(1).

 Domestic Support Obligations

 Extensions of credit in an involuntary case

 Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the 

appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(3).



 Wages, salaries, and commissions

 Wages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying

independent sales representatives up to $10,950* per person earned within 180 days immediately preceding the filing of the original petition, or the

cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(4).



 Contributions to employee benefit plans

 Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the

cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(5).



 Certain farmers and fishermen

 Claims of certain farmers and fishermen, up to $5,400* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(6).





 Claims of individuals up to $2,425* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use,

that were not delivered or provided. 11 U.S.C. § 507(a)(7).

 Deposits by individuals

 Taxes and Certain Other Debts Owed to Governmental Units

 Taxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11 U.S.C. § 507(a)(8).

1 continuation sheets attached

 Claims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of

Governors of the Federal Reserve System, or their predecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C.

§ 507 (a)(9).

 Commitments to Maintain the Capital of an Insured Depository Institution

 * Amounts are subject to adjustment on April 1, 2010, and every three years thereafter with respect to cases commenced on or after the date of 

adjustment.

 

 Claims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug, or 

another substance. 11 U.S.C. § 507(a)(10).

Claims for Death or Personal Injury While Debtor Was Intoxicated

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 20 of 57
B6E (Official Form 6E) (12/07) – Cont.

, In re Case No.

(If known) Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet)

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

 AMOUNT 

OF CLAIM

AMOUNT

ENTITLED TO

PRIORITY

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION 

FOR CLAIM

AMOUNT

NOT

ENTITLED TO

PRIORITY, IF

ANY

ACCOUNT NO. $0.00

Sheet no. 1 of 1 continuation sheets attached to Schedule of $

Creditors Holding Priority Claims

Subtotals

(Totals of this page)

 $ 0.00 0.00$ 0.00

Total

(Use only on last page of the completed 

Schedule E. Report also on the Summary of 

Schedules.)



0.00

0.00

Total

(Use only on last page of the completed 

Schedule E. If applicable, report also on the 

Statistical Summary of Certain Liabilities 

and Related Data. )



0.00

$

$ $

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 21 of 57
,

B6F (Official Form 6F) (12/07)

In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

 Check this box if debtor has no creditors holding unsecured claims to report on this Schedule F.

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. LB118509-03 H 12/12/2009 491.70

A All Financial Services Inc.

1251 N Skokie Highway

Lake Bluff, IL 6004

payday loan

ACCOUNT NO. LB118509-02 H 11/27/2009 535.40

A All Financial Services Inc.

1251 N Skokie Highway

Lake Bluff, IL 60044

payday loan

ACCOUNT NO. 70375111 W 628.30

Bureau of Collection Recovery LLC

P.O. Box 9001

Minnetonka, MN 55345-9001

AT&T Mobility

P.O. Box 6428

Carol Stream, IL 60197

cell phone bill

ACCOUNT NO. 5178-0572-8861-3834 H 07/01/2007 1,909.63

Blatt, Hasenmiller, Leibsker & Moore LLC

125 S Wacker Drive, Suite 400

Chicago, IL 60606-4440

Capital One Bank

P.O. Box 71083

Charlotte, NC 28272-1083

credit card

8 Continuation sheets attached

Subtotal  $ 3,565.03

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 22 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 252753531 H 11/09/2009 188.57

Cash Banc

29L Atlantic Avenue Ste. 324

Ocean View, DE 19970

payday loan

ACCOUNT NO. 1169171 H 300.00

CashNetUSA

200 W Jackson, Ste. 1400

Chicago, IL 60606-6941

payday loan

ACCOUNT NO. 4266-8411-0915-**** J 08/01/06 1,769.00

Chase Bank USA

800 Brooksedge Blvd

Westerville, OH 43081

credit card

ACCOUNT NO. 4266-8410-9294-  04/01/2006 433.00

Chase Bank USA

800 Brooksedge Blvd

Westerville, OH 43081

credit card

ACCOUNT NO. 3389494** ** W 03/01/2008 1,969.00

Citibank NA

701 E 60th St N

Sioux Falls, SD 57104

installment

Subtotal  4,659.57 Sheet no. 1 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 23 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 3389494  W 03/01/2008 516.00

Citibank NA

701 E 60th St N

Sioux Falls, SD 57104

installment

ACCOUNT NO. 3389494** ** W 03/01/2007 1,098.00

Citibank NA

701 E 60th St N

Sioux Falls, SD 57104

installment

ACCOUNT NO. 5049-9401-5957-  W 04/01/2009 560.00

LVNV Funding, LLC

P.O. Box 10497

Greenville, SC 29603

Citibank Sears Premier Card

P.O. Box 6189

Sioux Falls, SD 57117

credit card

ACCOUNT NO. 7945012905449** ** J 03/2007 1,924.00

Dell Computer/Web Bank

12234 N IH 35 SB Bldg B

Austin, TX 78753

revolving account

Subtotal  4,098.00 Sheet no. 2 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 24 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 149978001 W 06/01/2008 77.00

Elmhurst Emergency Med Services

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

medical bill

ACCOUNT NO. 1305  1,164.03

Encore Receivable Management

400 N Rogers Road

Olathe, KS 66062

unknown

ACCOUNT NO. 627645603773** ** 321.58

Fingerhut

P.O. Box 166

Newark, NJ 07101

credit account

ACCOUNT NO. 794501290  1,645.00

Fingerhut

P.O. Box 166

Newark, NJ 07101

credit account

ACCOUNT NO. 627645602466** * 217.24

Fingerhut

P.O. Box 166

Newark, NJ 07101

credit account

Subtotal  3,424.85 Sheet no. 3 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 25 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 585637338563**** 266.00

First Consumers Financial

14580 Florida Blvd

Baton Rouge, LA 70819

credit account

ACCOUNT NO. 794501290  992.00

Focus Receivables Management

1130 Northcase Pkwy

Ste. 150

Marietta, GA 30067

unknown

ACCOUNT NO. 2486805** ** W 03/01/2007 337.00

GEMB/JC Penney

P.O. Box 981131

El Paso, TX 79998

credit card

ACCOUNT NO. 2270863 W 10/01/2009 350.00

FBCS Services

2200 Byberry Rd Ste 120

Hatboro, PA 19040-3738

Guaranty Bank/Best Bank

c/o Professional Placement S

316 N Milwaukee St

Suite 410

Milwaukee, WI 53202

bank fees

Subtotal  1,945.00 Sheet no. 4 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 26 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 41004000106523 H 04/01/2008 2,409.30

HFC

P.O. Box 8873

Virginia Beach, VA 23450-8873

credit account

ACCOUNT NO. 6035-3202-7308-5686 W 1,267.62

Blatt, Hasenmiller, Leibsker & Moore LLC

125 S Wacker Drive, Suite 400

Chicago, IL 60606

Home Depot Credit Services

P.O. Box 689100

Des Moines, IA 50368-9100

credit card

ACCOUNT NO. 6011-3810-0510-9846 H 01/01/2007 1,278.37

National Credit Adjusters

P.O. Box 3023

327 W 4th St

Hutchinson, KS 67504-3023

HSBC

P.O. Box 5891

Carol Stream, IL 60197-5891

credit card

Subtotal  4,955.29 Sheet no. 5 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 27 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 5489-5551-1918-9480 H 03/01/2005 847.10

Blatt, Hasenmiller, Leibsker & Moore LLC

125 South Wacker Dr

Suite 400

Chicago, IL 60606-4440

HSBC Bank

P.O. Box 81622

Salina, CA 93912

credit card

ACCOUNT NO. 5407-9150-2745-  610.53

HSBC Bank

P.O. Box 81622

Salina, CA 93912

credit card

ACCOUNT NO. 50499401** ** 560.00

Northland Group Inc.

