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The Bankruptcy Cover Sheet Petition form, also known as Local Bankruptcy Form 1002-1.1, serves as a critical starting point for individuals and businesses looking to file for bankruptcy. This form is essential for indicating the type of bankruptcy being pursued, whether it be Chapter 7, Chapter 11, Chapter 12, or Chapter 13, and requires the filer to check applicable boxes to confirm all attached documents. The debtor's name, attorney information, and the associated filing fee must be clearly stated. For personal bankruptcy, compliance with the credit counseling requirement is mandatory, as outlined in Exhibit D. The form also specifies a host of necessary documents, such as the Voluntary Petition, Statement of Financial Affairs, and various schedules that provide insight into the debtor's financial situation. Additional disclosures may be required based on the debtor's chapter type, for example, the Statement of Current Monthly Income for Chapter 7 debtors or plans for repayment in Chapter 13 cases. This form not only streamlines the filing process but also ensures that all relevant information is readily available for court review, thus playing a fundamental role in the protection and organization of a debtor's financial affairs during a challenging time.

Bankruptcy Cover Sheet Petition Example

Local Bankruptcy Form 1002-1.1

COVER SHEET FOR PETITION

CHECK APPLICABLE BOXES TO SHOW ALL DOCUMENTS ATTACHED

Name of debtor(s):

[

] Attorney (firm name, address, telephone, and

 

registration number):

 

[

] No attorney (“pro se”)(home address, telephone):

 

 

 

Filing fee (revised 11/1/11 per directive of the Judicial Conference of the United States):

[ ] $306 for chapter 7

[ ] $1,213 for chapter 11 [ ] $246 for chapter 12 [ ] $281 for chapter 13

[ ] Other fee paid: $_________. Enter amount AND attach applicable application under FED.

R. BANKR. P. 1006 to pay in installments or pursuant to 28 U.S.C. § 1930(f) (if applicable).

Individual and business debtor(s) (except as otherwise noted):

[ ] Exhibit D Statement of Compliance with Credit Counseling Requirement for each individual debtor (a list of all authorized Credit Counselors for Colorado is found at http://www.usdoj.gov/ust or the court has a list that may be viewed in the Records/Public Information Room 114 of the court.)

[ ] Voluntary Petition – Official Form 1

[ ] Statement of Financial Affairs – Official Form 7

[ ] Summary of Schedules A–J – Official Form 6–Summary

[ ] Schedules A, B, C, D, E, F, G, H, I, and J – Official Forms 6A, 6B, 6C, 6D, 6E, 6F, 6Iand 6J

[ ] Declaration Concerning Debtor’s Schedules – Official Form 6–Declaration

[ ] Notice to Debtor by Non-Attorney Bankruptcy Petition Preparer – Official Form 19 (submitted only if debtor used the services of a bankruptcy petition preparer)

[ ] For each individual debtor, copies of all payment advices, paycheck stubs, or other evidence of all salary, commissions or income received within 60 days before the bankruptcy case was filed, copied on 8 ½ by 11 paper with the debtor’s first and last name printed on top of each page (and bankruptcy case number, if a number has been assigned); OR, as applicable, complete L.B. Form 1007-6.1 (“Statement Under Penalty of Perjury Concerning Payment Advices”) for each debtor.

[ ] A record of any interest in an education individual retirement account (“IRA”) (26 U.S.C. § 530(b)(1)) or qualified state tuition program (26 U.S.C. § 529(b)(1) plans).

[] Attorney Fee Disclosure Statement – Director’s Procedural Form B 203

[] Verification of Creditors’ Matrix – L.B. Form 1007-2.1

[] Creditors’ Matrix (see L.B.R. 1007-2 and L.B.R. 1007-2App. for instructions).

Additional items due from ALL individual debtors:

[] Statement of Social Security Number(s) – Official Form 21

Chapter 7 individual debtors also must file:

[] Statement of Current Monthly Income and Means Test Calculation – Official Form 22A*

[] Statement of Intention – Official Form 8 (due thirty days post-petition) (the failure to comply with this statement and file reaffirmation agreements or motions to redeem personal property that the debtor does not intend to surrender has ramifications 45 days after the first scheduled meeting of creditors under 11 U.S.C. § 362(h) of the Bankruptcy Code)

Chapter 11 individual debtors also must file:

[] Statement of Current Monthly Income – Official Form 22B Chapter 13 individual debtors also must file:

[] Statement of Current Monthly Income and Disposable Income Calculation – Official Form 22C*

[] Plan –L.B. Form 3015.1

*The links for the updated Internal Revenue Service and Census Bureau Information that may be needed to complete Statement of Current Monthly Income, Official Forms 22A and 22B, can be reached from the web site: http://www.usdoj.gov/ust/. (Not applicable in chapter 7 cases if debts are primarily business debts.)

