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B7 (Official Form 7) (12/12)

IN RE: Case No. 

Debtor(s)

Chapter 

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

is combined. If the case is filed under chapter 12 or chapter 13, a married debtor must furnish information for both spouses whether or not a joint petition

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

farmer, or self-employed professional, should provide the information requested on this statement concerning all such activities as well as the individual's

personal affairs. To indicate payments, transfers and the like to minor children, state the child's initials and the name and address of the child's parent or

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

Questions 1 - 18 are to be completed by all debtors. Debtors that are or have been in business, as defined below, also must complete Questions 19 -

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

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

DEFINITIONS

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

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

an officer, director, managing executive, or owner of 5 percent or more of the voting or equity securities of a corporation; a partner, other than a limited

partner, of a partnership; a sole proprietor or self-employed full-time or part-time. An individual debtor also may be “in business” for the purpose of this

form if the debtor engages in a trade, business, or other activity, other than as an employee, to supplement income from the debtor’s primary employment.

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

which the debtor is an officer, director, or person in control; officers, directors, and any persons in control of a corporate debtor and their relatives;

affiliates of the debtor and insiders of such affiliates; any managing agent of the debtor. 11 U.S.C. § 101(2),(31).

United States Bankruptcy Court

District of New Hampshire

STATEMENT OF FINANCIAL AFFAIRS

12-13875-jmd

Merullo, Anthony A. 13

1. Income from employment or operation of business

None State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of the debtor's business,

including part-time activities either as an employee or in independent trade or business, from the beginning of this calendar year to the date this

case was commenced. State also the gross amounts received during the two years immediately preceding this calendar year. (A debtor that

maintains, or has maintained, financial records on the basis of a fiscal rather than a calendar year may report fiscal year income. Identify the

beginning and ending dates of the debtor's fiscal year.) If a joint petition is filed, state income for each spouse separately. (Married debtors filing

under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed, unless the spouses are separated and a

joint petition is not filed.)

AMOUNT SOURCE

 3,870.00 2012 Wages

 15,600.00 2012 Rents

 16,512.00 2011 Wages

 13,000.00 2011 Rents

 23,424.25 2010 Wages

 15,400.00 2010 Rents

2. Income other than from employment or operation of business

None State the amount of income received by the debtor other than from employment, trade, profession, operation of the debtor’s business during the

two years immediately preceding the commencement of this case. Give particulars. If a joint petition is filed, state income for each spouse

separately. (Married debtors filing under chapter 12 or chapter 13 must state income for each spouse whether or not a joint petition is filed, unless

the spouses are separated and a joint petition is not filed.)

AMOUNT SOURCE

 6,664.00 2012 Unemployment Compensation

 9,012.00 2011 Unemployment Compensation

 8,646.00 2010 Unemployment Compensation

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 1 of 33
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3. Payments to creditors

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

None a. Individual or joint debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods or services, and other

debts to any creditor made within 90 days immediately preceding the commencement of this case unless the aggregate value of all property that

constitutes or is affected by such transfer is less than $600. Indicate with an asterisk (*) any payments that were made to a creditor on account of

a domestic support obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit

counseling agency. (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint

petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

None b. Debtor whose debts are not primarily consumer debts: List each payment or other transfer to any creditor made within 90 days immediately

preceding the commencement of the case unless the aggregate value of all property that constitutes or is affected by such transfer is less than

$5,850.* If the debtor is an individual, indicate with an asterisk (*) any payments that were made to a creditor on account of a domestic support

obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency. (Married

debtors filing under chapter 12 or chapter 13 must include payments and other transfers by either or both spouses whether or not a joint petition

is filed, unless the spouses are separated and a joint petition is not filed.)

* Amount subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after the date of adjustment.

9

None c. All debtors: List all payments made within one year immediately preceding the commencement of this case to or for the benefit of creditors

who are or were insiders. (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not 9

a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

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

None a. List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding the filing of this

bankruptcy case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or

not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

CAPTION OF SUIT COURT OR AGENCY STATUS OR

AND CASE NUMBER NATURE OF PROCEEDING AND LOCATION DISPOSITION

Mundaca Investment Corp. vs. Contract Rockingham Superior Courtm P. Jungment

Anthony A. Merullo, et.al, Docket O. Box 1258, Kingston, NH 03848

No. 97-C-0534

Scot Schmid vs. Anthony A. Contract Concord District Court Judgment

Meruello et al.

None b. Describe all property that has been attached, garnished or seized under any legal or equitable process within one year immediately preceding

the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either

or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

5. Repossessions, foreclosures and returns

None List all property that has been repossessed by a creditor, sold at a foreclosure sale, transferred through a deed in lieu of foreclosure or returned to

the seller, within one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must

include information concerning property of either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a

joint petition is not filed.)

9

6. Assignments and receiverships

None a. Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the commencement of this case.

(Married debtors filing under chapter 12 or chapter 13 must include any assignment by either or both spouses whether or not a joint petition is filed,

unless the spouses are separated and joint petition is not filed.)

9

None b. List all property which has been in the hands of a custodian, receiver, or court-appointed official within one year immediately preceding the

commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both

spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

7. Gifts

None List all gifts or charitable contributions made within one year immediately preceding the commencement of this case except ordinary and usual

gifts to family members aggregating less than $200 in value per individual family member and charitable contributions aggregating less than $100

per recipient. (Married debtors filing under chapter 12 or chapter 13 must include gifts or contributions by either or both spouses whether or not

a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 2 of 33
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8. Losses

None List all losses from fire, theft, other casualty or gambling within one year immediately preceding the commencement of this case or since the

commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include losses by either or both spouses whether or not

a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

9. Payments related to debt counseling or bankruptcy

None List all payments made or property transferred by or on behalf of the debtor to any persons, including attorneys, for consultation concerning debt

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

of this case.

9

10. Other transfers

None a. List all other property, other than property transferred in the ordinary course of the business or financial affairs of the debtor, transferred either

absolutely or as security within two years immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or

chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint

petition is not filed.)

9

None b. List all property transferred by the debtor within ten years immediately preceding the commencement of this case to a self-settled trust or similar

9 device of which the debtor is a beneficiary.

11. Closed financial accounts

None List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed, sold, or otherwise

transferred within one year immediately preceding the commencement of this case. Include checking, savings, or other financial accounts,

certificates of deposit, or other instruments; shares and share accounts held in banks, credit unions, pension funds, cooperatives, associations,

brokerage houses and other financial institutions. (Married debtors filing under chapter 12 or chapter 13 must include information concerning

accounts or instruments held by or for either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint

petition is not filed.)

9

12. Safe deposit boxes

None List each safe deposit or other box or depository in which the debtor has or had securities, cash, or other valuables within one year immediately

preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include boxes or depositories of either or

both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

13. Setoffs

None List all setoffs made by any creditor, including a bank, against a debt or deposit of the debtor within 90 days preceding the commencement of this

case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint

petition is filed, unless the spouses are separated and a joint petition is not filed.)

9

14. Property held for another person

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

9

15. Prior address of debtor

None If debtor has moved within three years immediately preceding the commencement of this case, list all premises which the debtor occupied during

9 that period and vacated prior to the commencement of this case. If a joint petition is filed, report also any separate address of either spouse.

16. Spouses and Former Spouses

None If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona, California, Idaho, Louisiana,

Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight years immediately preceding the commencement of the case, 9

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

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 3 of 33
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17. Environmental Information

For the purpose of this question, the following definitions apply:

“Environmental Law” means any federal, state, or local statute or regulation regulating pollution, contamination, releases of hazardous or toxic substances,

wastes or material into the air, land, soil, surface water, groundwater, or other medium, including, but not limited to, statutes or regulations regulating

the cleanup of these substances, wastes or material.

“Site” means any location, facility, or property as defined under any Environmental Law, whether or not presently or formerly owned or operated by the

debtor, including, but not limited to, disposal sites.

