Nco Financial Systems

KNC425

507 Prudential Rd

Horsham, PA 19044

ALW Sourcing LLC

1804 Washington Blvd

Baltimore, MD 21230

American Honda Finance

93236078

PO Box 168088

Irving, TX 75016

Arrow Financial Services

30399957

5996 W Touhy Ave

Niles, IL 60714

ATG Credit LLC

99914

PO Box 14895

Chicago, IL 60614-4895

Blatt, Hasenmiller, et al

09 SC 5863

125 South Wacker Drive

Suite 400

Chicago, IL 60606

Capital 1 Bank

5178057282980858

Attn: C/O Tsys Debt Management

PO Box 5155

Norcross, GA 30091

Captial Management

726 Exchange Street

Suite 700

Buffalo, NY 14720

Citibank Usa (Home Depot)

6035320218381323

Attn.: Centralized Bankruptcy

PO Box 20507

Kansas City, MO 64195

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 1 of 49
Citifinancial

67130047-0205849

PO Box 499

Hanover, MD 21076

City of Aurora Animal Control

57203

Finance Department

44 E Downer Place

Aurora, IL 60507-2067

Collection/LVNV

4447962141510747

Attn: Bankrutpcy Department

PO Box 10587

Greenville, SC 29603

Collection Professional, Inc/lasal

568762

723 1St St

La Salle, IL 61301

Commonweath Edison

PO Box 6111

Carol Stream, IL 60197-6111

Credit Collection Services

06 015865953

Two Wells Avenue

Dept 9135

Newton, MA 02459

Credit Recovery Inc

70202

311 E McKinley Rd

Ottawa, IL 61350

Dell Financial Services

79450129054225852

Attn: Bankruptcy Dept.

12234 North Ih 35

Austin, TX 78753

Dependon Collection Services

335729441172

Attn: Bankruptcy

PO Box 4833

Oak Brook, IL 60523

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 2 of 49
Diversified Svs Group

I93115J51253

5800 E Thomas Rd

Ste 107

Scottsdale, AZ 85251

Diversidied Adjustment Service, Inc

11038697

PO Box 32145

Fridley, MN 55432

Diversified Svs Group

C16854K43857 & LO5950

5800 E Thomas Rd

Ste 107

Scottsdale, AZ 85251

Emergency Treatment, SC

32752-261986

900 Jorie Blvd

Suite 220

Oak Brook, IL 60523

Fashion Bug/soanb

6004669590832460

Attn: Bankruptcy

6356 Corley Rd

Norcross, GA 30091

First National Bank Of Marin/credit One

4447962141510747

Customer Service

PO Box 98873

Las Vegas, NV 89193

Fox Metro

682 State Route 31

Oswego, IL 60543

Fox Metro Water Reclamation District

09 SC 3902

682 State Route 31

Oswego, IL 60543

Frank M. Bonifacic, attorney

X00216170

111 West Washington

Suite 1850

Chicago, IL 60602

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 3 of 49
G M A C

154910767819

15303 S 94Th Ave

Orland Park, IL 60462

Hsbc Cc

41001300110445

PO Box 8633

Elmhurst, IL 60126

Internal Revenue Service

PO Box 21126

Philadelphi, PA 19114

Internal Revenue Service

3504

PO Box 211126

Philadelphia, PA 19114

JC Christensen & Assoc Inc

92909948

PO Box 519

Sauk Rapids, MN 56379

MCS Collections, INC

199-0443 & 209-9498 & 211-1963

725 Sourth Wells Street

Suite 501

Chicago, IL 60607

NCO Credit

507 Prudential road

Horsham, PH 19044

NCO Financial Services

636102420

507 Prudential Road

Horsham, PA 19044

Nco Financial Systems

6698668

507 Prudential Rd

Horsham, PA 19044

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 4 of 49
NCO Financial Systems

ZX5876

507 Prudential Rd

Horsham, PA 19044

Nicor Gas

37-15-74-8320 9

PO Box 2020

Aurora, IL 60507-2020

North Shore Agency

2659033

270 Spagnoli Road

Suite 111

Melville, NY 11747-3515

Northland Group

F9725430

Atten: Bankruptcy

PO Box 390846

Edina, MN 55439

Palisad Coll

PAL1ATT5093721146

Attention: Banktruptcy Department

PO Box 100018

Kennesaw, GA 30156

Professional Bureau of Collections, MD

FAS28639

PO Box 628

Elk Grove, CA 95759-0628

Receivables Management Inc. (rmi)/ Mortg

172097

Attn: Bankruptcy

3348 Ridge Rd

Lansing, IL 60438

Retrieval Masters Creditors Bureau

00322774811

2269 South Saw Mill River Road

Building 3

Elmsford, NY 10523

Rush Copley

Patient Financial Services

2000 Ogden Avenue

Aurora, IL 60507

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 5 of 49
United Recovery Systems

