Form B22B (Chapter 11) (10/05)
In re ______________________________
Debtor(s)
Case Number: __________________
(If known)
STATEMENT OF CURRENT MONTHLY INCOME
FOR USE IN CHAPTER 11
In addition to Schedules I and J, this statement must be completed by every individual Chapter 11 debtor, whether or not filing
jointly. Joint debtors may complete one statement only.
Part I. CALCULATION OF CURRENT MONTHLY 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, not filing jointly. Complete only Column A (“Debtor’s Income”) for Lines 2-10.
c.
Married, filing jointly. 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
different 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.
Column A
Debtor’s
Income
Column B
Spouse’s
Income
2 Gross wages, salary, tips, bonuses, overtime, commissions.
$
$
3
Net 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.
a.
Gross receipts
$
b.
Ordinary and necessary business expenses
$
c.
Business income
Subtract Line b from Line a
$
$
4
Net rental and other real property income. Subtract Line b from Line a and enter the
difference on Line 4. Do not enter a number less than zero.
a.
Gross receipts
$
b.
Ordinary and necessary operating expenses
$
c.
Rental income
Subtract Line b from Line a
$
$
5
Interest, dividends, and royalties.
$
$
6 Pension and retirement income.
$
$
7
Regular cont