“Hazardous Material” means anything defined as a hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, or contaminant

or similar term under an Environmental Law.

None a. List the name and address of every site for which the debtor has received notice in writing by a governmental unit that it may be liable or

potentially liable under or in violation of an Environmental Law. Indicate the governmental unit, the date of the notice, and, if known, the

Environmental Law.

9

None b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release of Hazardous Material. Indicate

9 the governmental unit to which the notice was sent and the date of the notice.

None c. List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law with respect to which the debtor

9 is or was a party. Indicate the name and address of the governmental unit that is or was a party to the proceeding, and the docket number.

18. Nature, location and name of business

None a. If the debtor is an individual, list the names, addresses, taxpayer-identification numbers, nature of the businesses, and beginning and ending dates

of all businesses in which the debtor was an officer, director, partner, or managing executive of a corporation, partner in a partnership, sole

proprietor, or was self-employed in a trade, profession, or other activity either full- or part-time within six years immediately preceding the

commencement of this case, or in which the debtor owned 5 percent or more of the voting or equity securities within six years immediately

preceding the commencement of this case.

If the debtor is a partnership, list the names, addresses, taxpayer identification numbers, nature of the businesses, and beginning and ending dates

of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities, within six years immediately

preceding the commencement of this case.

If the debtor is a corporation, list the names, addresses, taxpayer identification numbers, nature of the businesses, and beginning and ending dates

of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities within six years immediately

preceding the commencement of this case.

9

None b. Identify any business listed in response to subdivision a., above, that is “single asset real estate” as defined in 11 U.S.C. § 101.

9

[If completed by an individual or individual and spouse]

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

thereto and that they are true and correct.

Date: Signature

of Debtor

Date: Signature

of Joint Debtor

(if any)

January 15, 2013 /s/ Anthony A. Merullo

Anthony A. Merullo

 continuation pages attached

Penalty for making a false statement: Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.C. § 152 and 3571.

 0

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 4 of 33
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B6A (Official Form 6A) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

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

property, or in which the debtor has a life estate. Include any property in which the debtor holds rights and powers exercisable for the debtor’s own benefit. If the debtor is

married, state whether the husband, wife, both, or the marital community own the property by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint,

or Community.” If the debtor holds no interest in real property, write “None” under “Description and Location of Property.”

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

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

interest in the property, write “None” in the column labeled “Amount of Secured Claim.”

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

DESCRIPTION AND LOCATION OF PROPERTY NATURE OF DEBTOR'S

INTEREST IN PROPERTY

HUSBAND, WIFE, JOINT,

OR COMMUNITY

CURRENT VALUE OF

DEBTOR'S INTEREST IN

PROPERTY WITHOUT

DEDUCTING ANY

SECURED CLAIM OR

EXEMPTION

AMOUNT OF SECURED

CLAIM

TOTAL 

(Report also on Summary of Schedules)

SCHEDULE A - REAL PROPERTY

 205,800.00

Merullo, Anthony A. 12-13875-jmd

43 Rangers Drive, Hudson, Hillsborough County 205,800.00 311,173.50

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 5 of 33
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B6B (Official Form 6B) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

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

appropriate position in the column labeled “None.” If additional space is needed in any category, attach a separate sheet properly identified with the case name, case number,

and the number of the category. If the debtor is married, state whether the husband, wife, both, or the marital community own the property by placing an “H,” “W,” “J,” or

“C” in the column labeled “Husband, Wife, Joint, or Community.” If the debtor is an individual or a joint petition is filed, state the amount of any exemptions claimed only

in Schedule C - Property Claimed as Exempt.

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

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

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

not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

TYPE OF PROPERTY

N

O

N

E

DESCRIPTION AND LOCATION OF PROPERTY

HUSBAND, WIFE, JOINT,

OR COMMUNITY

CURRENT VALUE OF

DEBTOR'S INTEREST IN

PROPERTY WITHOUT

DEDUCTING ANY

SECURED CLAIM OR

EXEMPTION

SCHEDULE B - PERSONAL PROPERTY

Merullo, Anthony A. 12-13875-jmd

1. Cash on hand. Cash in pocket 20.00

2. Checking, savings or other financial

accounts, certificates of deposit or

shares in banks, savings and loan,

thrift, building and loan, and

homestead associations, or credit

unions, brokerage houses, or

cooperatives.

TD Bank Checking Account 532.94

3. Security deposits with public utilities,

telephone companies, landlords, and

others.

X

4. Household goods and furnishings,

include audio, video, and computer

equipment.

Household goods & furnishings 450.00

5. Books, pictures and other art objects,

antiques, stamp, coin, record, tape,

compact disc, and other collections or

collectibles.

X

6. Wearing apparel. Clothing 100.00

7. Furs and jewelry. Wedding ring 75.00

8. Firearms and sports, photographic,

and other hobby equipment.

,22 calibre rifle and Winchester Model 94 30/30 rifle. 100.00

22 year old mountain bike 50.00

9. Interest in insurance policies. Name

insurance company of each policy and

itemize surrender or refund value of

each.

X

10. Annuities. Itemize and name each

issue.

X

11. Interests in an education IRA as

defined in 26 U.S.C. § 530(b)(1) or

under a qualified State tuition plan as

defined in 26 U.S.C. § 529(b)(1).

Give particulars. (File separately the

record(s) of any such interest(s). 11

U.S.C. § 521(c).)

X

12. Interests in IRA, ERISA, Keogh, or

other pension or profit sharing plans.

Give particulars.

X

13. Stock and interests in incorporated

and unincorporated businesses.

Itemize.

X

14. Interests in partnerships or joint

ventures. Itemize.

X

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 6 of 33
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Merullo, Anthony A. 12-13875-jmd

15. Government and corporate bonds and

other negotiable and non-negotiable

instruments.

X

16. Accounts receivable. X

17. Alimony, maintenance, support, and

property settlements in which the

debtor is or may be entitled. Give

particulars.

X

18. Other liquidated debts owed to debtor

including tax refunds. Give

particulars.

X

19. Equitable or future interest, life

estates, and rights or powers

exercisable for the benefit of the

debtor other than those listed in

Schedule A - Real Property.

X

20. Contingent and noncontingent

interests in estate of a decedent, death

benefit plan, life insurance policy, or

trust.

X

21. Other contingent and unliquidated

claims of every nature, including tax

refunds, counterclaims of the debtor,

and rights to setoff claims. Give

estimated value of each.

X

22. Patents, copyrights, and other

intellectual property. Give particulars.

X

23. Licenses, franchises, and other

general intangibles. Give particulars.

X

24. Customer lists or other compilations

containing personally identifiable

information (as defined in 11 U.S.C. §

101(41A)) provided to the debtor by

individuals in connection with

obtaining a product or service from

the debtor primarily for personal,

family, or household purposes.

X

25. Automobiles, trucks, trailers, and

other vehicles and accessories.

1989 BMW 735i - need fuel pump 700.00

26. Boats, motors, and accessories. X

27. Aircraft and accessories. X

28. Office equipment, furnishings, and

supplies.

X

29. Machinery, fixtures, equipment, and

supplies used in business.

X

30. Inventory. X

31. Animals. X

32. Crops - growing or harvested. Give

particulars.

X

33. Farming equipment and implements. X

34. Farm supplies, chemicals, and feed. X

B6B (Official Form 6B) (12/07) - Cont.

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

TYPE OF PROPERTY

N

O

N

E

DESCRIPTION AND LOCATION OF PROPERTY

HUSBAND, WIFE, JOINT,

OR COMMUNITY

CURRENT VALUE OF

DEBTOR'S INTEREST IN

PROPERTY WITHOUT

DEDUCTING ANY

SECURED CLAIM OR

EXEMPTION

SCHEDULE B - PERSONAL PROPERTY

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 7 of 33
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Merullo, Anthony A. 12-13875-jmd

35. Other personal property of any kind

not already listed. Itemize.

X

B6B (Official Form 6B) (12/07) - Cont.