12961548

PO Box 722929

Houston, TX 77272-2929

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 6 of 49
UNITED STATES BANKRUPTCY COURT

NORTHERN DISTRICT OF ILLINOIS

In Re: Bankruptcy Case Number:

Lee Ortega

Arleen Garcia Ortega

VERIFICATION OF CREDITOR MATRIX

Number of Creditors: 51

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

knowledge.

s/ Lee Ortega

Lee Ortega

Dated: 

Debtor

12/28/2009

s/ Arleen Garcia Ortega

Joint Debtor

Arleen Garcia Ortega

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 7 of 49
B 1 (Official Form 1) (1/08)

Ortega, Lee, 

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

Ortega, Arleen, Garcia

Northern District of Illinois Voluntary Petition United States Bankruptcy Court

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

Arleen Garcia

Arleen Garcia Ortega

All Other Names used by the 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): 3504 7693

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):

570 N Trask

Aurora, IL 

570 N Trask

Aurora, IL 

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

ZIP CODE 60505 60505 ZIP CODE

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

Kane Kane

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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 8 of 49
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) Lee Ortega, Arleen Garcia Ortega

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.)

/s/Deanna L. Aguinaga

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

12/28/2009

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

Deanna L. Aguinaga 6228728



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)). 

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 9 of 49
B 1 (Official Form 1) (1/08) FORM B1, Page 3

Voluntary Petition Name of Debtor(s):

Lee Ortega, Arleen Garcia Ortega (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/ Lee Ortega

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/ Arleen Garcia Ortega

Signature of Debtor (Signature of Foreign Representative) Lee Ortega

Signature of Joint Debtor Arleen Garcia Ortega (Printed Name of Foreign Representative)

Telephone Number (If not represented by attorney)

Date

12/28/2009 Date

Aguinaga, Serrano & Low

340 N. Lake Street 2nd Floor

Deanna L. Aguinaga Bar No. 6228728 

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

/s/Deanna L. Aguinaga

(630)844-8781 (630)844-8789

12/28/2009

Telephone Number

 Aurora, IL 60506 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. 

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 10 of 49
B6A (Official Form 6A) (12/07)

, In re: Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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 residence J

570 N. Trask

Aurora, IL 60505

Fee Owner $ 128,000.00 $ 152,714.08

Total  $ 128,000.00

(Report also on Summary of Schedules.)

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 11 of 49
B6B (Official Form 6B) (12/07)

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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 X

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 Savings account for wife #7782 W 0.00

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.

Earthmover's Credit Union savings account #5007 H 100.00

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.

WAMU checking account #333-7 W 20.00

Security deposits with public utilities, 

telephone companies, landlords, and 

others.

3. X

Household goods and furnishings, 

including audio, video, and computer 

equipment.

4. dell computer J 200.00

Household goods and furnishings, 

including audio, video, and computer 

equipment.

sofa set, beds, computer desk J 400.00

Books, pictures and other art objects, 

antiques, stamp, coin, record, tape, 

compact disc, and other collections or 

collectibles.

5. X

6. Wearing apparel. coats clothing and shoes (6 people) W 750.00

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. Amsted Industries (through former employer 

Burgess Norton Mfg Co) ESOP account

H 283,456.07

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 12 of 49
B6B (Official Form 6B) (12/07) -- Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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

Stock and interests in incorporated and 

unincorporated businesses. Itemize.

13. X

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. 2007 Chevy Aveo, 4 door with 24,960 miles, good 

condition

6,900.00

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. dog -chihuahua W 0.00

Crops - growing or harvested. Give 

particulars.

32. X

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 13 of 49
B6B (Official Form 6B) (12/07) -- Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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  $ 291,826.07

(Include amounts from any continuation sheets 

attached. Report total also on Summary of 

Schedules.)

2 continuation sheets attached

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 14 of 49
, In re Case No.

