Official Form 1 (1/08)

United States Bankruptcy Court Voluntary Petition

NORTHERN DISTRICT OF ILLINOIS

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

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

(include married, maiden, and trade names):

NONE

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

(if more than one, state all): 1262

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

128 Concord Lane

Carol Stream IL

County of Residence or of the

Principal Place of Business: Dupage

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

Location of Principal Assets of Business Debtor

(if different from street address above):

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

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

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

Street Address of Joint Debtor

Mailing Address of Joint Debtor

(include married, maiden, and trade names):

dba Allison M. Kovats

(if more than one, state all):

(No. & Street, City, and State):

County of Residence or of the

Principal Place of Business: Dupage

(if different from street address):

9986

SAME SAME

128 Concord Lane

Carol Stream IL

NOT APPLICABLE

Martinez, Jose A. Martinez, Allison M.

ZIPCODE

ZIPCODE

60188 60188

ZIPCODE

ZIPCODE

ZIPCODE

Railroad

Stockbroker

Commodity Broker

Other (if debtor is not one of the above

Partnership Chapter 13

Chapter 12 Chapter 15 Petition for Recognition

Chapter 9

Chapter 11

Chapter 7

Chapter of Bankruptcy Code Under Which 

the Petition is Filed (Check one box)

Nature of Debts

Filing Fee (Check one box)

(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.

Chapter 11 Debtors:

Check one box:

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

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

Debtor’s aggregate noncontingent liquidated debts (excluding debts

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

Clearing Bank

entities, check this box and state type of

entity below

of a Foreign Nonmain Proceeding

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

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

Nature of Business

(Check

Health Care Business

Single Asset Real Estate as defined

in 11 U.S.C. § 101 (51B)

(Form of organization)

Corporation (includes LLC and LLP)

Individual (includes Joint Debtors)

Type of Debtor

(Check

Chapter 15 Petition for Recognition

of a Foreign Main Proceeding

Check if:

 one box.)

 one box.)

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).

Debts are primarily consumer debts, defined

in 11 U.S.C. § 101(8) as "incurred by an

individual primarily for a personal, family,

Debts are primarily

business debts.

or household purpose"

See Exhibit D on page 2 of this form.

Other

Tax-Exempt Entity

(Check box, if applicable.)

Debtor is a tax-exempt organization

under Title 26 of the United States

Code (the Internal Revenue Code).

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

Statistical/Administrative Information THIS SPACE IS FOR COURT USE ONLY

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

Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for

distribution to unsecured creditors.

Estimated Number of Creditors

Estimated Assets

Estimated Liabilities

100,000

100-199

5,000

200-999

10,000 25,000 50,000 100,000

1-49 50-99 1,000- 5,001- 10,001- 25,001- 50,001- Over

$1,000,001

to $10

million

$500,001

to $1

million

$0 to

$50,000

$50,001 to

$100,000

$100,001 to

$500,000

$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

$0 to

$50,000

$50,001 to

$100,000

$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

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Official Form 1 (1/08) FORM B1, Page 2

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.

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

Information Regarding the Debtor - Venue

(Check any applicable box)

Name of Debtor:

District:

Case Number:

Relationship:

Date Filed:

Judge:

NONE

Location Where Filed: Case Number: Date Filed:

NONE

Voluntary Petition

(This page must be completed and filed in every case)

Name of Debtor(s):

Jose A . Martinez and

Allison M. Martinez

or safety?

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

No

X

Exhibit A

(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)

Exhibit A is attached and made a part of this petition

Exhibit B

(To be completed if debtor is an individual 

whose debts are primarily consumer debts)

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

/s/ Richard S. Bass

Signature of Attorney for Debtor(s) Date

Exhibit C

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

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

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

required by 11 U.S.C. §342(b).

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 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.

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 part of this petition.

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

If this is a joint petition:

Location Where Filed: Case Number: Date Filed:

have informed the petitioner that [he or she] may proceed under chapter 7, 11, 12

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

each such chapter. I further certify that I have delivered to the debtor the notice

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

(Check all applicable boxes.)

(Name of landlord that obtained judgment)

(Address of landlord)

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

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 

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

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Official Form 1 (1/08) FORM B1, Page 3

Jose A . Martinez and

Allison M. Martinez

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

Code, specified in this petition.

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

proceed under chapter 7.

understand the relief available under each such chapter, and choose to

under chapter 7, 11, 12, or 13 of title 11, United States Code,

and has chosen to file under chapter 7] I am aware that I may proceed

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

petition is true and correct.

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

X

X

Date

Signature of Debtor

Signature of Joint Debtor

Telephone Number (if not represented by attorney)

/s/ Jose A . Martinez

/s/ Allison M. Martinez

Signatures

[If no attorney represents me and no bankruptcy petition preparer

11 U.S.C. §342(b)

signs the petition] I have obtained and read the notice required by

X

(Date)

(Signature of Foreign Representative)

(Printed name of 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.

Signature of a Foreign Representative

Voluntary Petition

(This page must be completed and filed in every case)

Name of Debtor(s):

I request relief in accordance with chapter 15 of title 11, United States

Code. Certified copies of the documents required by 11 U.S.C. § 1515

are attached.

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

chapter of title 11 specified in this petition. A certified copy of the

order granting recognition of the foreign main proceeding is attached.

(Check only one box.)

Signature of Attorney for Debtor(s)

Oak Brook IL 60521

630-953-8655

Law Office of Richard S. Bass, LTD.

Richard S. Bass 6189009

Signature of Attorney*

Signature of Non-Attorney Bankruptcy Petition Preparer

Telephone Number

Firm Name

Date

Address

Printed Name of Attorney for Debtor(s)

X 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

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.)

Address

Printed Name and title, if any, of Bankruptcy Petition Preparer

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.

If more than one person prepared this document, attach additional

sheets conforming to the appropriate official form for each person.

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. X

2021 Midwest Road

/s/ Richard S. Bass

Signature of Debtor (Corporation/Partnership)

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.

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.

The debtor requests the relief in accordance with the chapter of

title 11, United States Code, specified in this petition.

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

Signature of Authorized Individual

Printed Name of Authorized Individual

Title of Authorized Individual

Date

X

Signature of bankruptcy petition preparer or officer, principal,

responsible person, or partner whose Social-Security number is provided

Date

*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.

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

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

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

UNITED STATES BANKRUPTCY COURT

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 jointlyaddressed envelope, unless you file a statement with the court requesting that each spouse receive a separate copy of

all notices. 

1. Services Available from Credit Counseling Agencies

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

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

for credit counseling and provides assistance in performing a budget analysis. The briefing must be given

within 180 days before the bankruptcy filing. The briefing may be provided individually or in a group (including

briefings conducted by telephone or on the Internet) and must be provided by a nonprofit budget and credit

counseling agency approved by the United States trustee or bankruptcy administrator. The clerk of the bankruptcy

court has a list that you may consult of the approved budget and credit counseling agencies. Each debtor in a joint

case must complete the briefing.

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

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

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

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

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

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

debts. Debtors whose debts are primarily consumer debts are subject to a “means test” designed to determine

whether the case should be permitted to proceed under chapter 7. If your income is greater than the median income

for your state of residence and family size, in some cases, the United States trustee (or bankruptcy administrator), the

trustee, or creditors have the right to file a motion requesting that the court dismiss your case under § 707(b) of the

Code. It is up to the court to decide whether the case should be dismissed.

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

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

pay your creditors.

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

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

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. 

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

fee, $39 administrative fee: Total fee $274)

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

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

certain dollar amounts set forth in the Bankruptcy Code.

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

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

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

effect.

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

support obligations; most student loans; certain taxes; most criminal fines and restitution obligations; certain debts

which are not properly listed in your bankruptcy papers; certain debts for acts that caused death or personal injury;

and certain long term secured obligations.

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

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

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

with an attorney.

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

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

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

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

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

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

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

both. All information supplied by a debtor in connection with a bankruptcy case is subject to examination by the

Attorney General acting through the Office of the United States Trustee, the Office of the United States Attorney,

and other components and employees of the Department of Justice.

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

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

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

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

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

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

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

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

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

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Jose A . Martinez and Allison M. Martinez

FORM B6A (Official Form 6A) (12/07)

In re

Debtor(s)

Case No.

(if known)

SCHEDULE A-REAL PROPERTY

,

Do not include interests in executory contracts and unexpired leases on this schedule. List them in Schedule G-Executory

Contracts and Unexpired Leases.

Except as directed below, list all real property in which the debtor has any legal, equitable, or future interest, including all property owned as a

cotenant community property, or in which the debtor has a life estate. Include any property in which the debtor holds rights and powers

exercisable for the debtor’s own benefit. If the debtor is married, state whether the husband, wife, both, or the marital community own the property

by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.” If the debtor holds no interest in real property, write

“None” under “Description and Location of Property.”

If an entity claims to have a lien or hold a secured interest in any property, state the amount of the secured claim. See Schedule D. If no entity

claims to hold a secured interest in the property, write “None” in the column labeled “Amount of Secured Claim.”

If the debtor is an individual or if a joint petition is filed, state the amount of any exemption claimed in the property only in Schedule C - Property

Claimed as Exempt.

Description and Location of Property Nature of Debtor's

Interest in Property

Husband--H

Wife--W

Joint--J

Community--C

Current

Value

of Debtor's Interest,

in Property Without

Deducting any

Secured Claim or

Exemption

Amount of

Secured Claim

128 Concord Ln, Carol Stream, IL

(Residence)

Debtor residence W $ 188,000.00 $ 204,400.00

No continuation sheets attached TOTAL $

(Report also on Summary of Schedules.)