7831 Glenroy Road Ste. 250

Edina, MN 55439

unknown

ACCOUNT NO. 22  645.68

Partners Financial Services

403 Axminster Dr

Fenton, MO 63026

credit account

Subtotal  2,663.31 Sheet no. 6 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 28 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 95000** ** 410.00

Peoples Energy

130 E Randolph Dr

Chicago, IL 60601

gas account

ACCOUNT NO. 610901002 W 03/01/2004 100.00

SCH Pathology Consultants

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

medical bill

ACCOUNT NO. 6866399 03/01/04 100.00

St. Elizabeth Hospital

c/o Illinois Collection Service

P.O. Box 1010

Tinley Park, IL 60477

medical bill

ACCOUNT NO. 134376785783  H 11/2002 20,789.00

Student Loan Consol Cnt

2401 International Ln

Madison, WI 53704

student loan

ACCOUNT NO. 6011-6443-1305-** ** W 06/01/2007 335.00

The Childrens Place/Citibank

P.O. Box 6497

Sioux Falls, SD 57117

credit card

Subtotal  21,734.00 Sheet no. 7 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 29 of 57
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS 

INCURRED AND 

CONSIDERATION FOR 

CLAIM.

 IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

CREDITOR'S NAME,

MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

AMOUNT OF 

CLAIM

CODEBTOR

HUSBAND, WIFE, JOINT

OR COMMUNITY

CONTINGENT

UNLIQUIDATED

DISPUTED

ACCOUNT NO. 6432  W 04/01/2007 625.00

United Consumer Financial

865 Bassett Road

Westlake, OH 44145

installment

ACCOUNT NO. 6048-7000-0566-** ** J 02/01/2007 2,310.00

Wells Fargo Financial Cards

3201 N 4th Ave

Sioux Falls, SD 57104

credit card

ACCOUNT NO. 4071-1000-1288-**** J 02/01/2007 1,017.26

Wells Fargo Financial Cards

3201 N 4t Ave

Sioux Falls, SD 57104

credit card

ACCOUNT NO. 5856-3733-8563-0053 W 470.16

WFNNB - Newport News

P.O. Box 659705

San Antonio, TX 78265-9705

credit card

Subtotal  4,422.42 Sheet no. 8 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total

51,467.47 

$

(Use only on last page of the completed Schedule F.)

(Report also on Summary of Schedules and, if applicable on the Statistical 

Summary of Certain Liabilities and Related Data.)

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 30 of 57
Ronald E. Griesheimer 01057774

Attorney for the Petitioner(s)

UNITED STATES BANKRUPTCY COURT

In Re:

Debtor: Brett Jay Holloway

Social Security Number: 7857

Case No: 

Joint Debtor: Ramona S Holloway

Social Security Number: 9447 Numbered Listing of Creditors

Chapter 7

Ronald E. Griesheimer

Attorney at Law

321 Grand Avenue

Waukegan, IL 60085

847-244-3131

Northern District of Illinois

Eastern Division

Creditor name and mailing address Category of Claim Amount of Claim

1 . A All Financial Services Inc. Unsecured Claims

1251 N Skokie Highway

Lake Bluff, IL 6004

$ 491.70

2 . A All Financial Services Inc. Unsecured Claims

1251 N Skokie Highway

Lake Bluff, IL 60044

$ 535.40

3 . AT&T Mobility Unsecured Claims

P.O. Box 6428

Carol Stream, IL 60197

$ 628.30

4 . Capital One Bank Unsecured Claims

P.O. Box 71083

Charlotte, NC 28272-1083

$ 1,909.63

5 . Cash Banc Unsecured Claims

29L Atlantic Avenue Ste. 324

Ocean View, DE 19970

$ 188.57

Numbered Listing of Creditors - Page 1

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 Document Page 31 of 57
In re: Brett Jay Holloway Case No. _____________________

Ramona S Holloway

6 . CashNetUSA Unsecured Claims

200 W Jackson, Ste. 1400

Chicago, IL 60606-6941

$ 300.00

7 . Chase Bank USA Unsecured Claims

800 Brooksedge Blvd

Westerville, OH 43081

$ 433.00

8 . Chase Bank USA Unsecured Claims

800 Brooksedge Blvd

Westerville, OH 43081

$ 1,769.00

9 . Citibank NA Unsecured Claims

701 E 60th St N

Sioux Falls, SD 57104

$ 516.00

10 . Citibank NA Unsecured Claims

701 E 60th St N

Sioux Falls, SD 57104

$ 1,098.00

11 . Citibank NA Unsecured Claims

701 E 60th St N

Sioux Falls, SD 57104

$ 1,969.00

12 . Citibank Sears Premier Card Unsecured Claims

P.O. Box 6189

Sioux Falls, SD 57117

$ 560.00

13 . Citifinancial Auto Secured Claims

2208 Highway 121 Ste. 100

Bedford, TX 76021

$ 4,179.00

14 . Citifinancial Auto Secured Claims

2208 Highway 121 Ste 100

Bedford, TX 76021

$ 2,737.00

Numbered Listing of Creditors - Page 2

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 Document Page 32 of 57
In re: Brett Jay Holloway Case No. _____________________

Ramona S Holloway

15 . Citimortgage Secured Claims

P.O. Box 9438

Gaithersburg, MD 20898

$ 149,464.00

16 . Dell Computer/Web Bank Unsecured Claims

12234 N IH 35 SB Bldg B

Austin, TX 78753

$ 1,924.00

17 . Elmhurst Emergency Med Services Unsecured Claims

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

$ 77.00

18 . Encore Receivable Management Unsecured Claims

400 N Rogers Road

Olathe, KS 66062

$ 1,164.03

19 . Fingerhut Unsecured Claims

P.O. Box 166

Newark, NJ 07101

$ 321.58

20 . Fingerhut Unsecured Claims

P.O. Box 166

Newark, NJ 07101

$ 217.24

21 . Fingerhut Unsecured Claims

P.O. Box 166

Newark, NJ 07101

$ 1,645.00

22 . First Consumers Financial Unsecured Claims

14580 Florida Blvd

Baton Rouge, LA 70819

$ 266.00

23 . Focus Receivables Management Unsecured Claims

1130 Northcase Pkwy

Ste. 150

Marietta, GA 30067

$ 992.00

Numbered Listing of Creditors - Page 3

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 Document Page 33 of 57
In re: Brett Jay Holloway Case No. _____________________