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

TYPE OF PROPERTY

N

O

N

E

DESCRIPTION AND LOCATION OF PROPERTY

HUSBAND, WIFE, JOINT,

OR COMMUNITY

CURRENT VALUE OF

DEBTOR'S INTEREST IN

PROPERTY WITHOUT

DEDUCTING ANY

SECURED CLAIM OR

EXEMPTION

TOTAL

(Include amounts from any continuation sheets attached.

 continuation sheets attached Report total also on Summary of Schedules.)

SCHEDULE B - PERSONAL PROPERTY

 2,027.94

 0

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 8 of 33
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B6C (Official Form 6C) (04/10)

IN RE

Debtor(s)

Case No. 

(If known)

Debtor elects the exemptions to which debtor is entitled under: Check if debtor claims a homestead exemption that exceeds $146,450. *

(Check one box)

 11 U.S.C. § 522(b)(2)

 11 U.S.C. § 522(b)(3)

DESCRIPTION OF PROPERTY SPECIFY LAW PROVIDING EACH EXEMPTION VALUE OF CLAIMED

EXEMPTION

CURRENT VALUE

OF PROPERTY

WITHOUT DEDUCTING

EXEMPTIONS

* Amount subject to adjustment on 4/1/13 and every three years thereafter with respect to cases commenced on or after the date of adjustment.

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

9

Merullo, Anthony A. 12-13875-jmd

SCHEDULE B - PERSONAL PROPERTY

Cash in pocket 11 USC § 522(d)(5) 20.00 20.00

TD Bank Checking Account 11 USC § 522(d)(5) 532.94 532.94

Household goods & furnishings 11 USC § 522(d)(3) 450.00 450.00

Clothing 11 USC § 522(d)(3) 100.00 100.00

Wedding ring 11 USC § 522(d)(4) 75.00 75.00

,22 calibre rifle and Winchester Model 94 11 USC § 522(d)(3) 100.00 100.00

30/30 rifle.

22 year old mountain bike 11 USC § 522(d)(3) 50.00 50.00

1989 BMW 735i - need fuel pump 11 USC § 522(d)(2) 700.00 700.00

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 9 of 33
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B6D (Official Form 6D) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

State the name, mailing address, including zip code, and last four digits of any account number of all entities holding claims secured by property of the debtor as of the

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

the debtor chooses to do so. List creditors holding all types of secured interests such as judgment liens, garnishments, statutory liens, mortgages, deeds of trust, and other

security interests.

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

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

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

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

schedule of creditors, and complete Schedule H – Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable

on each claim by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.”

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

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

Total the columns labeled “Amount of Claim Without Deducting Value of Collateral” and “Unsecured Portion, if Any” in the boxes labeled “Total(s)” on the last sheet

of the completed schedule. Report the total from the column labeled “Amount of Claim Without Deducting Value of Collateral” also on the Summary of Schedules and,

if the debtor is an individual with primarily consumer debts, report the total from the column labeled “Unsecured Portion, if Any” on the Statistical Summary of Certain

Liabilities and Related Data.

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

CREDITOR'S NAME AND MAILING ADDRESS

INCLUDING ZIP CODE AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED,

NATURE OF LIEN, AND DESCRIPTION AND VALUE OF

PROPERTY SUBJECT TO LIEN

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT OF

CLAIM WITHOUT

DEDUCTING

VALUE OF

COLLATERAL

UNSECURED

PORTION, IF ANY

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

 continuation sheets attached

Subtotal

(Total of this page) $ $

Total

(Use only on last page) $ $

(Report also on

Summary of

Schedules.)

(If applicable, report

also on Statistical

Summary of Certain

Liabilities and Related

Data.)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

Merullo, Anthony A. 12-13875-jmd

X X X 74,617.52 74,617.52

205,800.00

Internal Revenue Service

Centralized Insolvency Operation

PO Box 7346

Philadelphia, PA 19101-7346

Notice of Federal Tax Lien

VALUE $

Internal Revenue Service

P. O. Box 9502

Portsmouth, NH 03802

Assignee or other notification for:

Internal Revenue Service

VALUE $

153,923.42 30,755.98

205,800.00

Merullo, Deyise L.

PO Box 7068

Loudon, NH 03307-7068

Second Mortgage, Opened 04/23/1996

VALUE $

8139 82,632.56

205,800.00

Ocwen Loan Servcing LLC

1661 Worthington Rd Ste 100

West Palm Beach, FL 33409-6493

First Mortgage, Opened 4/4/1996

VALUE $

 1 311,173.50 105,373.50

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 10 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

CREDITOR'S NAME AND MAILING ADDRESS

INCLUDING ZIP CODE AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED,

NATURE OF LIEN, AND DESCRIPTION AND VALUE OF

PROPERTY SUBJECT TO LIEN

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT OF

CLAIM WITHOUT

DEDUCTING

VALUE OF

COLLATERAL

UNSECURED

PORTION, IF ANY

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no. of continuation sheets attached to

Schedule of Creditors Holding Secured Claims

Subtotal

(Total of this page) $ $

Total

(Use only on last page) $ $

(Report also on

Summary of

Schedules.)

(If applicable, report

also on Statistical

Summary of Certain

Liabilities and Related

Data.)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

Goldman Sachs Mortgage Company

Bankruptcyt Dept., Ocwen Loan Ser., LLC

1661 Worthington Rd Ste 100

West Palm Beach, FL 33409-6493

Assignee or other notification for:

Ocwen Loan Servcing LLC

VALUE $

John S. McNicholas, Esq.

Korde & Associates, P.C.

321 Billerica Rd Ste 210

Chelmsford, MA 01824-4100

Assignee or other notification for:

Ocwen Loan Servcing LLC

VALUE $

Schechtman Halperin Savage, LLP

1080 Main St

Pawtucket, RI 02860-4847

Assignee or other notification for:

Ocwen Loan Servcing LLC

VALUE $

VALUE $

VALUE $

VALUE $

 1 1

311,173.50 105,373.50

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 11 of 33
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Merullo, Anthony A. 12-13875-jmd

B6E (Official Form 6E) (04/10)

IN RE

Debtor(s)

Case No. 

(If known)

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

priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name, mailing address, including zip code, and last four digits of the account

number, if any, of all entities holding priority claims against the debtor or the property of the debtor, as of the date of the filing of the petition. Use a separate continuation

sheet for each type of priority and label each with the type of priority.

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

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

not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

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

schedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable

on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in the column labeled

"Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You

may need to place an "X" in more than one of these three columns.)

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

on the last sheet of the completed schedule. Report this total also on the Summary of Schedules.

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

on this Schedule E in the box labeled “Totals” on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on the

Statistical Summary of Certain Liabilities and Related Data.

Report the total of amounts not entitled to priority listed on each sheet in the box labeled “Subtotals” on each sheet. Report the total of all amounts not entitled to priority

listed on this Schedule E in the box labeled “Totals” on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on

the Statistical Summary of Certain Liabilities and Related Data.

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

TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets)

Domestic Support Obligations

Claims for domestic support that are owed to or recoverable by a spouse, former spouse, or child of the debtor, or the parent, legal guardian, or

responsible relative of such a child, or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in 11

U.S.C. § 507(a)(1).

Extensions of credit in an involuntary case

Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the

appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(3).

Wages, salaries, and commissions

Wages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying

independent sales representatives up to $11,725* per person earned within 180 days immediately preceding the filing of the original petition, or the

cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(4).

Contributions to employee benefit plans

Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the

cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(5).

Certain farmers and fishermen

Claims of certain farmers and fishermen, up to $5,775* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(6).

Deposits by individuals

Claims of individuals up to $2,600* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that

were not delivered or provided. 11 U.S.C. § 507(a)(7).

Taxes and Certain Other Debts Owed to Governmental Units

Taxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11 U.S.C. § 507(a)(8).

Commitments to Maintain the Capital of an Insured Depository Institution

Claims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors

of the Federal Reserve System, or their predecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C. § 507 (a)(9).