Debtors (If known)

Lee Ortega Arleen Garcia Ortega

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

2007 Chevy Aveo, 4 door with 

24,960 miles, good condition

735 ILCS 5/12-1001(c) 4,800.00 6,900.00

Amsted Industries (through 

former employer Burgess 

Norton Mfg Co) ESOP account

§40 ILCS 5/3-144.1, §40 ILCS 283,456.07

5/5-218, 4-135, 6-213, 19-117

283,456.07

coats clothing and shoes (6 

people)

735 ILCS 5/12-1001(a),(e) 750.00 750.00

Earthmover's Credit Union 

savings account #5007

735 ILCS 5/12-1001(b) 100.00 100.00

single family residence

570 N. Trask

Aurora, IL 60505

735 ILCS 5/12-901 30,000.00 128,000.00

sofa set, beds, computer desk 735 ILCS 5/12-1001(b) 0.00 400.00

WAMU checking account 

#333-7

735 ILCS 5/12-1001(b) 20.00 20.00

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 15 of 49
B6D (Official Form 6D) (12/07)

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 09 SC 5863 W 2,556.00 Security Agreement

NOTCE ONLY

dell computer

__________________________

VALUE $0.00

Blatt, Hasenmiller, et al

125 South Wacker Drive

Suite 400

Chicago, IL 60606

0.00

ACCOUNT NO. 67130047-0205849 J 02/01/2007 152,714.08 First Lien on Residence

single family residence

570 N. Trask

Aurora, IL 60505

__________________________

VALUE $128,000.00

Citifinancial

PO Box 499

Hanover, MD 21076

24,714.08

ACCOUNT NO. 79450129054225852 W 2,556.00 Security Agreement

dell computer

__________________________

VALUE $200.00

Dell Financial Services

Attn: Bankruptcy Dept.

12234 North Ih 35

Austin, TX 78753

2,356.00

ACCOUNT NO. 154910767819 W 03/01/2007 8,972.00 Security Agreement

2007 Chevy Aveo, 4 door with 

24,960 miles, good condition

__________________________

VALUE $6,900.00

G M A C

15303 S 94Th Ave

Orland Park, IL 60462

2,072.00

0

attached

continuation sheets

$ $ 29,142.08 (Total of this page)

Subtotal  166,798.08

$ 29,142.08 $

(Use only on last page)

Total  166,798.08

(If applicable, report 

also on Statistical 

Summary of Certain 

Liabilities and 

Related Data.)

(Report also on Summary of 

Schedules)

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 16 of 49
B6E (Official Form 6E) (12/07)

, Case No. In re

(If known) Debtors

Lee Ortega Arleen Garcia Ortega

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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 17 of 49
B6E (Official Form 6E) (12/07) – Cont.

, In re Case No.

(If known) Lee Ortega Arleen Garcia Ortega

Debtors

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet)

Type of Priority: Taxes and Certain Other Debts Owed to Governmental Units

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

income taxes for the 

year 2007

397.97 397.97 ACCOUNT NO. W

Internal Revenue Service

PO Box 21126

Philadelphi, PA 19114

$0.00

2007 income tax 2,707.00 2,707.00 ACCOUNT NO. 3504 H

Internal Revenue Service

PO Box 211126

Philadelphia, PA 19114

$0.00

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

Creditors Holding Priority Claims

Subtotals

(Totals of this page)

 $ 3,104.97 3,104.97$ 0.00

Total

(Use only on last page of the completed 

Schedule E. Report also on the Summary of 

Schedules.)



3,104.97

3,104.97

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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 18 of 49
,

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

In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. H 0.00

ALW Sourcing LLC

1804 Washington Blvd

Baltimore, MD 21230

NOTICEONLY

collection of Nextel cellular services, 

assigned to NCO Financial 

ACCOUNT NO. 93236078 J 03/01/2007 7,457.25

American Honda Finance

PO Box 168088

Irving, TX 75016

repossessed 2007 Honda Civic Sedan 

leased vehicle

ACCOUNT NO. 30399957 W 06/2005 114.02

Arrow Financial Services

5996 W Touhy Ave

Niles, IL 60714

Collection attorney for 5th 3rd bank

ACCOUNT NO. 99914 W 187.00

ATG Credit LLC

PO Box 14895

Chicago, IL 60614-4895

Collection for Valley Imaging 

Consultants 

ACCOUNT NO. 517805727315 H 526.00

Capital 1 Bank

Attn: C/O Tsys Debt Management

PO Box 5155

Norcross, GA 30091

Credit card charges debtor does not 

recall exact purchases card was used 

for miscellaneous household expenses 

used approximately 01/2008 to 2008

8 Continuation sheets attached

Subtotal  $ 8,284.27

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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 19 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 5178057282980858 W 775.00