188,000.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

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B6B (Official Form 6B) (12/07)

In re Jose A . Martinez and Allison M. Martinez

Debtor(s)

SCHEDULE B-PERSONAL PROPERTY

Case No.

(if known)

,

Except as directed below, list all personal property of the debtor of whatever kind. If the debtor has no property in one or more of the categories,

place an “x” in the appropriate position in the column labeled “None.” If additional space is needed in any category, attach a separate sheet properly

identified with the case name, case number, and the number of the category. If the debtor is married, state whether the husband, wife, both, or the

marital community own the property by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.” If the debtor is an

individual or a joint petition is filed, state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt.

If the property is being held for the debtor by someone else, state that person’s name and address under “Description and Location of Property.” If

the property is being held for a minor child, simply state the child's initials and the name and address of the child's parent or guardian, such as

"A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

Do not list interests in executory contracts and unexpired leases on this schedule. List them in Schedule G-Executory Contracts

and Unexpired Leases.

Description and Location of Property

Husband--H

Wife--W

Joint--J

Community--C

Type of Property

Current

Value

of Debtor's Interest,

in Property Without

Deducting any

Exemption

Secured Claim or

N

o

n

e

1. Cash on hand. Cash

Location: In debtor's possession

$ 100.00

2. 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.

Checking: Bank of America

Location: In debtor's possession

J $ 1,500.00

Savings: Bank of America

Location: In debtor's possession

J $ 500.00

3. Security deposits with public utilities,

telephone companies, landlords, and

others.

X

4. Household goods and furnishings,

including audio, video, and computer

equipment.

Misc used household goods, furniture &

furnishings

Location: In debtor's possession

J $ 2,000.00

5. Books, pictures and other art objects,

antiques, stamp, coin, record, tape,

compact disc, and other collections or

collectibles.

Misc used personal items, books and pictures

Location: In debtor's possession

J $ 500.00

6. Wearing apparel. Misc used personal clothing

Location: In debtor's possession

J $ 800.00

7. Furs and jewelry. X

8. Firearms and sports, photographic, and

other hobby equipment.

X

9. Interests in insurance policies. Name

insurance company of each policy and

itemize surrender or refund value of each.

Life Insurance (Term Policy)

Location: In debtor's possession

W $ 1.00

Page 1 of 3

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B6B (Official Form 6B) (12/07)

In re Jose A . Martinez and Allison M. Martinez

Debtor(s)

SCHEDULE B-PERSONAL PROPERTY

Case No.

(if known)

,

(Continuation Sheet)

Description and Location of Property

Husband--H

Wife--W

Joint--J

Community--C

Type of Property

Current

Value

of Debtor's Interest,

in Property Without

Deducting any

Exemption

Secured Claim or

N

o

n

e

10. Annuities. Itemize and name each issuer. X

11. Interest 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).)

X

12. Interests in IRA, ERISA, Keogh, or other

pension or profit sharing plans. Give

particulars.

X

13. Stock and interests in incorporated and

unincorporated businesses. Itemize.

X

14. Interests in partnerships or joint ventures.

Itemize.

X

15. Government and corporate bonds and

other negotiable and non-negotiable

instruments.

X

16. Accounts Receivable. X

17. Alimony, maintenance, support, and

property settlements to which the debtor

is or may be entitled. Give particulars.

X

18. Other liquidated debts owed to debtor

including tax refunds. Give particulars.

X

19. Equitable or future interests, life estates,

and rights or powers exercisable for the

benefit of the debtor other than those

listed in Schedule of Real Property.

X

20. Contingent and non-contingent interests

in estate of a decedent, death benefit

plan, life insurance policy, or trust.

X

21. 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.

X

22. Patents, copyrights, and other intellectual

property. Give particulars.

X

23. Licenses, franchises, and other general

intangibles. Give particulars.

X

24. Customer lists or other compilations

containing personally identifiable

information (as described 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.

X

25. Automobiles, trucks, trailers and other

vehicles and accessories.

2002 Chevy Monte Carlo

Location: In debtor's possession

$ 5,000.00

Page 2 of 3

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B6B (Official Form 6B) (12/07)

In re Jose A . Martinez and Allison M. Martinez

Debtor(s)

SCHEDULE B-PERSONAL PROPERTY

Case No.

(if known)

,

(Continuation Sheet)

Description and Location of Property

Husband--H

Wife--W

Joint--J

Community--C

Type of Property

Current

Value

of Debtor's Interest,

in Property Without

Deducting any

Exemption

Secured Claim or

N

o

n

e

2006 Nissan Pathfinder

Location: In debtor's possession

$ 18,000.00

26. Boats, motors, and accessories. X

27. Aircraft and accessories. X

28. Office equipment, furnishings, and

supplies.

X

29. Machinery, fixtures, equipment and

supplies used in business.

X

30. Inventory. X

31. Animals. X

32. Crops - growing or harvested.

Give particulars.

X

33. Farming equipment and implements. X

34. Farm supplies, chemicals, and feed. X

35. Other personal property of any kind not

already listed. Itemize.

X

Page 3 of 3

(Report total also on Summary of Schedules.)

Total $ 28,401.00

Include amounts from any continuation sheets attached.

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 9 of 57
B6C (Official Form 6C) (12/07)

In re Jose A . Martinez and Allison M. Martinez

Debtor(s)

SCHEDULE C-PROPERTY CLAIMED AS EXEMPT

Case No.

(if known)

,

Debtor claims the exemptions to which debtor is entitled under:

(Check one box)

11 U.S.C. § 522(b) (2)

11 U.S.C. § 522(b) (3)

Check if debtor claims a homestead exemption that exceeds $136,875.

Description of Property Providing each

Current

Value of Property

Exemption

Specify Law

Without Deducting

Exemptions

Value of

Claimed

Exemption

128 Concord Ln, Carol Stream,

IL

735 ILCS 5/12-901 $ 30,000.00 $ 188,000.00

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

Checking: Bank of America 735 ILCS 5/12-1001(b) $ 1,500.00 $ 1,500.00

Savings: Bank of America 735 ILCS 5/12-1001(b) $ 500.00 $ 500.00

Misc used household goods,

furniture & furnishings

735 ILCS 5/12-1001(b) $ 2,000.00 $ 2,000.00

Misc used personal items,

books and pictures

735 ILCS 5/12-1001(a) $ 500.00 $ 500.00

Misc used personal clothing 735 ILCS 5/12-1001(a) $ 800.00 $ 800.00

Life Insurance (Term Policy) 735 ILCS 5/12-1001(f) $ 1.00 $ 1.00

2002 Chevy Monte Carlo 735 ILCS 5/12-1001(c) $ 0.00 $ 5,000.00

2006 Nissan Pathfinder 735 ILCS 5/12-1001(c) $ 0.00 $ 18,000.00

Page No. 1 of 1

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 10 of 57
Case No.

(if known)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

In reJose A . Martinez and Allison M. Martinez ,

B6D (Official Form 6D) (12/07)

Debtor(s)

State the name, mailing address, including zip code, and last four digits of any account number of all entities holding

claims secured by property of the debtor as of the date of filing of the petition. The complete account number of any account the

debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. List

creditors holding all types of secured interests such as judgment liens, garnishments, statutory liens, mortgages, deeds of trust,

and other security interests.

List creditors in alphabetical order to the extent practicable. If a minor child is the creditor, state the child's initials and the

name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the

child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). If all secured creditors will not fit on this page, use the

continuation sheet provided.

If any entity other than a spouse in a joint case may be jointly liable on a claim, place an “X” in the column labeled

“Codebtor,” include the entity on the appropriate schedule of creditors, and complete Schedule H – Codebtors. If a joint petition is

filed, state whether the husband, wife, both of them, or the marital community may be liable on each claim by placing an “H,” “W,”

“J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.”

If the claim is contingent, place an “X” in the column labeled “Contingent.” If the claim is unliquidated, place an “X” in the

column labeled “Unliquidated.” If the claim is disputed, place an “X” in the column labeled “Disputed.” (You may need to place an

“X” in more than one of these three columns.)

Total the columns labeled “Amount of Claim Without Deducting Value of Collateral” and “Unsecured Portion, if Any” in

the boxes labeled “Total(s)” on the last sheet of the completed schedule. Report the total from the column labeled “Amount of

Claim Without Deducting Value of Collateral” also on the Summary of Schedules and, if the debtor is an individual with primarily

consumer debts, report the total from the column labeled “Unsecured Portion, if Any” on the Statistical Summary of Certain

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

Creditor's Name and

Mailing Address

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred, Nature

of Lien, and Description and Market

Value of Property Subject to Lien

Amount of Claim

Without

Deducting Value

of Collateral

Unsecured

Portion, If Any

Including ZIP Code and

Account Number

(See Instructions Above.)