Claims for Death or Personal Injury While Debtor Was Intoxicated

Claims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol,

a drug, or another substance. 11 U.S.C. § 507(a)(10).

* Amounts are subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after the date of adjustment.

 continuation sheets attached

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

9

 0

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 12 of 33
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B6F (Official Form 6F) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

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

or the property of the debtor, as of the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to the trustee and

the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or

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

listed in Schedules D and E. If all creditors will not fit on this page, use the continuation sheet provided.

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

schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable

on each claim by placing an “H,” “W,” “J,” or “C” in the column labeled “Husband, Wife, Joint, or Community.”

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

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

Report the total of all claims listed on this schedule in the box labeled “Total” on the last sheet of the completed schedule. Report this total also on the Summary of

Schedules and, if the debtor is an individual with primarily consumer debts, report this total also on the Statistical Summary of Certain Liabilities and Related Data.

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

CREDITOR'S NAME, MAILING ADDRESS

INCLUDING ZIP CODE, AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED AND

CONSIDERATION FOR CLAIM. IF CLAIM IS

SUBJECT TO SETOFF, SO STATE

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT

OF

CLAIM

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

 continuation sheets attached

Subtotal

(Total of this page) $

Total

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

the Summary of Schedules and, if applicable, on the Statistical

Summary of Certain Liabilities and Related Data.) $

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Merullo, Anthony A. 12-13875-jmd

1707

404.72

Balanced Healthcare Receivables

141 Burke St

Nashua, NH 03060-4757

Medical Service

9845

4,094.12

Capital One

P. O. Box 30281

Salt Lake City, UT 84130

Revolving, Opened 03/23/2002

Capital One Bank (USA) NA

PO Box 71083

Charlotte, NC 28272-1083

Assignee or other notification for:

Capital One

Portfolio Recovery Asso. LLC

PO Box 41067

Norfolk, VA 23541-1067

Assignee or other notification for:

Capital One

 4 4,498.84

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 13 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

CREDITOR'S NAME, MAILING ADDRESS

INCLUDING ZIP CODE, AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED AND

CONSIDERATION FOR CLAIM. IF CLAIM IS

SUBJECT TO SETOFF, SO STATE

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT

OF

CLAIM

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no. of continuation sheets attached to

Schedule of Creditors Holding Unsecured Nonpriority Claims

Subtotal

(Total of this page) $

Total

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

the Summary of Schedules, and if applicable, on the Statistical

Summary of Certain Liabilities and Related Data.) $

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

0541

34.85

Concord Eye Care PC

248 Pleasant St

Concord, NH 03301-2588

Medical Service

Benuck & Rainy, Inc.

399 US Highway 4

Barrington, NH 03825

Assignee or other notification for:

Concord Eye Care PC

0473

425.50

Concord Imaging Center

248 Pleasant St

Concord, NH 03301-2588

Medical Service

Electromedical Associates, Inc.

PO Box 473

Amherst, NH 03031-0473

Assignee or other notification for:

Concord Imaging Center

ious

2,900.00

Dartmouth Hitchcock Clinic

PO Box 10547

Bedford, NH 03110-0547

Medical Service

Firstsource Advantage LLC

205 Bryant Woods S

Amherst, NY 14228-3609

Assignee or other notification for:

Dartmouth Hitchcock Clinic

Medical Financial Solutions

PO Box 50868

Kalamazoo, MI 49005-0868

Assignee or other notification for:

Dartmouth Hitchcock Clinic

 1 4

3,360.35

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 14 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

CREDITOR'S NAME, MAILING ADDRESS

INCLUDING ZIP CODE, AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED AND

CONSIDERATION FOR CLAIM. IF CLAIM IS

SUBJECT TO SETOFF, SO STATE

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT

OF

CLAIM

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no. of continuation sheets attached to

Schedule of Creditors Holding Unsecured Nonpriority Claims

Subtotal

(Total of this page) $

Total

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

the Summary of Schedules, and if applicable, on the Statistical

Summary of Certain Liabilities and Related Data.) $

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

4611

11,788.96

Discover Financial Services LLC

PO Box 15316

Wilmington, DE 19850-5316

Revolvingm Opened 03/27/1987

Discover Bank

DB Servicing Corporation

PO Box 3025

New Albany, OH 43054-3025

Assignee or other notification for:

Discover Financial Services LLC

2043

8,842.03

GE Money Bank/Care Credit

P. O. Box 965036

Orlando, FL 32896-5036

Revolving, Opened 02/2009

GE Capital Retail Bank

Attn: Bankruptcy Dept.

P. O. Box 960061

Orlando, FL 32896-0061

Assignee or other notification for:

GE Money Bank/Care Credit

2522 X

1,727.00

HSBC

MRC

PO Box 115

Dekalb, IL 60115-0115

ADDED CREDITOR - Account closed in 2000 - 

Time barred.

6661

815.00

HSBC Best Buy

PO Box 5253

Carol Stream, IL 60197-5253

Revolving, Opened 11/12/2011

Capital One Bank (USA) NA

PO Box 12907

Norfolk, VA 23541-0907

Assignee or other notification for:

HSBC Best Buy

 2 4

23,172.99

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 15 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

CREDITOR'S NAME, MAILING ADDRESS

INCLUDING ZIP CODE, AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED AND

CONSIDERATION FOR CLAIM. IF CLAIM IS

SUBJECT TO SETOFF, SO STATE

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT

OF

CLAIM

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no. of continuation sheets attached to

Schedule of Creditors Holding Unsecured Nonpriority Claims

Subtotal

(Total of this page) $

Total

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

the Summary of Schedules, and if applicable, on the Statistical

Summary of Certain Liabilities and Related Data.) $

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

20,000.00

Joe Coulp

106 Dover Neck Rd

Dover, NH 03820-4931

Personal Loan

5,955.00

Medical-Elliot Physicians Network

40 Buttrick Rd

Londonderry, NH 03053-3381

Medical Service, Placed foir collection during 2009

Gragil Associates

29 Winter St

Pembroke, MA 02359-1987

Assignee or other notification for:

Medical-Elliot Physicians Network

XXX

unknown

Mundaca Investment Corp.

C/O Haughey, Philpot & Laurent, P.A.

816 N Main St

Laconia, NH 03246-2603

141.13

New England Brace Co., Inc.

15 Nelson St Ste 1

Manchester, NH 03103-2706

Medical Expense, 2011

1,140.58

Scot Schmid

675 N Pembroke Rd

Pembroke, NH 03275-3818

Judgment

0874

70.58

SEARS/CBNA

PO Box 6282

Sioux Falls, SD 57117-6282

Revolving, Opened 08/01/1981

 3 4

27,307.29

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 16 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

(Continuation Sheet)

CREDITOR'S NAME, MAILING ADDRESS

INCLUDING ZIP CODE, AND ACCOUNT NUMBER.

(See Instructions Above.)

CODEBTOR

HUSBAND, WIFE, JOINT,

OR COMMUNITY

DATE CLAIM WAS INCURRED AND

CONSIDERATION FOR CLAIM. IF CLAIM IS

SUBJECT TO SETOFF, SO STATE

CONTINGENT

UNLIQUIDATED

DISPUTED

AMOUNT

OF

CLAIM

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no. of continuation sheets attached to

Schedule of Creditors Holding Unsecured Nonpriority Claims

Subtotal

(Total of this page) $

Total

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

the Summary of Schedules, and if applicable, on the Statistical

Summary of Certain Liabilities and Related Data.) $

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Portfolio Recovery Asso. LLC

PO Box 41067

Norfolk, VA 23541-1067

Assignee or other notification for:

SEARS/CBNA

 4 4

58,339.47

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 17 of 33
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B6G (Official Form 6G) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

Describe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests. State nature of debtor’s interest in

contract, i.e., “Purchaser,” “Agent,” etc. State whether debtor is the lessor or lessee of a lease. Provide the names and complete mailing addresses of all other parties to each

lease or contract described. If a minor child is a party to one of the leases or contracts, state the child's initials and the name and address of the child's parent or guardian,

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

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

NAME AND MAILING ADDRESS, INCLUDING ZIP CODE

OF OTHER PARTIES TO LEASE OR CONTRACT

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTOR’S INTEREST.

STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY.

STATE CONTRACT NUMBER OF ANY GOVERNMENT CONTRACT.

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

9

Merullo, Anthony A. 12-13875-jmd

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 18 of 33
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B6H (Official Form 6H) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

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

of creditors. Include all guarantors and co-signers. If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona,

California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within the eight-year period immediately preceding the commencement

of the case, identify the name of the debtor’s spouse and of any former spouse who resides or resided with the debtor in the community property state, commonwealth, or

territory. Include all names used by the nondebtor spouse during the eight years immediately preceding the commencement of this case. If a minor child is a codebtor or

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

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

 Check this box if debtor has no codebtors.

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

SCHEDULE H - CODEBTORS

9

Merullo, Anthony A. 12-13875-jmd

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 19 of 33
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Merullo, Anthony A. 12-13875-jmd

B6I (Official Form 6I) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

The column labeled “Spouse” must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petition is filed, unless the spouses

are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthly income calculated on this form may differ from the current

monthly income calculated on From 22A, 22B, or 22C.

Debtor's Marital Status DEPENDENTS OF DEBTOR AND SPOUSE

RELATIONSHIP(S): AGE(S):

EMPLOYMENT: DEBTOR SPOUSE

Occupation

Name of Employer

How long employed

Address of Employer

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

1. Current monthly gross wages, salary, and commissions (prorate if not paid monthly) $ $ 

2. Estimated monthly overtime $ $ 

3. SUBTOTAL $ $ 

4. LESS PAYROLL DEDUCTIONS

a. Payroll taxes and Social Security $ $ 

b. Insurance $ $ 

c. Union dues $ $ 

d. Other (specify) $ $ 

$ $ 

5. SUBTOTAL OF PAYROLL DEDUCTIONS $ $ 

6. TOTAL NET MONTHLY TAKE HOME PAY $ $ 

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

8. Income from real property $ $ 

9. Interest and dividends $ $ 

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

that of dependents listed above $ $ 

11. Social Security or other government assistance

(Specify) $ $ 

$ $ 

12. Pension or retirement income $ $ 

13. Other monthly income

(Specify) $ $ 

$ $ 

$ $ 

14. SUBTOTAL OF LINES 7 THROUGH 13 $ $ 

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

16. COMBINED AVERAGE MONTHLY INCOME: (Combine column totals from line 15;

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

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

Statistical Summary of Certain Liabilities and Related Data)

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

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

Married

AAM Builders

 186.33

 186.33 0.00

 10.53

 10.53 0.00

 175.80 0.00

 1,300.00

Unemployment Compensation 765.40

 2,065.40

 2,241.20 0.00

 2,241.20

None

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 20 of 33
United States Bankruptcy Court

District of New Hampshire

IN RE: Case No. 12-11640-jmd

Merullo, Anthony A.

Debtor(s)

Chapter 13

Schedule J - Expenditures

The Debtor has scheduled his contribution to his Spouse's household expenses including utilities.

Food includes paper products, cleaning supplies. and items of personal hygiene.

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 21 of 33
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Merullo, Anthony A. 12-13875-jmd

B6J (Official Form 6J) (12/07)

IN RE

Debtor(s)

Case No. 

(If known)

Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor’s family at time case filed. Prorate any payments made biweekly,

quarterly, semi-annually, or annually to show monthly rate. The average monthly expenses calculated on this form may differ from the deductions from income allowed

on Form22A or 22C.

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

expenditures labeled “Spouse.”

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

a. Are real estate taxes included? Yes No 

b. Is property insurance included? Yes No 

2. Utilities:

a. Electricity and heating fuel $ 

b. Water and sewer $ 

c. Telephone $ 

d. Other $ 

$ 

3. Home maintenance (repairs and upkeep) $ 

4. Food $ 

5. Clothing $ 

6. Laundry and dry cleaning $ 

7. Medical and dental expenses $ 

8. Transportation (not including car payments) $ 

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

10. Charitable contributions $ 

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

a. Homeowner’s or renter’s $ 

b. Life $ 

c. Health $ 

d. Auto $ 

e. Other $ 

$ 

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

(Specify) $ 

$ 

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

a. Auto $ 

b. Other $ 

$ 

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

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

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

17. Other $ 

$ 

$ 

18. AVERAGE MONTHLY EXPENSES (Total lines 1-17. Report also on Summary of Schedules and, if

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

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

20. STATEMENT OF MONTHLY NET INCOME

a. Average monthly income from Line 15 of Schedule I $ 

b. Average monthly expenses from Line 18 above $ 

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

SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)

 1,225.28

9

9

Cable/Isp 55.13

 325.00

 25.00

 64.00

 41.33

Real Estate Tax 378.33

Personal Care 7.00

 2,121.07

None

 2,241.20

 2,121.07

 120.13

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 22 of 33
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Merullo, Anthony A. 12-13875-jmd

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

IN RE

Debtor(s)

Case No. 

(If known)

DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR

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

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

Date: Signature: Debtor

Date: Signature:

(Joint Debtor, if any)

[If joint case, both spouses must sign.]

DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110)

I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for

compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h),

and 342 (b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by

bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting

any fee from the debtor, as required by that section.

 Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social Security No. (Required by 11 U.S.C. § 110.)

If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social security number of the officer, principal,

responsible person, or partner who signs the document.

Address

 Signature of Bankruptcy Petition Preparer Date

Names and Social Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer

is not an individual:

If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person.

A bankruptcy petition preparer's failure to comply with the provision of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or

imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.

DECLARATION UNDER PENALTY OF PERJURY ON BEHALF OF CORPORATION OR PARTNERSHIP

I, the (the president or other officer or an authorized agent of the corporation or a

member or an authorized agent of the partnership) of the 

(corporation or partnership) named as debtor in this case, declare under penalty of perjury that I have read the foregoing summary and

schedules, consisting of sheets (total shown on summary page plus 1), and that they are true and correct to the best of my

knowledge, information, and belief.

Date: Signature:

(Print or type name of individual signing on behalf of debtor)

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.]

Penalty for making a false statement or concealing property: Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.C. §§ 152 and 3571.

DECLARATION CONCERNING DEBTOR'S SCHEDULES

 20

January 15, 2013 /s/ Anthony A. Merullo

Anthony A. Merullo

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 23 of 33
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B22C (Official Form 22C) (Chapter 13) (12/10) According to the calculations required by this statement:

The applicable commitment period is 3 years.

The applicable commitment period is 5 years.

Disposable income is determined under § 1325(b)(3).

Disposable income is not determined under § 1325(b)(3).

(Check the boxes as directed in Lines 17 and 23 of this statement.)

In re: 

Debtor(s)

Case Number: 

(If known)

AND CALCULATION OF COMMITMENT PERIOD AND DISPOSABLE INCOME

In addition to Schedules I and J, this statement must be completed by every individual Chapter 13 debtor, whether or not filing jointly.

Joint debtors may complete one statement only.

Part I. REPORT OF INCOME

1

Marital/filing status. Check the box that applies and complete the balance of this part of this statement as directed.

a. Unmarried. Complete only Column A (“Debtor’s Income”) for Lines 2-10.

b. Married. Complete both Column A (“Debtor’s Income”) and Column B (“Spouse’s Income”) for Lines 2-10.

All figures must reflect average monthly income received from all sources, derived during

the six calendar months prior to filing the bankruptcy case, ending on the last day of the

month before the filing. If the amount of monthly income varied during the six months, you

must divide the six-month total by six, and enter the result on the appropriate line.

