B1040 (FORM 1040) (12/15)

ADVERSARY PROCEEDING COVER SHEET

(Instructions on Reverse)

ADVERSARY PROCEEDING NUMBER

(Court Use Only)

PLAINTIFFS DEFENDANTS

ATTORNEYS (Firm Name, Address, and Telephone No.) ATTORNEYS (If Known)

PARTY (Check One Box Only)

Debtor Admin

Creditor Other

Trustee

PARTY (Check One Box Only)

Debtor U.S. Trustee/BankruptcyAdmin

Creditor Other

Trustee

CAUSE OF ACTION (WRITE A BRIEF STATEMENT OF CAUSE OF ACTION, INCLUDING ALL U.S. STATUTES INVOLVED)

NATURE OF SUIT

(Number up to five (5) boxes starting with lead cause of action as 1, first alternative cause as 2, second alternative cause as 3, etc.)

FRBP 7001(1) – Recovery of Money/Property

11-Recovery of money/property - §542 turnover of property

12-Recovery of money/property - §547 preference

13-Recovery of money/property - §548 fraudulent transfer

14-Recovery of money/property - other 

FRBP 7001(2) – Validity, Priority or Extent of Lien

21-Validity, priority or extent of lien or other interest in property

FRBP 7001(3) – Approval of Sale of Property

31-Approval of sale of property of estate and of a co-owner - §363(h) 

FRBP 7001(4) – Objection/Revocation of Discharge

41-Objection / revocation of discharge - §727(c),(d),(e)

FRBP 7001(5) – Revocation of Confirmation

51-Revocation of confirmation

FRBP 7001(6) – Dischargeability

66-Dischargeability - §523(a)(1),(14),(14A) priority tax claims

62-Dischargeability - §523(a)(2), false pretenses, false representation,

actual fraud

67-Dischargeability - §523(a)(4), fraud as fiduciary, embezzlement, larceny

(continued next column)

FRBP 7001(6) – Dischargeability (continued)

61-Dischargeability - §523(a)(5), domestic support

68-Dischargeability - §523(a)(6), willful and malicious injury 

63-Dischargeability - §523(a)(8), student loan

64-Dischargeability - §523(a)(15), divorce or separation obligation

(other than domestic support)

65-Dischargeability - other 

FRBP 7001(7) – Injunctive Relief

71-Injunctive relief – imposition of stay

72-Injunctive relief – other 

FRBP 7001(8) Subordination of Claim or Interest

81-Subordination of claim or interest

FRBP 7001(9) Declaratory Judgment

91-Declaratory judgment 

FRBP 7001(10) Determination of Removed Action

01-Determination of removed claim or cause

Other

SS-SIPA Case – 15 U.S.C. §§78aaa et.seq.

02-Other (e.g. other actions that would have been brought in state court 

if unrelated to bankruptcy case)

Check if this case involves a substantive issue of statelaw Check if this is asserted to be a class action under FRCP23

Check if a jury trial is demanded in complaint Demand $

Other Relief Sought

Case: 19-30088 Doc# 2599-1 Filed: 06/18/19 Entered: 06/18/19 19:28:34 Page 1

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B1040 (FORM 1040) (12/15)

BANKRUPTCY CASE IN WHICH THIS ADVERSARY PROCEEDING ARISES

NAME OF DEBTOR BANKRUPTCY CASE NO.

DISTRICT IN WHICH CASE IS PENDING DIVISION OFFICE NAME OF JUDGE

RELATED ADVERSARY PROCEEDING (IF ANY)

PLAINTIFF DEFENDANT ADVERSARY 

PROCEEDING NO.

DISTRICT IN WHICH ADVERSARY IS PENDING DIVISION OFFICE NAME OF JUDGE

SIGNATURE OF ATTORNEY (OR PLAINTIFF)

DATE PRINT NAME OF ATTORNEY (OR PLAINTIFF)

INSTRUCTIONS

The filing of a bankruptcy case creates an “estate” under the jurisdiction of the bankruptcy court which consists of 

all of the property of the debtor, wherever that property is located. Because the bankruptcy estate is so extensive and the 

jurisdiction of the court so broad, there may be lawsuits over the property or property rights of the estate. There also may be 

lawsuits concerning the debtor’s discharge. If such a lawsuit is filed in a bankruptcy court, it is called an adversary 

proceeding.

A party filing an adversary proceeding must also must complete and file Form 1040, the Adversary Proceeding 

Cover Sheet, unless the party files the adversary proceeding electronically through the court’s Case Management/Electronic 

Case Filing system (CM/ECF). (CM/ECF captures the information on Form 1040 as part of the filing process.) When 

completed, the cover sheet summarizes basic information on the adversary proceeding. The clerk of court needs the 

information to process the adversary proceeding and prepare required statistical reports on court activity.

The cover sheet and the information contained on it do not replace or supplement the filing and service of pleadings 

or other papers as required by law, the Bankruptcy Rules, or the local rules of court. The cover sheet, which is largely selfexplanatory, must be completed by the plaintiff’s attorney (or by the plaintiff if the plaintiff is not represented by an 

attorney). A separate cover sheet must be submitted to the clerk for each complaint filed.

Plaintiffs and Defendants. Give the names of the plaintiffs and defendants exactly as they appear on the complaint.

Attorneys. Give the names and addresses of the attorneys, if known.

Party. Check the most appropriate box in the first column for the plaintiffs and the second column for the defendants.

Demand. Enter the dollar amount being demanded in the complaint.

Signature. This cover sheet must be signed by the attorney of record in the box on the second page of the form. If the 

plaintiff is represented by a law firm, a member of the firm must sign. If the plaintiff is pro se, that is, not represented by an 

attorney, the plaintiff must sign.

Case: 19-30088 Doc# 2599-1 Filed: 06/18/19 Entered: 06/18/19 19:28:34 Page 2

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