Phillips, Erlewine, Given & Carlin LLP 

39 Mesa Street, Suite 201 

San Francisco, CA 94129 

PARTY (Check One Box Only) PARTY (CheckOneBoxOnly) 

6]:)ebtor [g]J.S. Trustee/Bankruptcy Admin [i]Debtor [g U.S. Trustee/Bankruptcy Admin 

hlreditor ~ther lreditor Cg Other 

[i]rrustee rustee 

CAUSE OF ACITON (WRITE ABRlff STATEMINf OF CAUSE OF ACTION, INO.lJDING ALLU.S. STATUfES IN\.OLVID) 

Negligence. 

NATURE OF SUIT 

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

t<Kur ,vvJtIJ Kecovery 011noney,rropeny t<Kur ,vvitoJ u1scnargeau1my tconnnui:uJ 

D I I-Recovery of money/property - §542 turnover of property D 61-Dischargeability - §523(aX5), domestic support D 12-Recovery of money/property - §547 prei'!rence D 68-Dischargeability - §523(aX6), willrul and malicious injury D 13-Recovery of money/property - §548 fraudulent transfa D 63-Dischargeability - §523(aX8), student loan 

liJ 14-Recovery of money/property - other D 64-Dischargeability - §523(aX15), divorce or separation obligation 

(other than domestic support) 

FRBP 7001(2) - Validity, Priority or Extent of Lien D 65-Dischargeability - other D 21-Validity, priority or extent oflien or other interest in property 

FRBP 7001(7) -Injunctive Relief 

FRBP 7001(3)-Approval of Sale of Property D 71-h1junctive relief - imposition of stay 

D 31-Approval of sale of property of estate and of a co-owner - §363(h) 72-Injunctive relief - other 

FRBP 7001(4) -Objection/Revocation of Discharge FRBP 7001(8) Subordination of Claim or Interest 

D 41-Obj~tion / revocation of discharge - §727(c),(d),(e) D 81-Subordination of claim or interest 

FRBP 7001(5) -Revocation of Confirmation FRBP 7001(9) Declaratory Judgment 

D 5 I-Revocation of confirmation D 91-Declaratory judgment 

FRBP 7001(6) -Dischargeability FRBP 7001(10) Determination of Removed Action D 66-Dischargeability - §523(a)(l),(14),(14A) priority tax claims D 01-Determination of removed claim or cause D 62-Dischargeability - §523(a)(2), false pretenses, false representation, 

actual fraud Other 

D 67-Dischargcability - §523(a)(4), fraud as fiduciary, embezzlement, larceny 0 SS-SIPACase-15 U.S.C. §§78aaael.seq. 

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

if unrelated to bankruptcy case) 

I Check if this case involves a substantive issueofstatelaw I Check if this is asserted to be a class actionunderFRCP23 

II Check if aju1y ttial is demanded in complaint Demand $2,500,000,000.00 (at least) 

Other Relief Sought 

Damages according to proof and injunctive relief; attorneys' fees; prejudgment interest; punitive damages; costs of suit; 

and other and further relief as the Court deems just and proper. 

Case: 19-30088 Doc# 5171-1 Filed: 12/19/19 Entered: 12/19/19 13:52:48 Page 1

of 2
December 19, 2019

PROCEEDING NO. 

DISTRICT IN WHICHADVERSARY IS PENDING DIVISION OFFICE NAMEOF JUDGE 

SIGNATURE OF ATTORNEY (OR PLAINTIFF) 

DATE PRINT NAME OF ATTORNEY (OR PLAINTIFF) 

/s/ Nicholas A. Carlin 

INSTRUCTIONS 

The filing ofa bankmptcycase creates an "estate"underthejurisdiction of the bankruptcy court which consists of 

all ofthe propertyofthe debtor, wherever that prope1ty is located. Because the bankruptcy estate is so extensive and the 

jurisdiction ofthc comt so broad, there may be lawsuits ovcrthcpropcrty or property tights 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 adversruy proceeding must also must complete and file Form 1040, the Adversary Proceeding 

Cover Sheet, unless the party files the adversrny proceeding electronically through the court's CaseManagement/Electronic 

Case Filings ystem(CM/ECF), (C'M/ECF captures the infonnation on Fonn 1040 as part ofthe filing process.) When 

completed, the coversheet summarizes basic infonnationon the adversary proceeding. Theclerkofeourt needs the 

infotmation to process the adversruy proceeding and prepare required statistical repo1ts on court activity, 

The coversheetandthc infonnationcontained on it do notreplaceorsupplemcnt the filing and serviccofplcadings 

or other papers as required by law, the Bankruptcy Rules, or the local rules of co Ult. The coversheet, which is largely selfexplanat01y, must be completed by the plaintiff's attomey (orby the plaintiffifthe plaintiffis not represented by an 

attomey), A separate coversheetmust be submitted to the clerk for each complaint filed, 

Plaintiffs and Defendants. Give the names of the plaintiffs and defendants exactly as they appea11ron the complaint. 

Attorneys. Give the nan-es and addressesofthe attomeys, ifknown. 

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

Demand. Enter the dollaraimunt being demanded in the complaint. 

Signature. This coversheetmust be signed by the attorney of record in the boxon the second page of the fonn If the 

plaintiff is represented by a law firm, a member of the firm must sign. Iftheplaintiffis prose, that is, not represented by an 

attorney, the plaintiff must sign. 

Case: 19-30088 Doc# 5171-1 Filed: 12/19/19 Entered: 12/19/19 13:52:48 Page 2

of 2