Co-DebtorContingentUnliquidatedDisputed

2006 Nissan Pathfinder

Account No:

Creditor # :

Value:

1

2008

Purchase Money Security

$ 18,000.00

1832 $ 21,000.00 $ 3,000.00

HSBC Auto Finance

Attn: Bankruptcy Dept

PO Box 17548

Baltimore MD 21297-1548

128 Concord Lane Carol Stream

IL (Residence-Jr. Mortgage)

Acct:4489619840170954

Account No:

Creditor # :

Value:

2

2008

Junior Mortgage

$ 188,000.00

0954 W $ 57,400.00 $ 16,400.00

PNC Bank (National City)

Attn: Bankruptcy Dept

PO Box 5570

Cleveland OH 44101-0570

128 Concord Ln, Carol Stream,

IL (ResidenceAcct:0012051280) Sr. Mortgage

Account No:

Creditor # :

Value:

3

2008

Mortgage

$ 188,000.00

3249 W $ 147,000.00 $ 0.00

Select Portfolio Servicing Inc

Attn: Bankruptcy Dept

PO BOX 65250

Salt Lake City UT 84165

1 continuation sheets attached

(Use only on last page)

Total $

(Total of this page)

Subtotal $ $ 225,400.00 $ 19,400.00

(Report also on Summary of

Schedules.)

(If applicable, report also on

Statistical Summary of

Certain Liabilities and

Related Data)

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 11 of 57
Case No.

(if known)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

In reJose A . Martinez and Allison M. Martinez ,

B6D (Official Form 6D) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name and

Mailing Address

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred, Nature

of Lien, and Description and Market

Value of Property Subject to Lien

Amount of Claim

Without

Deducting Value

of Collateral

Unsecured

Portion, If Any

Including ZIP Code and

Account Number

(See Instructions Above.)

Co-DebtorContingentUnliquidatedDisputed

2002 Chevy Monte Carlo

Account No:

Creditor # :

Value:

4

2008

Purchase Money Security

$ 5,000.00

3417 $ 8,000.00 $ 3,000.00

State Farm Bank

Attn: Auto Loan Dept

PO Box 3299

Milwaukee WI 53201-3299

Account No:

Value:

Account No:

Value:

Account No:

Value:

Account No:

Value:

Account No:

Value:

1

Holding Secured Claims

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

(Use only on last page)

Total $

(Total of this page)

Subtotal $ $ 8,000.00

$ 233,400.00

$ 3,000.00

$ 22,400.00

(Report also on Summary of

Schedules.)

(If applicable, report also on

Statistical Summary of

Certain Liabilities and

Related Data)

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

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

Case No.

(if known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

In re Jose A . Martinez and Allison M. Martinez ,

Debtor(s)

 A complete list of claims entitled to priority, listed separately by type of priority, is to be set forth on the sheets provided. Only holders of

unsecured claims entitled to priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name, mailing address,

including zip code, and last four digits of the account number, if any, of all entities holding priority claims against the debtor or the property of the

debtor, as of the date of the filing of the petition. Use a separate continuation sheet for each type of priority and label each with the type of priority.

 The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the

debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as

"A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

 If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on

the appropriate schedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband, wife, both of them

or the marital community may be liable on each claim by placing an "H", "W", "J", or "C" in the column labeled "Husband, Wife, Joint, or Community." If

the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If

the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.)

 Report the total of claims listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all claims listed on this Schedule E

in the box labeled "Total" on the last sheet of the completed schedule. Report this total also on the Summary of Schedules.

 Report the total of amounts entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts

entitled to priority listed on this Schedule E in the box labeled “Totals” on the last sheet of the completed schedule. Individual debtors with primarily

consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.

 Report the total of amounts NOT entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all

amounts not entitled to priority listed on this Schedule E in the box labeled "Total" on the last sheet of the completed schedule. Individual debtors with

primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.

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)

Domestic Support Obligations

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).

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, 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).

Wages, salaries, and commissions

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).

Deposits by individuals

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).

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).

Commitments to Maintain the Capital of an Insured Depository Institution

Claims based on commitments to 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).

Claims for Death or Personal Injury While Debtor Was Intoxicated

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).

*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.

1No continuation sheets attached

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 13 of 57
In re Jose A . Martinez and Allison M. Martinez , Case No.

(if known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

Official Form 6E (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Type of Priority for Claims Listed on This Sheet: Domestic Support Obligations

Creditor's Name, Mailing Address

Including ZIP Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred and

Consideration for Claim

Amount of

Claim

Amount

Entitled to

Priority

and Account Number

Amount not

Entitled to

Priority,

if any

Co-DebtorContingentUnliquidatedDisputed

(See instructions above.)

Account No:

Creditor # : 1

Illinois Dept of Child

Support

Attn: Bankruptcy Dept

509 S. Sixth St Floor 6

Springfield IL 62701

2000-09

Notice to State Agency

H $ 0.00 $ 0.00

Notice to state agency

$ 0.00

Account No:

Creditor # : 2

Lynn Roscoe

211 Blue Bonnett Dr

Brighton CO 80608

200

Notice to Support Recipient

H $ 0.00 $ 0.00

Notice to support recipient

$ 0.00

Account No:

Creditor # : 3

Wanda Alvarado

2415 N. Kostner

Chicago IL 60639

2000

Notice to Support Recipient

H $ 0.00 $ 0.00

Notice to support recipient

$ 0.00

Account No:

Account No:

Account No:

Sheet No. of continuation sheets

attached to Schedule of Creditors Holding Priority Claims

(Use only on last page of the completed Schedule E. If applicable,

report also on the Statistical Summary of Certain Liabilities and

Total $

0.00 0.00

0.00

1 1

(Use only on last page of the completed Schedule E. Report total also

on Summary of Schedules)

Subtotal $

(Total of this page)

Total $

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 14 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

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

Debtor(s)

 State the name, mailing address, including zip code, and last four digits of any account number, of all entities holding unsecured claims without

priority against the debtor or the property of the debtor, as of the date of filing of the petition. The complete account number of any account the

debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a

creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian."

Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Do not include claims listed in Schedules D and E. If all

creditors will not fit on this page, use the continuation sheet provided.

 If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity

on the appropriate schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of

them, or the marital community may be liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or

Community."

 If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled

"Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three

columns.)

 Report total of all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedules. Report this total also on

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

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 1

Academy Collection Service Inc

RE: Premier Bankcard

10965 Decatur Road

Philadelphia PA 19154-3210

2003-2009

Notie to c

0423 $ 0.00

Account No:

Creditor # : 2

ACC International Collection

RE: Stratford Orthopaedic

919 Estes Ct

Schaumburg IL 60193-4427

2003-2009

Collection on Medical Bills

4957 $ 144.00

Account No:

Creditor # : 3

Accounts Receivable Management

RE: Premier Bankcard

PO Box 129

Thorofare NJ 08086-0129

2003-2009

Notice to Collector

2928 $ 0.00

Account No:

Creditor # : 4

Advocate Medical Group

Attn: Patient Accounts

701 Lee Street

Des Plaines IL 60016

2003-2009

Medical Bills

9560 $ 105.00

14 continuation sheets attached

(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

Total $

Subtotal $ $ 249.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 15 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 5

Aegis Receivables Management

RE: American Express

PO BOX 165809

Irving TX 75016

2003-2009

Notice to Collector

1000 $ 0.00

Account No:

Creditor # : 6

Alliance One Receivables Mgt

RE: Resurgent Capital

1160 Centre Pointe Dr, #1

Mendota Heights MN 55120

2003-2009

Notice to Collector

M121 $ 0.00

Account No:

Creditor # : 7

American Coradius Inc

RE: Chase

2420 Sweet Home Rd, #150

Amherst NY 14228-2244

2003-2009

Notice to Collector

3624 $ 0.00

Account No:

Creditor # : 8

American Express

Attn: Bankruptcy Dept

PO BOX 6618

Omaha NE 68105-0618

2003-2009

Credit Card Purchases

1000 $ 24,437.00

Account No:

Creditor # : 9

Asset Acceptance LLC

RE: Circuit City Chase

PO BOX 2036

Warren MI 48090-2036

2003-2009

Notice to Collector

3280 $ 0.00

Account No:

Creditor # : 10

Bally Total Fitness

Attn: Bankruptcy Dept

12440 Imperial Highway, #300

Norwalk CA 90650-8309

2003-2009

Notice 

7632 $ 0.00

1

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 24,437.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 16 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Case No 03 M1 169445

Account No:

Creditor # : 11

Bonlar Loan Co

Attn: Bankruptcy Dept

2247 W. Lawrence

Chicago IL 60625

2003

Judgement

$ 1,761.00

Account No:

Creditor # : 12

Capital One

Attn: Bankruptcy Dept

P.O. BOX 5155

Norcross GA 30091

2003-2009

Notice 

4754 $ 0.00

Account No:

Creditor # : 13

CCSI

RE: Citifinancial

PO BOX 34119

Memphis TN 38184

2003-2009

Notice to Other Location

2295 $ 0.00

Account No:

Creditor # : 14

Central Credit Services Inc.