Capital 1 Bank

Attn: C/O Tsys Debt Management

PO Box 5155

Norcross, GA 30091

Credit card charges debtor does not 

recall exact purchases card was used 

for miscellaneous household expenses 

used approximately 04/2007 to 2008

ACCOUNT NO. H 0.00

Captial Management

726 Exchange Street

Suite 700

Buffalo, NY 14720

NOTICE ONLY 

collection for Arrow Financial, Fifth 

Thrid Bank, Northland Group

ACCOUNT NO. 6035320218381323 W 844.00

Citibank Usa (Home Depot)

Attn.: Centralized Bankruptcy

PO Box 20507

Kansas City, MO 64195

Credit card charges debtor does not 

recall exact purchases card was used 

for miscellaneous household expenses 

used approximately 01/2007 to 1/082008

ACCOUNT NO. 6071304727365395 H 8,989.00

Citifinancial

PO Box 499

Hanover, MD 21076

Credit card charges debtor does not 

recall exact purchases card was used 

for miscellaneous household expenses 

used approximately 06/06/2007 to Jan., 

2008 (Judgment entered in Kane 

County Circuit Court, Illinois 09 SC 

1246)

ACCOUNT NO. 57203 H 200.00

City of Aurora Animal Control

Finance Department

44 E Downer Place

Aurora, IL 60507-2067

Animal Control P- ticket 

Subtotal  10,808.00 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 20 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 568762 H 10/2008 1,072.00

Collection Professional, Inc/lasal

723 1St St

La Salle, IL 61301

Collection attorney original creditor 

Oswego Animal Hosptial acct # 18071

ACCOUNT NO. 4447962141510747 W 10/2008 939.00

Collection/LVNV

Attn: Bankrutpcy Department

PO Box 10587

Greenville, SC 29603

collection account original creditor is 

Marin

ACCOUNT NO. J 378.00

Commonweath Edison

PO Box 6111

Carol Stream, IL 60197-6111

electric service to residence

ACCOUNT NO. 06 015865953 J X 327.60

Credit Collection Services

Two Wells Avenue

Dept 9135

Newton, MA 02459

collection of Allstate Insurance 

Company 

ACCOUNT NO. 70202 02/2008 168.00

Credit Recovery Inc

311 E McKinley Rd

Ottawa, IL 61350

Collection attorney original creditor 

Fairview Dental/Dr Tonner

Subtotal  2,884.60 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 21 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 335729441172 H 12/2003 329.00

Dependon Collection Services

Attn: Bankruptcy

PO Box 4833

Oak Brook, IL 60523

Collection attorney original creditor 

James C Pauly DDS

ACCOUNT NO. 11038697 H 605.62

Diversidied Adjustment Service, Inc

PO Box 32145

Fridley, MN 55432

collection of Sprint account 498043582

ACCOUNT NO. I93115J51253 W 09/2004 50.00

Diversified Svs Group

5800 E Thomas Rd

Ste 107

Scottsdale, AZ 85251

Collection attorney original creditor 

Rush Copley Medical Center

ACCOUNT NO. C16854K43857 & LO5950 W 12/2005 150.00

Diversified Svs Group

5800 E Thomas Rd

Ste 107

Scottsdale, AZ 85251

Collection attorney for Rush Copley 

Medical Center

ACCOUNT NO. 32752-261986 H 300.00

Emergency Treatment, SC

900 Jorie Blvd

Suite 220

Oak Brook, IL 60523

medical services on 12-06-09 Copley 

Memorial Hospital

Subtotal  1,434.62 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 22 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 6004669590832460 W 215.00