Additional items due from chapter 11 debtors:

[] List of Twenty Largest Creditors – Official Form 4

[] Corporate Ownership Statement – Required by FED. R BANKR. P. 1007(a)(1) for corporations. L.B. Form 1007-4.1.

[] List of Equity Interest Holders – Required by FED. R. BANKR. P. 1007(a)(3) for

corporations. L.B. Form 1007-4.2.

[] Small business debtors must file the most recent 1) balance sheet, 2) statements of operations, 3) cash-flow statement and 4) federal income tax return; OR a verified statement that those documents do not exist and have not been prepared or filed.

[] Disclosure Regarding Receivers Bankruptcy Form 1007-7.1.

Date:

Printed name of party signing:

Signature of attorney (or debtor without counsel):

97

UNITED STATES BANKRUPTCY COURT

DISTRICT OF COLORADO

NOTICE REGARDING E-MAIL NOTIFICATION FOR DEBTORS WITHOUT AN

ATTORNEY AND PARTIES WITHOUT AN ATTORNEY

If you are not represented by an attorney and are a debtor or party in a bankruptcy case and you have an internet e-mail address, you can receive an electronic notice by e-mail whenever a filing is made in a case where you are a debtor or party. Benefits of receiving such notices are:

•If your e-mail program supports viewing documents from hyper links and you have Adobe Acrobat Reader installed, you may be able to view the document filed through a hyperlink in the e-mail notice.

•One look at the document is free (any additional opening(s) of the document will require a PACER account which may be obtained at the following web site: http://pacer.psc.uscourts.gov.)1

•You will get immediate notification through e-mail when something is docketed in a case where you are a party.

To sign up for e-mail notification of filings made in a case where you are a debtor or party, provide the information requested below and return this form to the address stated.

By submitting this Notice, you are consenting to receive all notices required to be sent to you by the Bankruptcy Court by e-mail ONLY and you acknowledge and agree that such notices will NOT be sent to you by regular mail. You must keep the court notified of any changes in your e- mail address, which you may do by completing this form again and sending it to the court.

Please note: you are not allowed to file documents electronically with the Court or to communicate with the court through e-mail or fax transmission. (The only exceptions are our Court’s web based proof of claim program for qualified creditors and the creditor mailing matrix program for debtors.)

Your name: ____________________________________________________________________

(ONLY ONE NAME AND E-MAIL ADDRESS PER FORM)

Your case number or case number where you are a party: ________________________________

Your internet e-mail address: ______________________________________________________

Return Completed form to:

US Bankruptcy Court

721 19th St.

Denver, CO 80202

VISIT OUR WEBSITE FOR MORE INFORMATION: http://www.cob.uscourts.gov

1It is recommended that you download the document or print it out at that time.

B1 (Official Form 1) (04/13)

 

 

UNITED STATES BANKRUPTCY COURT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

__________ District of __________

 

 

 

 

 

VOLUNTARY PETITION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Debtor (if individual, enter Last, First, Middle):

 

 

 

Name of Joint Debtor (Spouse) (Last, First, Middle):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All Other Names used by the Debtor in the last 8 years

 

 

 

 

 

 

All Other Names used by the Joint Debtor in the last 8 years

 

 

 

(include married, maiden, and trade names):

 

 

 

 

 

 

(include married, maiden, and trade names):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last four digits of Soc. Sec. or Individual-Taxpayer I.D. (ITIN)/Complete EIN

 

Last four digits of Soc. Sec. or Individual-Taxpayer I.D. (ITIN)/Complete EIN

(if more than one, state all):

 

 

 

 

 

 

 

(if more than one, state all):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address of Debtor (No. and Street, City, and State):

 

 

 

Street Address of Joint Debtor (No. and Street, City, and State):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP CODE

 

 

 

 

 

 

 

 

ZIP CODE

 

County of Residence or of the Principal Place of Business:

 

 

 

 

 

County of Residence or of the Principal Place of Business:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address of Debtor (if different from street address):

 

 

 

Mailing Address of Joint Debtor (if different from street address):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP CODE

 

 

 

 

 

 

 

 

ZIP CODE

 

Location of Principal Assets of Business Debtor (if different from street address above):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP CODE

 

 

Type of Debtor

 

 

 

 

Nature of Business

 

 

 

Chapter of Bankruptcy Code Under Which

 

(Form of Organization)

 

 

 

(Check one box.)