RE: Chase/Circuit City

PO BOX 15118

Jacksonville FL 32239

2003-2009

Notice to Collector

3624 $ 0.00

Account No:

Creditor # : 15

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield IL 60190-1295

2003-2009

Medical Bills

1001 $ 137.00

Account No:

Creditor # : 16

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield IL 60190-1295

2003-2009

Medical Bills

9001 $ 120.00

2

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 2,018.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 17 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 17

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield IL 60190-1295

2003-2009

Medical Bills

2001 $ 100.00

Account No:

Creditor # : 18

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield IL 60190-1295

2003-2009

Medical Bills

6001 $ 53.00

Account No:

Creditor # : 19

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield IL 60190-1295

2003-2009

Medical Bills

7813 $ 210.00

Account No:

Creditor # : 20

Central DuPage Physician Group

Attn: Patient Accts

PO BOX 479

Winfield IL 60190

2003-2009

Medical Bills

8336 $ 406.00

Account No:

Creditor # : 21

Central DuPage Physician Group

Attn: Patient Accts

PO BOX 479

Winfield IL 60190

2003-2009

Medical Bills

1123 $ 126.00

Account No:

Creditor # : 22

Chase

Attn: Bankruptcy Dept

PO BOX 15298

Wilmington DE 19850-5298

2003-2009

Notice 

1029 $ 0.00

3

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 895.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 18 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 23

Chase

Attn: Bankruptcy Dept

PO BOX 15298

Wilmington DE 19850-5298

2003-2009

Notice 

6061 $ 0.00

Account No:

Creditor # : 24

Chase/Circuit City

Attn: Bankruptcy Dept

800 Brooksedge Blvd

Westerville OH 43081-2822

2003-2009

Notice 

3624 $ 0.00

Account No:

Creditor # : 25

CitiFinancial

Bankruptcy Dept

PO BOX 499

Hanover MD 21076-0499

2003-2009

Notice 

2295 $ 0.00

Account No:

Creditor # : 26

CitiFinancial Retail Services

Attn: Bankruptcy Dept

PO BOX 22066

Tempe AZ 85285-2066

2003-2009

Notice to Other Location

2435 $ 0.00

Account No:

Creditor # : 27

DRS Bonded Collections

RE: Citifinancial

PO BOX 498609

Cincinnati OH 45249-8609

2003-2009

Collection

2295 $ 2,783.00

Account No:

Creditor # : 28

Enhanced Recovery Corp

RE: GE Money

8014 Bayberry Rd

Jacksonville FL 32256

2003-2009

Notice to Collector

7037 $ 0.00

4

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 2,783.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 19 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 29

FaCS Group

Attn: Bankruptcy Dept

9111 Duke Blvd

Mason OH 45040

2003-2009

Notice 

4010 $ 0.00

Account No:

Creditor # : 30

First Premier Bank

Attn: Bankruptcy Dept

PO Box 5524

Sioux Falls SD 57117-5512

2003-2009

Credit Card Purchases

0423 $ 403.00

Account No:

Creditor # : 31

First Source Advantage LLC

RE: American Express

205 Bryant Woods South

Amherst NY 14228

2003-2009

Notice to Collector

8875 $ 0.00

Account No:

Creditor # : 32

FirstStar Bank

Attn: Bankruptcy Dept

425 Walnut St

Cincinnati OH 45202-3923

2003-2009

Notice 

6559 $ 0.00

Account No:

Creditor # : 33

Frederick J. Hanna & Assoc.

RE: Chase Bank

1427 Roswell Rd

Marietta GA 30062

2003-2009

Notice to Collector

3624 $ 0.00

Account No:

Creditor # : 34

GE Money Bank (Old Navy)

Attn: Bankruptcy Dept

PO BOX 103104

Roswell GA 30076

2003-2009

Credit Card Purchases

1272 $ 422.00

5

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 825.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 20 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 35

GE Money Bank/Jewelry Exchange

Attn: Bankruptcy Dept

PO BOX 103104

Roswell GA 30076

2003-2009

Credit Card Purchases

2007 $ 5,108.00

Account No:

Creditor # : 36

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove IL 60515

2003-2009

Medical Bills

4910 $ 84.00

Account No:

Creditor # : 37

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove IL 60515

2003-2009

Medical Bills

1585 $ 175.00

Account No:

Creditor # : 38

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove IL 60515

2003-2009

Medical Bills

9872 $ 79.00

Account No:

Creditor # : 39

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove IL 60515

2003-2009

Medical Bills

5116 $ 1,403.00

Account No:

Creditor # : 40

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove IL 60515

2003-2009

Medical Bills

9565 $ 269.00

6

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 7,118.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 21 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 41

Hilco Receivables LLC

RE: GE Money

5 Revere Dr #206

Northbrook IL 60062

2003-2009

Notice to Collector

364 $ 0.00

Account No:

Creditor # : 42

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Collection on Medical Bills

0429 $ 137.00

Account No:

Creditor # : 43

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Collection on Medical Bills

0084 $ 265.00

Account No:

Creditor # : 44

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Collection on Medical Bills

3896 $ 262.00

Account No:

Creditor # : 45

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Collection on Medical Bills

6939 $ 210.00

Account No:

Creditor # : 46

HR Accounts Inc.

RE: Central Dupage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Notice 

9325 $ 0.00

7

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 874.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 22 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 47

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Notice to Collector

9923 $ 0.00

Account No:

Creditor # : 48

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline IL 61266-0672

2003-2009

Collection on Medical Bills

9026 $ 120.00

Account No:

Creditor # : 49

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Notice to Collector

1941 $ 0.00

Account No:

Creditor # : 50

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Collection on Medical Bills

6629 $ 242.00

Account No:

Creditor # : 51

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Collection on Medical Bills

1613 $ 98.00

Account No:

Creditor # : 52

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Collection on Medical Bills

1020 $ 12.00

8

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 472.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 23 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 53

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Notice to Collector

2135 $ 0.00

Account No:

Creditor # : 54

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Notice to Collector

9688 $ 0.00

Account No:

Creditor # : 55

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park IL 60477-9110

2003-2009

Notice to Collector

0936 $ 0.00

Account No:

Creditor # : 56

Illinois Dept Employ Security

Attn: Bankruptcy Dept

PO BOX 6996 Banking Unit

Chicago IL 60680-1292

2000

Notice to State Agency

H $ 0.00

Account No:

Creditor # : 57

Illinois Dept Employ Security

Attn Benefit Payment-Bankrupt

PO Box 19286

Springfield IL 62794-9286

J $ 0.00

Account No:

Creditor # : 58

Illinois Dept Employ Security

Attn Bankruptcy Unit 3rd Floor

401 S. State St

Chicago IL 60605

2003-09

Notice to State Agency

H $ 0.00

9

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 0.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 24 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 59

Just Energy

Attn: Bankruptcy Dept

35190 Eagle Way

Chicago IL 60678-1351

2003-2009

Collection on Utility Bills

3546 $ 959.00

Account No:

Creditor # : 60

KCA Financial

RE: Columbia House

PO Box 53

Geneva IL 60134

2003-2009

Collection

9972 $ 136.00

DuPage Case No 2009 SC 005390

Account No:

Creditor # : 61

Law Office Heller & Frisone

Acct: Wells Fargo

33 N. LaSalle St #300

Chicago IL 60603-1203

2009

Collection

$ 2,000.00

Cook County Suit 08 M1 301260

Auto Accident-Injury Claim

Account No:

Creditor # : 62

Law Office Steven Mevorah

Acct: Kathleen Ford

900 E. Roosevelt Rd

Lombard IL 60148

2008

Notice to Attorney

H $ 0.00

Account No:

Creditor # : 63

LVNV Funding LLC

Attn: CitiBank

PO BOX 10584

Greenville SC 29603-0584

2003-2009

Notice to Collector

4112 $ 0.00

Account No:

Creditor # : 64

Macy's/Marshall Fields

Attn: Bankruptcy Dept

PO BOX 9475

Minneapolis MN 55440

2003-2009

Notice 

2487 $ 0.00

10

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 3,095.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 25 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 65

Medical Business Bureau

RE: Cental DuPage Emerg Phys

1460 Renaissance Dr, #400

Park Ridge IL 60068

2003-2009

Collection on Medical Bills

4163 $ 60.00

Account No:

Creditor # : 66

Medical Business Bureau

RE: Central Dupage Emerg Phys

1460 Renaissance Dr, #400

Park Ridge IL 60068

2003-2009

Collection on Medical Bills

3659 $ 451.00

Account No:

Creditor # : 67

MiraMed Revenue Group, LLC

RE: Central DuPage Hospital

PO BOX 77000, Dept 77304

Detroit MI 48277-0304

2003-2009

Notice to Collector

2249 $ 0.00

Account No:

Creditor # : 68

NCI Collection

RE: R. McLaughlin MD

3601 Algonquin Rd #232

Rollling Meadows IL 60008-3106

2003-2009

Collection on Medical Bills

$ 484.00

Account No:

Creditor # : 69

NCO Fin/99

RE: Commonwealth Edison

PO BOX 41466

Philadelphia PA 19101

2003-2009

Notice 

2716 $ 0.00

Account No:

Creditor # : 70

NCO Financial Systems Inc.

RE: American Express

507 Prudential Road

Horsham PA 19044

2003-2009

Notice to Collector

1037 $ 0.00

11

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 995.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 26 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 71

Nelnet Loan Services

Attn: Bankruptcy Dept

3015 S. Parker Rd, #425

Aurora CO 80014-2904

2003-2009

Notice 

7699 $ 0.00

Account No:

Creditor # : 72

NICOR Gas

Attn: Bankruptcy Dept

1844 W. Ferry Road

Naperville IL 60563-9662

2003-2009

Utility Bills

8615 $ 190.00

Account No:

Creditor # : 73

Northstar Location Services

RE: Chase

4285 Genessee St

Cheektowaga NY 14225-1943

2003-2009

Notice to Collector

3624 $ 0.00

Account No:

Creditor # : 74

Northwest Collectors

RE: R McLaughlin MD

3601 Algonquin Rd #500

Rolling Meadows IL 60008

2003-2009

Collection on Medical Bills

4095 $ 484.00

Account No:

Creditor # : 75

OakBrook Pediatrics Ctr

Attn: Patient Accts

3825 Highland Ave, #2-C

Downers Grove IL 60515

2003-2009

Medical Bills

L000 $ 1,510.00

Account No:

Creditor # : 76

Pellettieri & Associates, Inc.