Column A

Debtor’s

Income

Column B

Spouse’s

Income

2 Gross wages, salary, tips, bonuses, overtime, commissions. $ $

3

Income from the operation of a business, profession, or farm. Subtract Line b from Line

a and enter the difference in the appropriate column(s) of Line 3. If you operate more than

one business, profession or farm, enter aggregate numbers and provide details on an

attachment. Do not enter a number less than zero. Do not include any part of the business

expenses entered on Line b as a deduction in Part IV.

$ $

a. Gross receipts $

b. Ordinary and necessary operating expenses $

c. Business income Subtract Line b from Line a

4

Rent and other real property income. Subtract Line b from Line a and enter the

difference in the appropriate column(s) of Line 4. Do not enter a number less than zero. Do

not include any part of the operating expenses entered on Line b as a deduction in

Part IV.

$ $

a. Gross receipts $

b. Ordinary and necessary operating expenses $

c. Rent and other real property income Subtract Line b from Line a

5 Interest, dividends, and royalties. $ $

6 Pension and retirement income. $ $

7

Any amounts paid by another person or entity, on a regular basis, for the household

expenses of the debtor or the debtor’s dependents, including child support paid for

that purpose. Do not include alimony or separate maintenance payments or amounts paid

by the debtor’s spouse. Each regular payment should be reported in only one column; if a

payment is listed in Column A, do not report that payment in Column B. $ $

CHAPTER 13 STATEMENT OF CURRENT MONTHLY INCOME

Merullo, Anthony A.

12-13875-jmd

9

9

9

 329.67 447.92

 1,300.00

 414.66

 885.34

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 24 of 33
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B22C (Official Form 22C) (Chapter 13) (12/10)

8

Unemployment compensation. Enter the amount in the appropriate column(s) of Line 8.

However, if you contend that unemployment compensation received by you or your spouse

was a benefit under the Social Security Act, do not list the amount of such compensation in

Column A or B, but instead state the amount in the space below: 

$ $

Unemployment compensation

claimed to be a benefit under the

Social Security Act Debtor $ Spouse $ 

9

Income from all other sources. Specify source and amount. If necessary, list additional

sources on a separate page. Total and enter on Line 9. Do not include alimony or separate

maintenance payments paid by your spouse, but include all other payments of alimony

or separate maintenance. Do not include any benefits received under the Social Security

Act or payments received as a victim of a war crime, crime against humanity, or as a victim

of international or domestic terrorism.

$ $

a. $

b. $

10 Subtotal. Add Lines 2 thru 9 in Column A, and, if Column B is completed, add Lines 2

through 9 in Column B. Enter the total(s). $ $

11

Total. If Column B has been completed, add Line 10, Column A to Line 10, Column B,

and enter the total. If Column B has not been completed, enter the amount from Line 10,

Column A. $

Part II. CALCULATION OF § 1325(b)(4) COMMITMENT PERIOD

12 Enter the amount from Line 11. $

13

Marital Adjustment. If you are married, but are not filing jointly with your spouse, AND if you contend

that calculation of the commitment period under § 1325(b)(4) does not require inclusion of the income of

your spouse, enter on Line 13 the amount of the income listed in Line 10, Column B that was NOT paid on

a regular basis for the household expenses of you or your dependents and specify, in the lines below, the

basis for excluding this income (such as payment of the spouse’s tax liability or the spouse’s support of

persons other than the debtor or the debtor’s dependents) and the amount of income devoted to each

purpose. If necessary, list additional adjustments on a separate page. If the conditions for entering this

adjustment do not apply, enter zero.

$

a. $

b. $

c. $

Total and enter on Line 13.

14 Subtract Line 13 from Line 12 and enter the result. $

15 Annualized current monthly income for § 1325(b)(4). Multiply the amount from Line 14 by the number

12 and enter the result. $

16

Applicable median family income. Enter the median family income for the applicable state and

household size. (This information is available by family size at www.usdoj.gov/ust/ or from the clerk of

the bankruptcy court.)

a. Enter debtor’s state of residence: b. Enter debtor’s household size: $

17

Application of § 1325(b)(4). Check the applicable box and proceed as directed.

The amount on Line 15 is less than the amount on Line 16. Check the box for “The applicable commitment period is

3 years” at the top of page 1 of this statement and continue with this statement.

The amount on Line 15 is not less than the amount on Line 16. Check the box for “The applicable commitment

period is 5 years” at the top of page 1 of this statement and continue with this statement.

Part III. APPLICATION OF § 1325(b)(3) FOR DETERMINING DISPOSABLE INCOME

 1,910.00 238.33

 3,125.01 686.25

 3,811.26

 3,811.26

 0.00

 3,811.26

 45,735.12

New Hampshire 2 64,495.00

9

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 25 of 33
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B22C (Official Form 22C) (Chapter 13) (12/10)

18 Enter the amount from Line 11. $

19

Marital adjustment. If you are married, but are not filing jointly with your spouse, enter on Line 19 the

total of any income listed in Line 10, Column B that was NOT paid on a regular basis for the household

expenses of the debtor or the debtor’s dependents. Specify in the lines below the basis for excluding the

Column B income (such as payment of the spouse’s tax liability or the spouse’s support of persons other

than the debtor or the debtor’s dependents) and the amount of income devoted to each purpose. If

necessary, list additional adjustments on a separate page. If the conditions for entering this adjustment do

not apply, enter zero.

$

a. $

b. $

c. $

Total and enter on Line 19.

20 Current monthly income for § 1325(b)(3). Subtract Line 19 from Line 18 and enter the result. $

21 Annualized current monthly income for § 1325(b)(3). Multiply the amount from Line 20 by the number

12 and enter the result. $

22 Applicable median family income. Enter the amount from Line 16. $

23

Application of § 1325(b)(3). Check the applicable box and proceed as directed.

The amount on Line 21 is more than the amount on Line 22. Check the box for “Disposable income is determined

under § 1325(b)(3)” at the top of page 1 of this statement and complete the remaining parts of this statement.

The amount on Line 21 is not more than the amount on Line 22. Check the box for “Disposable income is not

determined under § 1325(b)(3)” at the top of page 1 of this statement and complete Part VII of this statement. Do not

complete Parts IV, V, or VI.

Part IV. CALCULATION OF DEDUCTIONS ALLOWED UNDER § 707(b)(2)

Subpart A: Deductions under Standards of the Internal Revenue Service (IRS)

24A

National Standards: food, apparel and services, housekeeping supplies, personal care, and

miscellaneous. Enter in Line 24A the “Total” amount from IRS National Standards for Allowable Living

Expenses for the applicable number of persons. (This information is available at www.usdoj.gov/ust/ or

from the clerk of the bankruptcy court.) The applicable number of persons is the number that would

currently be allowed as exemptions on your federal income tax return, plus the number of any additional

dependents whom you support. $

24B

National Standards: health care. Enter in Line a1 below the amount from IRS National Standards for

Out-of-Pocket Health Care for persons under 65 years of age, and in Line a2 the IRS National Standards for

Out-of-Pocket Health Care for persons 65 years of age or older. (This information is available at

www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.) Enter in Line b1 the applicable number of

persons who are under 65 years of age, and enter in Line b2 the applicable number of persons who are 65

years of age or older. (The applicable number of persons in each age category is the number in that

category that would currently be allowed as exemptions on your federal income tax return, plus the number

of any additional dependents whom you support.) Multiply Line a1 by Line b1 to obtain a total amount for

persons under 65, and enter the result in Line c1. Multiply Line a2 by Line b2 to obtain a total amount for

persons 65 and older, and enter the result in Line c2. Add Lines c1 and c2 to obtain a total health care

amount, and enter the result in Line 24B.

