Instructions 

Bankruptcy Forms for Individuals 

U.S. Bankruptcy Court | December 2015 (Rev. 

April 2022) 
 

 

About this Booklet of Instructions ..................................................................................... 1

About the bankruptcy forms and filing bankruptcy .................................................................................................. 2

Understand the terms used in the forms ................................................................................................................. 2

Things to remember when filling out these forms ................................................................................................... 4

On what date was a debt incurred? ........................................................................................................................ 4

About the Process for Filing a Bankruptcy Case for Individuals ........................................................ 5

Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) .............. 10

The types of bankruptcy that are available to individuals ..................................................................................... 10

Bankruptcy crimes have serious consequences................................................................................................... 13

Make sure the court has your mailing address ..................................................................................................... 13

Understand which services you could receive from credit counseling agencies .................................................. 13

Instructions for Selected Forms...................................................................................... 15

Schedule A/B: Property (Official Form 106A/B) ............................................................................... 16

Schedule C: The Property You Claim as Exempt (Official Form 106C)........................................... 18

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D) ..................... 19

Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F) .............................. 22

Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G) ............................. 26

Schedule H: Your Codebtors (Official Form 106H) ......................................................................... 27

Schedule I: Your Income (Official Form 106I) ................................................................................. 28

Schedule J: Your Expenses (Official Form 106J) ............................................................................ 30

Summary of Your Assets and Liabilities and Certain Statistical Information (Official Form 

106Sum) .......................................................................................................................................... 31

Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107) .................. 32

Chapter 7 Statement of Your Current Monthly Income and Means Test Calculation (Official 

Forms 122A–1, 122A-1Supp, and 122A–2) .................................................................................... 33

Chapter 11 Statement of Your Current Monthly Income (Official Form 122B) ................................. 35

Chapter 13 Statement of Your Current Monthly Income, Calculation of Commitment Period 

and Chapter 13 Calculation of Your Disposable Income (Official Forms 122C–1 and 122C–2) ...... 36

Statement of Intention for Individuals Filing Under Chapter 7 (Official Form 108) ........................... 38

Application for Individuals to Pay the Filing Fee in Installments (Official Form 103A) ..................... 40

Application to Have the Chapter 7 Filing Fee Waived (Official Form 103B) .................................... 41

For Individual Chapter 11 Cases: List of Creditors Who Have the 20 Largest Unsecured 

Claims Against You and Are Not Insiders (Official Form 104) ......................................................... 38

Glossary ................................................................................................................... 40

Definitions of Some Terms Used in the Forms for Individuals Filing for Bankruptcy ....................... 41
 About this Booklet of Instructions page 1

 About this Booklet of Instructions 

This booklet provides instructions for 

completing selected forms that individuals 

filing for bankruptcy must submit to the U.S. 

Bankruptcy Court. You can download all of the 

required forms without charge from: 

http://www.uscourts.gov/FormsAndFees/Forms/Bank

ruptcyForms.aspx. 

The instructions are designed to accompany the 

forms and are intended to help you understand 

what information is required to properly file. 

You are responsible for properly completing the 

forms. These instructions are not intended to 

provide, and should not be understood to 

provide, legal advice. They are not designed to 

fully explain, or to be relied upon in 

interpreting, the law. 

Completing the forms is only a part of the 

bankruptcy process. You are strongly 

encouraged to hire a qualified attorney not only 

to help you complete the forms but also to give 

you general advice about bankruptcy and to 

represent you in your bankruptcy case. If you 

cannot afford to pay an attorney, you might 

qualify for free legal services if they are 

provided in your area. Contact your state or 

local bar association for help in obtaining free 

legal services or in hiring an attorney. 

Note: It is extremely difficult to succeed in a 

chapter 11, 12, or 13 case without an 

attorney.

If an attorney represents you, you must provide 

information so the attorney can prepare your 

forms. Once the attorney prepares the forms, 

you must make sure that the forms are accurate 

and complete. These instructions may help you 

perform those tasks. If you are filing for 

bankruptcy without the help of an attorney, this 

booklet tells you which forms must be filed and 

provides information about them. 

You should carefully read this booklet and keep 

it with your records. Review the individual 

forms as you read the instructions for each. 

Although bankruptcy petition preparers can 

help you type the bankruptcy forms, they cannot 

tell you how to complete the forms, they cannot 

file the documents for you, and they cannot give 

you legal advice. Court employees cannot give 

you legal advice, either. 
 About this Booklet of Instructions page 2

Read These Important Warnings

Because bankruptcy can have serious long-term financial and legal consequences, including 

loss of your property, you should hire an attorney and carefully consider all of your options 

before you file. Only an attorney can give you legal advice about what can happen as a result 

of filing for bankruptcy and what your options are. If you do file for bankruptcy, an attorney 

can help you fill out the forms properly and protect you, your family, your home, and your 

possessions. 

Although the law allows you to represent yourself in bankruptcy court, you should understand 

that many people find it difficult to represent themselves successfully. The rules are technical, 

and a mistake or inaction may harm you. If you file without an attorney, you are still 

responsible for knowing and following all of the legal requirements. 

You should not file for bankruptcy if you are not eligible to file or if you do not intend to file 

the necessary documents. 

Bankruptcy fraud is a serious crime; you could be fined and imprisoned if you commit fraud in 

your bankruptcy case. Making a false statement, concealing property, or obtaining money or 

property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or 

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

About the bankruptcy forms and 

filing bankruptcy 

Use the forms that are numbered in the 100 

series to file bankruptcy for individuals or 

married couples. Use the forms that are 

numbered in the 200 series if you are preparing 

a bankruptcy on behalf of a nonindividual, such 

as a corporation, partnership, or limited liability 

company (LLC). Sole proprietors must use the 

forms that are numbered in the 100 series. 

When a bankruptcy is filed, the U.S. 

Bankruptcy Court opens a case. It is important 

that the answers to the questions on the forms 

be complete and accurate so that the case 

proceeds smoothly. A person filing bankruptcy 

who gives false information could be charged 

with a federal crime or could lose all the 

benefits of filing for bankruptcy. 

You should understand that filing a bankruptcy 

case is not private. Anyone has a right to see 

your bankruptcy forms after you file them, 

unless the court orders otherwise under 

11 U.S.C. § 107. Certain information in court 

filings, however, must be protected from public 

disclosure under Bankruptcy Rule 9037. 

Understand the terms used in the 

forms 

The forms for individuals use you and Debtor 1
 About this Booklet of Instructions page 3 

to refer to a debtor filing alone. A married 

couple may file a bankruptcy case together—

called a joint case—and in joint cases, these 

forms use you to ask for information from both 

debtors. 

 
 About this Booklet of Instructions page 4 

For example, if a form asks, “Do you own a 

car?” the answer would be yes if either debtor 

owns a car. When information is needed about 

the spouses separately, the forms use Debtor 1

and Debtor 2 to distinguish between them. In 

joint cases, one of the spouses must report 

information as Debtor 1 and the other as 

Debtor 2. The same person must be Debtor 1 in 

all of the forms. 

To understand other terms used in the forms and 

the instructions, see the Glossary at the end of 

this booklet. 

Things to remember when filling 

out these forms 

 Do not file these instructions with the 

bankruptcy forms that you file with the 

court. 

 Be as complete and accurate as possible. 

 If more space is needed, attach a separate 

sheet to the form. On the top of any 

additional pages, write your name and case 

number (if known). Also identify the form 

and line number to which the additional 

information applies. 

 If two married people are filing together, 

both are equally responsible for supplying 

correct information. 

 Do not list a minor child’s full name. 

Instead, fill in only the child’s initials and 

the full name and address of the child’s 

parent or guardian. For example, write A.B., 

a minor child (John Doe, parent, 123 Main 

St., City, State). 11 U.S.C. § 112; 

Bankruptcy Rule 1007(m) and 9037. 

 For your records, be sure to keep a copy of 

your bankruptcy documents and all 

attachments that you file. 

On what date was a debt incurred? 

When a debt was incurred on a single date, fill 

in the actual date that the debt was incurred. 

When a debt was incurred on multiple dates, fill 

in the range of dates. For example, if the debt is 

from a credit card, fill in the month and year of 

the first and last transaction. 
About the Process for Filing a Bankruptcy Case for Individuals page 5 

About the Process for Filing a Bankruptcy Case for 

Individuals

Before you file your bankruptcy case 

Before you file for bankruptcy, you must do 

several things: 

 Receive a briefing about credit counseling from 

an approved agency within 180 days before 

you file. (If you and your spouse are filing 

together, each of you must receive a briefing 

before you file. Failure to do so may result in 

the dismissal of your case.) You may have a 

briefing about credit counseling one-on-one 

or in a group, by telephone, or by internet. 

For a list of approved providers, go to: 

https://www.justice.gov/ust/list-creditcounseling-agencies-approved-pursuant-11-

usc-111

In Alabama and North Carolina, go to: 

https://www.uscourts.gov/servicesforms/bankruptcy/credit-counseling-anddebtor-education-courses. 

After you finish the briefing, you will receive a 

certificate that you will need to file in your 

bankruptcy case. 

 Find out in which bankruptcy court you must 

file your bankruptcy case. It is important that 

you file in the correct district within your 

state. To find out which district you are in, go 

to: 

http://www.uscourts.gov/courtlinks 

 Check the local court’s website for any 

specific local requirements that you might 

have to meet. Go to: 

http://www.uscourts.gov/courtlinks 

 Find out which chapters of the Bankruptcy 

Code you are eligible for. For descriptions of 

each chapter, review the information 

contained in the notice, Notice Required by 

11 U.S.C. § 342(b) for Individuals Filing for 

Bankruptcy (Form B2010), which is included 

in this booklet. 
 

About the Process for Filing a Bankruptcy Case for Individuals page 6

When you file your bankruptcy case 

There are several forms and documents that you 

must give the court at the time you file. 

Additional forms and documents must be filed no 

later than 14 days after you file your bankruptcy 

case, although they may be filed at the same time 

you file your case. 

You must file the forms listed below on the date 

you open your bankruptcy case. For copies of the 

forms listed here, go to 

https://www.uscourts.gov/forms/bankruptcy-forms. 

(The list continues on the next page.): 

 Voluntary Petition for Individuals Filing for 

Bankruptcy (Official Form 101). This form 

opens the case. Directions for filling it out are 

included in the form itself. 