 

 

 

 

 

the Petition is Filed (Check one box.)

 

(Check one box.)

 

 

 

 

Health Care Business

 

 

 

Chapter 7

Chapter 15 Petition for

 

 

 

 

 

 

 

 

 

 

Individual (includes Joint Debtors)

 

 

 

 

Single Asset Real Estate as defined in

 

Chapter 9

Recognition of a Foreign

See Exhibit D on page 2 of this form.

 

 

 

 

11 U.S.C. § 101(51B)

 

 

 

Chapter 11

Main Proceeding

Corporation (includes LLC and LLP)

 

 

 

Railroad

 

 

 

 

 

Chapter 12

Chapter 15 Petition for

Partnership

 

 

 

 

 

Stockbroker

 

 

 

 

 

Chapter 13

Recognition of a Foreign

Other (If debtor is not one of the above entities, check

 

Commodity Broker

 

 

 

 

Nonmain Proceeding

this box and state type of entity below.)

 

 

 

Clearing Bank

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

Chapter 15 Debtors

 

 

 

 

Tax-Exempt Entity

 

 

 

 

Nature of Debts

 

 

 

Country of debtor’s center of main interests:

 

 

 

(Check box, if applicable.)

 

 

 

 

(Check one box.)

 

 

 

 

 

 

 

 

 

 

 

 

 

Debts are primarily consumer

Debts are

 

 

 

 

 

 

 

Debtor is a tax-exempt organization

 

Each country in which a foreign proceeding by, regarding, or

 

 

debts, defined in 11 U.S.C.

primarily

 

under title 26 of the United States

 

§ 101(8) as “incurred by an

business debts.

against debtor is pending:

 

 

 

 

 

Code (the Internal Revenue Code).

 

individual primarily for a

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

personal, family, or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

household purpose.”

 

 

 

 

 

Filing Fee (Check one box.)

 

 

 

 

 

 

 

 

Chapter 11 Debtors

 

 

 

 

 

 

 

 

 

 

 

 

 

Check one box:

 

 

 

 

 

 

 

Full Filing Fee attached.

 

 

 

 

 

 

 

Debtor is a small business debtor as defined in 11 U.S.C. § 101(51D).

Filing Fee to be paid in installments (applicable to individuals only). Must attach

Debtor is not a small business debtor as defined in 11 U.S.C. § 101(51D).

 

 

 

 

 

 

 

 

 

 

 

signed application for the court’s consideration certifying that the debtor is

 

Check if:

 

 

 

 

 

 

 

 

 

 

unable to pay fee except in installments. Rule 1006(b). See Official Form 3A.

 

Debtor’s aggregate noncontingent liquidated debts (excluding debts owed to

 

 

 

 

 

 

 

 

 

 

insiders or affiliates) are less than $2,490,925 (amount subject to adjustment

Filing Fee waiver requested (applicable to chapter 7 individuals only). Must

 

on 4/01/16 and every three years thereafter).

 

 

 

attach signed application for the court’s consideration. See Official Form 3B.

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check all applicable boxes:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A plan is being filed with this petition.

 

 

 

 

 

 

 

 

 

 

 

 

 

Acceptances of the plan were solicited prepetition from one or more classes

 

 

 

 

 

 

 

 

 

 

of creditors, in accordance with 11 U.S.C. § 1126(b).

 

 

 

Statistical/Administrative Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS SPACE IS FOR

 

Debtor estimates that funds will be available for distribution to unsecured creditors.

 

 

 

 

 

 

 

COURT USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for

 

 

 

 

 

distribution to unsecured creditors.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Estimated Number of Creditors

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1-49

50-99

100-199

200-999

1,000-

 

 

5,001-

 

10,001-

25,001-

 

50,001-

Over

 

 

 

 

 

 

 

 

5,000

 

 

10,000

 

25,000

50,000

 

 

100,000

100,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Estimated Assets

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$0 to

$50,001 to

$100,001 to

$500,001

$1,000,001

$10,000,001

 

$50,000,001

$100,000,001

$500,000,001

More than

 

 

 

 

$50,000

$100,000

$500,000

to $1

to $10

to $50

to $100

to $500

to $1 billion

$1 billion

 

 

 

 

 

 

 

million

million

million

million

million

 

 

 

 

 

 

 

Estimated Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$0 to

$50,001 to

$100,001 to

$500,001

$1,000,001

$10,000,001

 

$50,000,001

$100,000,001

$500,000,001

More than

 

 

 

 

$50,000

$100,000

$500,000

to $1

to $10

to $50

to $100

to $500

to $1 billion

$1 billion

 

 

 

 

 

 

 

million

million

million

million

million

 

 

 

 

 

 

 

B1 (Official Form 1) (04/13)

Page 2

Voluntary Petition

Name of Debtor(s):

(This page must be completed and filed in every case.)

