Transitional Local Bankruptcy Form 3015-1, 13 Plan
[Caption as in Bankruptcy Official Form No. B16A]
[DO NOT DELETE ANY PROVISION OF THIS FORM.
MARK PROVISIONS THAT DO NOT APPLY AS N/A.
ANY ADDITIONAL PROVISIONS MUST BE RECITED IN PART V. G.]
CHAPTER 13 PLAN INCLUDING VALUATION OF COLLATERAL AND CLASSIFICATION OF CLAIMS
Date of Plan:________________________
I. RELEVANT INFORMATION
A. Prior bankruptcies pending within one year of the petition date for this case:
Case No. & Chapter
Discharge or Dismissal/Conversion
Date
B. The debtor(s): ____is eligible for a discharge; or
____is not eligible for a discharge and is not seeking a discharge.
C. Prior states of domicile: within 730 days______________________________________________
within 910 days______________________________________________.
The debtor is claiming exemptions available in the state of _______________________________
or federal exemptions____.
D. The debtor owes or anticipates owing a Domestic Support Obligation as defined in 11 U.S.C.
§ 101(14A). Notice will/should be provided to these parties in interest:
E.
1.
Parent____________________________________________________________________
2. Government_______________________________________________________________
3. Assignee or other___________________________________________________________
The debtor _____has provided the Trustee with the phone number of the Domestic Support Obligation
recipient or _____cannot provide the phone number because it is not available.
F. The current monthly income of the debtor, as reported on Interim Form B22C is:
_____below _____equal to or ______above the applicable median income.
II. PLAN ANALYSIS
A. Total Debt Provided for under the Plan and Administrative Expenses
1. Total Priority Claims (Class One)
a. Unpaid attorney’s fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_______________
Total attorney’s fees are estimated to be $_______________
of which $_______________ has been prepaid.
b. Unpaid attorney’s costs (estimat