 Statement About Your Social Security 

Numbers (Official Form 121). This form gives 

the court your full Social Security number or 

federal Individual Taxpayer Identification 

number. To protect your privacy, the court 

will make only the last four digits of your 

number known to the general public. 

However, the court will make your full 

number available to your creditors, the U.S. 

trustee or bankruptcy administrator, and the 

trustee assigned to your case. This form has no 

separate instructions. 

 Your filing fee. If you cannot pay the entire 

filing fee, you must also include: 

 Application for Individuals to Pay the 

Filing Fee in Installments (Official Form 

103A), or 

 Application to Have the Chapter 7 Filing 

Fee Waived (Official Form 103B). Use 

this form only if you are filing under 

chapter 7 and you meet the criteria to have 

the chapter 7 filing fee waived. 

 A list of names and addresses of all of your 

creditors, formatted as a mailing list according 

to instructions from the bankruptcy court in 

which you file. (Your court may call this a 

creditor matrix or mailing matrix.) 

 Your credit counseling certificate from an 

approved credit counseling agency. (See 

Before you file your bankruptcy case, above). 

If you have received the briefing about credit 

counseling but have not yet received the 

certificate, file it no later than 14 days after 

you file for bankruptcy. If you have not 

already received the briefing and believe you 

are entitled to a temporary waiver from 

receiving it or that you are not required to 

receive the briefing, see line 15 of the 

Voluntary Petition for Individuals Filing for 

Bankruptcy (Official Form 101). 

 For Individual Chapter 11 Cases: List of 

Creditors Who Have the 20 Largest 

Unsecured Claims Against You and Are Not 

Insiders (Official Form 104). Fill out this form 

only if you file under chapter 11. 

 Initial Statement About an Eviction Judgment 

Against You (Official Form 101A) and 

Statement About Payment of an Eviction 

Judgment Against You (Official Form 101B). 

Use Form 101A if your landlord has an 

eviction judgment against you. If you 

complete Form 101A and you want to stay in 

your residence for the first 30 days after you 

file, you must indicate that on the form. Use 

Form 101B if you have completed Form 101A 

and you want to stay in your rented residence 

form more than 30 days after you file for 

bankruptcy. 

 Bankruptcy Petition Preparer’s Notice, 

Declaration, and Signature (Official Form 119) 

and Disclosure of Compensation of Bankruptcy 

Petition Preparer (Form 2800). Use these forms 

if a bankruptcy petition preparer typed your 
 

About the Process for Filing a Bankruptcy Case for Individuals page 7

forms. 

 When you file your bankruptcy case or within 14 days after you file

You must file the forms listed below either when you file your bankruptcy case or within 14 days after 

you file your Voluntary Petition for Individuals Filing for Bankruptcy (Official Form 101). If you do 

not do so, your case may be dismissed. Although it is possible to open your case by submitting only 

the documents that are listed under When you file your bankruptcy case, you should file the entire set 

of forms at one time to help your case proceed smoothly. 

Although some forms may ask you similar questions, you must fill out all of the forms completely to 

protect your legal rights.

The list below shows the forms that all individuals must file as well as the forms that are specific to 

each chapter. For copies of the official forms listed here, go to https://www.uscourts.gov/forms/bankruptcyforms. 

 All individuals who file for bankruptcy 

must file these forms and the forms for the 

specific chapter: 

 Schedules of Assets and Liabilities (Official 

Form 106) which includes these forms: 

 Schedule A/B: Property (Official 

Form 106A/B)

 Schedule C: The Property You Claim as 

Exempt (Official Form 106C) 

 Schedule D: Creditors Who Have Claims 

Secured by Your Property (Official Form 

106D)

 Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F)

 Schedule G: Executory Contracts and 

Unexpired Leases (Official Form 106G)

 Schedule H: Your Codebtors (Official 

Form 106H)

 Schedule I: Your Income (Official 

Form 106I)

 Schedule J: Your Expenses (Official 

Form 106J) 

 Summary of Your Assets and Liabilities 

and Certain Statistical Information 

(Official Form 106Sum). This form gives 

an overview of the totals on the schedules 

 Declaration About an Individual Debtor’s 

Schedules (Official Form 106Dec)

 Statement of Financial Affairs for Individuals 

Filing for Bankruptcy (Official Form 107)

 Disclosure of Compensation to Debtor’s 

Attorney  Unless local rules provide 

otherwise, Director’s Form 2030 may be used. 

 Credit counseling certificate that you received 

from an approved credit counseling agency 

 Copies of all payment advices (pay stubs) or 

other evidence of payment that you received 

within 60 days before you filed your bankruptcy 

case. Some local courts may require that you 

submit these documents to the trustee assigned 

to your case rather than filing them with the 
 

About the Process for Filing a Bankruptcy Case for Individuals page 8

court. Check the local court’s website to find 

out if local requirements apply. Go to 

http://www.uscourts.gov/courtlinks. 

 
 

About the Process for Filing a Bankruptcy Case for Individuals page 9

 If you file under chapter 7, you must also file: 

 Statement of Intention for Individuals Filing 

Under Chapter 7 (Official Form 108) 

 Chapter 7 Statement of Your Current Monthly 

Income (Official Form 122A-1) 

 If necessary, Chapter 7 Means Test 

Calculation (Official Form 122A-2) 

 If necessary, Statement of Exemption from 

Presumption of Abuse Under § 707(b)(2)

(Official Form 122A-1Supp) 

 If you file under chapter 11, you must also file: 

 Chapter 11 Statement of Your Current 

Monthly Income (Official Form 122-B) 

If you file under chapter 11 and are a small 

business debtor (that is, if you are self-employed 

and your debts are less than $3,024,725*), within 

7 days after you file your bankruptcy forms to 

open your case, you must also file your most 

recent: 

 Balance sheet 

 Statement of operations 

 Cash-flow statement 

 Federal income tax return

If you do not have these documents, you must 

file a statement made under penalty of perjury 

that you have not prepared either a balance sheet, 

statement of operations, or cash-flow statement 

or you have not filed a federal tax return. 

If you file under chapter 11, you must file 

additional documents beyond the scope of these 

instructions. You should consult your attorney. 

* Subject to adjustment on 4/01/25, and every 3 years 

after that for cases begun on or after the date of 

adjustment.

 If you file under chapter 12, you must also file: 

 Chapter 12 Plan (within 90 days after you file 

your bankruptcy forms to open your case) 

 If you file under chapter 13, you must also file: 

 Chapter 13 Statement of Your Current Monthly 

Income and Calculation of Commitment Period 

(Official Form 122C-1) 

 If necessary, Chapter 13 Calculation of Your 

Disposable Income (Official Form 122C-2) 

 Chapter 13 Plan (Official Form 113, if in 

effect). If Official Form 113 is not effective 

when you file, many bankruptcy courts 

require you to use a local form plan. Check 

the local court’s website for any specific form 

that you might have to use. Go to 

http://www.uscourts.gov/courtlinks.)
 

Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 10

Notice Required by 11 U.S.C. § 342(b) for 

Individuals Filing for Bankruptcy (Form 2010)

This notice is for you if: 

You are an individual filing for 

bankruptcy, and 

Your debts are primarily consumer 

debts. Consumer debts are defined in 

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

individual primarily for a personal, 

family, or household purpose.” 

The types of bankruptcy that are 

available to individuals 

Individuals who meet the qualifications may file 

under one of four different chapters of the 

Bankruptcy Code: 

 Chapter 7 — Liquidation 

 Chapter 11 — Reorganization 

 Chapter 12 — Voluntary repayment plan 

for family farmers or 

fishermen 

 Chapter 13 — Voluntary repayment plan 

for individuals with regular 

income 

You should have an attorney review your 

decision to file for bankruptcy and the choice of 

chapter. 

Chapter 7: Liquidation 

 $245 filing fee 

 $78 administrative fee 

+ $15 trustee surcharge 

 $338 total fee 

Chapter 7 is for individuals who have financial 

difficulty preventing them from paying their 

debts and who are willing to allow their nonexempt property to be used to pay their 

creditors. The primary purpose of filing under 

chapter 7 is to have your debts discharged. The 

bankruptcy discharge relieves you after 

bankruptcy from having to pay many of your 

pre-bankruptcy debts. Exceptions exist for 

particular debts, and liens on property may still 

be enforced after discharge. For example, a 

creditor may have the right to foreclose a home 

mortgage or repossess an automobile. 

However, if the court finds that you have 

committed certain kinds of improper conduct 

described in the Bankruptcy Code, the court 

may deny your discharge. 

You should know that even if you file 

chapter 7 and you receive a discharge, some 

debts are not discharged under the law. 

Therefore, you may still be responsible to pay: 

 most taxes; 

 most student loans; 

 domestic support and property settlement 

obligations; 

 
 

Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 11

 most fines, penalties, forfeitures, and 

criminal restitution obligations; and 

 certain debts that are not listed in your 

bankruptcy papers. 

You may also be required to pay debts arising 

from: 

 fraud or theft; 

 fraud or defalcation while acting in breach 

of fiduciary capacity; 

 intentional injuries that you inflicted; and 

 death or personal injury caused by 

operating a motor vehicle, vessel, or 

aircraft while intoxicated from alcohol or 

drugs. 

If your debts are primarily consumer debts, the 

court can dismiss your chapter 7 case if it finds 

that you have enough income to repay 

creditors a certain amount. You must file 

Chapter 7 Statement of Your Current Monthly 

Income (Official Form 122A–1) if you are an 

individual filing for bankruptcy under 

chapter 7. This form will determine your 

current monthly income and compare whether 

your income is more than the median income 

that applies in your state. 

If your income is not above the median for 

your state, you will not have to complete the 

other chapter 7 form, the Chapter 7 Means 

Test Calculation (Official Form 122A–2). 

If your income is above the median for your 

state, you must file a second form —the 

Chapter 7 Means Test Calculation (Official 

Form 122A–2). The calculations on the form—

sometimes called the Means Test—deduct 

from your income living expenses and 

payments on certain debts to determine any 

amount available to pay unsecured creditors. If 

your income is more than the median income 

for your state of residence and family size, 

depending on the results of the Means Test, the 

U.S. trustee, bankruptcy administrator, or 

creditors can file a motion to dismiss your case 

under § 707(b) of the Bankruptcy Code. If a 

motion is filed, the court will decide if your 

case should be dismissed. To avoid dismissal, 

you may choose to proceed under another 

chapter of the Bankruptcy Code. 