Ramona S Holloway

24 . GEMB/JC Penney Unsecured Claims

P.O. Box 981131

El Paso, TX 79998

$ 337.00

25 . Guaranty Bank/Best Bank Unsecured Claims

c/o Professional Placement S

316 N Milwaukee St

Suite 410

Milwaukee, WI 53202

$ 350.00

26 . HFC Unsecured Claims

P.O. Box 8873

Virginia Beach, VA 23450-8873

$ 2,409.30

27 . Home Depot Credit Services Unsecured Claims

P.O. Box 689100

Des Moines, IA 50368-9100

$ 1,267.62

28 . HSBC Unsecured Claims

P.O. Box 5891

Carol Stream, IL 60197-5891

$ 1,278.37

29 . HSBC Bank Unsecured Claims

P.O. Box 81622

Salina, CA 93912

$ 610.53

30 . HSBC Bank Unsecured Claims

P.O. Box 81622

Salina, CA 93912

$ 847.10

31 . Northland Group Inc. Unsecured Claims

7831 Glenroy Road Ste. 250

Edina, MN 55439

$ 560.00

32 . Partners Financial Services Unsecured Claims

403 Axminster Dr

Fenton, MO 63026

$ 645.68

Numbered Listing of Creditors - Page 4

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 Document Page 34 of 57
In re: Brett Jay Holloway Case No. _____________________

Ramona S Holloway

33 . Peoples Energy Unsecured Claims

130 E Randolph Dr

Chicago, IL 60601

$ 410.00

34 . SCH Pathology Consultants Unsecured Claims

c/o Medical Business Bureau

140 Renaissance Dr

Park Ridge, IL 60068

$ 100.00

35 . St. Elizabeth Hospital Unsecured Claims

c/o Illinois Collection Service

P.O. Box 1010

Tinley Park, IL 60477

$ 100.00

36 . Student Loan Consol Cnt Unsecured Claims

2401 International Ln

Madison, WI 53704

$ 20,789.00

37 . The Childrens Place/Citibank Unsecured Claims

P.O. Box 6497

Sioux Falls, SD 57117

$ 335.00

38 . United Consumer Financial Unsecured Claims

865 Bassett Road

Westlake, OH 44145

$ 625.00

39 . Wells Fargo Financial Cards Unsecured Claims

3201 N 4t Ave

Sioux Falls, SD 57104

$ 1,017.26

40 . Wells Fargo Financial Cards Unsecured Claims

3201 N 4th Ave

Sioux Falls, SD 57104

$ 2,310.00

41 . WFNNB - Newport News Unsecured Claims

P.O. Box 659705

San Antonio, TX 78265-9705

$ 470.16

Numbered Listing of Creditors - Page 5

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 Document Page 35 of 57
In re: Brett Jay Holloway Case No. _____________________

Ramona S Holloway

(The penalty for making a false statement or concealing property is a fine up to $500,000 or 

imprisonment for up to 5 years or both. 18 U.S.C. secs. 152 and 3571.)

DECLARATION

I, Brett Jay Holloway, and I, Ramona S Holloway, named as debtors in this case, declare under penalty of perjury that we 

have read the foregoing Numbered Listing of Creditors, consisting of 5 sheets (not including this declaration), and that it is true 

and correct to the best of our information and belief.

Signature:

Dated: 1/14/2010

s/ Ramona S Holloway

Signature: s/ Brett Jay Holloway

Brett Jay Holloway

Dated: 1/14/2010

Ramona S Holloway

Numbered Listing of Creditors - Page 6

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, Case No. In re:

B6G (Official Form 6G) (12/07)

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

 Check this box if debtor has no executory contracts or unexpired leases.

NAME AND MAILING ADDRESS, INCLUDING ZIP CODE,

OF OTHER PARTIES TO LEASE OR CONTRACT.

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF

DEBTOR'S INTEREST, STATE WHETHER LEASE IS FOR

NONRESIDENTIAL REAL PROPERTY. STATE CONTRACT

NUMBER OF ANY GOVERNMENT CONTRACT.

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 Document Page 37 of 57
B6H (Official Form 6H) (12/07)

In re: Case No. , (If known)

Brett Jay Holloway Ramona S Holloway

Debtors

SCHEDULE H - CODEBTORS

 Check this box if debtor has no codebtors.

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

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 Document Page 38 of 57
B6I (Official Form 6I) (12/07)

In re Case No. , Brett Jay Holloway Ramona S Holloway

Debtors (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled “Spouse” must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petition is

filed, unless the spouses are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthly income

calculated on this form may differ from the current monthly income calculated on Form 22A, 22B, or 22C.

Debtor’s Marital

Status: DEPENDENTS OF DEBTOR AND SPOUSE

married

RELATIONSHIP(S): AGE(S):

daughter 9

son 7

son 4

DEBTOR SPOUSE

Occupation 

How long employed

Address of Employer

unemployed Caregiver/Chef

3200 Grant Street

Evanston, IL 60201 

Name of Employer Presbyterian Homes

Employment:

INCOME: (Estimate of average or projected monthly income at time

 case filed) DEBTOR SPOUSE

3. SUBTOTAL

4. LESS PAYROLL DEDUCTIONS

 b. Insurance 0.00 0.00

 c. Union dues $ 0.00 $ 0.00

$ $

 a. Payroll taxes and social security $ $ 0.00 121.07

2. Estimate monthly overtime 0.00 $ 0.00

$ 0.00 $ 1,512.46 (Prorate if not paid monthly.)

