Form 6-Summary
(10/05)
United States Bankruptcy Court
_______________ District Of ______________
In re ___________________________________,
Case No. ___________________
Debtor
Chapter ____________
SUMMARY OF SCHEDULES
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 must also complete the “Statistical
Summary of Certain Liabilities.”
AMOUNTS SCHEDULED
NAME OF SCHEDULE
ATTACHED
(YES/NO)
NO. 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
$
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
Debtors(s)
$
TOTAL
$
$
Form 6-Summ2
(10/05)
United States Bankruptcy Court
_______________ District Of ______________
In re ___________________________________,
Case No. ___________________
Debtor
Chapter ____________
STATISTICAL SUMMARY OF CERTAIN LIABILITIES (28 U.S.C. § 159)
[Individual Debtors Only]
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 Debt