 

All Prior Bankruptcy Cases Filed Within Last 8 Years (If more than two, attach additional sheet.)

Location

 

Case Number:

Date Filed:

Where Filed:

 

 

 

Location

 

Case Number:

Date Filed:

Where Filed:

 

 

 

 

Pending Bankruptcy Case Filed by any Spouse, Partner, or Affiliate of this Debtor (If more than one, attach additional sheet.)

Name of Debtor:

 

Case Number:

Date Filed:

 

 

 

 

District:

 

Relationship:

Judge:

 

 

 

 

Exhibit A

 

Exhibit B

(To be completed if debtor is required to file periodic reports (e.g., forms 10K and

 

(To be completed if debtor is an individual

10Q) with the Securities and Exchange Commission pursuant to Section 13 or 15(d)

 

whose debts are primarily consumer debts.)

of the Securities Exchange Act of 1934 and is requesting relief under chapter 11.)

I, the attorney for the petitioner named in the foregoing petition, declare that I have

 

 

informed the petitioner that [he or she] may proceed under chapter 7, 11, 12, or 13

 

of title 11, United States Code, and have explained the relief available under each

 

such chapter. I further certify that I have delivered to the debtor the notice required

Exhibit A is attached and made a part of this petition.

by 11 U.S.C. § 342(b).

 

 

 

 

 

 

 

X

 

 

 

 

Signature of Attorney for Debtor(s)

(Date)

 

Exhibit C

Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to public health or safety?

Yes, and Exhibit C is attached and made a part of this petition.

No.

Exhibit D

(To be completed by every individual debtor. If a joint petition is filed, each spouse must complete and attach a separate Exhibit D.)

Exhibit D, completed and signed by the debtor, is attached and made a part of this petition.

If this is a joint petition:

Exhibit D, also completed and signed by the joint debtor, is attached and made a part of this petition.

Information Regarding the Debtor - Venue

(Check any applicable box.)

Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this 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.

There is a bankruptcy case concerning debtor’s affiliate, general partner, or partnership pending in this District.

Debtor is a debtor in a foreign proceeding and has its principal place of business or principal assets in the United States in this District, or has no principal place of business or assets in the United States but is a defendant in an action or proceeding [in a federal or state court] in this District, or the interests of the parties will be served in regard to the relief sought in this District.

Certification by a Debtor Who Resides as a Tenant of Residential Property

(Check all applicable boxes.)

Landlord has a judgment against the debtor for possession of debtor’s residence. (If box checked, complete the following.)

(Name of landlord that obtained judgment)

(Address of landlord)

Debtor claims that under applicable nonbankruptcy law, there are circumstances under which the debtor would be permitted to cure the entire monetary default that gave rise to the judgment for possession, after the judgment for possession was entered, and

Debtor has included with this petition the deposit with the court of any rent that would become due during the 30-day period after the filing of the petition.

Debtor certifies that he/she has served the Landlord with this certification. (11 U.S.C. § 362(l)).

B1 (Official Form 1) (04/13)

 

 

Page 3

Voluntary Petition

Name of Debtor(s):

 

 

 

 

(This page must be completed and filed in every case.)

 

 

 

 

 

 

 

 

 

Signatures

 

 

 

 

 

Signature(s) of Debtor(s) (Individual/Joint)

 

Signature of a Foreign Representative

I declare under penalty of perjury that the information provided in this petition is true

I declare under penalty of perjury that the information provided in this petition is true

and correct.

and correct, that I am the foreign representative of a debtor in a foreign proceeding,

[If petitioner is an individual whose debts are primarily consumer debts and has

and that I am authorized to file this petition.

chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12

(Check only one box.)

 

 

 

 

or 13 of title 11, United States Code, understand the relief available under each such

 

 

 

 

 

 

 

 

 

 

chapter, and choose to proceed under chapter 7.