$ 0.00 $ 1,512.46

1. Monthly gross wages, salary, and commissions

$

 d. Other (Specify) $ $ 0.00 0.00

5. SUBTOTAL OF PAYROLL DEDUCTIONS

 

11. Social security or other government assistance

 debtor’s use or that of dependents listed above. $ $

10. Alimony, maintenance or support payments payable to the debtor for the

$ $

8. Income from real property $ $

 (Attach detailed statement) $ $

7. Regular income from operation of business or profession or farm

6. TOTAL NET MONTHLY TAKE HOME PAY $ $

$ $

(Specify) $ $

9. Interest and dividends

0.00 121.07

0.00 1,391.39

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

$ $ 12. Pension or retirement income 0.00 0.00

Affordable Home Care Services $ $ 0.00 280.74 (Specify)

13. Other monthly income

15. AVERAGE MONTHLY INCOME (Add amounts shown on lines 6 and 14) $ 0.00 $ 1,672.13

$ 0.00 $ 280.74

16. COMBINED AVERAGE MONTHLY INCOME: (Combine column

totals from line 15)

$ 1,672.13

(Report also on Summary of Schedules and, if applicable, on 

Statistical Summary of Certain Liabilities and Related Data)

14. SUBTOTAL OF LINES 7 THROUGH 13

17. Describe any increase or decrease in income reasonably anticipated to occur within the year following the filing of this document.:

Husband is looking for employment; wife will work more hours, if possible.

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 Document Page 39 of 57
B6J (Official Form 6J) (12/07)

Debtors (If known)

Brett Jay Holloway Ramona S Holloway Case No. In re ,

SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)

 Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor’s family at time case filed. Prorate 

any payments made biweekly, quarterly, semi-annually, or annually to show monthly rate. The average monthly expenses calculated on this form may 

differ from the deductions from income allowed on Form22A or 22C.

 Check this box if a joint petition is filed and debtor's spouse maintains a separate household. Complete a separate schedule of

 expenditures labeled "Spouse."

 a. Are real estate taxes included?

 b. Is property insurance included?

2. Utilities:

160.00

73.00

170.00

1,211.91

No

Yes No

1. Rent or home mortgage payment (include lot rented for mobile home) $

Yes 



 a. Electricity and heating fuel $

 b. Water and sewer $

 c. Telephone $

d. Other $ 0.00

130.00

0.00

20.00

0.00

0.00

0.00

250.00

0.00

0.00

0.00

800.00

0.00

b. Life

9. Recreation, clubs and entertainment, newspapers, magazines, etc. $

10. Charitable contributions $

d. Auto

c. Health

$

a. Homeowner’s or renter’s $

11. Insurance (not deducted from wages or included in home mortgage payments)

8. Transportation (not including car payments) $

7. Medical and dental expenses $

$

$

6. Laundry and dry cleaning $

4. Food $

3. Home maintenance (repairs and upkeep) $

5. Clothing $

e. Other $ 0.00

0.00

380.00

12. Taxes (not deducted from wages or included in home mortgage payments)

a. Auto

13. Installment payments: (In chapter 11, 12, and 13 cases, do not list payments to be included in the plan)

(Specify) $

$

b. Other $ 0.00

0.00

0.00

0.00

15. Payments for support of additional dependents not living at your home $

16. Regular expenses from operation of business, profession, or farm (attach detailed statement) $

14. Alimony, maintenance, and support paid to others $

17. Other $ 0.00

$ 3,194.91 18. AVERAGE MONTHLY EXPENSES (Total lines 1-17. Report also on Summary of Schedules and,

if applicable, on the Statistical Summary of Certain Liabilities and Related Data.)

19. Describe any increase or decrease in expenditures reasonably anticipated to occur within the year following the filing of this document:

20. STATEMENT OF MONTHLY NET INCOME

a. Average monthly income from Line 15 of Schedule I $

b. Average monthly expenses from Line 18 above

c. Monthly net income (a. minus b.)

$

$ -1,522.78

3,194.91

1,672.13

Case 10-01213 Doc 1 Filed 01/14/10 Entered 01/14/10 10:44:28 Desc Main

 Document Page 40 of 57
Form 6 - Statistical Summary (12/07)

United States Bankruptcy Court

Northern District of Illinois

Eastern Division

In re Case No. ,

Chapter 7

Brett Jay Holloway Ramona S Holloway

Debtors

STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)

 If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C.

§ 101(8)), filing a case under chapter 7, 11 or 13, you must report all information requested below.

 Check this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to report any

information here.



This information is for statistical purposes only under 28 U.S.C. § 159.

$

$

$

$

$

$

Amount

TOTAL

Obligations to Pension or Profit-Sharing, and Other Similar Obligations 

(from Schedule F)

Domestic Support, Separation Agreement, and Divorce Decree 

Obligations Not Reported on Schedule E.

Student Loan Obligations (from Schedule F)

Claims for Death or Personal Injury While Debtor Was

Intoxicated (from Schedule E) (whether disputed or undisputed)

Domestic Support Obligations (from Schedule E)

Taxes and Certain Other Debts Owed to Governmental Units (from 

Schedule E) 

Type of Liability

Summarize the following types of liabilities, as reported in the Schedules, and total them.

$

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Current Monthly Income (from Form 22A Line 12; OR, Form

22B Line 11; OR, Form 22C Line 20 )

Average Expenses (from Schedule J, Line 18)

$

$

Average Income (from Schedule I, Line 16) $

State the following:

1,672.13

3,194.91

3,142.64

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 Document Page 41 of 57
United States Bankruptcy Court

Northern District of Illinois

Eastern Division

In re Case No. ,

Chapter 7

Brett Jay Holloway Ramona S Holloway

Debtors

State the following:

1. Total from Schedule D, “UNSECURED PORTION, IF ANY” column

2. Total from Schedule E, “AMOUNT ENTITLED TO PRIORITY” 

column.

3. Total from Schedule E, “AMOUNT NOT ENTITLED TO PRIORITY, 

IF ANY” column

4. Total from Schedule F

5. Total of non-priority unsecured debt (sum of 1, 3, and 4)

$

$

$

$

$

54,875.00

0.00

0.00

51,467.47

106,342.47

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 Document Page 42 of 57
B6 Summary (Official Form 6 - Summary) (12/07)

United States Bankruptcy Court

Northern District of Illinois

Eastern Division

Case No. 

Debtors

Chapter 7

, In re Brett Jay Holloway Ramona S Holloway

SUMMARY OF SCHEDULES

Indicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from Schedules A, B, D, E, F, I,

and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor’s assets. Add the amounts of all claims from 

Schedules D, E, and F to determine the total amount of the debtor’s liabilities. Individual debtors also must complete the “Statistical Summary of Certain Liabilities 

and Related Data” if they file a case under chapter 7, 11, or 13.

NAME OF SCHEDULE ATTACHED

(YES/NO)

NO. OF SHEETS ASSETS LIABILITIES OTHER

Real Property

Personal Property

Property Claimed

as Exempt

Creditors Holding

Secured Claims

Creditors Holding Unsecured

Priority Claims

(Total of Claims on Schedule E)

Creditors Holding Unsecured

Nonpriority Claims

Executory Contracts and

Unexpired Leases

Codebtors

Current Expenditures of 

Individual Debtor(s)

TOTAL

$ 

$

$

$

$

$

$

$ $

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

A -

B -

C -

D -

E -

F -

G -

H -

I -

J -

Current Income of

Individual Debtor(s)

1

3

1

1

2

9

1

1

1

1

102,620.00 207,847.47

98,505.00

4,115.00

156,380.00

0.00

51,467.47

1,672.13

3,194.91

21

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 Document Page 43 of 57
, In re Case No.