RE: Central DuPage Hosp

991 Oak Creek Dr

Lombard IL 60148-6408

2003-2009

Collection on Medical Bills

1775 $ 95.00

12

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 2,279.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 27 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Account No:

Creditor # : 77

Portfolio Recovery Associates

RE: Wickes Furniture

PO Box 12914

Norfolk VA 23541

2003-2009

Collection

2295 $ 2,857.00

Account No:

Creditor # : 78

Portfolio Recovery Associates

RE: Citifinancial

120 Corporate Blvd, #100

Norfolk VA 23502

2003-2009

Notice to Collector

5015 $ 0.00

Account No:

Creditor # : 79

Professional Bureau Collection

RE: GE Money/Old Navy

PO BOX 628

Elk Grove CA 95759-0628

2003-2009

Notice to Collector

3642 $ 0.00

Account No:

Creditor # : 80

RAB, Inc.

RE: Citifinancial

7000 Goodlett Farms Parkway

Memphis TN 38016

2003-2009

Notice to Collector

2295 $ 0.00

Account No:

Creditor # : 81

Radiologist of DuPage

Attn: Patient Accts

520 E. 22nd St

Lombard IL 60148

2003-2009

Medical Bills

2488 $ 12.00

Account No:

Creditor # : 82

Retailer National Bank

Attn: Bankruptcy Dept

PO BOX 702

Minneapolis MN 55440-0702

2003-2009

Notice 

2487 $ 0.00

13

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 2,869.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 28 of 57
Case No.

(if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS 

In re Jose A . Martinez and Allison M. Martinez ,

B6F (Official Form 6F) (12/07) - Cont.

Debtor(s)

(Continuation Sheet)

Creditor's Name, Mailing Address

including Zip Code,

H--Husband

W--Wife

J--Joint

C--Community

Date Claim was Incurred,

and Consideration for Claim.

If Claim is Subject to Setoff, so State.

Amount of Claim

And Account Number

(See instructions above.)

Co-Debtor

ContingentUnliquidatedDisputed

Case No 2009 SC 005390 Heller &

Frisone attorneys for Wells Fargo

Account No:

Creditor # : 83

Wells Fargo Financial

Attn: Bankruptcy Dept

800 Walnut St

Des Moines IA 50309-3506

2003-2009

Lawsuit

$ 0.00

Account No:

Creditor # : 84

Weltman, Weinberg & Reis Co.

RE: LVNV Funding LLC/Citibank

323 W. Lakeside Ave, Suite 200

Cleveland OH 44113-1099

2003-2009

Collection

0752 $ 19,070.00

Account No:

Creditor # : 85

WFNNB/Express

Attn: Bankrupcty Dept

PO BOX 182125

Columbus OH 43218-2125

2003-2009

Notice 

0774 $ 0.00

Account No:

Creditor # : 86

WFNNB/Victoria's Sercret

Attn: Bankrupcty Dept

PO BOX 182128

Columbus OH 43218

2003-2009

Notice 

7621 $ 0.00

Account No:

Creditor # : 87

Zwicker & Associates, P.C.

RE: GE Money Bank

80 Minuteman Rd

Andover MA 01810-1031

2003-2009

Notice to Collector

7037 $ 0.00

Account No:

$ 67,979.00

14

Creditors Holding Unsecured Nonpriority Claims

Sheet No. of 14 continuation sheets attached to Schedule of 

(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

Total $

Subtotal $ $ 19,070.00

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 29 of 57
B6G (Official Form 6G) (12/07)

In re Jose A . Martinez and Allison M. Martinez / Debtor

SCHEDULE G-EXECUTORY CONTRACTS AND UNEXPIRED LEASES

Case No.

(if known)

Describe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests. State the nature of

name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 

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

debtor's interests in contract, i.e., "Purchaser," "Agent," etc. State whether debtor is the lessor or lessee of a lease. Provide the names and complete mailing

addresses of all other parties to each lease or contract described. If a minor child is a party to one of the leases or contracts, state the child's initials and the

11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

Including Zip Code, of

Description of Contract or Lease and

Nature of Debtor's Interest.

Other Parties to Lease

Name and Mailing Address,

State whether Lease is for Nonresidential Real Property.

or Contract. State Contract Number of any Government Contract.

Page 1 of 1

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 30 of 57
B6H (Official Form 6H) (12/07)

In re Jose A . Martinez and Allison M. Martinez / Debtor

SCHEDULE H-CODEBTORS

Case No.

(if known)

Check this box if the debtor has no codebtors.

Provide the information requested concerning any person or entity, other than a spouse in a joint case, that is also liable on any debts listed by the

debtor in the schedules of creditors. Include all guarantors and co-signers. 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 the eight year period immediately preeceding the commencement of the case, identify the name of the debtors spouse and of

any former spouse who resides or resided with the debtor in the community property state, commonwealth, or territory. Include all names used by

the nondebtor spouse during the eight years immediately preceding the commencement of this case. If a minor child is a codebtor or a creditor,

state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not

disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

Name and Address of Codebtor Name and Address of Creditor

Page 1 of 1

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 31 of 57
B6I (Official Form 6I) (12/07)

In re Jose A . Martinez and Allison M. Martinez , Case No.

Debtor(s) (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

RELATIONSHIP(S): AGE(S):

Married son 1yr

EMPLOYMENT: DEBTOR SPOUSE

Occupation

Name of Employer

How Long Employed

Address of Employer

2 years

VKE Renzel USA

Warehouseman Production Planner

Plexus Corp

2 years

2420 E. Okaton

Arlington Height IL 60005

2400 Millbrook Lane

Buffalo Grove IL

INCOME: (Estimate of average or projected monthly income at time case filed) DEBTOR SPOUSE

3,520.00

1. Monthly gross wages, salary, and commissions (Prorate if not paid monthly) $

2. Estimate monthly overtime

3. SUBTOTAL

$

$ $

$

$

4. LESS PAYROLL DEDUCTIONS

a. Payroll taxes and social security

b. Insurance

c. Union dues

$

$

$

$

$

$

3,520.00

0.00

5,470.83

0.00

5,470.83

550.00

0.00

0.00

1,516.67

888.33

0.00

d. Other (Specify): Child Support $ 640.00 $ 0.00

5. SUBTOTAL OF PAYROLL DEDUCTIONS

6. TOTAL NET MONTHLY TAKE HOME PAY

$

$

$

$

1,190.00

2,330.00 3,065.83

2,405.00

7. Regular income from operation of business or profession or farm (attach detailed statement) 

8. Income from real property

9. Interest and dividends

10. Alimony, maintenance or support payments payable to the debtor for the debtor's use or that

of dependents listed above.

11. Social security or government assistance

$

$

$

$

$

$

$ $

(Specify): $ $

12. Pension or retirement income

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

$ 0.00 $ 0.00

(Specify): $ 0.00 $ 0.00

13. Other monthly income

16. COMBINED AVERAGE MONTHLY INCOME:

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

Statistical Summary of Certain Liabilities and Related Data)

15. AVERAGE MONTHLY INCOME 

5,395.83

(Add amounts shown on lines 6 and 14) $ 2,330.00 $ 3,065.83

14. SUBTOTAL OF LINES 7 THROUGH 13 $ 0.00 $ 0.00

(Combine column totals

from line 15; if there is only one debtor repeat total reported on line 15)

$

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

Page No. 1 of 1

Case 09-49492 Doc 1 Filed 12/31/09 Entered 12/31/09 09:45:00 Desc Main

 Document Page 32 of 57
B6J(Official Form 6J)(12/07)

Case No.

(if known)

SCHEDULE J-CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR

In re Jose A . Martinez and Allison M. Martinez ,

Debtor(s)

 Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor's family. Prorate any payments

made bi-weekly, 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 Form 22 A or 22C.

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

"Spouse."

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

a. Are real estate taxes included?

b. Is property insurance included?

$

$

2. Utilities: a. Electricity and heating fuel

b. Water and sewer

c. Telephone

d. Other

$

$

$

1,165.00

200.00

45.00

0.00

444.00

$ 155.00

Junior Mortgage

Association Assessment

$ 180.00

Yes

Yes

No

No

Line 2 Continuation Page Total (see continuation page for itemization)

 Other

..................................................................................................................................................

..............................................................................................................................................................

...................................................................................................................................................................

.....................................................................................................................

3. Home maintenance (repairs and upkeep)

4. Food

5. Clothing

7. Medical and dental expenses

6. Laundry and dry cleaning

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

8. Transportation (not including car payments)

10. Charitable contributions

a. Homeowner's or renter's

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

b. Life

c. Health

d. Auto

e. Other

 Other

Child Care

$ 100.00

$ 800.00

$

$ 20.00

100.00

$ 50.00

$

$ 100.00

200.00

$ 40.00

$ 0.00

$ 0.00

207.00

$ 0.00

$

$ 1,260.00

$ 0.00

..............................................................................................................................................

.................................................................................................................................................................................

........................................................................................................................................................

..................................................................................................................

....................................................................................................................................................

......................................................................................................................................................................

........................................................................................................................................................................

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

(Specify) $

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

a. Auto $

$

$

0.00

208.00

692.00

80.00

b. Other: Auto Payment

c. Other: Auto repair, upkeep & license

........................................................................................................................................................................