If you are an individual filing for chapter 7 

bankruptcy, the trustee may sell your property 

to pay your debts, subject to your right to 

exempt the property or a portion of the 

proceeds from the sale of the property. The 

property, and the proceeds from property that 

your bankruptcy trustee sells or liquidates that 

you are entitled to, is called exempt property. 

Exemptions may enable you to keep your 

home, a car, clothing, and household items or 

to receive some of the proceeds if the property 

is sold. 

Exemptions are not automatic. To exempt 

property, you must list it on Schedule C: The 

Property You Claim as Exempt (Official Form 

106C). If you do not list the property, the 

trustee may sell it and pay all of the proceeds 

to your creditors.

Chapter 11: Reorganization 

 $1,167 filing fee 

+ $571 administrative fee 

 $1,738 total fee 

Chapter 11 is often used for reorganizing a 

business, but is also available to individuals. 

The provisions of chapter 11 are too 

complicated to summarize briefly. 
 

Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 12

Chapter 12: Repayment plan for family 

farmers or fishermen 

 $200 filing fee 

+ $78 administrative fee 

 $278 total fee 

Similar to chapter 13, chapter 12 permits 

family farmers and fishermen to repay their 

debts over a period of time using future 

earnings and to discharge some debts that are 

not paid. 

Chapter 13: Repayment plan for 

individuals with regular 

income 

 $235 filing fee 

+ $78 administrative fee 

 $313 total fee 

Chapter 13 is for individuals who have regular 

income and would like to pay all or part of 

their debts in installments over a period of time 

and to discharge some debts that are not paid. 

You are eligible for chapter 13 only if your 

debts are not more than certain dollar amounts 

set forth in 11 U.S.C. § 109. 

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, usually using your 

future earnings. If the court approves your 

plan, the court will allow you to repay your 

debts, as adjusted by the plan, within 3 years or 

5 years, depending on your income and other 

factors. 

After you make all the payments under your 

plan, many of your debts are discharged. The 

debts that are not discharged and that you may 

still be responsible to pay include: 

 domestic support obligations, 

 most student loans, 

 certain taxes, 

 debts for fraud or theft, 

 debts for fraud or defalcation while acting 

in a fiduciary capacity, 

 most criminal fines and restitution 

Read These Important Warnings

Because bankruptcy can have serious long-term financial and legal consequences, including loss of 

your property, you should hire an attorney and carefully consider all of your options before you file. 

Only an attorney can give you legal advice about what can happen as a result of filing for bankruptcy 

and what your options are. If you do file for bankruptcy, an attorney can help you fill out the forms 

properly and protect you, your family, your home, and your possessions. 

Although the law allows you to represent yourself in bankruptcy court, you should understand that 

many people find it difficult to represent themselves successfully. The rules are technical, and a 

mistake or inaction may harm you. If you file without an attorney, you are still responsible for knowing 

and following all of the legal requirements. 

You should not file for bankruptcy if you are not eligible to file or if you do not intend to file the 

necessary documents. 

Bankruptcy fraud is a serious crime; you could be fined and imprisoned if you commit fraud in your 

bankruptcy case. Making a false statement, concealing property, or obtaining money or property by 

fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for up to 

20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571. 
 

Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 13

obligations, 

 certain debts that are not listed in your 

bankruptcy papers, 

 certain debts for acts that caused death or 

personal injury, and 

 certain long-term secured debts. 

Bankruptcy crimes have serious 

consequences 

 If you knowingly and fraudulently conceal 

assets or make a false oath or statement 

under penalty of perjury—either orally or 

in writing—in connection with a 

bankruptcy case, you may be fined, 

imprisoned, or both. 

 All information you supply in connection 

with a bankruptcy case is subject to 

examination by the Attorney General acting 

through the Office of the U.S. Trustee, the 

Office of the U.S. Attorney, and other 

offices and employees of the U.S. 

Department of Justice. 

Make sure the court has your 

mailing address 

The bankruptcy court sends notices to the 

mailing address you list on Voluntary Petition 

for Individuals Filing for Bankruptcy (Official 

Form 101). To ensure that you receive 

information about your case, Bankruptcy 

Rule 4002 requires that you notify the court of 

any changes in your address. 

A married couple may file a bankruptcy case 

together—called a joint case. If you file a joint 

case and each spouse lists the same mailing 

address on the bankruptcy petition, the 

bankruptcy court generally will mail you and 

your spouse one copy of each notice, unless 

you file a statement with the court asking that 

each spouse receive separate copies. 

Understand which services you 

could receive from credit 

counseling agencies 

The law generally requires that you receive a 

credit counseling briefing from an approved 

credit counseling agency. 11 U.S.C. § 109(h). 

If you are filing a joint case, both spouses must 

receive the briefing. With limited exceptions, 

you must receive it within the 180 days before

you file your bankruptcy petition. This briefing 

is usually conducted by telephone or on the 

Internet. 

In addition, after filing a bankruptcy case, you 

generally must complete a financial 

management instructional course before you 

can receive a discharge. If you are filing a joint 

case, both spouses must complete the course. 

You can obtain the list of agencies approved to 

provide both the briefing and the instructional 

course from: https://www.justice.gov/ust/listcredit-counseling-agencies-approved-pursuant-11-

Warning: File Your Forms on Time

Section 521(a)(1) of the Bankruptcy Code 

requires that you promptly file detailed information 

about your creditors, assets, liabilities, income, 

expenses and general financial condition. The 

court may dismiss your bankruptcy case if you do 

not file this information within the deadlines set by 

the Bankruptcy Code, the Bankruptcy Rules, and 

the local rules of the court. 

For more information about the documents and 

their deadlines, go to: 

https://www.uscourts.gov/forms/bankruptcyforms. 
 

Notice Required by 11 U.S.C. U.S.C. § 342(b) for Individuals Filing for Bankruptcy (Form 2010) page 14

usc-111. 

In Alabama and North Carolina, go to: 

https://www.uscourts.gov/servicesforms/bankruptcy/credit-counseling-anddebtor-education-courses. 

If you do not have access to a computer, the 

clerk of the bankruptcy court may be able to 

help you obtain the list. 
 

Instructions for Selected Forms page 15

 Instructions for Selected Forms
 

Schedule A/B: Property (Official Form 106A/B) page 16

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

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

lists property interests that are involved in a 

bankruptcy case. All individuals filing for 

bankruptcy must list everything they own or 

have a legal or equitable interest in. Legal or 

equitable interest is a broad term and includes 

all kinds of property interests in both tangible 

and intangible property, whether or not anyone 

else has an interest in that property. 

The information in this form is grouped by 

category and includes several examples for 

many items. Note that those examples are meant 

to give you an idea of what to include in the 

categories. They are not intended to be 

complete lists of everything within that 

category. Make sure you list everything you 

own or have an interest in. 

You must verify under penalty of perjury that 

the information you provide is complete and 

accurate. Making a false statement, concealing 

property, or obtaining money or property by 

fraud in connection with a bankruptcy case can 

result in fines up to $250,000, or imprisonment 

for up to 20 years, or both. 18 U.S.C. §§ 152, 

1341, 1519, and 3571. 

Understand the terms used in this form 

Community property — Type of property 

ownership available in certain states for 

property owned by spouses and, in some 

instances, legal equivalents of spouses. 

Community property states and territories 

include Arizona, California, Idaho, Louisiana, 

Nevada, New Mexico, Puerto Rico, Texas, 

Washington, and Wisconsin.

Current value — In this form, report the current 

value of the property that you own in each 

category. Current value is sometimes called fair 

market value and, for this form, is the fair 

market value as of the date of the filing of the 

petition. Current value is how much the 

property is worth, which may be more or less 

than when you purchased the property. Property 

you own includes property you have purchased, 

even if you owe money on it, such as a home 

with a mortgage or an automobile with a lien. 

Report the current value of the portion 

you own 

For each question, report the current value of 

the portion of the property that you own. To do 

this, you would usually determine the current 

value of the entire property and the percentage 

of the property that you own. Multiply the 

current value of the property by the percentage 

that you own. Report the result where the form 

asks for Current value of the portion you own. 

For example: 

 If you own a house by yourself, you own 

100% of that house. Report the entire 

current value of the house. 

 If you and a sister own the house equally, 

report 50% of the value of the house (or half 

of the value of the house). 

In certain categories, current value may be 

difficult to figure out. When you cannot find the 

value from a reputable source (such as a pricing 

guide for your car), estimate the value and be 

prepared to explain how you determined it. 
Schedule A/B: Property (Official Form 106A/B) page 17

List items once on this form 

List items only once on this form; do not list 

them in more than one category. List all real 

estate in Part 1 and other property in the other 

parts of the form. 

Where you list similar items of minimal value 

(such as clothing), add the value of the items 

and report a total. 

Be specific when you describe each item. If you 

have an item that you think could fit into more 

than one category, select the most suitable 

category and list the item there. 

Separately describe and list individual items 

worth more than $500. 

Match the values to the other schedules 

Make sure that the values you report on this form 

match the values you report on Schedule D: 

Creditors Who Have Claims Secured by Your 

Property (Official Form 106D) and Schedule C: 

The Property You Claim as Exempt (Official 

Form 106C). 
Schedule C: The Property You Claim as Exempt (Official Form 106C) page 18

Schedule C: The Property You Claim as Exempt

(Official Form 106C)

How exemptions work 

If you are an individual filing for bankruptcy, the 

law may allow you to keep some property, or it 

may entitle you to part of the proceeds if the 

property is sold after your case is filed. Property 

that the law permits you to keep is called exempt

property. For example, exemptions may enable 

you to keep your home, a car, clothing, and 

household items. 

Exemptions are not automatic. For property to be 

considered exempt, you must list the property on

Schedule C: The Property You Claim as Exempt 

(Official Form 106C). If you do not list the 

property, the trustee may sell it and pay all of the 

proceeds to your creditors. 

You may unnecessarily lose property if you 

do not claim exemptions to which you are 

entitled. You are strongly encouraged to 

hire a qualified attorney to advise you.

Determine which set of exemptions you 

will use 

Before you fill out this form, you must learn 

which set of exemptions you can use. In general, 

exemptions are determined on a state-by-state 

basis. Some states permit you to use the 

exemptions provided by the Bankruptcy Code. 

11 U.S.C. § 522. 

The Bankruptcy Code provides that you use the 

exemptions in the law of the state where you had 

your legal home for 730 days before you file for 

bankruptcy. Special rules may apply if you did 

not have the same home state for 730 days before 

you file. 

