United States Bankruptcy Court
IN RE (Name of Debtor - If Individual: Last, First, Middle)
ALL OTHER NAMES used by debtor in the last 6 years
(Include married, maiden, and trade names.)
SOC. SEC./TAX I.D. NO. (If more than one, state all.)
STREET ADDRESS OF DEBTOR (No. and street, city, state, and zip code) MAILING ADDRESS OF DEBTOR (If different from street address)
COUNTY OF RESIDENCE OR
PRINCIPAL PLACE OF BUSINESS
LOCATION OF PRINCIPAL ASSETS OF BUSINESS DEBTOR (If different from previously listed addresses)
CHAPTER OF BANKRUPTCY CODE UNDER WHICH PETITION IS FILED
INFORMATION REGARDING DEBTOR (Check applicable boxes)
TYPE OF DEBTOR
Debts are primarily consumer debts
Corporation Publicly Held
Debts are primarily business debts (complete sections A and B)
Corporation Not Publicly Held
A. TYPE OF BUSINESS (Check one)
B. BRIEFLY DESCRIBE NATURE OF BUSINESS
Debtor has been domiciled or has had a residence, principal place of business, or principal assets in the District for 180 days immediately
preceding the date of this petition or for a longer part of such 180 days than in any other District.
A bankruptcy case concerning debtor’s affiliate, general partner or partnership is pending in this District.
PENDING BANKRUPTCY CASE FILED BY OR AGAINST ANY PARTNER
OR AFFILIATE OF THIS DEBTOR (Report information for any additional cases on attached sheets.)
Name of Debtor
(Check applicable boxes)
Petitioner(s) are eligible to file this petition pursuant to 11 U.S.C. § 303(b).
The debtor is a person against whom an order for relief may be entered under title 11
of the United States Code.