........................................................................................................................................................................

$ 0.00

$ 0.00

$ 0.00

14. Alimony, maintenance, and support paid to others 

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

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

17. Other: Personal care items & grooming

Other: Newspapers, subscription misc

$

$

40.00

30.00

0.00

..................................................................................................................................

....................................................................................

...............................................................................................................................................................................

18. AVERAGE MONTHLY EXPENSES Total lines 1-17. Report also on Summary of Schedules $ 6,116.00

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

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

a. Average monthly income from Line 16 of Schedule I

b. Average monthly expenses from Line 18 above

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

20. STATEMENT OF MONTHLY NET INCOME

$ 5,395.83

$

$

6,116.00

(720.17)

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In re

B6J(Official Form 6J)(12/07)-Continuation Page

SCHEDULE J-CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR

Jose A . Martinez and Allison M. Martinez , Case No.

Debtor(s)

(Continuation page)

2. (continuation) OTHER UTILITIES

Cell Phones ......................................................................................................................................................................................

$ 100.00

Internet-Cable ......................................................................................................................................................................................

$ 80.00

 Line 2 Continuation Page Total (seen as line item "2" on Schedule J) $ 180.00

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

Case No.

UNITED STATES BANKRUPTCY COURT

In re

/ Debtor

Jose A . Martinez and Allison M. Martinez

NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

Chapter 7

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 must also complete the "Statistical Summary of Certain Liabilities and Related Data"if they

file a case under chapter 7, 11, or 13.

SUMMARY OF SCHEDULES

NAME OF SCHEDULE

Attached

(Yes/No)

No. of

Sheets ASSETS LIABILITIES OTHER

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

1

3

1

2

2

15

1

1

1

2

A-Real Property

B-Personal Property

C-Property Claimed as

Exempt

D-Creditors Holding Secured

Claims

E-Creditors Holding

Unsecured Priority Claims

F-Creditors Holding

Unsecured Nonpriority Claims

G-Executory Contracts and

Unexpired Leases

H-Codebtors

I-Current Income of Individual

Debtor(s)

J-Current Expenditures of

Individual Debtor(s)

$ 188,000.00

$ 28,401.00

$ 233,400.00

$ 0.00

$ 67,979.00

$ 5,395.83

$ 6,116.00

(Total of Claims on Schedule E)

TOTAL 29 $ 216,401.00 $ 301,379.00

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

NORTHERN DISTRICT OF ILLINOIS

UNITED STATES BANKRUPTCY COURT

In re

/ Debtor

Jose A . Martinez and Allison M. Martinez

Chapter 7

Case No.

EASTERN DIVISION

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

Type of Liability

Domestic Support Obligations (from Schedule E)

Taxes and Certain Other Debts Owed to Governmental Units (from Schedule E)

Claims for Death or Personal Injury While Debtor Was Intoxicated (from Schedule E) (whether

disputed or undisputed)

Student Loan Obligations (from Schedule F)

Domestic Support, Separation Agreement, and Divorce Decree Obligations Not Reported on

Schedule E

Obligations to Pension or Profit-Sharing, and Other Similar Obligations (from Schedule F)

TOTAL

Amount

$

$

$

$

$

$

0.00

0.00

0.00

0.00

0.00

0.00

0.00

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

$

chapter 7, 11, or 13, you must report all information requested below.

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

State the following:

Average Income (from Schedule I, Line 16)

Average Expenses (from Schedule J, Line 18)

Current Monthly Income (from Form 22A Line 12; OR, Form 22B Line 11; OR, Form 22C Line 20)

$

$

$

5,395.83

6,116.00

8,997.00

1. Total from Schedule D, "UNSECURED PORTION, IF ANY" column $ 22,400.00

State the following:

2. Total from Schedule E, "AMOUNT ENTITLED TO PRIORITY" column $ 0.00

3. Total from Schedule E, "AMOUNT NOT ENTITLED TO PRIORITY, IF ANY" column $ 0.00

4. Total from Schedule F $ 67,979.00

5. Total of non-priority unsecured debt (sum of 1, 3, and 4) $ 90,379.00

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.

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

In re

DECLARATION CONCERNING DEBTOR'S SCHEDULES

Debtor

Case No.

(if known)

DECLARATION UNDER PENALTY OF PERJURY BY AN INDIVIDUAL DEBTOR

Jose A . Martinez and Allison M. Martinez

I declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of 30 sheets, and that they are true and

correct to the best of my knowledge, information and belief.

Date: Signature

Jose A . Martinez

Signature

Allison M. Martinez

Date:

/s/ Jose A . Martinez

/s/ Allison M. Martinez

[If joint case, both spouses must sign.]

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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Form 7 (12/07)

Jose A . Martinez

and

Allison M. Martinez

dba Allison M. Kovats

Case No.

EASTERN DIVISION

NORTHERN DISTRICT OF ILLINOIS

UNITED STATES BANKRUPTCY COURT

In re:

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor. Spouses filing a joint petition may file a single statement on which the information for

both spouses is combined. If the case is filed under chapter 12 or chapter 13, a married debtor must furnish information for both spouses whether

or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed. An individual debtor engaged in business as a sole

proprietor, partner, family farmer, or self-employed professional, should provide the information requested on this statement concerning all such

activities as well as the individual's personal affairs. To indicate payments, transfers and the like to minor children, state the child's initials and the

name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not diclose the child's name. See, 11

U.S.C. § 112 and Fed. R. Bankr. P. 1007(m).

Questions 1-18 are to be completed by all debtors. Debtors that are or have been in business, as defined below, also must complete

Questions 19-25. If the answer to an applicable question is "None," mark the box labeled "None." If additional space is needed for the answer to

any question, use and attach a separate sheet properly identified with the case name, case number (if known), and the number of the question.

DEFINITIONS

"In business." A debtor is "in business" for the purpose of this form if the debtor is a corporation or partnership. An individual debtor is "in

business" for the purpose of this form if the debtor is or has been, within the six years immediately preceding the filing of this bankruptcy case,

any of the following: an officer, director, managing executive, or owner of 5 percent or more of the voting or equity securities of a corporation; a

partner, other than a limited partner, of a partnership; a sole proprietor or self-employed full-time or part-time. An individual debtor my also be "in

business" for the purpose of this form if the debtor engages in a trade, business, or other activity, other than as an employee, to supplement

income from the debtor's primary employment.

"Insider." The term "insider" includes but is not limited to: relatives of the debtor; general partners of the debtor and their relatives;

corporations of which the debtor is an officer, director, or person in control; officers, directors, and any owner of 5 percent or more of the voting

or equity securities of a corporation debtor and their relatives; affiliates of the debtor and insiders of such affiliates; any managing agent of the

debtor. 11 U.S.C. §101.

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

Year to date:$39,000.00

appr

 Last Year:$31,821.00

Year before:29,900.00

2009 Wages from employment Husband

2008 Same

2007 Same

Year to date:$67,000.00

appr

 Last Year:$69,292.00

Year before:60,317.00

2009 Wages from employment Wife

2008 Same

2007 Same

Statement of Affairs - Page 1

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Form 7 (12/07)

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 

Year to date:$0.00

 Last Year:$0.00

Year before:$0.00

2009 None Husband

2009 None

2007 None

Year to date:$0.00

 Last Year:$0.00

Year before:19,423.00

2009 None Wife

2008 None

2007 Pension disbursement

3. Payments to creditors

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

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 creditor 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 this 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 creditor counseling agency. (Married debtors filingunder 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.)

None

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.)

None

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

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.)

None

CAPTION OF SUIT

AND CASE NUMBER NATURE OF PROCEEDING AND LOCATION STATUS OR DISPOSITION

COURT OR AGENCY 

Kathleen Ford Vs.

Jose Martinez &

Allison Kovats

08 M1 301260

Auo Accident Personal

Injury Claim

Cook County Circuit

Court

Judgment

Wells Fargo

Financial vs.

Allison Martinez

Collection DuPage County

Circuit Court

Prior to judgment

Statement of Affairs - Page 2

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Form 7 (12/07)

CAPTION OF SUIT

AND CASE NUMBER NATURE OF PROCEEDING AND LOCATION STATUS OR DISPOSITION

COURT OR AGENCY 

09 SC 5390

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.)

None

5. Repossessions, foreclosures and returns

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.)

None

6. Assignments and receiverships

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.)

None

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

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.)

None

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.)

None

9. Payments related to debt counseling or bankruptcy

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

consolidation, relief under the bankruptcy law or preparation of a petition in bankruptcy within one year immediately preceding the commencement of

 this case.

None

NAME AND ADDRESS OF PAYEE

DATE OF PAYMENT,

NAME OF PAYER IF OTHER THAN DEBTOR

AMOUNT OF MONEY OR 

DESCRIPTION AND VALUE OF PROPERTY

Payee: Richard S. Bass

Address:

2021 Midwest Road

Oak Brook, IL 60521

Date of Payment:

Payor: Allison M. Martinez

$1,000.00

Statement of Affairs - Page 3

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Form 7 (12/07)

10. Other transfers

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

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 benificiary.

None

11. Closed financial accounts

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.)

None

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.)

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.)

None

14. Property held for another person

None List all property owned by another person that the debtor holds or controls.

15. Prior address of debtor

If the 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.

None

16. Spouses and Former Spouses

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

New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight years immediately preceding the commencement of the case, identify the name of

the debtor's spouse and of any former spouse who resides or resided with the debtor in the community property state.

