Form B22C (Chapter 13) (10/05)
In re __________________________________
Case Number: _______________________
According to the calculations required by this statement:
F The applicable commitment period is 3 years.
F The applicable commitment period is 5 years.
F Disposable income is determined under § 1325(b)(3).
F Disposable income is not determined under § 1325(b)(3).
(Check the boxes as directed in Lines 17 and 23 of this statement.)
STATEMENT OF CURRENT MONTHLY INCOME
AND CALCULATION OF COMMITMENT PERIOD AND DISPOSABLE INCOME
FOR USE IN CHAPTER 13
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
Marital/filing status. Check the box that applies and complete the balance of this part of this statement as directed.
Unmarried. Complete only Column A (“Debtor’s Income”) for Lines 2-10.
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 for the six calendar months prior to filing the
bankruptcy case, ending on the last day of the month before the filing. If you received differ-
ent amounts of income during these six months, you must total the amounts received during
the six months, divide this total by six, and enter the result on the appropriate line.
2 Gross wages, salary, tips, bonuses, overtime, commissions.
Income from the operation of a business, profession, or farm. Subtract Line b from
Line a and enter the difference on Line 3. Do not enter a number less than zero. Do not in-
clude any part of the business expenses entered on Line b as a deduction in Part IV.
Ordinary and necessary business expenses
Subtract Line b from Line a
Rent and other real