$

Persons under 65 years of age Persons 65 years of age or older

a1. Allowance per person a2. Allowance per person

b1. Number of persons b2. Number of persons

c1. Subtotal c2. Subtotal

 3,811.26

 686.25

Paycheck deductions 70.64

Retained by spouse 615.61

 3,125.01

 37,500.12

 64,495.00

9

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B22C (Official Form 22C) (Chapter 13) (12/10)

25A

Local Standards: housing and utilities; non-mortgage expenses. Enter the amount of the IRS Housing

and Utilities Standards; non-mortgage expenses for the applicable county and family size. (This

information is available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court). The applicable

family size consists of the number that would currently be allowed as exemptions on your federal income

tax return, plus the number of any additional dependents whom you support. $

25B

Local Standards: housing and utilities; mortgage/rent expense. Enter, in Line a below, the amount of

the IRS Housing and Utilities Standards; mortgage/rent expense for your county and family size (this

information is available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court) (The applicable

family size consists of the number that would currently be allowed as exemptions on your federal income

tax return, plus the number of any additional dependents whom you support.); enter on Line b the total of

the Average Monthly Payments for any debts secured by your home, as stated in Line 47; subtract Line b

from Line a and enter the result in Line 25B. Do not enter an amount less than zero.

$

a. IRS Housing and Utilities Standards; mortgage/rental expense $

b. Average Monthly Payment for any debts secured by your home, if

any, as stated in Line 47 $

c. Net mortgage/rental expense Subtract Line b from Line a

26

Local Standards: housing and utilities; adjustment. If you contend that the process set out in Lines 25A

and 25B does not accurately compute the allowance to which you are entitled under the IRS Housing and

Utilities Standards, enter any additional amount to which you contend you are entitled, and state the basis

for your contention in the space below:

$

27A

Local Standards: transportation; vehicle operation/public transportation expense. You are entitled to

an expense allowance in this category regardless of whether you pay the expenses of operating a vehicle

and regardless of whether you use public transportation.

Check the number of vehicles for which you pay the operating expenses or for which the operating

expenses are included as a contribution to your household expenses in Line 7.

 0 1 2 or more.

If you checked 0, enter on Line 27A the “Public Transportation” amount from IRS Local Standards:

Transportation. If you checked 1 or 2 or more, enter on Line 27A the “Operating Costs” amount from IRS

Local Standards: Transportation for the applicable number of vehicles in the applicable Metropolitan

Statistical Area or Census Region. (These amounts are available at www.usdoj.gov/ust/ or from the clerk

of the bankruptcy court.) $

27B

Local Standards: transportation; additional public transportation expense. If you pay the operating

expenses for a vehicle and also use public transportation, and you contend that you are entitled to an

additional deduction for your public transportation expenses, enter on Line 27B the “Public

Transportation” amount from IRS Local Standards: Transportation. (This amount is available at

www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.) $

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 27 of 33
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B22C (Official Form 22C) (Chapter 13) (12/10)

28

Local Standards: transportation ownership/lease expense; Vehicle 1. Check the number of vehicles for

which you claim an ownership/lease expense. (You may not claim an ownership/lease expense for more

than two vehicles.)

 1 2 or more.

Enter, in Line a below, the “Ownership Costs” for “One Car” from the IRS Local Standards:

Transportation (available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b

the total of the Average Monthly Payments for any debts secured by Vehicle 1, as stated in Line 47;

subtract Line b from Line a and enter the result in Line 28. Do not enter an amount less than zero.

$

a. IRS Transportation Standards, Ownership Costs $

b.

Average Monthly Payment for any debts secured by Vehicle 1, as

stated in Line 47 $

c. Net ownership/lease expense for Vehicle 1 Subtract Line b from Line a

29

Local Standards: transportation ownership/lease expense; Vehicle 2. Complete this Line only if you

checked the “2 or more” Box in Line 28.

Enter, in Line a below, the “Ownership Costs” for “One Car” from the IRS Local Standards:

Transportation (available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b

the total of the Average Monthly Payments for any debts secured by Vehicle 2, as stated in Line 47;

subtract Line b from Line a and enter the result in Line 29. Do not enter an amount less than zero.

$

a. IRS Transportation Standards, Ownership Costs $

b.

Average Monthly Payment for any debts secured by Vehicle 2, as

stated in Line 47 $

c. Net ownership/lease expense for Vehicle 2 Subtract Line b from Line a

30

Other Necessary Expenses: taxes. Enter the total average monthly expense that you actually incur for all

federal, state, and local taxes, other than real estate and sales taxes, such as income taxes, self-employment

taxes, social-security taxes, and Medicare taxes. Do not include real estate or sales taxes. $

31

Other Necessary Expenses: involuntary deductions for employment. Enter the total average monthly

deductions that are required for your employment, such as mandatory retirement contributions, union dues,

and uniform costs. Do not include discretionary amounts, such as voluntary 401(k) contributions. $

32

Other Necessary Expenses: life insurance. Enter total average monthly premiums that you actually pay

for term life insurance for yourself. Do not include premiums for insurance on your dependents, for

whole life or for any other form of insurance. $

33

Other Necessary Expenses: court-ordered payments. Enter the total monthly amount that you are

required to pay pursuant to the order of a court or administrative agency, such as spousal or child support

payments. Do not include payments on past due obligations included in Line 49. $

34

Other Necessary Expenses: education for employment or for a physically or mentally challenged

child. Enter the total average monthly amount that you actually expend for education that is a condition of

employment and for education that is required for a physically or mentally challenged dependent child for

whom no public education providing similar services is available. $

35

Other Necessary Expenses: childcare. Enter the total average monthly amount that you actually expend

on childcare—such as baby-sitting, day care, nursery and preschool. Do not include other educational

payments. $

36

Other Necessary Expenses: health care. Enter the total average monthly amount that you actually

expend on health care that is required for the health and welfare of yourself or your dependents, that is not

reimbursed by insurance or paid by a health savings account, and that is in excess of the amount entered in

Line 24B. Do not include payments for health insurance or health savings accounts listed in Line 39. $

37

Other Necessary Expenses: telecommunication services. Enter the total average monthly amount that

you actually pay for telecommunication services other than your basic home telephone and cell phone

service—such as pagers, call waiting, caller id, special long distance, or internet service—to the extent

necessary for your health and welfare or that of your dependents. Do not include any amount previously

deducted. $

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B22C (Official Form 22C) (Chapter 13) (12/10)

38 Total Expenses Allowed under IRS Standards. Enter the total of Lines 24 through 37. $

Subpart B: Additional Expense Deductions under § 707(b)

Note: Do not include any expenses that you have listed in Lines 24-37

39

Health Insurance, Disability Insurance, and Health Savings Account Expenses. List the monthly

expenses in the categories set out in lines a-c below that are reasonably necessary for yourself, your

spouse, or your dependents.

$

a. Health Insurance $

b. Disability Insurance $

c. Health Savings Account $

Total and enter on Line 39

If you do not actually expend this total amount, state your actual total average monthly expenditures in

the space below:

$ 

40

Continued contributions to the care of household or family members. Enter the total average actual

monthly expenses that you will continue to pay for the reasonable and necessary care and support of an

elderly, chronically ill, or disabled member of your household or member of your immediate family who is

unable to pay for such expenses. Do not include payments listed in Line 34. $

41

Protection against family violence. Enter the total average reasonably necessary monthly expenses that

you actually incur to maintain the safety of your family under the Family Violence Prevention and

Services Act or other applicable federal law. The nature of these expenses is required to be kept

confidential by the court. $

42

Home energy costs. Enter the total average monthly amount, in excess of the allowance specified by IRS

Local Standards for Housing and Utilities, that you actually expend for home energy costs. You must

provide your case trustee with documentation of your actual expenses, and you must demonstrate

that the additional amount claimed is reasonable and necessary. $

43

Education expenses for dependent children under 18. Enter the total average monthly expenses that you

actually incur, not to exceed $147.92 per child, for attendance at a private or public elementary or

secondary school by your dependent children less than 18 years of age. You must provide your case

trustee with documentation of your actual expenses, and you must explain why the amount claimed

is reasonable and necessary and not already accounted for in the IRS Standards. $

44

Additional food and clothing expense. Enter the total average monthly amount by which your food and

clothing expenses exceed the combined allowances for food and clothing (apparel and services) in the IRS

National Standards, not to exceed 5% of those combined allowances. (This information is available at

www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.) You must demonstrate that the

additional amount claimed is reasonable and necessary. $

45

Charitable contributions. Enter the amount reasonably necessary for you to expend each month on

charitable contributions in the form of cash or financial instruments to a charitable organization as defined

in 26 U.S.C. § 170(c)(1)-(2). Do not include any amount in excess of 15% of your gross monthly

income. $

46 Total Additional Expense Deductions under § 707(b). Enter the total of Lines 39 through 45. $

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B22C (Official Form 22C) (Chapter 13) (12/10)

Subpart C: Deductions for Debt Payment

47

Future payments on secured claims. For each of your debts that is secured by an interest in property that

you own, list the name of the creditor, identify the property securing the debt, state the Average Monthly

Payment, and check whether the payment includes taxes or insurance. The Average Monthly Payment is

the total of all amounts scheduled as contractually due to each Secured Creditor in the 60 months

following the filing of the bankruptcy case, divided by 60. If necessary, list additional entries on a separate

page. Enter the total of the Average Monthly Payments on Line 47.