Fashion Bug/soanb

Attn: Bankruptcy

6356 Corley Rd

Norcross, GA 30091

Credit card charges incurred for 

clothing used approximately 07/30/2007 

to ___/2008

ACCOUNT NO. 4447962141510747 W 08/2007 840.00

First National Bank Of Marin/credit One

Customer Service

PO Box 98873

Las Vegas, NV 89193

Credit card charges debtor does not 

recall purchases or dates

ACCOUNT NO. H 355.58

Fox Metro

682 State Route 31

Oswego, IL 60543

sewage for residence

ACCOUNT NO. 09 SC 3902 H X 380.00

Fox Metro Water Reclamation District

682 State Route 31

Oswego, IL 60543

Judgment entered in Kane County 

Circuit Court Client believes judgment 

was paid, still appears on credit report

ACCOUNT NO. X00216170 H 206.00

Frank M. Bonifacic, attorney

111 West Washington

Suite 1850

Chicago, IL 60602

collection for Waubonsee Community 

College

Subtotal  1,996.58 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 23 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 41001300110445 H 3,703.00

Hsbc Cc

PO Box 8633

Elmhurst, IL 60126

Credit card charges debtor does not 

recall exact purchases card was used 

for miscellaneous household expenses 

used approximately 06/2008 to 10/2007

ACCOUNT NO. 92909948 W 0.00

JC Christensen & Assoc Inc

PO Box 519

Sauk Rapids, MN 56379

NOTICE ONLY

Collection of Credit One Bank NA sold 

to LVNV Funding account # 

4447962141510747, sold to Resurgent 

Capital Services LP (retained JCC to 

collect in Illinois)

ACCOUNT NO. 199-0443 & 209-9498 & 211-19 H 830.00

MCS Collections, INC

725 Sourth Wells Street

Suite 501

Chicago, IL 60607

medical collection for Emergency 

Treatment, SC

ACCOUNT NO. W 0.00

NCO Credit

507 Prudential road

Horsham, PH 19044

NOTICE ONLY

collection of Home Depot/Citibank 

account

ACCOUNT NO. 636102420 H 987.19

NCO Financial Services

507 Prudential Road

Horsham, PA 19044

collection for Nextel cellular telephone 

service

Subtotal  5,520.19 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 24 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. KNC425 W 0.00

Nco Financial Systems

507 Prudential Rd

Horsham, PA 19044

Notice only

collection for Captial One Bank NA 

(517805727315921)

ACCOUNT NO. 6698668 W 03/2005 147.00

Nco Financial Systems

507 Prudential Rd

Horsham, PA 19044

collection for SBC

ACCOUNT NO. ZX5876 H 164.22

NCO Financial Systems

507 Prudential Rd

Horsham, PA 19044

Collection of Fox Valley Park District 

account 0021958844

ACCOUNT NO. 37-15-74-8320 9 H 225.78

Nicor Gas

PO Box 2020

Aurora, IL 60507-2020

Natural gas service for 570 Trask Street,

Aurora

ACCOUNT NO. 2659033 W 125.68

North Shore Agency

270 Spagnoli Road

Suite 111

Melville, NY 11747-3515

Disney Movie Club collection

Subtotal  662.68 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 25 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. F9725430 H 0.00

Northland Group

Atten: Bankruptcy

PO Box 390846

Edina, MN 55439

NOTICE ONLY

collection for Arrow Financial 

Services/Fifth Third Bank (6197891) 

(5424321261166907

ACCOUNT NO. PAL1ATT5093721146 H 09/2005 679.00

Palisad Coll

Attention: Banktruptcy Department

PO Box 100018

Kennesaw, GA 30156

collection for ATT wireless

ACCOUNT NO. FAS28639 W 0.00

Professional Bureau of Collections, MD

PO Box 628

Elk Grove, CA 95759-0628

NOTICE ONLY

collection for Spirit of America (fashion 

Bug) (account 6004669590832460

ACCOUNT NO. 172097 H 399.00

Receivables Management Inc. (rmi)/ Mortg

Attn: Bankruptcy

3348 Ridge Rd

Lansing, IL 60438

collection for City of Aurora

ACCOUNT NO. 172095 W 399.00

Receivables Management Inc. (rmi)/ Mortg

Attn: Bankruptcy

3348 Ridge Rd

Lansing, IL 60438

collection for City of Aurora

Subtotal  1,477.00 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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 26 of 49
B6F (Official Form 6F) (12/07) - Cont.

, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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. 86756 H 90.00

Receivables Management Inc. (rmi)/ Mortg

Attn: Bankruptcy

3348 Ridge Rd

Lansing, IL 60438

collection for City of Aurora

ACCOUNT NO. 91764 & 1366582 H 100.00

Receivables Management Inc. (rmi)/ Mortg

Attn: Bankruptcy

3348 Ridge Rd

Lansing, IL 60438

collection for City of Aurora

ACCOUNT NO. 00322774811 J 25.68

Retrieval Masters Creditors Bureau

2269 South Saw Mill River Road

Building 3

Elmsford, NY 10523

collection of Which Way USA Account

ACCOUNT NO. W 750.00

Rush Copley

Patient Financial Services

2000 Ogden Avenue

Aurora, IL 60507

medical services account numbers 

28440113 & 28264968 & 28822435 & 

28789071 & 26943399 & 26649624

ACCOUNT NO. 12961548 W 7,187.41

United Recovery Systems

PO Box 722929

Houston, TX 77272-2929

collection for Honda Financial Services 

acct No. 93236078

Subtotal  8,153.09 Sheet no. 8 of 8 continuation sheets attached to Schedule of Creditors 

Holding Unsecured

Nonpriority Claims

$

Total

41,221.03 

$

(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 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 27 of 49
, Case No. In re:

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

(If known)

Lee Ortega Arleen Garcia Ortega

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.

American Honda Finance automobile lease, maturity date 3/19/2011

PO Box 168088

Irving, TX 75016

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 28 of 49
B6H (Official Form 6H) (12/07)

In re: Case No. , (If known)

Lee Ortega Arleen Garcia Ortega

Debtors

SCHEDULE H - CODEBTORS

 Check this box if debtor has no codebtors.

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 29 of 49
B6I (Official Form 6I) (12/07)

In re Case No. , Lee Ortega Arleen Garcia Ortega

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):

son 18

daughter 16

daughter 13

daughter 10

DEBTOR SPOUSE

Occupation 

How long employed

Address of Employer

electrician

3 years

Route 30

Montgomery, IL 

Realtor/tax advisor

3 months/2 years

Galena Blvd

Aurora, IL 

Name of Employer Caterpillar Charles Rutenberg/H&R Block

Employment:

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

 case filed) DEBTOR SPOUSE

3. SUBTOTAL

4. LESS PAYROLL DEDUCTIONS

 b. Insurance 123.70 0.00

 c. Union dues $ 47.60 $ 0.00

$ $

 a. Payroll taxes and social security $ $ 335.00 58.00

2. Estimate monthly overtime 0.00 $ 0.00

$ 3,353.00 $ 580.00

 (Prorate if not paid monthly.)

$ 3,353.00 $ 580.00

1. Monthly gross wages, salary, and commissions

$

 d. Other (Specify) TDRP loan $ $ 80.66 0.00

5. SUBTOTAL OF PAYROLL DEDUCTIONS

social security death benefit for child 

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

586.96 58.00

2,766.04 522.00

0.00

0.00

0.00

0.00

636.00

0.00

0.00

0.00

0.00

0.00

$ $ 12. Pension or retirement income 0.00 0.00

(Specify) $ 0.00 $ 0.00

13. Other monthly income

15. AVERAGE MONTHLY INCOME (Add amounts shown on lines 6 and 14) $ 3,402.04 $ 522.00

$ 636.00 $ 0.00

16. COMBINED AVERAGE MONTHLY INCOME: (Combine column

totals from line 15)

$ 3,924.04

(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

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 Document Page 30 of 49
B6I (Official Form 6I) (12/07) - Cont.

In re Case No. , Lee Ortega Arleen Garcia Ortega

Debtors (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

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

Ms. Ortega is seeking full-time employment

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 31 of 49
B6J (Official Form 6J) (12107) 

In fe Lee Ortega Arleen Garcia Ortega Case No. ___	~==~. 

Debtors (If known) 


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. 

(J 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." 


1. Rent or home mortgage payment (include lot rented for mobile home) 	 $ 983.49 

a. Are real estate taxes included? Yes 	 No --~----

b. Is property insurance included? Yes 	 No 

2. Utilities: a. Electricity and heating fuel 	 $ 476.00 

b. Water and sewer 	 $ 85.00 

c. Telephone 	 $ 149.00 

d. Other television (cable/satelite) 	 $ 149.00 --..-----­ 3. Home maintenance (repairs and upkeep) 	 $ 50.00 