You may lose property if you do not use the best 

set of exemptions for your situation. 

If your spouse is filing with you and you are 

filing in a state in which you may choose 

between state and federal sets of bankruptcy 

exemptions, you both must use the same set of 

exemptions. 

Claiming exemptions 

Using the property and values that you listed on 

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

as your source, list on this form the property that 

you claim as exempt. 

Listing the amount of each exemption 

For each item of property you claim as exempt, 

you must specify the amount of the exemption 

you claim. Usually, a specific dollar amount is 

claimed as exempt, but in some circumstances, 

the amount of the exemption claimed might be 

indicated as 100% of fair market value. For 

example, a debtor might claim 100% of fair 

market value for an exemption that is unlimited 

in dollar amount, such as some exemptions for 

health aids. 

Listing which laws apply 

In the last column of the form, you must identify 

the laws that allow you to claim the property as 

exempt. If you have questions about exemptions, 

consult a qualified attorney. 
Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D) page 19

Schedule D: Creditors Who Have Claims Secured by 

Property (Official Form 106D)

The people or organizations to whom you owe 

money are called your creditors. A claim is a 

creditor’s right to payment. When you file for 

bankruptcy, the court needs to know who all 

your creditors are and what types of claims they 

have against you. 

Typically, in bankruptcy cases, there are more 

debts than assets to pay those debts. The court 

must know as much as possible about your 

creditors to make sure that their claims are 

properly treated according to the rules. 

Creditors may have different types of claims: 

 Secured claims. Report these on Schedule D: 

Creditors Who Have Claims Secured by 

Property (Official Form 106D). 

 Unsecured claims. Report these on 

Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F). 

If your debts are not paid, a creditor with a 

secured claim may be able to get paid from 

specific property in which that creditor has an 

interest, such as a mortgage or a lien. That 

property is sometimes called collateral for your 

debt and could include items such as your house, 

your car, or your furniture. Creditors with 

unsecured claims do not have rights against 

specific property. 

Many creditors’ claims have a specific amount, 

which you do not dispute. However, some claims 

are uncertain when you file for bankruptcy, or 

they become due only after you file. You must 

list the claims of all your creditors in your 

schedules, even if the claims are contingent, 

unliquidated, or disputed. 

Claims may be contingent, unliquidated, 

or disputed 

Claims may be: 

 Contingent claims, 

 Unliquidated claims, or 

 Disputed claims. 

A claim is contingent if you are not obligated to 

pay it unless a particular event occurs after you 

file for bankruptcy. For example, if you cosigned 

someone else’s note, you may not have to pay 

unless that other person later fails to repay the 

loan. 

A claim is unliquidated if the amount of the debt 

cannot be readily determined, such as by 

referring to an agreement or by a simple 

computation. An unliquidated claim is one for 

which there may be a definite liability but where 

the value has not been set. For instance, if you 

were involved in a car accident, the victim may 

have an unliquidated claim against you because 

the amount of damages has not been determined. 

A claim is disputed if you disagree about 

whether you owe the debt. For instance, if a bill 

collector demands payment for a bill you believe 

you already fully paid, you may describe the 

claim as disputed. 

A single claim can have one, more than one, or 

none of these characteristics. 

On Schedule D: Creditors Who Have Claims 

Secured by Property (Official Form 106D), list 

all creditors who have a claim that is secured by 

your property. 
 Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D) page 20

Do not leave out any secured creditors 

In alphabetical order (as much as possible), list 

anyone who has judgment liens, garnishments, 

statutory liens, mortgages, deeds of trust, and 

other security interests against your property. 

When listing creditors who have secured claims, 

be sure to include all of them. For example, 

include the following: 

 Your relatives or friends who have a lien or 

security interest in your property; 

 Car or truck lenders, stores, banks, credit 

unions, and others who made loans to enable 

you to finance the purchase of property and 

who have a lien against that property; 

 Anyone who has a mortgage or deed of trust 

on real estate that you own; 

 Contractors or mechanics who have liens on 

property you own because they did work on 

the property and were not paid; 

 Someone who won a lawsuit against you and 

has a judgment lien; 

 Another parent or a government agency that 

has a lien for unpaid child support; 

 Doctors or attorneys who have liens on the 

outcome of a lawsuit; 

 Federal, state, or local government agencies 

such as the IRS that have tax liens against 

property for unpaid taxes; and 

 Anyone who is trying to collect a secured 

debt from you, such as collection agencies 

and attorneys. 

List the debt in Part 1 only once and list any 

others that should be notified about that debt in 

Part 2. For example, if a collection agency or an 

attorney is trying to collect from you for a debt 

you owe to someone else, list the person to 

whom you owe the debt in Part 1, and list the 

collection agency in Part 2. If you are not sure 

who the creditor is, list the person you are paying 

in Part 1 and list anyone else who has contacted 

you about this debt in Part 2. 

If a creditor’s full claim is more than the value of 

your property securing that claim—for instance, 

a car loan in an amount greater than the value of 

the car—the creditor’s claim may be partly 

secured and partly unsecured. In that situation, 

list the claim only once on Schedule D: 

Creditors Who Have Claims Secured by 

Property (Official Form 106D). Do not repeat it 

on Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F). List 

a creditor in Schedule D even if it appears that 

there is no value to support that creditor’s 

secured claim. 

Determine the unsecured portion of 

secured claims 

To determine the amount of a secured claim, 

compare the amount of the claim to the value of 

your portion of the property that supports the 

claim. If that value is greater than the amount of 

the claim, then the entire amount of the claim is 

secured. But if that value is less than the amount 

of the claim, the difference is an unsecured 

portion. For example, if the outstanding balance 

of a car loan is $10,000 and the car is worth 

$8,000, the car loan has a $2,000 unsecured 

portion. 
 Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D) page 21

If there is more than one secured claim against 

the same property, the claim that is entitled to be 

paid first must be subtracted from the property 

value to determine how much value remains for 

the next claim. 

For example, if a home worth $300,000 has a 

first mortgage of $200,000 and a second 

mortgage of $150,000, the first mortgage would 

be fully secured, and there would be $100,000 of 

property value for the second mortgage, which 

would have an unsecured portion of $50,000. 

$300,000 value of a home 

- $200,000 first mortgage 

 $100,000 remaining property value 

 $150,000 second mortgage 

- $100,000 remaining property value 

 $ 50,000 unsecured portion of second mortgage 

 
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F) page 22

Schedule E/F: Creditors Who Have Unsecured 

Claims (Official Form 106E/F)

The people or organizations to whom you owe 

money are called your creditors. A claim is a 

creditor’s right to payment. When you file for 

bankruptcy, the court needs to know who all 

your creditors are and what types of claims they 

have against you. 

Typically in bankruptcy cases, there are more 

debts than assets to pay those debts. The court 

must know as much as possible about your 

creditors to make sure that their claims are 

properly treated according to the rules. 

Use Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F) to 

identify everyone who has an unsecured claim 

against you when you file your bankruptcy 

petition, unless you have already listed them on 

Schedule D: Creditors Who Have Claims 

Secured by Your Property (Official Form 

106D). 

Creditors may have different types of claims: 

 Secured claims. Report these on Schedule D: 

Creditors Who Have Claims Secured by 

Property (Official Form 106D). 

 Unsecured claims. Report these on 

Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F). 

If your debts are not paid, creditors with 

secured claims may be able to get paid from 

specific property in which that creditor has an 

interest, such as a mortgage or a lien. That 

property is sometimes called collateral for your 

debt and could include items such as your 

house, your car, or your furniture. Creditors 

with unsecured claims do not have rights 

against specific property. 

Many creditors’ claims have a specific amount, 

which you do not dispute. However, some 

claims are uncertain when you file for 

bankruptcy, or they become due only after you 

file. You must list the claims of all your 

creditors in your schedules, even if the claims 

are contingent, unliquidated, or disputed. 

Claims may be contingent, unliquidated, 

or disputed 

Claims may be: 

 Contingent claims, 

 Unliquidated claims, or 

 Disputed claims. 

A claim is contingent if you are not obligated to 

pay it unless a particular event occurs after you 

file for bankruptcy. For example, if you 

cosigned someone else’s note, you may not 

have to pay unless that person later fails to 

repay the loan. 

A claim is unliquidated if the amount of the 

debt cannot be readily determined, such as by 

referring to an agreement or by a simple 

computation. An unliquidated claim is one for 

which there may be a definite liability but 

where the value has not been set. For instance, 

if you were involved in a car accident, the 

victim may have an unliquidated claim against 

you because the amount of damages has not 

been set. 
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F) page 23

A claim is disputed if you disagree about 

whether you owe the debt. For instance, if a bill 

collector demands payment for a bill you 

believe you already fully paid, you may 

describe the claim as disputed. 

A single claim can have one, more than one, or 

none of these characteristics. 

Creditors with unsecured claims do not have 

liens on or other security interests in your 

property. Secured creditors have a right to take 

property if you do not pay them. Common 

examples are lenders for your car, your home, 

or your furniture. 

Do not leave out any unsecured 

creditors 

List all unsecured creditors in each part of the 

form in alphabetical order as much as possible. 

Even if you plan to pay a creditor, you must list 

that creditor. When listing creditors who have 

unsecured claims, be sure to include all of them. 

For instance, include the following: 

 Your relatives or friends to whom you owe 

money; 

 Your ex-spouse, if you are still obligated 

under a divorce decree or settlement 

agreement to pay joint debts; 

 A credit card company, even if you intend to 

fully pay your credit card bill; 

 A lender, even if the loan is cosigned; 

 Anyone who has a loan or promissory note 

that you cosigned for someone else; 

 Anyone who has sued or may sue you 

because of an accident, dispute, or similar 

event that has occurred; or 

 Anyone who is trying to collect a debt from 

you such as a bill collector or attorney. 

Unsecured claims could be priority or 

nonpriority claims 

What are priority unsecured claims? 

In bankruptcy cases, priority unsecured claims

are those debts that the Bankruptcy Code 

requires to be paid before most other unsecured 

claims are paid. The most common priority 

unsecured claims are certain income tax debts 

and past due alimony or child support. Priority 

unsecured claims include those you owe for: 

 Domestic support obligations—If you owe 

domestic support to a spouse or former 

spouse; a child or the parent, legal guardian, 

or responsible relative of a child; or a 

governmental unit to whom such a domestic 

support claim has been assigned. 