(If known)

Brett Jay Holloway Ramona S Holloway

Debtors

B6 Declaration (Official Form 6 - Declaration) (12/07)

DECLARATION CONCERNING DEBTOR'S SCHEDULES

DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR

sheets, and that they are true and correct to the best of my knowledge, information, and belief.

 I declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of 23

Date: Signature:

Brett Jay Holloway

1/14/2010 s/ Brett Jay Holloway

Debtor

Ramona S Holloway

Date: 1/14/2010 Signature:

(Joint Debtor, if any)

s/ Ramona S Holloway

[If joint case, both spouses must sign]

DECLARATION UNDER PENALTY OF PERJURY ON BEHALF OF CORPORATION OR PARTNERSHIP

(NOT APPLICABLE)

Penalty for making a false statement or concealing property: Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.C §§ 152 and 3571.

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 Document Page 44 of 57
B7 (Official Form 7) (12/07)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Eastern Division

Case No. In re: , (If known)

Brett Jay Holloway Ramona S Holloway

Debtors

STATEMENT OF FINANCIAL AFFAIRS

1. Income from employment or operation of business

State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of the 

debtor's business, including part-time activities either as an employee or in independent trade or business, from the 

beginning of this calendar year to the date this case was commenced. State also the gross amounts received during the two 

years immediately preceding this calendar year. (A debtor that maintains, or has maintained, financial records on the basis 

of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning and ending dates of the debtor's 

fiscal year.) If a joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or 

chapter 13 must state income of both spouses whether or not a joint petition is filed, unless the spouses are separated and a 

joint petition is not filed.)



None

AMOUNT SOURCE FISCAL YEAR PERIOD

64,219.00 Employment 2007

50,386.00 Employment 2008

28,026.28 Employment 2009

1,331.83 Employment 2010 (YTD)

2. Income other than from employment or operation of business

State the amount of income received by the debtor other than from employment, trade, profession, operation of the debtor's 

business during the two years immediately preceding the commencement of this case. Give particulars. If a joint petition is 

filed, state income for each spouse separately. (Married debtors filing under chapter 12 or chapter 13 must state income for 

each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)



None

AMOUNT SOURCE FISCAL YEAR PERIOD

465.00 Unemployment Compensation 2007

2,929.00 Unemployment Compensation 2008

15,618.00 Unemployment Compensation 2009

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 Document Page 45 of 57
2

3. Payments to creditors

Complete a. or b., as appropriate, and c.

None

NAME AND ADDRESS OF 

CREDITOR

DATES OF

PAYMENTS

AMOUNT

PAID

AMOUNT

STILL OWING



a. Individual or joint debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods or 

services, and other debts to any creditor made within 90 days immediately preceding the commencement of this case unless 

the aggregate value of all property that constitutes or is affected by such transfer is less than $600. Indicate with an asterisk 

(*) any payments that were made to a creditor on account of a domestic support obligation or as part of an alternative 

repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors filing 

under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed, 

unless the spouses are separated and a joint petition is not filed.)

Citimortgage

P.O. Box 9438

Gaithersburg, MD 20898

12/31/09 1,211.91 149,464.50



None b. Debtor whose debts are not primarily consumer debts: List each payment or other transfer to any creditor made within 90

days immediately preceding the commencement of the case unless the aggregate value of all property that constitutes or is

affected by such transfer is less than $5,475. If the debtor is an individual, indicate with an asterisk (*) any payments that

were made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule under

a plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors filing under chapter 12 or chapter

13 must include payments and other transfers by either or both spouses whether or not a joint petition is filed, unless the

spouses are separated and a joint petition is not filed.)

NAME AND ADDRESS OF CREDITOR DATES OF

PAYMENTS/

TRANSFERS

AMOUNT

PAID OR

VALUE OF

TRANSFERS

AMOUNT

STILL

OWING

None

NAME AND ADDRESS OF CREDITOR

AND RELATIONSHIP TO DEBTOR

DATE OF

PAYMENT

AMOUNT AMOUNT

PAID STILL OWING



c. All debtors: List all payments made within one year immediately preceding the commencement of this case to or for the 

benefit of creditors who are or were insiders. (Married debtors filing under chapter 12 or chapter 13 must include payments 

by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is 

not filed.)

 

4. Suits and administrative proceedings, executions, garnishments and attachments



None a. List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding 

the filing of this bankruptcy case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning 

either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is 

not filed.)

CAPTION OF SUIT

AND CASE NUMBER NATURE OF PROCEEDING

COURT OR AGENCY

AND LOCATIO

STATUS OR

DISPOSITION

Citibank (South Dakota) N.A. v. 

Ramona S. Holloway

 09 SC 9851

19th Judicial Circuit

18 N County Street

Waukegan, IL 60085

collection lawsuit pending

Capital One Bank v. Brett J. 

Holloway

 09 SC 11054

19th Judicial Circuit

18 N County Street

Waukegan, IL 60085

collection lawsuit judgment

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3

None b. Describe all property that has been attached, garnished or seized under any legal or equitable process within one year

immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include 

information concerning property of either or both spouses whether or not a joint petition is filed, unless the spouses are 

separated and a joint petition is not filed.)



NAME AND ADDRESS DESCRIPTION

OF PERSON FOR WHOSE DATE OF AND VALUE OF 

BENEFIT PROPERTY WAS SEIZED SEIZURE PROPERTY

5. Repossessions, foreclosures and returns

None List all property that has been repossessed by a creditor, sold at a foreclosure sale, transferred through a deed in lieu of 

foreclosure or returned to the seller, within one year immediately preceding the commencement of this case. (Married 

debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses 

whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)



DATE OF REPOSSESSION, DESCRIPTION

NAME AND ADDRESS FORECLOSURE SALE, AND VALUE OF

OF CREDITOR OR SELLER TRANSFER OR RETURN PROPERTY

6. Assignments and receiverships

None a. Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the 

commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include any assignment by either 

or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not

filed.)



TERMS OF

NAME AND ADDRESS DATE OF ASSIGNMENT

OF ASSIGNEE ASSIGNMENT OR SETTLEMENT

b. List all property which has been in the hands of a custodian, receiver, or court-appointed official within one year

immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must

include information concerning property of either or both spouses whether or not a joint petition is filed, unless the

spouses are separated and a joint petition is not filed.)