None

Statement of Affairs - Page 4

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Form 7 (12/07)

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 hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, or contaminant or

similar termunder 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

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

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

18. Nature, location and name of business

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 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 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 six years immediately preceding the

commencment of this case.

 If the debtor is a corporation, 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 six years immediately preceding the

commencment of this case.

None

None 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.

Statement of Affairs - Page 5

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Form 7 (12/07)

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or

has been, within six years immediately preceding the commencement of this case, any of the following: an officer, director, managing executive, or

owner of more than 5 percent of the voting or equity securities of a corporation; a partner, other than a limited partner, of a partnership; a sole

proprietor, or self-employed in a trade, profession, or other activity, either full- or part-time.

(An individual or joint debtor should complete this portion of the statement only if the debtor is or has been in business, as defined above,

within six years immediately preceding the commencement of this case. A debtor who has not been in business within those six years should go

directly to the signature page.)

19. Books, records and financial statements

a. List all bookkeepers and accountants who within two years immediately preceding the filing of this bankruptcy case kept or supervised the keeping of

books of account and records of the debtor.

None

b. List all firms or individuals who within two years immediately preceding the filing of this bankruptcy case have audited the books of account and records,

or prepared a financial statement of the debtor.

None

c. List all firms or individuals who at the time of the commencement of this case were in possession of the books of account and records of the debtor. If

any of the books of account and records are not available, explain.

None

d. List all financial institutions, creditors and other parties, including mercantile and trade agencies, to whom a financial statement was issued by the debtor

within two years immediately preceding the commencement of this case.

None

20. Inventories

a. List the dates of the last two inventories taken of your property, the name of the person who supervised the taking of each inventory, and the dollar

amount and basis of each inventory.

None

None b. List the name and address of the person having possession of the records of each of the inventories reported in a., above.

21. Current Partners, Officers, Directors and Shareholders

None a. If the debtor is a partnership, list the nature and percentage of partnership interest of each member of the partnership.

Statement of Affairs - Page 6

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Form 7 (12/07)

b. If the debtor is a corporation, list all officers and directors of the corporation, and each stockholder who directly or indirectly owns, controls, or holds 5

percent or more of the voting or equity securities of the corporation.

None

22. Former partners, officers, directors and shareholders

None a. If the debtor is a partnership, list each member who withdrew from the partnership within one year immediately preceding the commencement of this case.

b. If the debtor is a corporation, list all officers, or directors whose relationship with the corporation terminated within one year immediately preceding the

commencement of this case.

None

23. Withdrawals from a partnership or distribution by a corporation

If the debtor is a partnership or corporation, list all withdrawals or distributions credited or given to an insider, including compensation in any form, bonuses,

loans, stock redemptions, options exercised and any other perquisite during one year immediately preceding the commencement of this case.

None

24. Tax Consolidation Group.

If the debtor is a corporation, list the name and federal taxpayer-identification number of the parent corporation of any consolidated group for tax purposes

of which the debtor has been a member at any time within six years immediately preceeding the commencement of the case.

None

25. Pension Funds.

If the debtor is not an individual, list the name and federal taxpayer-identification number of any pension fund to which the debtor, as an employer, has been

responsible for contributing at any time within six years immediately preceding the commencement of the case.

None

they are true and correct.

I declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs and any attachments thereto and that

[If completed by an individual or individual and spouse]

Signature

of Debtor

of Joint Debtor

Signature

(if any)

Date

Date

/s/ Jose A . Martinez

/s/ Allison M. Martinez

Statement of Affairs - Page 7

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

In re Jose A . Martinez and Allison M. Martinez

/ Debtor

Case No.

Chapter 7

EASTERN DIVISION

NORTHERN DISTRICT OF ILLINOIS

UNITED STATES BANKRUPTCY COURT

CHAPTER 7 STATEMENT OF INTENTION - HUSBAND'S DEBTS

Part A - Debts Secured by property of the estate. (Part A must be completed for EACH debt which is secured by property of the estate.

Attach additional pages if necessary.)

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

Claimed as exempt Not claimed as exempt

Property is (check one) :

Other. Explain 

Reaffirm the debt

Redeem the property

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

Surrendered Retained

Property will be (check one) :

None

Creditor's Name : Describe Property Securing Debt :

Property No.

Part B - Personal property subject to unexpired leases. (All three columns of Part B must be completed for each unexpired lease. Attach

additional pages if necessary.)

Property No.

Lessor's Name:

None

Describe Leased Property: Lease will be assumed

pursuant to 11 U.S.C. §

365(p)(2):

Yes No

Date: Debtor:

Signature of Debtor(s)

/s/ Jose A . Martinez

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.

Page 1 of 5

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

In re Jose A . Martinez and Allison M. Martinez

/ Debtor

Case No.

Chapter 7

EASTERN DIVISION

NORTHERN DISTRICT OF ILLINOIS

UNITED STATES BANKRUPTCY COURT

CHAPTER 7 STATEMENT OF INTENTION - WIFE'S DEBTS

Part A - Debts Secured by property of the estate. (Part A must be completed for EACH debt which is secured by property of the estate.

Attach additional pages if necessary.)

Property No. 1

Creditor's Name :

Select Portfolio Servicing Inc

Describe Property Securing Debt :

128 Concord Ln, Carol Stream, IL

Property will be (check one) :

Surrendered Retained

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

Redeem the property

Reaffirm the debt

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

Property is (check one) :

Claimed as exempt Not claimed as exempt

Property No. 2

Creditor's Name :

PNC Bank (National City)

Describe Property Securing Debt :

128 Concord Ln, Carol Stream, IL

Property will be (check one) :

Surrendered Retained

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

Redeem the property

Reaffirm the debt

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

Property is (check one) :

Claimed as exempt Not claimed as exempt

Page 2 of 5

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

Part B - Personal property subject to unexpired leases. (All three columns of Part B must be completed for each unexpired lease. Attach

additional pages if necessary.)

Property No.

Lessor's Name:

None

Lease will be assumed

pursuant to 11 U.S.C. §

365(p)(2):

Describe Leased Property:

Yes No

Date: Debtor:

Signature of Debtor(s)

/s/ Allison M. Martinez

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.

Page 3 of 5

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

In re Jose A . Martinez and Allison M. Martinez

/ Debtor

Case No.

Chapter 7

EASTERN DIVISION

NORTHERN DISTRICT OF ILLINOIS

UNITED STATES BANKRUPTCY COURT

CHAPTER 7 STATEMENT OF INTENTION - JOINT DEBTS

Part A - Debts Secured by property of the estate. (Part A must be completed for EACH debt which is secured by property of the estate.

Attach additional pages if necessary.)

Property No. 1

Creditor's Name :

HSBC Auto Finance

Describe Property Securing Debt :

2006 Nissan Pathfinder

Property will be (check one) :

Surrendered Retained

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

Redeem the property

Reaffirm the debt

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

Claimed as exempt Not claimed as exempt

Property is (check one) :

Property No. 2

Creditor's Name :

State Farm Bank

Describe Property Securing Debt :

2002 Chevy Monte Carlo

Property will be (check one) :

Surrendered Retained

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

Redeem the property

Reaffirm the debt

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

Claimed as exempt Not claimed as exempt

Property is (check one) :

Page 4 of 5

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

Part B - Personal property subject to unexpired leases. (All three columns of Part B must be completed for each unexpired lease. Attach

additional pages if necessary.)

Property No.

Lease will be assumed

pursuant to 11 U.S.C. §

365(p)(2):

Describe Leased Property:

None

Lessor's Name:

Yes No

Date: Debtor:

Signature of Debtor(s)

/s/ Jose A . Martinez

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: Joint Debtor: /s/ Allison M. Martinez

Page 5 of 5

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Rule 2016(b) (8/91)

UNITED STATES BANKRUPTCY COURT

NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

In re Case No.

Chapter

Jose A . Martinez

 and

Allison M. Martinez

dba Allison M. Kovats

7

Attorney for Debtor: Richard S. Bass

/ Debtor

STATEMENT PURSUANT TO RULE 2016(B)

The undersigned, pursuant to Rule 2016(b), Bankruptcy Rules, states that:

1. The undersigned is the attorney for the debtor(s) in this case.

2.

a)

connection with this case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Prior to the filing of this statement, debtor(s) have paid . . . . . . . . . . . . . . . $

The unpaid balance due and payable is . . . . . . . . . . . . . . . . . . . . . . . . . . . $

b)

c)

The compensation paid or agreed to be paid by the debtor(s), to the undersigned is:

For legal services rendered or to be rendered in contemplation of and in

1,000.00

1,000.00

0.00

3. $ 299.00 of the filing fee in this case has been paid.

4.

a)

file a petition under title 11 of the United States Code.

b)

c)

Analysis of the financial situation, and rendering advice and assistance to the debtor(s) in determining whether to

The Services rendered or to be rendered include the following:

Preparation and filing of the petition, schedules, statement of financial affairs and other documents required by the

Representation of the debtor(s) at the meeting of creditors.

court.

5.

services performed, and

The source of payments made by the debtor(s) to the undersigned was from earnings, wages and compensation for

None other

6.

be from earnings, wages and compensation for services performed, and

The source of payments to be made by the debtor(s) to the undersigned for the unpaid balance remaining, if any, will

None other

7.

the value stated:

The undersigned has received no transfer, assignment or pledge of property from debtor(s) except the following for

None

8.

law firm, any compensation paid or to be paid except as follows:

The undersigned has not shared or agreed to share with any other entity, other than with members of undersigned's

None

Dated:

Attorney for Petitioner:

Respectfully submitted,

Richard S. Bass

Law Office of Richard S. Bass, LTD.