11 U.S.C. § 507(a)(1). 

 Taxes and certain other debts you owe the 

government—If you owe certain federal, 

state, or local government taxes, customs 

duties, or penalties. 

11 U.S.C. § 507(a)(8). 

 Claims for death or personal injury that you 

caused while you were intoxicated—If you 

have a claim against you for death or 

personal injury that resulted from your 

unlawfully operating a motor vehicle or 

vessel while you were unlawfully 

intoxicated from alcohol, drugs, or another 

substance. This priority does not apply to 

claims for property damage. 

11 U.S.C. § 507(a)(10). 

 
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F) page 24

 Other: 

 Deposits by individuals—If you received 

money from someone for the purchase, 

lease, or rental of your property or the use 

of your services but you never delivered 

or performed. For the debt to have 

priority, the property or services must 

have been intended for personal, family, 

or household use (only the first $3,350* 

per person is a priority debt). 11 

U.S.C. § 507(a)(7). 

 Wages, salaries, and commissions—If 

you owe wages, salaries, and 

commissions, including vacation, 

severance, and sick leave pay and those 

amounts were earned within 180 days 

before you filed your bankruptcy petition 

or ceased business. In either instance, 

only the first $15,150* per claim is a 

priority debt. 11 U.S.C. § 507(a)(4). 

 Contributions to employee benefit 

plans—If you owe contributions to an 

employee benefit plan for services an 

employee rendered within 180 days 

before you file your bankruptcy petition, 

or within 180 days before your business 

ends. Count only the first $15,150* per 

employee, less any amounts owed for 

wages, salaries, and commissions. 

11 U.S.C. § 507(a)(5). 

* Subject to adjustment on 4/01/25, and every 3 years 

after that for cases begun on or after the date of 

adjustment.

What are nonpriority unsecured claims? 

Nonpriority unsecured claims are those debts 

that generally will be paid after priority 

unsecured claims are paid. The most common 

examples of nonpriority unsecured claims are 

credit card bills, medical bills, and educational 

loans. 

What if a claim has both priority and 

nonpriority amounts? 

If a claim has both priority and nonpriority 

amounts, list that claim in Part 2 and show both 

priority and nonpriority amounts. Do not list it 

again in Part 3. 

In Part 3, list all of the creditors you have not 

listed before. You must list every creditor that 

you owe, regardless of the amount you owe and 

even if you plan to pay a particular debt. If you 

do not list a debt, it may not be discharged. 

What is needed for statistical purposes? 

For statistical reasons, the court must collect 

information about some specific categories of 

unsecured claims. 

The categories for priority unsecured claims 

are: 

 Domestic support obligations 

 Taxes and certain other debts you owe the 

government 

 Claims for death or personal injury that you 

caused while you were intoxicated

 
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F) page 25

The categories for nonpriority unsecured claims 

are: 

 Student loans—If you owe money for any 

loans that you used to pay for your 

education; 

 Obligations arising out of a separation 

agreement or divorce that you did not report 

as priority claims—If you owe debts for 

separation or divorce agreements or for 

domestic support and you did not report 

those debts in Part 2; and 

 Debts to pension or profit-sharing plans and 

other similar debts—If you owe money to a 

pension or profit-sharing plan. 
Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G) page 26

Schedule G: Executory Contracts and Unexpired 

Leases (Official Form 106G)

Use Schedule G: Executory Contracts and 

Unexpired Leases (Official Form 106G) to 

identify your ongoing leases and certain 

contracts. List all of your executory contracts 

and unexpired leases. 

Executory contracts are contracts between you 

and someone else in which neither you nor the 

other party has performed all of the 

requirements by the time you file for 

bankruptcy. Unexpired leases are leases that 

are still in effect; the lease period has not yet 

ended. 

You must list all agreements that may be 

executory contracts or unexpired leases, even 

if they are listed on Schedule A/B: Property

(Official Form 106A/B), including the 

following: 

 Residential leases (for example, a rental 

agreement for a place where you live or 

vacation, even if it is only a verbal or 

month-to-month arrangement); 

 Service provider agreements (for example, 

contracts for cell phones and personal 

electronic devices); 

 Internet and cable contracts; 

 Vehicle leases; 

 Supplier or service contracts (for example, 

contracts for lawn care or home alarm or 

security systems); 

 Timeshare contracts or leases; 

 Rent-to-own contracts; 

 Employment contracts; 

 Real estate listing agreements; 

 Contracts to sell a residence, building, land, 

or other real property; 

 Equipment leases; 

 Leases for business or investment property; 

 Supplier and service contracts for your 

business; 

 Copyright and patent license agreements; 

and 

 Development contracts. 
 Schedule H: Your Codebtors (Official Form 106H) page 27

Schedule H: Your Codebtors (Official Form 106H)

If you have any debts that someone else may 

also be responsible for paying, these people or 

entities are called codebtors. Use Schedule H: 

Your Codebtors (Official Form 106H) to list 

any codebtors who are responsible for any debts 

you have listed on the other schedules. 

To help fill out this form, use both Schedule D: 

Creditors Who Have Claims Secured by 

Property (Official Form 106D) and Schedule 

E/F: Creditors Who Have Unsecured Claims

(Official Form 106E/F). 

List all of your codebtors and the creditors to 

whom you owe the debt. For example, if 

someone cosigned for the car loan that you owe, 

you must list that person on this form. 

If you are filing a joint case, do not list either 

spouse as a codebtor. 

Other codebtors could include the following: 

 Cosigner; 

 Guarantor; 

 Former spouse; 

 Unmarried partner; 

 Joint contractor; or 

 Nonfiling spouse—even if the spouse is not 

a cosigner—where the debt is for necessities 

(such as food or medical care) if state law 

makes the nonfiling spouse legally 

responsible for debts for necessities. 
Schedule I: Your Income (Official Form 106I) page 28

Schedule I: Your Income (Official Form 106I)

In Schedule I: Your Income (Official Form 106I),

you will give the details about your employment 

and monthly income as of the date you file this 

form. If you are married and your spouse is living 

with you, include information about your spouse 

even if your spouse is not filing with you. If you are 

separated and your spouse is not filing with you, do 

not include information about your spouse. 

How to report employment and income 

If you have nothing to report for a line, write 

$0. 

In Part 1, line 1, fill in employment 

information for you and, if appropriate, for a 

non-filing spouse. If either person has more 

than one employer, attach a separate page with 

information about the additional employment. 

In Part 2, give details about the monthly 

income you currently expect to receive. Show 

all totals as monthly payments, even if income 

is not received in monthly payments. 

If your income is received in another time 

period, such as daily, weekly, quarterly, 

annually, or irregularly, calculate how much 

income would be by month, as described 

below. 

If either you or a non-filing spouse has more 

than one employer, calculate the monthly 

amount for each employer separately, and then 

combine the income information for all 

employers for that person on lines 2-7. 

One easy way to calculate how much income 

per month is to total the payments earned in a 

year, then divide by 12 to get a monthly figure. 

For example, if you are paid seasonally, you 

would simply divide the amount you expect to 

earn in a year by 12 to get the monthly amount 

Below are other examples of how to calculate 

monthly amount. 

Example for weekly payments: 

If you are paid $1,000 every week, figure your 

monthly income in this way: 

 $1,000 income every week

X 52 number of pay periods in the year

 $52,000 total income for the year

$52,000 (income for year)_________ = $4,333 monthly income

 12 (number of months in year)

Example for bi-weekly payments: 

If you are paid $2,500 every other week, figure 

your monthly income in this way: 

 $2,500 income every other week

X 26 number of pay periods in the year

 $65,000 total income for the year

$65,000 (income for year)_________ = $5,417 monthly income

 12 (number of months in year)

 
Schedule I: Your Income (Official Form 106I) page 29

Example for daily payments: 

If you are paid $75 a day and you work about 8 

days a month, figure your monthly income in 

this way: 

 $75 income a day

X 96 days a year

 $7,200 total income for the year

 $7,200 (income for year) = $600 monthly income

 12 (number of months in year)

or this way: 

 $75 income a day

X 8 payments a month

 $600 income for the month

Example for quarterly payments: 

If you are paid $15,000 every quarter, figure 

your monthly income in this way: 

 $15,000 income every quarter

X 4 pay periods in the year 

 $60,000 total income for the year

$60,000 (income for year) = $5,000 (number of months in year)

12 monthly income

Example for irregular payments: 

If you are paid $4,000 8 times a year, figure 

your monthly income in this way: 

 $4,000 income a payment

X 8 payments a year

$32,000 income for the year

 $32,000 (income for year) = $2,667 monthly income

 12 (number of months in year)

In Part 2, line 11, fill in amounts that other 

people provide to pay the expenses you list on 

Schedule J: Your Expenses. For example, if you 

and a person to whom you are not married pay 

all household expenses together and you list all 

your joint household expenses on Schedule J, 

you must list the amounts that person 

contributes monthly to pay the household 

expenses on line 11. If you have a roommate and 

you divide the rent and utilities, do not list the 

amounts your roommate pays on line 11 if you 

have listed only your share of those expenses on 

Schedule J. Do not list on line 11 contributions 

that you already disclosed elsewhere on the 

form. 

Note that the income you report on Schedule I 

may be different from the income you report on 

other bankruptcy forms. For example, the 

Chapter 7 Statement of Your Current Monthly 

Income (Official Form 122A-1), Chapter 11 

Statement of Your Current Monthly Income

(Official Form 122B), and the Chapter 13 

Statement of Your Current Monthly Income and 

Calculation of Commitment Period (Official 

Form 122C-1) all use a different definition of 

income and apply that definition to a different 

period of time. Schedule I asks about the income 

that you are now receiving, while the other 

forms ask about income you received in the 

applicable time period before filing. So the 

amount of income reported in any of those forms 

may be different from the amount reported here. 

If, after filing Schedule I, you need to file an 

estimate of income in a chapter 13 case for a 

date after your bankruptcy, you may complete 

a supplemental Schedule I. To do so you must 

check the “supplement” box at the top of the 

form and fill in the date.
Schedule J: Your Expenses (Official Form 106J) page 30

Schedule J: Your Expenses (Official Form 106J and 106J-2)

Schedule J: Your Expenses (Official Form 

106J) provides an estimate of the monthly 

expenses, as of the date you file for 

bankruptcy, for you, your dependents, and the 

other people in your household whose income 

is included on Schedule I: Your Income

(Official Form 106I). 

If you are married and are filing individually, 

include your non-filing spouse’s expenses 

unless you are separated. 