None



NAME AND ADDRESS DESCRIPTION

NAME AND ADDRESS OF COURT DATE OF AND VALUE OF

OF CUSTODIAN CASE TITLE & NUMBER ORDER PROPERTY

7. Gifts

List all gifts or charitable contributions made within one year immediately preceding the commencement of this case except 

ordinary and usual gifts to family members aggregating less than $200 in value per individual family member and charitable 

contributions aggregating less than $100 per recipient. (Married debtors filing under chapter 12 or chapter 13 must include 

gifts or contributions by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a 

joint petition is not filed.)

NAME AND ADDRESS RELATIONSHIP DESCRIPTION

OF PERSON TO DEBTOR, DATE AND VALUE OF

OR ORGANIZATION IF ANY OF GIFT GIFT

None



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4

8. Losses

List all losses from fire, theft, other casualty or gambling within one year immediately preceding the commencement

of this case or since the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must

include losses by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a

joint petition is not filed.)

DESCRIPTION DESCRIPTION OF CIRCUMSTANCES AND, IF

AND VALUE OF LOSS WAS COVERED IN WHOLE OR IN PART DATE OF

PROPERTY BY INSURANCE, GIVE PARTICULARS LOSS

None



9. Payments related to debt counseling or bankruptcy

List all payments made or property transferred by or on behalf of the debtor to any persons, including attorneys, for 

consultation concerning debt consolidation, relief under the bankruptcy law or preparation of a petition in bankruptcy within 

one year immediately preceding the commencement of this case.

NAME AND ADDRESS DATE OF PAYMENT, AMOUNT OF MONEY OR

OF PAYEE NAME OF PAYOR IF DESCRIPTION AND VALUE

OTHER THAN DEBTOR OF PROPERTY

None



Chestnut Health Systems, Inc. 1/12/10 $55.00

Ronald E. Griesheimer

Attorney at Law

321 Grand Avenue

Waukegan, IL 60085

1/11/2010 1,799.00

10. Other transfers

DESCRIBE PROPERTY 

NAME AND ADDRESS OF TRANSFEREE, TRANSFERRED

RELATIONSHIP TO DEBTOR DATE AND VALUE RECEIVED

None



a. List all other property, other than property transferred in the ordinary course of the business or financial affairs of the 

debtor, transferred either absolutely or as security within two years immediately preceding the commencement of this case. 

(Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint 

petition is filed, unless the spouses are separated and a joint petition is not filed.)

 



None

DEVICE TRANSFER(S)

DATE(S) OF

INTEREST IN PROPERTY

NAME OF TRUST OR OTHER

AND VALUE OF PROPERTY OR DEBTOR

AMOUNT OF MONEY OR DESCRIPTION

b. List all property transferred by the debtor within ten years immediately preceding the commencement of this case to a 

self-settled trust or similar device of which the debtor is a beneficiary.

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5

11. Closed financial accounts



None List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed, 

sold, or otherwise transferred within one year immediately preceding the commencement of this case. Include checking, 

savings, or other financial accounts, certificates of deposit, or other instruments; shares and share accounts held in banks, 

credit unions, pension funds, cooperatives, associations, brokerage houses and other financial institutions. (Married debtors 

filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or 

both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

OF INSTITUTION AND AMOUNT OF FINAL BALANCE OR CLOSING

NAME AND ADDRESS DIGITS OF ACCOUNT NUMBER, DATE OF SALE

TYPE OF ACCOUNT, LAST FOUR AMOUNT AND

12. Safe deposit boxes

List each safe deposit or other box or depository in which the debtor has or had securities, cash, or other valuables within 

one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 

must include boxes or depositories of either or both spouses whether or not a joint petition is filed, unless the spouses are 

separated and a joint petition is not filed.)

NAME AND ADDRESS NAMES AND ADDRESSES DESCRIPTION DATE OF TRANSFER

OF BANK OR OF THOSE WITH ACCESS OF OR SURRENDER,

OTHER DEPOSITORY TO BOX OR DEPOSITOR CONTENTS IF ANY

None



13. Setoffs

List all setoffs made by any creditor, including a bank, against a debt or deposit of the debtor within 90 days preceding

the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information

concerning either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint

petition is not filed.)

DATE OF AMOUNT OF

NAME AND ADDRESS OF CREDITOR SETOFF SETOFF

None



14. Property held for another person

List all property owned by another person that the debtor holds or controls.

NAME AND ADDRESS DESCRIPTION AND VALUE

OF OWNER OF PROPERTY LOCATION OF PROPERTY

None



15. Prior address of debtor

If debtor has moved within three years immediately preceding the commencement of this case, list all premises which the 

debtor occupied during that period and vacated prior to the commencement of this case. If a joint petition is filed, report also 

any separate address of either spouse.

ADDRESS NAME USED DATES OF OCCUPANCY

None



16. Spouses and Former Spouses

If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona, 

California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight years

immediately preceding the commencement of the case, identify the name of the debtor 's spouse and of any former spouse 

who resides or resided with the debtor in the community property state. 

None



NAME 

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6

17. Environmental Information.

For the purpose of this question, the following definitions apply:

"Environmental Law" means any federal, state or local statute or regulation regulating pollution, contamination, releases of 

hazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, or other medium, 

including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes, or material.

"Site" means any location, facility, or property as defined under any Environmental Law, whether or not presently or 

formerly owned or operated by the debtor, including, but not limited to, disposal sites.

"Hazardous Material" means anything defined as a hazardous waste, hazardous substance, toxic substance, 

hazardous material, pollutant, or contaminant or similar term under an Environmental Law. 

a. List the name and address of every site for which the debtor has received notice in writing by a governmental unit 

that it may be liable or potentially liable under or in violation of an Environmental Law. Indicate the governmental unit, the 

date of the notice, and, if known, the Environmental Law. 

None



SITE NAME AND NAME AND ADDRESS DATE OF ENVIRONMENTAL 

ADDRESS OF GOVERNMENTAL UNIT NOTICE LAW 

b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release of 

Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice. 

None



SITE NAME AND NAME AND ADDRESS DATE OF ENVIRONMENTAL 

ADDRESS OF GOVERNMENTAL UNIT NOTICE LAW 

c. List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law with 

respect to which the debtor is or was a party. Indicate the name and address of the governmental unit that is or was a party 

to the proceeding, and the docket number. 

None



NAME AND ADDRESS DOCKET NUMBER STATUS OR 

OF GOVERNMENTAL UNIT DISPOSITION 

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7

18. Nature, location and name of business

If the debtor is a corporation, list the names, addresses, taxpayer identification numbers, nature of the business, and 

beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or 

equity securities within the six years immediately preceding the commencement of this case. 