4. Food 	 $ 800.00 

5. Clothing 	 $ 100.00 

6. Laundry and dry cleaning 	 $ 180.00 

7. Medical and dental expenses 	 $ 0.00 

8. Transportation (not including car payments) 	 $ 200.00 

9. Recreation, clubs and entertainment, newspapers, magazines, etc. 	 $ 0.00 

10. Charitable contributions 	 $ 0.00 

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

a. Homeowner's or renter's 	 $ 77.00 

b. Life 	 $ 0.00 

c. Health 	 $ 0.00 

d. Auto $ 	 160.00 

e. Other 	 $ 0.00 

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

(Specify) Real Estate property tax $ 275.00 

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

a. Auto $ 0.00 

b. Other $ 0.00 

14. Alimony, maintenance, and support paid to others $ 0.00 

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

0.00 

16. Regular expenses from operation of business, profession, or farm (attach detailed statement) $ 0.00 

17. Otherpersonal grooming, cleaning and household items $ 200.00 

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.) 
 [ $ ----. 3,884.49 -.J

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 $ _~.--W4.04 

b. Average monthly expenses from Line 18 above $ 3,884.49 

c. Monthly net income (a. minus b.) $ 39.55 

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 Document Page 32 of 49
Form 6 - Statistical Summary (12107) 

United States Bankruptcy Court 


Northern District of Illinois 


In re Lee Ortega Arleen Garcia Ortega Case No. 


Debtors Chapter 7 


----,--­

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. 


o 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 . 

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

. -

Type of Liability Amount 

Domestic Support Obligations (from Schedule E) $ 0.00 

Taxes and Certain Other Debts Owed to Governmental Units (from 

Schedule E) $ 3,104.97 

Claims for Death or Personal Injury While Debtor Was 

Intoxicated (from Schedule E) (whether disputed or undisputed) $ 0.00 

Student Loan Obligations (from Schedule F) $ 0.00 

Domestic Support, Separation Agreement, and Divorce Decree 

Obligations Not Reported on Schedule E. $ 0.00 

Obligations to Pension or Profit-Sharing, and Other Similar 

Obligations (from Schedule F) $ 0.00 

TOTAL $ 3,104.97 

State the following: 

!Averag~ Income (from Schedule I, Line 1~) $ 3,924.04 

l Average Expenses (from Schedule J, Line 18) $ 3,884.49 

I Current Monthly Income (from Form 22A Line 12; OR, Form I 22B Line 11; OR. Form 22C Line 20 ) $ 4,265.15 

State the following: 

1. Total from Schedule 0, "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) 

Case 09-49535 Doc 1 Filed 12/31/09 Entered 12/31/09 11:05:50 Desc Main

 Document Page 33 of 49
86 Summary (Official Form 6· Summary) (12/07) 

United States Bankruptcy Court 


Northern District of Illinois 


It. re Lee Ortega Arleen Garcia Ortega Case No. 

Debtors 2-______________________ Chapter 7 

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 NO. OF SHEETS ASSETS LIABILITIES OTHER 

(YES/NO) 

A - Real Property YES 1 $ 

B - Personal Property YES 3 $ 

C - Property Claimed 

as Exempt YES 1

o -Creditors Holding YES 1 

Claims 

E - Creditors Holding Unsecured 

Priority Claims YES 2 3,104.97

(Total of Claims on Schedule E) 

F - Creditors Holding Unsecured YES 9 41.221.03 

Nonpriority Claims 

G -Executory Contracts and YES 1 

Unexpired Leases 

H - Codebtors YES 1 

I - Current Income of 

Individual Debtor(s) YES 2 

J - Current Expenditures of YES 1 

Individual Debtor(s) 3.884.49

TOTAL 22 

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 Document Page 34 of 49
, In re Case No.

(If known)

Lee Ortega Arleen Garcia Ortega

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 24

Date: Signature:

Lee Ortega

12/28/2009 s/ Lee Ortega

Debtor

Arleen Garcia Ortega

Date: 12/28/2009 Signature:

(Joint Debtor, if any)

s/ Arleen Garcia Ortega

[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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B7 (Official Form 7) (12/07)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Case No. In re: , (If known)

Lee Ortega Arleen Garcia Ortega

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

19,633.00 Coldwell Banker Wife 2007

71,430.00 Caterpillar Husband 2007

Wife Walmart, H & R Block, Primus 

Realty Corp

6,835.42 2008

58,575.72 Husband Caterpillar 2008

42,213.19 Caterpillar Husband 2009 as of 11/13/09

17,697.00 Coldwell Banker and H&R Block Wife 2009 as of 11/20/09

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

11,837.72 Husband's Amsted Industries ESOP 2008

4,742.50 Husband's Amsted Industries ESOP 2009

1,920.00 Wife's unemployment compensation 2009 as of 12/1/09

770.00 Husband's unemployment compensation 2009 as of 12/1/09

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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.)