$

Name of Creditor Property Securing the Debt

Average

Monthly

Payment

Does payment

include taxes or

insurance?

a. $ yes no

b. $ yes no

c. $ yes no

Total: Add lines a, b and c.

48

Other payments on secured claims. If any of debts listed in Line 47 are secured by your primary

residence, a motor vehicle, or other property necessary for your support or the support of your dependents,

you may include in your deduction 1/60th of any amount (the “cure amount”) that you must pay the

creditor in addition to the payments listed in Line 47, in order to maintain possession of the property. The

cure amount would include any sums in default that must be paid in order to avoid repossession or

foreclosure. List and total any such amounts in the following chart. If necessary, list additional entries on a

separate page.

$

Name of Creditor Property Securing the Debt

1/60th of the

Cure Amount

a. $

b. $

c. $

Total: Add lines a, b and c.

49

Payments on prepetition priority claims. Enter the total amount, divided by 60, of all priority claims,

such as priority tax, child support and alimony claims, for which you were liable at the time of your

bankruptcy filing. Do not include current obligations, such as those set out in Line 33. $

50

Chapter 13 administrative expenses. Multiply the amount in Line a by the amount in Line b, and enter

the resulting administrative expense.

$

a. Projected average monthly Chapter 13 plan payment. $

b. Current multiplier for your district as determined under

schedules issued by the Executive Office for United States

Trustees. (This information is available at

www.usdoj.gov/ust/ or from the clerk of the bankruptcy

court.) X

c. Average monthly administrative expense of Chapter 13

case

Total: Multiply Lines a

and b

51 Total Deductions for Debt Payment. Enter the total of Lines 47 through 50. $

Subpart D: Total Deductions from Income

52 Total of all deductions from income. Enter the total of Lines 38, 46, and 51. $

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B22C (Official Form 22C) (Chapter 13) (12/10)

Part V. DETERMINATION OF DISPOSABLE INCOME UNDER § 1325(b)(2)

53 Total current monthly income. Enter the amount from Line 20. $

54

Support income. Enter the monthly average of any child support payments, foster care payments, or

disability payments for a dependent child, reported in Part I, that you received in accordance with

applicable nonbankruptcy law, to the extent reasonably necessary to be expended for such child. $

55

Qualified retirement deductions. Enter the monthly total of (a) all amounts withheld by your employer

from wages as contributions for qualified retirement plans, as specified in § 541(b)(7) and (b) all required

repayments of loans from retirement plans, as specified in § 362(b)(19). $

56 Total of all deductions allowed under § 707(b)(2). Enter the amount from Line 52. $

57

Deduction for special circumstances. If there are special circumstances that justify additional expenses

for which there is no reasonable alternative, describe the special circumstances and the resulting expenses

in lines a-c below. If necessary, list additional entries on a separate page. Total the expenses and enter the

total in Line 57. You must provide your case trustee with documentation of these expenses and you must

provide a detailed explanation of the special circumstances that make such expenses necessary and

reasonable.

$

Nature of special circumstances

Amount of

expense

a. $

b. $

c. $

Total: Add Lines a, b, and c

58 Total adjustments to determine disposable income. Add the amounts on Lines 54, 55, 56, and 57 and

enter the result. $

59 Monthly Disposable Income Under § 1325(b)(2). Subtract Line 58 from Line 53 and enter the result. $

Part VI. ADDITIONAL EXPENSE CLAIMS

60

Other Expenses. List and describe any monthly expenses, not otherwise stated in this form, that are required for the health

and welfare of you and your family and that you contend should be an additional deduction from your current monthly

income under § 707(b)(2)(A)(ii)(I). If necessary, list additional sources on a separate page. All figures should reflect your

average monthly expense for each item. Total the expenses.

Expense Description Monthly Amount

a. $

b. $

c. $

Total: Add Lines a, b and c $

Part VII. VERIFICATION

61

I declare under penalty of perjury that the information provided in this statement is true and correct. (If this a joint case,

both debtors must sign.)

Date: Signature: 

(Debtor)

Date: Signature: 

(Joint Debtor, if any)

January 15, 2013 /s/ Anthony A. Merullo

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 31 of 33
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B6 Summary (Form 6 - Summary) (12/07)

IN RE: Case No. 

Debtor(s)

Chapter 

Indicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from Schedules A, B, D, E, F, I, and J in the boxes

provided. Add the amounts from Schedules A and B to determine the total amount of the debtor’s assets. Add the amounts of all claims from Schedules D, E, and F to

determine the total amount of the debtor’s liabilities. Individual debtors also must complete the “Statistical Summary of Certain Liabilities and Related Data” if they file

a case under chapter 7, 11, or 13.

NAME OF SCHEDULE ATTACHED

(YES/NO)

NUMBER OF

SHEETS ASSETS LIABILITIES OTHER

A - Real Property $

B - Personal Property $

C - Property Claimed as Exempt

D - Creditors Holding Secured Claims $

E - Creditors Holding Unsecured Priority

Claims (Total of Claims on Schedule E) $

F - Creditors Holding Unsecured

Nonpriority Claims $

G - Executory Contracts and Unexpired

Leases

H - Codebtors

I - Current Income of Individual

Debtor(s) $

J - Current Expenditures of Individual

Debtor(s) $

TOTAL $ $

United States Bankruptcy Court

District of New Hampshire

SUMMARY OF SCHEDULES

12-13875-jmd

Merullo, Anthony A. 13

Yes 1 205,800.00

Yes 3 2,027.94

Yes 1

Yes 2 311,173.50

Yes 1 0.00

Yes 5 58,339.47

Yes 1

Yes 1

Yes 2 2,241.20

Yes 1 2,121.07

 18 207,827.94 369,512.97

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 32 of 33
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Form 6 - Statistical Summary (12/07)

IN RE: Case No. 

Debtor(s)

Chapter 

If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C. §

101(8)), filing a case under chapter 7, 11 or 13, you must report all information requested below.

 Check this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to report any

information here.

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

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

Type of Liability Amount

Domestic Support Obligations (from Schedule E) $

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

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

disputed or undisputed) $

Student Loan Obligations (from Schedule F) $

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

Schedule E $

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

TOTAL $

State the following:

Average Income (from Schedule I, Line 16) $

Average Expenses (from Schedule J, Line 18) $

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

Line 20 ) $

State the following:

1. Total from Schedule D, “UNSECURED PORTION, IF ANY” column $

2. Total from Schedule E, “AMOUNT ENTITLED TO PRIORITY” column. $

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

4. Total from Schedule F $

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

United States Bankruptcy Court

District of New Hampshire

STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)

12-13875-jmd

Merullo, Anthony A. 13

 0.00

 0.00

 0.00

 0.00

 0.00

 0.00

 0.00

 2,241.20

 2,121.07

 3,125.01

 105,373.50

 0.00

 0.00

 58,339.47

 163,712.97

Case: 12-13875-BAH Doc #: 20 Filed: 01/18/13 Desc: Main Document Page 33 of 33