If the debtor is a partnership, list the names, addresses, taxpayer identification numbers, nature of the businesses,

and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of

the voting or equity securities, within the six years immediately preceding the commencement of this case.

a. If the debtor is an individual, list the names, addresses, taxpayer identification numbers, nature of the businesses,

and beginning and ending dates of all businesses in which the debtor was an officer, director, partner, or managing

executive of a corporation, partner in a partnership, sole proprietor, or was self-employed in a trade, profession, or

other activity either full- or part-time within the six years immediately preceding the commencement of this case,

or in which the debtor owned 5 percent or more of the voting or equity securities within the six years immediately

preceding the commencement of this case.

None



LAST FOUR DIGITS

OF SOCIAL SECURITY

OR OTHER INDIVIDUAL

TAXPAYER-I.D. NO.

(ITIN)/ COMPLETE EIN

ADDRESS BEGINNING AND ENDING 

DATES 

NAME NATURE OF 

BUSINESS

b. Identify any business listed in response to subdivision a., above, that is "single asset real estate" as defined in 11 

U.S.C. § 101.

None

NAME ADDRESS



* * * * * *

I declare under penalty of perjury that I have read the answers contained in the foregoing statement

1/14/2010 s/ Brett Jay Holloway

of financial affairs and any attachments thereto and that they are true and correct.

Date Signature

of Debtor Brett Jay Holloway

[if completed by an individual or individual and spouse]

Ramona S Holloway

Signature

of Joint Debtor

(if any)

Date 1/14/2010 s/ Ramona S Holloway

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B 8 (Official Form 8) (12/08)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Eastern Division

Debtors

In re Brett Jay Holloway Ramona S Holloway , Case No.

Chapter 7

CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION

PART A – Debts secured by property of the estate. (Part A must be fully completed for EACH debt which is secured 

by property of the estate. Attach additional pages if necessary.)

Citifinancial Auto 2000 Dodge Caravan, 107,000 miles

Property No. 1

Creditor's Name: Describe Property Securing Debt:

 Other. Explain ___________________________ (for example, avoid lien using 11 U.S.C. § 522(f))

 Reaffirm the debt

 Redeem the property

If retaining the property, I intend to (check at least one):

 Surrendered  Retained

Property will be (check one):

Property is (check one):

   Claimed as exempt Not claimed as exempt

Citifinancial Auto 2003 Chrysler Voyager, 75,000 miles

Property No. 2

Creditor's Name: Describe Property Securing Debt:

 Other. Explain ___________________________ (for example, avoid lien using 11 U.S.C. § 522(f))

 Reaffirm the debt

 Redeem the property

If retaining the property, I intend to (check at least one):

 Surrendered  Retained

Property will be (check one):

Property is (check one):

   Claimed as exempt Not claimed as exempt

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B 8 (Official Form 8) (12/08) Page 2

single family home

2218 24th Street

North Chicago, IL 60064

Citimortgage

Property No. 3

Creditor's Name: Describe Property Securing Debt:

 Other. Explain ___________________________ (for example, avoid lien using 11 U.S.C. § 522(f))

 Reaffirm the debt

 Redeem the property

If retaining the property, I intend to (check at least one):

 Surrendered  Retained

Property will be (check one):

Property is (check one):

  Claimed as exempt Not claimed as exempt 

PART B – Personal property subject to unexpired leases. (All three columns of Part B must be completed for

each unexpired lease. Attach additional pages if necessary.)

Property No. 1

Lessor's Name: Describe Leased Property: Lease will be Assumed pursuant

to 11 U.S.C. § 365(p)(2):

 YES  NO

None

0 continuation sheets attached (if any)

I declare under penalty of perjury that the above indicates my intention as to any property of my estate 

securing a debt and/or personal property subject to an unexpired lease.

Date: 1/14/2010 s/ Brett Jay Holloway

Brett Jay Holloway

Signature of Debtor

s/ Ramona S Holloway

Ramona S Holloway

Signature of Joint Debtor (if any)

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B 203

(12/94)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Eastern Division

Chapter

Case No.

 7

In re: Brett Jay Holloway Ramona S Holloway

Debtors

DISCLOSURE OF COMPENSATION OF ATTORNEY 

FOR DEBTOR

1. Pursuant to 11 U.S.C. § 329(a) and Bankruptcy Rule 2016(b), I certify that I am the attorney for the above-named debtor(s) 

 and that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be 

 paid to me, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in 

 connection with the bankruptcy case is as follows:

Debtor  Other (specify)

 Balance Due $

 Prior to the filing of this statement I have received $

 For legal services, I have agreed to accept $

 1,799.00

2. The source of compensation paid to me was:

 1,799.00

 0.00

3. The source of compensation to be paid to me is:

  Debtor Other (specify)

4. I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates 

of my law firm.

I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of

my law firm. A copy of the agreement, together with a list of the names of the people sharing in the compensation, is 





attached.

5. In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case,

 including:

Analysis of the debtor's financial situation, and rendering advice to the debtor in determining whether to file 

a petition in bankruptcy;

a) 

b) Preparation and filing of any petition, schedules, statement of affairs, and plan which may be required;

c) Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;

d) Representation of the debtor in adversary proceedings and other contested bankruptcy matters;

e) [Other provisions as needed]

None

6. By agreement with the debtor(s) the above disclosed fee does not include the following services:

None

Ronald E. Griesheimer, Bar No. 01057774

Dated:

representation of the debtor(s) in this bankruptcy proceeding.

 I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for 

CERTIFICATION

Attorney for Debtor(s)

Ronald E. Griesheimer

Ronald E. Griesheimer

1/14/2010

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B 201A (Form 201A) (12/09)

WARNING: Effective December 1, 2009, the 15-day deadline to file schedules and certain other documents under 

Bankruptcy Rule 1007(c) is shortened to 14 days. For further information, see note at bottom of page 2.

UNITED STATES BANKRUPTCY COURT

NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

NOTICE TO CONSUMER DEBTOR(S) UNDER § 342(b)

OF THE BANKRUPTCY CODE

 In accordance with § 342(b) of the Bankruptcy Code, this notice to individuals with primarily consumer debts: (1) 

Describes briefly the services available from credit counseling services; (2) Describes briefly the purposes, benefits and 

costs of the four types of bankruptcy proceedings you may commence; and (3) Informs you about bankruptcy crimes and 

notifies you that the Attorney General may examine all information you supply in connection with a bankruptcy case.

 You are cautioned that bankruptcy law is complicated and not easily described. Thus, you may wish to seek the 

advice of an attorney to learn of your rights and responsibilities should you decide to file a petition. Court employees cannot 

give you legal advice.

 Notices from the bankruptcy court are sent to the mailing address you list on your bankruptcy petition. In order to 

ensure that you receive information about events concerning your case, Bankruptcy Rule 4002 requires that you notify the 

court of any changes in your address. If you are filing a joint case (a single bankruptcy case for two individuals married to 

each other), and each spouse lists the same mailing address on the bankruptcy petition, you and your spouse will generally 

receive a single copy of each notice mailed from the bankruptcy court in a jointly-addressed envelope, unless you file a 

statement with the court requesting that each spouse receive a separate copy of all notices.