If you are filing jointly and Debtor 1 and 

Debtor 2 keep separate households, Debtor 2 

must complete and include Schedule J-2: 

Expenses for Separate Household of Debtor 2

(Official Form 106J-2). 

Do not include expenses that other members of 

your household pay directly from their income 

if you did not include that income on 

Schedule I. For example, if you have a 

roommate and you divide the rent and utilities 

and you have not listed your roommate’s 

contribution to household expenses in line 11 

of Schedule I, you would list only your share 

of these expenses on Schedule J.

Show all totals as monthly payments. If you 

have weekly, quarterly, or annual payments, 

calculate how much you would spend on those 

items every month. 

Do not list as expenses any payments on credit 

card debts incurred before filing bankruptcy. 

Do not include business expenses on this form. 

You have already accounted for those 

expenses as part of determining net business 

income on Schedule I. 

On line 20, do not include expenses for your 

residence or for any rental or business 

property. You have already listed expenses for 

your residence on lines 4 and 5 of this form. 

You listed the expenses for your rental and 

business property as part of the process of 

determining your net income from that 

property on Schedule I (line 8a). 

If you have nothing to report for a line, write 

$0. 

If, after filing Schedule J, you need to file an 

estimate of expenses in a chapter 13 case for a 

date after your bankruptcy, you may complete 

a supplemental Schedule J. To do so you must 

check the “supplement” box at the top of the 

form and fill in the date. 
Summary of Your Assets and Liabilities and Certain Statistical Information (Official Form 106Sum) page 31

Summary of Your Assets and Liabilities and Certain 

Statistical Information (Official Form 106Sum)

When you file for bankruptcy, you must 

summarize certain information from the 

following forms: 

 Schedule A/B: Property (Official 

Form 106A/B) 

 Schedule D: Creditors Who Have Claims 

Secured by Property (Official Form 106D) 

 Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F) 

 Schedule I: Your Income (Official 

Form 106I) 

 Schedule J: Your Expenses (Official Form 

106J) 

 Chapter 7 Statement of Your Current 

Monthly Income (Official Form 122A-1), 

Chapter 11 Statement of Your Current 

Monthly Income (Official Form 122B), or 

Chapter 13 Statement of Your Current 

Monthly Income and Calculation of 

Commitment Period (Official Form 122C-1) 

After you fill out all of the forms, complete 

Summary of Your Assets and Liabilities and 

Certain Statistical Information (Official Form 

106Sum) to report the totals of certain 

information that you listed in the forms. 

If you are filing an amended version of any of 

these forms at some time after you file your 

original forms, you must fill out a new Summary

to ensure that your information is up to date and 

you must check the box at the top. 
Statement of Financial Affairs for Individuals Filing for Bankruptcy (Official Form 107) page 32

Statement of Financial Affairs for Individuals Filing 

for Bankruptcy (Official Form 107)

Your Statement of Financial Affairs for 

Individuals Filing for Bankruptcy, provides a 

summary of your financial history over certain 

periods of time before you file for bankruptcy. 

If you are an individual in a bankruptcy case, 

you must fill out this statement. 

11 U.S.C. § 521(a) and Bankruptcy Rule 

1007(b)(1). 

If you are in business as a sole proprietor, 

partner, family farmer, or self-employed 

professional, you must provide the information 

about all of your business and personal financial 

activities. 

Although this statement may ask you questions 

that are similar to some questions on the 

schedules, you must fill out all of the forms 

completely to protect your legal rights.

Understand the terms used in this form 

Legal equivalent of a spouse — A person whom 

applicable nonfederal law recognizes as having 

a relationship with the debtor that grants legal 

rights and responsibilities equivalent, in whole 

or in part, to those granted to a spouse. 
Chapter 7 Statement of Current Monthly Income; Means Test Calculation (Official Forms 122A-1, 122A-2) page 33

Chapter 7 Statement of Your Current Monthly Income 

and Means Test Calculation (Official Forms 122A–1, 122A-1Supp, 

and 122A–2)

If you are filing under chapter 11, 

12, or 13, do not fill out this form.

Official Forms 122A–1 and 122A–2 determine 

whether your income and expenses create a 

presumption of abuse that may prevent you 

from obtaining relief from your debts under 

chapter 7 of the Bankruptcy Code. Chapter 7 

relief can be denied to a person who has 

primarily consumer debts if the court finds that 

the person has enough income to repay 

creditors an amount that, under the Bankruptcy 

Code, would be a sufficient portion of their 

claims. 

You must file Chapter 7 Statement of Your 

Current Monthly Income (Official Form122A–1) 

if you are an individual filing for bankruptcy 

under chapter 7. This form will determine your 

current monthly income and compare whether 

your income is more than the median income for 

households of the same size in your state. If your 

income is not above the median, there is no 

presumption of abuse and you will not have to 

fill out the second form. 

Similarly, Statement of Exemption from 

Presumption of Abuse Under § 707(b)(2)

(Official Form 122A-1Supp) determines 

whether you may be exempted from the 

presumption of abuse because you do not have 

primarily consumer debts or because you have 

provided certain military or homeland defense 

services. If one of these exemptions applies, you 

should file a supplement, Form 122A-1Supp, 

and verify the supplement by completing Part 3 

of Form 122A-1. If you qualify for an 

exemption, you are not required to fill out any 

part of Form 122A-1 other than the verification. 

If the exemptions do not apply, you should 

complete all of the parts of Form 122A-1 and 

file it without the supplemental form. 

If you and your spouse are filing together, you 

and your spouse may file a single Form 122A-1. 

However, if an exemption on Form122A-1Supp 

applies to only one of you, separate forms may 

be required. 11 U.S.C. § 707(b)(2)(C). 

If your completed Form 122A-1 shows income 

above the median, you must file the second 

form, Chapter 7 Means Test Calculation

(Official Form 122A –2). The calculations on 

this form—sometimes called the Means Test—

reduce your income by living expenses and 

payment of certain debts, resulting in an 

amount available to pay other debts. If this 

amount is high enough, it will give rise to a 

presumption of abuse. A presumption of abuse 

does not mean you are actually trying to abuse 

the bankruptcy system. Rather, the 

presumption simply means that you are 

presumed to have enough income that you 

should not be granted relief under chapter 7. 

You may overcome the presumption by 

showing special circumstances that reduce 

your income or increase your expenses. 

If you cannot obtain relief under chapter 7, you 

may be eligible to continue under another 
Chapter 7 Statement of Current Monthly Income; Means Test Calculation (Official Forms 122A-1, 122A-2) page 34

chapter of the Bankruptcy Code and pay 

creditors over a period of time. 

Read each question carefully. You may not be 

required to answer every question on this form. 

For example, your military status may 

determine whether you must fill out the entire 

form. The instructions will alert you if you 

may skip questions. 

If you have nothing to report for a line, write 

$0. 

Information for completing the forms 

To fill out several lines of the forms, you must 

look up information provided on websites or 

from other sources. For information: 

(1) to complete line 13 of Form 122A-1 

and lines 6-15, 30, and 36 of Form 

122A-2; or 

(2) if you are a servicemember, veteran, or 

the family member of a veteran, and 

are looking for a list of the types of 

benefits that the United States 

Department of Justice confirms need 

not be reported on lines 9 or 10 of 

Form 122A-1 on account of the 

veteran’s death or disability under the 

“Helping American Veterans in 

Extreme Need Act of 2019” (HAVEN 

Act); 

go to: 

https://www.justice.gov/ust/means-testing 

If your case is filed in Alabama or North 

Carolina, the administrative expense multiplier 

mentioned at line 36 can be found at: 

https://www.uscourts.gov/servicesforms/bankruptcy/trustees-andadministrators/administrative-expensemultipliers . 

For the Bankruptcy Basics information referred 

to on line 36 of Form 122A-2, go to: 

https://www.uscourts.gov/servicesforms/bankruptcy/bankruptcy-basics. 

If you do not have a computer with internet 

access, you may be able to use a public 

computer at the bankruptcy clerk’s office or at 

a public library.
Chapter 11 Statement of Your Current Monthly Income (Official Form 122B) page 35

Chapter 11 Statement of Your Current Monthly 

Income (Official Form 122B)

You must file the Chapter 11 Statement of Your 

Current Monthly Income (Official Form 122B)

if you are an individual filing for bankruptcy 

under chapter 11 (other than under subchapter 

V). 

Information for completing the forms 

If you have nothing to report for a line, write 

$0. 

If you are a servicemember, veteran, or the 

family member of a veteran, and are looking for 

a list of the types of benefits that the United 

States Department of Justice confirms need not 

be reported on lines 9 or 10 of Form 122B on 

account of the veteran’s death or disability 

under the “Helping American Veterans in 

Extreme Need Act of 2019” (HAVEN Act), go 

to: 

https://www.justice.gov/ust/means-testing

If you are filing under chapter 7, 

12, or 13, do not fill out this form.
Chapter 13 Statement of Current Monthly Income, Calculation of Commitment Period and 

Chapter 13 Calculation of Your Disposable Income (Official Forms 122C-1, 122C-2) page 36

Chapter 13 Statement of Your Current Monthly 

Income, Calculation of Commitment Period and 

Chapter 13 Calculation of Your Disposable Income 

(Official Forms 122C–1 and 122C–2)

Official Forms 122C─1 and 122C─2 

determine the commitment period for your 

payments to creditors, how the amount you 

may be required to pay to creditors is 

established, and, in some situations, how much 

you must pay. 

You must file the Chapter 13 Statement of 

Your Current Monthly Income and Calculation 

of Commitment Period (Official Form 

122C─1) if you are an individual and you are 

filing under chapter 13. This form will report 

your current monthly income and determine 

whether your income is at or below the median 

income for households of the same size in your 

state. If your income is equal to or less than the 

median, you will not have to fill out the second 

form. Form 122C-1 also will determine your 

applicable commitment period—the time period 

for making payments to your creditors, unless 

the court orders otherwise. 

If your income is above the median, you must file 

the second form, Chapter13 Calculation of Your 

Disposable Income (Official Form 122C─2). The 

calculations on this form—sometimes called the 

Means Test—reduce your income by living 

expenses and payment of certain debts, resulting in 

an amount available to pay unsecured debts. Your 

chapter 13 plan may be required to provide for 

payment of this amount toward unsecured debts. 

Read each question carefully. You may not be 

required to answer every question on this form. The 

instructions will alert you if you may skip 

questions. 