 

I request relief in accordance with chapter 15 of title 11, United States Code.

[If no attorney represents me and no bankruptcy petition preparer signs the petition] I

 

 

Certified copies of the documents required by 11 U.S.C. § 1515 are attached.

have obtained and read the notice required by 11 U.S.C. § 342(b).

 

 

 

 

 

 

 

I request relief in accordance with the chapter of title 11, United States Code,

 

Pursuant to 11 U.S.C. § 1511, I request relief in accordance with the

chapter of title 11 specified in this petition. A certified copy of the

specified in this petition.

 

order granting recognition of the foreign main proceeding is attached.

X

 

 

X

 

 

 

 

 

Signature of Debtor

 

(Signature of Foreign Representative)

 

 

 

X

 

 

 

 

 

 

 

 

 

Signature of Joint Debtor

 

(Printed Name of Foreign Representative)

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number (if not represented by attorney)

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

Signature of Attorney*

 

Signature of Non-Attorney Bankruptcy Petition Preparer

X

I declare under penalty of perjury that:

(1) I am a bankruptcy petition preparer as

 

Signature of Attorney for Debtor(s)

 

defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have

 

 

 

 

provided the debtor with a copy of this document and the notices and information

 

Printed Name of Attorney for Debtor(s)

required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and, (3) if rules or

 

 

 

 

guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum

 

Firm Name

 

fee for services chargeable by bankruptcy petition preparers, I have given the debtor

 

 

 

 

notice of the maximum amount before preparing any document for filing for a debtor

 

 

 

 

or accepting any fee from the debtor, as required in that section. Official Form 19 is

 

 

 

 

attached.

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number

 

 

Printed Name and title, if any, of Bankruptcy Petition Preparer

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

*In a case in which § 707(b)(4)(D) applies, this signature also constitutes a

 

Social-Security number (If the bankruptcy petition preparer is not an individual,

 

state the Social-Security number of the officer, principal, responsible person or

certification that the attorney has no knowledge after an inquiry that the information

 

partner of the bankruptcy petition preparer.) (Required by 11 U.S.C. § 110.)

in the schedules is incorrect.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Debtor (Corporation/Partnership)

 

 

 

 

 

 

I declare under penalty of perjury that the information provided in this petition is true

 

 

 

 

 

 

 

Address

 

 

 

 

and correct, and that I have been authorized to file this petition on behalf of the

 

 

 

 

 

 

debtor.

X

 

 

 

 

The debtor requests the relief in accordance with the chapter of title 11, United States

 

 

 

 

 

Signature

 

 

 

 

Code, specified in this petition.

 

 

 

 

 

 

X

 

 

 

 

 

 

 

Date

 

 

 

 

 

Signature of Authorized Individual

 

 

 

 

 

 

 

 

 

 

 

Signature of bankruptcy petition preparer or officer, principal, responsible person, or

 

Printed Name of Authorized Individual

 

partner whose Social-Security number is provided above.

 

 

 

 

 

 

 

 

 

Title of Authorized Individual

 

Names and Social-Security numbers of all other individuals who prepared or assisted

 

 

 

 

 

 

 

 

in preparing this document unless the

bankruptcy petition preparer is not an

 

Date

 

individual.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If more than one person prepared this document, attach additional sheets conforming

 

 

 

 

to the appropriate official form for each person.

 

 

 

 

A bankruptcy petition preparer’s failure to comply with the provisions of title 11 and

 

 

 

 

the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or

 

 

 

 

both. 11 U.S.C. § 110; 18 U.S.C. § 156.

 

 

 

 

B 1D (Official Form 1, Exhibit D) (12/09)

UNITED STATES BANKRUPTCY COURT

__________ District of __________

In re__________________________

Case No._____________

Debtor

(if known)

EXHIBIT D - INDIVIDUAL DEBTOR’S STATEMENT OF COMPLIANCE WITH

CREDIT COUNSELING REQUIREMENT

Warning: You must be able to check truthfully one of the five statements regarding credit counseling listed below. If you cannot do so, you are not eligible to file a bankruptcy case, and the court can dismiss any case you do file. If that happens, you will lose whatever filing fee you paid, and your creditors will be able to resume collection activities against you. If your case is dismissed and you file another bankruptcy case later, you may be required to pay a second filing fee and you may have to take extra steps to stop creditors’ collection activities.

Every individual debtor must file this Exhibit D. If a joint petition is filed, each spouse must complete and file a separate Exhibit D. Check one of the five statements below and attach any documents as directed.