2021 Midwest Road

Oak Brook IL 60521

X /s/ Richard S. Bass

630-953-8655

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UNITED STATES BANKRUPTCY COURT

EASTERN DIVISION

NORTHERN DISTRICT OF ILLINOIS

In re Jose A . Martinez

and

Allison M. Martinez

dba Allison M. Kovats

Chapter 7

Case No.

Attorney for Debtor: Richard S. Bass

/ Debtor

VERIFICATION OF CREDITOR MATRIX

The above named Debtor(s) hereby verify that the attached list of creditors is true and correct to the

best of our knowledge.

Date:

Debtor

/s/ Jose A . Martinez

Joint Debtor

/s/ Allison M. Martinez

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Academy Collection Service Inc

RE: Premier Bankcard

10965 Decatur Road

Philadelphia, PA 19154-3210

ACC International Collection

RE: Stratford Orthopaedic

919 Estes Ct

Schaumburg, IL 60193-4427

Accounts Receivable Management

RE: Premier Bankcard

PO Box 129

Thorofare, NJ 08086-0129

Advocate Medical Group

Attn: Patient Accounts

701 Lee Street

Des Plaines, IL 60016

Aegis Receivables Management

RE: American Express

PO BOX 165809

Irving, TX 75016

Alliance One Receivables Mgt

RE: Resurgent Capital

1160 Centre Pointe Dr, #1

Mendota Heights, MN 55120

American Coradius Inc

RE: Chase

2420 Sweet Home Rd, #150

Amherst, NY 14228-2244

American Express

Attn: Bankruptcy Dept

PO BOX 6618

Omaha, NE 68105-0618

Asset Acceptance LLC

RE: Circuit City Chase

PO BOX 2036

Warren, MI 48090-2036

Bally Total Fitness

Attn: Bankruptcy Dept

12440 Imperial Highway, #300

Norwalk, CA 90650-8309

Bonlar Loan Co

Attn: Bankruptcy Dept

2247 W. Lawrence 

Chicago, IL 60625

Capital One

Attn: Bankruptcy Dept

P.O. BOX 5155

Norcross, GA 30091

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CCSI

RE: Citifinancial

PO BOX 34119

Memphis, TN 38184

Central Credit Services Inc.

RE: Chase/Circuit City

PO BOX 15118

Jacksonville, FL 32239

Central DuPage Hospital

Attn: Patient Accounts

25 N. Winfield Road

Winfield, IL 60190-1295

Central DuPage Physician Group

Attn: Patient Accts

PO BOX 479

Winfield, IL 60190 

Chase 

Attn: Bankruptcy Dept

PO BOX 15298

Wilmington, DE 19850-5298

Chase/Circuit City

Attn: Bankruptcy Dept

800 Brooksedge Blvd

Westerville, OH 43081-2822

CitiFinancial 

Bankruptcy Dept

PO BOX 499

Hanover, MD 21076-0499

CitiFinancial Retail Services

Attn: Bankruptcy Dept

PO BOX 22066

Tempe, AZ 85285-2066

DRS Bonded Collections

RE: Citifinancial

PO BOX 498609

Cincinnati, OH 45249-8609

Enhanced Recovery Corp

RE: GE Money

8014 Bayberry Rd

Jacksonville, FL 32256

FaCS Group

Attn: Bankruptcy Dept

9111 Duke Blvd

Mason, OH 45040 

First Premier Bank

Attn: Bankruptcy Dept

PO Box 5524

Sioux Falls , SD 57117-5512

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First Source Advantage LLC

RE: American Express

205 Bryant Woods South

Amherst, NY 14228

FirstStar Bank

Attn: Bankruptcy Dept

425 Walnut St

Cincinnati, OH 45202-3923

Frederick J. Hanna & Assoc.

RE: Chase Bank

1427 Roswell Rd

Marietta, GA 30062

GE Money Bank (Old Navy)

Attn: Bankruptcy Dept

PO BOX 103104

Roswell, GA 30076

GE Money Bank/Jewelry Exchange

Attn: Bankruptcy Dept

PO BOX 103104

Roswell, GA 30076

Good Samaritan Hospital

Attn: Patient Accts

3815 Highland Ave

Downers Grove, IL 60515

Hilco Receivables LLC

RE: GE Money

5 Revere Dr #206

Northbrook, IL 60062 

HR Accounts Inc.

RE: Central Dupage Hosp

7017 John Deere Pkwy

Moline, IL 61266-0672

HR Accounts Inc.

RE: Central DuPage Hosp

7017 John Deere Pkwy

Moline, IL 61266-0672

HSBC Auto Finance

Attn: Bankruptcy Dept

PO Box 17548

Baltimore, MD 21297-1548

Illinois Collection Service

RE: Advocate Good Samaritan H

PO BOX 1010

Tinley Park, IL 60477-9110

Illinois Dept Employ Security

Attn: Bankruptcy Dept

PO BOX 6996 Banking Unit

Chicago, IL 60680-1292

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Illinois Dept Employ Security

Attn Bankruptcy Unit 3rd Floor

401 S. State St

Chicago, IL 60605

Illinois Dept Employ Security

Attn Benefit Payment-Bankrupt 

PO Box 19286

Springfield, IL 62794-9286

Illinois Dept of Child Support

Attn: Bankruptcy Dept

509 S. Sixth St Floor 6

Springfield, IL 62701

Just Energy

Attn: Bankruptcy Dept

35190 Eagle Way

Chicago, IL 60678-1351

KCA Financial

RE: Columbia House

PO Box 53

Geneva, IL 60134

Law Office Heller & Frisone

Acct: Wells Fargo

33 N. LaSalle St #300

Chicago, IL 60603-1203

Law Office Steven Mevorah

Acct: Kathleen Ford

900 E. Roosevelt Rd

Lombard, IL 60148

LVNV Funding LLC

Attn: CitiBank

PO BOX 10584

Greenville, SC 29603-0584

Macy's/Marshall Fields

Attn: Bankruptcy Dept

PO BOX 9475

Minneapolis, MN 55440 

Medical Business Bureau

RE: Central Dupage Emerg Phys

1460 Renaissance Dr, #400

Park Ridge, IL 60068

Medical Business Bureau

RE: Cental DuPage Emerg Phys

1460 Renaissance Dr, #400

Park Ridge, IL 60068

MiraMed Revenue Group, LLC

RE: Central DuPage Hospital

PO BOX 77000, Dept 77304

Detroit, MI 48277-0304

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NCI Collection

RE: R. McLaughlin MD

3601 Algonquin Rd #232

Rollling Meadows, IL 60008-3106

NCO Fin/99

RE: Commonwealth Edison

PO BOX 41466

Philadelphia, PA 19101

NCO Financial Systems Inc.

RE: American Express

507 Prudential Road

Horsham, PA 19044

Nelnet Loan Services

Attn: Bankruptcy Dept

3015 S. Parker Rd, #425

Aurora, CO 80014-2904

NICOR Gas

Attn: Bankruptcy Dept

1844 W. Ferry Road

Naperville, IL 60563-9662

Northstar Location Services

RE: Chase

4285 Genessee St

Cheektowaga, NY 14225-1943

Northwest Collectors

RE: R McLaughlin MD

3601 Algonquin Rd #500

Rolling Meadows, IL 60008

OakBrook Pediatrics Ctr

Attn: Patient Accts

3825 Highland Ave, #2-C

Downers Grove, IL 60515

Pellettieri & Associates, Inc.

RE: Central DuPage Hosp

991 Oak Creek Dr

Lombard, IL 60148-6408

PNC Bank (National City)

Attn: Bankruptcy Dept

PO Box 5570

Cleveland, OH 44101-0570

Portfolio Recovery Associates

RE: Citifinancial

120 Corporate Blvd, #100

Norfolk, VA 23502 

Portfolio Recovery Associates

RE: Wickes Furniture

PO Box 12914

Norfolk, VA 23541

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Professional Bureau Collection

RE: GE Money/Old Navy

PO BOX 628

Elk Grove, CA 95759-0628

RAB, Inc.

RE: Citifinancial

7000 Goodlett Farms Parkway

Memphis , TN 38016

Radiologist of DuPage

Attn: Patient Accts

520 E. 22nd St

Lombard, IL 60148

Retailer National Bank

Attn: Bankruptcy Dept

PO BOX 702

Minneapolis, MN 55440-0702

Select Portfolio Servicing Inc

Attn: Bankruptcy Dept

PO BOX 65250

Salt Lake City, UT 84165

State Farm Bank

Attn: Auto Loan Dept

PO Box 3299

Milwaukee, WI 53201-3299

Wells Fargo Financial 

Attn: Bankruptcy Dept

800 Walnut St

Des Moines, IA 50309-3506

Weltman, Weinberg & Reis Co.

RE: LVNV Funding LLC/Citibank

323 W. Lakeside Ave, Suite 200

Cleveland, OH 44113-1099

WFNNB/Express

Attn: Bankrupcty Dept

PO BOX 182125

Columbus, OH 43218-2125

WFNNB/Victoria's Sercret

Attn: Bankrupcty Dept

PO BOX 182128

Columbus, OH 43218 

Zwicker & Associates, P.C.

RE: GE Money Bank

80 Minuteman Rd

Andover, MA 01810-1031

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