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

Citifinancial Services

vs

Lee Ortega

 09 SC 1246

Kane County Circuit Court, 

Illinois

collection judgment 

entered 

$9,230.08

Dell Financial Services, LLC

vs 

Arleen Garcia Ortega

 09 SC 5863

16th Judicial Circuit

Kane County, Illinois

collection judgment 

entered/trying 

to garnish

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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

Citifinancial

PO Box 499

Hanover, MD 21076

05/28/2009 wage deduction

4526.26

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

American Honda Finance

PO Box 168088

Irving, TX 75016

04/12/2009 2007 Honda Civic value approximately 

$7,457.00

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



Garage at 570 N Trask, Aurora, IL 60505 The garage was damaged by a racoon. Claim was 

fully covered by insurance

12/08/2009

Home at 570 N Trask, Aurora, IL 60505 The home had wind damage. Claim was fully 

covered by insurance

01/09/2009

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



Aguinaga, Serrano & Low

340 N. Lake Street

Second Floor

Aurora, IL 60506

May 1, 2009 and July, 

2009

$1,500.00 

Hummingbird credit counseling November, 2009 $49.00

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



621 Second Avenue

Aurora, IL 60505

Arleen Garcia Ortega 2006-2007

712 E Benton

Aurora, IL 60505

Arleen Garcia Ortega 2007

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

12/28/2009 s/ Lee Ortega

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

Date Signature

of Debtor Lee Ortega

[if completed by an individual or individual and spouse]

Arleen Garcia Ortega

Signature

of Joint Debtor

(if any)

Date 12/28/2009 s/ Arleen Garcia Ortega

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 Document Page 42 of 49
B 8 (Official Form 8) (12/08)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Debtors

In re Lee Ortega Arleen Garcia Ortega , 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.)

NOTCE ONLY

dell computer

Blatt, Hasenmiller, et al

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 

single family residence

570 N. Trask

Aurora, IL 60505

Citifinancial

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

Dell Financial Services dell computer

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 

2007 Chevy Aveo, 4 door with 24,960 miles, good 

condition

G M A C

Property No. 4

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.)

American Honda Finance automobile lease, maturity date 

3/19/2011

Property No. 1

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

to 11 U.S.C. § 365(p)(2):

 YES  NO

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B 8 (Official Form 8) (12/08) Page 3

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: 12/28/2009 s/ Lee Ortega

Lee Ortega

Signature of Debtor

s/ Arleen Garcia Ortega

Arleen Garcia Ortega

Signature of Joint Debtor (if any)

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B 203

(12/94)

UNITED STATES BANKRUPTCY COURT

Northern District of Illinois

Chapter

Case No.

 7

In re: Lee Ortega Arleen Garcia Ortega

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 $

 0.00

2. The source of compensation paid to me was:

 1,500.00

 1,500.00

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) [Other provisions as needed]

flat fee contemplates pre-filing counseling, petition preparation, attendance at 341 meeting

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

representation in an adversary or costs association with petition preparation and filing

Deanna L. Aguinaga, Bar No. 6228728

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)

Aguinaga, Serrano & Low

/s/Deanna L. Aguinaga

12/28/2009

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B 201A (Form 201 A) (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 


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 Indiyidual 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 attomey. 

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 Enforc;;ement 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 B2oo, which is posted at 

http://www.uscourts.govlbkformslbankruptcvforms.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 1oo7(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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B 201B (Form 201 B) (12/09) 

UNITED STATES BANKRUPTCY COURT 


NORTHERN DISTRICT OF ILLINOIS 


In re Lee Ortega Case No. _____________________ 

Arleen Garcia Ortega 

Debtor Chapter _ ...7_ 

CERTIFICATION OF NOTICE TO CONSUMER DEBTOR(S) 


UNDER § 342(b) OF THE BANKRUPTCY CODE 


Certificate of the Debtor ., 

Lee Ortega x.~~~~~~_7~~----~-------------

Arleen Garcia Ortega ~at"re eO ct Debt6TJ 0 ~ Date 

Printed Name(s) of Debtor(s) 1

XU~ S1O.&.~.1~ ld'dZm 

Case No. (if known) Arleen Garcia Ortega 

------------------- Signature ct Joint Debtor Date 

Instructions: Attach a copy of Form B 201 A, 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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