1. Services Available from Credit Counseling Agencies

 With limited exceptions, § 109(h) of the Bankruptcy Code requires that all individual debtors who file for 

bankruptcy relief on or after October 17, 2005, receive a briefing that outlines the available opportunities for credit 

counseling and provides assistance in performing a budget analysis. The briefing must be given within 180 days 

before the bankruptcy filing. The briefing may be provided individually or in a group (including briefings conducted by 

telephone or on the Internet) and must be provided by a nonprofit budget and credit counseling agency approved by the 

United States trustee or bankruptcy administrator. The clerk of the bankruptcy court has a list that you may consult of the 

approved budget and credit counseling agencies. Each debtor in a joint case must complete the briefing.

 In addition, after filing a bankruptcy case, an individual debtor generally must complete a financial 

management instructional course before he or she can receive a discharge. The clerk also has a list of approved 

financial management instructional courses. Each debtor in a joint case must complete the course.

2. The Four Chapters of the Bankruptcy Code Available to Individual Consumer Debtors

 Chapter 7: Liquidation ($245 filing fee, $39 administrative fee, $15 trustee surcharge: Total fee $299)

 Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. 

Debtors whose debts are primarily consumer debts are subject to a “means test” designed to determine whether the case 

should be permitted to proceed under chapter 7. If your income is greater than the median income for your state of 

residence and family size, in some cases, the United States trustee (or bankruptcy administrator), the trustee, or creditors 

have the right to file a motion requesting that the court dismiss your case under § 707(b) of the Code. It is up to the court to 

decide whether the case should be dismissed. 

 Under chapter 7, you may claim certain of your property as exempt under governing law. A trustee may have the 

right to take possession of and sell the remaining property that is not exempt and use the sale proceeds to pay your 

creditors. 

 The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found to 

have committed certain kinds of improper conduct described in the Bankruptcy Code, the court may deny your discharge 

and, if it does, the purpose for which you filed the bankruptcy petition will be defeated. 

 Even if you receive a general discharge, some particular debts are not discharged under the law. Therefore, you 

may still be responsible for most taxes and student loans; debts incurred to pay nondischargeable taxes; domestic support 

and property settlement obligations; most fines, penalties, forfeitures, and criminal restitution obligations; certain debts 

which are not properly listed in your bankruptcy papers; and debts for death or personal injury caused by operating a motor 

vehicle, vessel, or aircraft while intoxicated from alcohol or drugs. Also, if a creditor can prove that a debt arose from fraud, 

breach of fiduciary duty, or theft, or from a willful and malicious injury, the bankruptcy court may determine that the debt is 

not discharged. 

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Form B 201A, Notice to Consumer Debtor(s) Page 2

 Chapter 13: Repayment of All or Part of the Debts of an Individual with Regular Income ($235 filing fee, $39 

administrative fee: Total fee $274)

 Chapter 13 is designed for individuals with regular income who would like to pay all or part of 

their debts in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar 

amounts set forth in the Bankruptcy Code. 

 Under chapter 13, you must file with the court a plan to repay your creditors all or part of the money that you owe 

them, using your future earnings. The period allowed by the court to repay your debts may be three years or five years, 

depending upon your income and other factors. The court must approve your plan before it can take effect. 

 After completing the payments under your plan, your debts are generally discharged except for domestic support 

obligations; most student loans; certain taxes; most criminal fines and restitution obligations; certain debts which are not 

properly listed in your bankruptcy papers; certain debts for acts that caused death or personal injury; and certain long term 

secured obligations. 

 Chapter 11: Reorganization ($1000 filing fee, $39 administrative fee: Total fee $1039)

 Chapter 11 is designed for the reorganization of a business but is also available to consumer debtors. Its provisions 

are quite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney. 

 Chapter 12: Family Farmer or Fisherman ($200 filing fee, $39 administrative fee: Total fee $239)

 Chapter 12 is designed to permit family farmers and fishermen to repay their debts over a period of time from 

future earnings and is similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose 

income arises primarily from a family-owned farm or commercial fishing operation. 

3. Bankruptcy Crimes and Availability of Bankruptcy Papers to Law Enforcement Officials

 A person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of 

perjury, either orally or in writing, in connection with a bankruptcy case is subject to a fine, imprisonment, or both. All 

information supplied by a debtor in connection with a bankruptcy case is subject to examination by the Attorney General 

acting through the Office of the United States Trustee, the Office of the United States Attorney, and other components and 

employees of the Department of Justice. 

WARNING: Section 521(a)(1) of the Bankruptcy Code requires that you promptly file detailed information regarding your 

creditors, assets, liabilities, income, expenses and general financial condition. Your bankruptcy case may be dismissed if 

this information is not filed with the court within the time deadlines set by the Bankruptcy Code, the Bankruptcy Rules, and 

the local rules of the court. The documents and the deadlines for filing them are listed on Form B200, which is posted at 

http://www.uscourts.gov/bkforms/bankruptcy_forms.html#procedure.

Many filing deadlines change on December 1, 2009. Of special note, 12 rules that set 15 days to act are amended to 

require action within 14 days, including Rule 1007(c), filing the initial case papers; Rule 3015(b), filing a chapter 13 

plan; Rule 8009(a), filing appellate briefs; and Rules 1019, 1020, 2015, 2015.1, 2016, 4001, 4002, 6004, and 6007.

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UNITED STATES BANKRUPTCY COURT

B 201B (Form 201B) (12/09)

NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

In re

Debtor Chapter

Case No.

7

Brett Jay Holloway

Ramona S Holloway

CERTIFICATION OF NOTICE TO CONSUMER DEBTOR(S)

UNDER § 342(b) OF THE BANKRUPTCY CODE

Certificate of the Debtor

We, the debtors, affirm that we have received and read the attached notice, as required by § 342(b) of the Bankruptcy Code.

Ramona S Holloway

Signature of Joint Debtor Date

Case No. (if known)

s/ Ramona S Holloway 1/14/2010 Printed Name(s) of Debtor(s)

1/14/2010

Signature of Debtor Date

s/ Brett Jay Holloway

Brett Jay Holloway

Brett Jay Holloway

Ramona S Holloway

X

X

Instructions: Attach a copy of Form B 201A, Notice to Consumer Debtor(s) Under § 342(b) of the Bankruptcy Code.

Use this form to certify that the debtor has received the notice required by 11 U.S.C. § 342(b) only if the certification has 

NOT been made on the Voluntary Petition, Official Form B1. Exhibit B on page 2 of Form B1 contains a certification by the 

debtor’s attorney that the attorney has given the notice to the debtor. The Declarations made by debtors and bankruptcy 

petition preparers on page 3 of Form B1 also include this certification.

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