Some of the questions require you to go to other 

sources for information. In those cases, the form 

has instructions for where to find the information 

you need. 

Generally, if you and your spouse are filing 

together, you should file one statement together. 

Information for completing the forms 

To fill out several lines of the forms, you must 

look up information provided on websites or 

from other sources. For information: 

(1) to complete line 16c of Form 122C-1 

and lines 6-15, 30, and 36 of Form 

122C-2; or 

(2) if you are a servicemember, veteran, or 

the family member of a veteran, and 

are looking for a list of the types of 

benefits that the United States 

Department of Justice confirms need 

not be reported on lines 9 or 10 of 

Form 122C-1 on account of the 

veteran’s death or disability under the 

If you are filing under chapter 7, 

11, or 12, do not fill out this form.
Chapter 13 Statement of Current Monthly Income, Calculation of Commitment Period and 

Chapter 13 Calculation of Your Disposable Income (Official Forms 122C-1, 122C-2) page 37

“Helping American Veterans in 

Extreme Need Act of 2019” (HAVEN 

Act); 

go to: 

https://www.justice.gov/ust/means-testing 

If your case is filed in Alabama or North Carolina, 

the administrative expense multiplier mentioned at 

line 36 can be found at: 

https://www.uscourts.gov/servicesforms/bankruptcy/trustees-andadministrators/administrative-expense-multipliers .

If you do not have a computer with internet 

access, you may be able to use a public 

computer at the bankruptcy clerk’s office or at 

a public library. 
Statement of Intention for Individuals Filing Under Chapter 7 (Official Form 108) page 38

Statement of Intention for Individuals Filing Under 

Chapter 7 (Official Form 108)

If you are an individual filing under chapter 7, 

you must fill out the Statement of Intention for 

Individuals Filing Under Chapter 7 (Official 

Form 108) if: 

 creditors have claims secured by your 

property, or 

 you have leased personal property and the 

lease has not expired. 

The Bankruptcy Code requires you to state your 

intentions about such claims and provides for 

early termination of the automatic stay as to 

personal property if the statement is not timely 

filed. The same early termination of the 

automatic stay applies to any unexpired lease of 

personal property unless you state that you 

intend to assume the unexpired lease if the 

trustee does not do so. 

To help fill out this form, use the information 

you have already provided on the following 

forms: 

 Schedule D: Creditors Who Have Claims 

Secured by Property (Official Form 106D),

 Schedule C: The Property You Claim as 

Exempt (Official Form 106C), and

 Schedule G: Executory Contracts and 

Unexpired Leases (Official Form 106G).

Explain what you intend to do with your 

property that is collateral for a claim 

If you have property that is collateral (or 

security) for a claim, you must state what you 

intend to do with that property. 

You may choose either to surrender the property 

to the creditor, or retain the property. Below is 

more information about each of these options. 

You may surrender the property to the creditor. If 

you surrender the property to the creditor, your 

bankruptcy discharge will protect you from any 

claim for the difference between what you owe 

the creditor and what the creditor receives from a 

sale of the property, unless the court determines 

that the debt is nondischargeable. 

You may want to retain the property. If you want 

to retain your secured personal property, you may 

be able to reaffirm the debt, redeem the property, 

or take other action (for example, avoid a lien 

using 11 U.S.C. § 522(f)). 

 You may be able to reaffirm the debt. You may 

decide to remain legally obligated to pay a 

debt so that you can keep the property 

securing the debt. This is called reaffirming a 

debt. You may reaffirm the debt in full on its 

original terms or you and the creditor may 

agree to change the terms. For example, if 

you want to keep your car, you may reaffirm 

a car loan, stating that you will continue to 

make monthly payments for it. Only reaffirm 

those debts that you are confident you can 

repay. You may seek to reaffirm the debt if 

you sign a Reaffirmation Agreement, which is 

a contract between you and a creditor, and 

If you are filing under chapter 11, 

12, or 13, do not fill out this form.
 Statement of Intention for Individuals Filing Under Chapter 7 (Official Form 108) page 39

you follow the proper procedure for the 

Reaffirmation Agreement. 11 U.S.C. § 524. 

The procedure is explained in greater detail in 

the Disclosures that are part of the 

reaffirmation documents.

 You may be able to redeem your property. 

11 U.S.C. § 722. You can redeem property 

only if all of the following apply:

 The property secures a debt that is a 

consumer debt ─ you incurred the debt 

primarily for personal, family, or 

household use. 

 The property is tangible personal 

property ─ the property is physical, such 

as furniture, appliances, and cars. 

 You are either claiming the property as 

exempt or the trustee has abandoned it. 

To obtain court authorization to redeem your 

property, you must file a motion with the 

court. If the court grants your motion, you pay 

the creditor the value of the property or the 

amount of the claim, whichever is less. The 

payment will be a single lump-sum payment. 

Explain what you intend to do with your 

leased personal property 

If you lease personal property such as your car, 

you may be able to continue your lease if the 

trustee does not assume the lease. To continue 

your lease, you can write to the lessor that you 

want to assume your lease. The creditor may, at 

its option, notify you that it is willing to have 

you assume the lease and may condition the 

assumption on cure of any outstanding default. 

If the lessor notifies you that it is willing to have 

you assume the lease, you must write to the 

lessor within 30 days stating that you assume the 

lease. 11 U.S.C. § 365(p)(2). 

File the Statement of Intention before the 

deadline 

You must file this form either within 30 days 

after you file your bankruptcy petition or by the 

date set for the meeting of creditors, whichever is 

earlier. You must also deliver copies of this 

statement to the creditors and lessors you listed 

on the form. Bankruptcy Rule 1007(b)(2). 

If two married people are filing together in a 

joint case, both are equally responsible for 

supplying correct information. Both debtors must 

sign and date the form. 
Application for Individuals to Pay the Filing Fee in Installments (Official Form 103A) page 40

Application for Individuals to Pay the Filing Fee in 

Installments (Official Form 103A)

If you cannot afford to pay the full filing fee 

when you first file for bankruptcy, you may 

pay the fee in installments. However, in most 

cases, you must pay the entire fee within 120 

days after you file, and the court must approve 

your payment timetable. Your debts will not be 

discharged until you pay your entire fee. 

Do not file this form if you can afford to pay 

your full fee when you file. 

If you are filing under chapter 7 and cannot afford 

to pay the full filing fee at all, you may be 

qualified to ask the court to waive your filing fee. 

See Application to Have Your Chapter 7 Filing 

Fee Waived (Official Form 103B). 

If a bankruptcy petition preparer helped you 

complete this form, make sure that person fills 

out the Bankruptcy Petition Preparer’s Notice, 

Declaration, and Signature (Official Form 119); 

include a copy of it when you file this 

application. 

This form includes a proposed order for use by 

the court in considering the application. The 

court may modify the form of the order or use its 

own version of the order. 
Application to Have the Chapter 7 Filing Fee Waived (Official Form 103B) page 41

Application to Have the Chapter 7 Filing Fee 

Waived (Official Form 103B) 

The fee for filing a bankruptcy case under 

chapter 7 is $335. If you cannot afford to pay 

the entire fee now in full or in installments 

within 120 days, use this form. If you can 

afford to pay your filing fee in installments, see

Application for Individuals to Pay the Filing 

Fee in Installments (Official Form 103A). 

If you file this form, you are asking the court 

to waive your fee. After reviewing your 

application, the court may waive your fee, set a 

hearing for further investigation, or require you 

to pay the fee in installments or in full. 

For your fee to be waived, all of these 

statements must be true: 

 You are filing for bankruptcy under 

chapter 7. 

 You are an individual. 

 The total combined monthly income for 

your family is less than 150% of the official 

poverty guideline last published by the U.S. 

Department of Health and Human Services 

(DHHS). (For more information about the 

guidelines, go to 

https://www.uscourts.gov/rulespolicies/judiciary-policies/bankruptcy-casepolicies.) 

 You cannot afford to pay the fee in 

installments. 

Your family includes you, your spouse, and any 

dependents listed on Schedule I. Your family 

may be different from your household, 

referenced on Schedules I and J. Your 

household may include your unmarried partner 

and others who live with you and with whom 

you share income and expenses. 

If a bankruptcy petition preparer helped you 

complete this form, make sure that person fills 

out Bankruptcy Petition Preparer’s Notice, 

Declaration, and Signature (Official Form 119); 

include a copy of it when you file this 

application. 

If you have already completed the following 

forms, the information on them may help you 

when you fill out this application: 

 Schedule A/B: Property (Official 

Form 106A/B) 

 Schedule I: Your Income (Official 

Form 106I) 

 Schedule J: Your Expenses (Official 

Form 106J) 

This form includes a proposed order for use by 

the court in considering the application. The 

court may modify the form of the order or use 

its own version of the order. 
Individual Chapter 11 Cases: Creditors Who Have 20 Largest Unsecured Claims (Official Form 104) page 38

For Individual Chapter 11 Cases: List of Creditors 

Who Have the 20 Largest Unsecured Claims 

Against You and Are Not Insiders (Official Form 104)

The people or organizations to whom you owe 

money are called your creditors. A claim is a 

creditor’s right to payment. If you are an 

individual filing for bankruptcy under chapter 11, 

you must fill out For Individual Chapter 11 

Cases: List of Creditors Who Have the 20 

Largest Unsecured Claims Against You and Are 

Not Insiders (Official Form 104). 

Creditors may have different types of claims: 

 Secured claims, or 

 Unsecured claims. 

If your debts are not paid, creditors with 

secured claims may be able to get paid from 

specific property in which that creditor has an 

interest, such as a mortgage or a lien. If a 

creditor has security interest in your property, 

but the value of the property available to pay 

the creditor is less than the amount you owe the 

creditor, the creditor has both a secured and an 

unsecured claim against you. The amount of the 

unsecured claim is the total claim minus the 

value of the property that is available to pay the 

creditor. 

Generally, creditors with unsecured claims do 

not have rights against specific property, or the 

specific property in which the creditor has 

rights is not worth enough to pay the creditor in 

full. For example, if you owe a creditor $30,000 

for your car and the creditor has a security 

interest in your car but the car is worth only 

$20,000, the creditor has a $20,000 secured 

claim and a $10,000 unsecured claim. 

$30,000 Total amount you owe creditor 

─ $20,000 Amount your car is worth (amount of 

secured claim) 

$10,000 Amount of unsecured claim 

Many claims have a specific amount, and you 

clearly owe them. However, some claims are 

uncertain when you file for bankruptcy, or they 

become due only after you file. You must 

include such claims when listing your 20 largest 

unsecured claims on this list. 

Claims may be contingent, unliquidated, 

or disputed. 

The form asks you to identify claims that are: 

 Contingent claims, 

 Unliquidated claims, or 

 Disputed claims. 

A claim is contingent if you are not obligated to 

pay it unless a particular event occurs after you 

file for bankruptcy. You owe a contingent 

claim, for example, if you cosigned someone 

else’s loan. You may not have to pay unless that 

person later fails to repay the loan. 

If you are filing under chapter 7, 

12, or 13, do not fill out this form.
Individual Chapter 11 Cases: Creditors Who Have 20 Largest Unsecured Claims (Official Form 104) page 39

A claim is unliquidated if the amount of the 

debt cannot be readily determined, such as by 

referring to an agreement or by a simple 

computation. An unliquidated claim is one for 

which there may be a definite liability but 

where the amount has not been set. For 

instance, if you were involved in a car accident, 

the victim may have an unliquidated claim 

against you because the amount of damages has 

not been set. 

A claim is disputed if you do not agree that you 

owe the debt. For instance, your claim is 

disputed if a bill collector demands payment for 

a bill you believe you already fully paid. 

A single claim can have one, more than one, or 

none of these characteristics. 

On this form, list the creditors with the 

20 largest unsecured claims who are not 

insiders 

You must file this form when you file your 

chapter 11 bankruptcy case with the court. 

When you list the 20 largest unsecured 

creditors, include all unsecured creditors, except 

for the following two types of creditors, even if 

you plan to pay them. Do not include: 

 Anyone who is an insider. Insiders include 

relatives; general partners of you or your 

relatives; corporations of which you are an 

officer, director, or person in control; and 

any managing agent. 11 U.S.C. § 101(31).

 Secured creditors, unless the unsecured 

claim resulting from inadequate collateral 

value places the creditor among the holders 

of the 20 largest unsecured claims. 

Make sure that all of the creditors listed on this 

form are also listed on either Schedule D: Creditors 

Who Have Claims Secured by Property (Official 

Form 106D) or Schedule E/F: Creditors Who Have 

Unsecured Claims (Official Form 106E/F). 

On the form, you will fill in what the claim is 

for. Examples include trade debts, bank loans, 

professional services, and government 

contracts. 
Glossary page 40 

 Glossary 
 Definitions Used in the Forms for Individuals Filing for Bankruptcy page 41 

Definitions of Some Terms Used in the Forms for 

Individuals Filing for Bankruptcy 

Here are definitions of some of the important terms used in the forms for individuals who are filing for 

bankruptcy. See Bankruptcy Basics (https://www.uscourts.gov/services-forms/bankruptcy/bankruptcybasics) for more information about filing for bankruptcy and other important terms you should know. 

These definitions are intended only to provide guidance. They are not a substitute for legal advice.

Annuity — A contract for the periodic 

payment of money to you, either for life or 

for a number of years. 

Bankruptcy petition preparer — A person or 

business, other than a lawyer or someone 

who works for a lawyer, that charges a fee to 

prepare bankruptcy documents. Under your 

direction and control, the bankruptcy petition 

preparer generates bankruptcy forms for you 

to file by typing them. Because they are not 

attorneys, they cannot give legal advice or 

represent you in bankruptcy court. Also 

called typing services.

Business debt — A debt that you incurred to 

obtain money for a business or investment or 

incurred through the operation of the 

business or investment.

Claim — A creditor’s right to payment, even 

if contingent, disputed, unliquidated, or 

unmatured. 

Codebtor — A person or entity that may also 

be responsible for paying a claim against the 

debtor. 

Collateral — Specific property subject to a 

lien from which a creditor may be paid ahead 

of other creditors without liens on that 

property. Includes a mortgage, security 

interest, judgment lien, statutory lien, or other 

lien. 

Community property — A type of property 

ownership available in certain states for 

property owned by spouses and, in some 

instances, legal equivalents of spouses. 

Community property states and territories 

include Arizona, California, Idaho, 

Louisiana, Nevada, New Mexico, Puerto 

Rico, Texas, Washington, and Wisconsin.

Consumer debt — A debt you incurred 

primarily for a personal, family, or household 

purpose. 

Contingent claim — A debt you are not 

obligated to pay unless a particular event 

occurs after you file for bankruptcy. You owe 

a contingent claim, for example, if you 

cosigned someone else’s loan. You may not 

have to pay unless that person later fails to 

repay the loan. 

 
 Definitions Used in the Forms for Individuals Filing for Bankruptcy page 42 

Creditor matrix or mailing matrix — A list of 

names and addresses of all of your creditors, 

formatted as a mailing list according to 

instructions from the bankruptcy court in 

which you file. 

Creditor — A person or organization to 

whom you owe money or who claims that 

you owe it money. 

Current value, fair market value, or value — 

The amount property is worth, which may be 

more or less than when you purchased the 

property. Absent specific instruction, the 

value should be the price that could be 

realized from a cash sale or liquidation 

without duress within a reasonable time. See 

the instructions for specific forms regarding 

whether the value requested is as of the date 

of the filing of the petition, the date you 

complete the form, or some other date. 

Debtor 1 — A debtor filing alone or one 

person in married couple who is filing a 

bankruptcy case with a spouse. The same 

person retains this designation in all of the 

forms. 

Debtor 2 — A second person in a married 

couple who is filing a bankruptcy case with a 

spouse.

Dependent — A person who is economically 

dependent on you regardless of whether the 

person can be claimed as a dependent on your 

federal tax return. However, Chapter 7 Means 

Test Calculation (Official Form 122A-2) and 

Chapter 13 Calculation of Your Disposable 

Income (Official Form 122C-2) use the term in 

a more limited way. See the instructions on 

those forms. 

Discharge — A discharge in bankruptcy 

relieves you after your bankruptcy case is 

over from having to pay debts that you owed 

before you filed your bankruptcy case. Most 

debts are covered by the discharge, but not 

all. (The instruction booklet explains more 

about common debts that are not discharged 

in bankruptcy.) Only your personal liability is 

removed by the discharge. 

Disputed claim — A debt you do not agree 

that you owe. For instance, your claim is 

disputed if a bill collector demands payment 

for a bill you believe you already fully paid.

Eviction judgment — A judgment for 

possession that your landlord has obtained in 

an eviction, unlawful detainer action, or 

similar proceeding. 

Executory contract — A contract between 

you and someone else in which both of you 

still have obligations to perform under the 

contract at the time you file for bankruptcy.

Exempt property — Property, or the value of 

a portion of it, that the law allows you to 

keep for your use rather than surrender it for 

the payment of your debts, provided that you 

follow the correct procedure to claim the 

exemption. 

Garnishment — A procedure by which a 

creditor can reach money of yours that is in 

the hands of a third party to satisfy a debt. 

Garnishments are sometimes used by 

creditors to obtain money from your wages or 

bank account. 

 
 Definitions Used in the Forms for Individuals Filing for Bankruptcy page 43 

Individual debtor — A human being who is 

filing for bankruptcy either alone or with a 

spouse, whether or not the individual owns a 

business.

Joint case — A single case filed by a married 

couple. 

Judgment lien — A lien that arises as a result 

of a judgment against you. 

Legal equivalent of a spouse — A person 

recognized by applicable nonfederal law as 

having a relationship with the debtor that 

grants legal rights and responsibilities 

equivalent, in whole or in part, to those 

granted to a spouse.

Legal or equitable interest — A broad term 

that includes all kinds of property interests in 

both tangible and intangible property, 

whether or not anyone else has an interest in 

that property. 

Negotiable instrument — A financial 

instrument that you can transfer to someone 

by signing or delivering it, including personal 

checks, cashiers’ checks, promissory notes, 

and money orders. 

Non-individual debtor — A debtor that is not 

a human being – for example, an artificial 

entity such as a corporation, partnership, or 

limited liability company (LLC).

Non-negotiable instrument — A financial 

instrument that you cannot transfer to 

someone by signing or delivering it. 

Nonpriority unsecured claim — A debt that 

generally will be paid after priority unsecured 

claims are paid. The most common examples 

are credit card bills, medical bills, and 

educational loans. 

Payment advice — A statement such as a pay 

stub or earnings statement from your 

employer that shows all earnings and 

deductions from your pay. 

Presumption of abuse — A rebuttable legal 

presumption that you have too much income 

after allowed expenses to be granted relief 

under chapter 7.

Priority unsecured claim — A debt that the 

Bankruptcy Code requires to be paid before 

most other unsecured claims are paid. The 

most common examples are certain income 

tax debts and past due alimony or child 

support. 

Property you own — Includes property you 

have purchased, even if you owe money on 

it, such as a home with a mortgage or an 

automobile with a lien. 

Reaffirming a debt — Agreeing to repay a 

debt that would otherwise be discharged by 

entering into a new written agreement with 

the creditor. A reaffirmation agreement may 

allow you to keep property that a creditor has 

the right to take from you because it secures 

the debt being reaffirmed. For a reaffirmation 

agreement to be effective, there are many 

procedural and legal requirements that must 

be satisfied during the bankruptcy case. 

 
 Definitions Used in the Forms for Individuals Filing for Bankruptcy page 44 

Secured claim — A claim that may be 

satisfied in whole or in part either 

 by a charge against or an interest in 

specific property of the debtor, or 

 by a right of setoff. 

Common examples of creditors who have 

secured claims are lenders from your car, 

your home, or your furniture. 

Sole proprietorship — A business you own as 

an individual that is not a separate legal 

entity such as a corporation, partnership, or 

LLC. Sole proprietors must use the 

bankruptcy forms that are numbered in the 

100 series. 

Statutory lien — A lien that arises as a result 

of a statute.

Unexpired lease —A lease that is in effect at 

the time you filed for bankruptcy. 

Unliquidated claim — A debt with an amount 

cannot be readily determined, such as by 

referring to an agreement or by a simple 

computation. An unliquidated claim is one 

for which there may be a definite liability but 

where the value has not been set. For instance, 

if you were involved in a car accident, the 

victim may have an unliquidated claim 

against you because the amount of damages 

has not been determined. 

Unsecured claim — A claim held by a 

creditor who does not have security interest 

in or other lien on your property or a right of 

setoff.

You — A debtor filing alone or one person in 

married couple who is filing a bankruptcy 

case with a spouse.