’1. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities for available credit counseling and assisted me in performing a related budget analysis, and I have a certificate from the agency describing the services provided to me. Attach a copy of the certificate and a copy of any debt repayment plan developed through the agency.

’2. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities for available credit counseling and assisted me in performing a related budget analysis, but I do not have a certificate from the agency describing the services provided to me. You must file a copy of a certificate from the agency describing the services provided to you and a copy of any debt repayment plan developed through the agency no later than 14 days after your bankruptcy case is filed.

B 1D (Official Form 1, Exh. D) (12/09) – Cont.

Page 2

 

’3. I certify that I requested credit counseling services from an approved agency but was unable to obtain the services during the seven days from the time I made my request, and the following exigent circumstances merit a temporary waiver of the credit counseling requirement so I can file my bankruptcy case now. [Summarize exigent circumstances here.]

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

If your certification is satisfactory to the court, you must still obtain the credit counseling briefing within the first 30 days after you file your bankruptcy petition and promptly file a certificate from the agency that provided the counseling, together with a copy of any debt management plan developed through the agency. Failure to fulfill these requirements may result in dismissal of your case. Any extension of the 30-day deadline can be granted only for cause and is limited to a maximum of 15 days. Your case may also be dismissed if the court is not satisfied with your reasons for filing your bankruptcy case without first receiving a credit counseling briefing.

’4. I am not required to receive a credit counseling briefing because of: [Check the applicable statement.] [Must be accompanied by a motion for determination by the court.]

’Incapacity. (Defined in 11 U.S.C. § 109(h)(4) as impaired by reason of mental illness or mental deficiency so as to be incapable of realizing and making rational decisions with respect to financial responsibilities.);

’Disability. (Defined in 11 U.S.C. § 109(h)(4) as physically impaired to the extent of being unable, after reasonable effort, to participate in a credit counseling briefing in person, by telephone, or through the Internet.);

’Active military duty in a military combat zone.

’5. The United States trustee or bankruptcy administrator has determined that the credit counseling requirement of 11 U.S.C. ' 109(h) does not apply in this district.

I certify under penalty of perjury that the information provided above is true and correct.

Signature of Debtor: ________________________

Date: _________________

B 1D (Official Form 1, Exhibit D) (12/09)

UNITED STATES BANKRUPTCY COURT

__________ District of __________

In re__________________________

Case No._____________

Debtor

(if known)

EXHIBIT D - INDIVIDUAL DEBTOR’S STATEMENT OF COMPLIANCE WITH

CREDIT COUNSELING REQUIREMENT

Warning: You must be able to check truthfully one of the five statements regarding credit counseling listed below. If you cannot do so, you are not eligible to file a bankruptcy case, and the court can dismiss any case you do file. If that happens, you will lose whatever filing fee you paid, and your creditors will be able to resume collection activities against you. If your case is dismissed and you file another bankruptcy case later, you may be required to pay a second filing fee and you may have to take extra steps to stop creditors’ collection activities.

Every individual debtor must file this Exhibit D. If a joint petition is filed, each spouse must complete and file a separate Exhibit D. Check one of the five statements below and attach any documents as directed.

’1. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities for available credit counseling and assisted me in performing a related budget analysis, and I have a certificate from the agency describing the services provided to me. Attach a copy of the certificate and a copy of any debt repayment plan developed through the agency.

’2. Within the 180 days before the filing of my bankruptcy case, I received a briefing from a credit counseling agency approved by the United States trustee or bankruptcy administrator that outlined the opportunities for available credit counseling and assisted me in performing a related budget analysis, but I do not have a certificate from the agency describing the services provided to me. You must file a copy of a certificate from the agency describing the services provided to you and a copy of any debt repayment plan developed through the agency no later than 14 days after your bankruptcy case is filed.

B 1D (Official Form 1, Exh. D) (12/09) – Cont.

Page 2

 

’3. I certify that I requested credit counseling services from an approved agency but was unable to obtain the services during the seven days from the time I made my request, and the following exigent circumstances merit a temporary waiver of the credit counseling requirement so I can file my bankruptcy case now. [Summarize exigent circumstances here.]

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

If your certification is satisfactory to the court, you must still obtain the credit counseling briefing within the first 30 days after you file your bankruptcy petition and promptly file a certificate from the agency that provided the counseling, together with a copy of any debt management plan developed through the agency. Failure to fulfill these requirements may result in dismissal of your case. Any extension of the 30-day deadline can be granted only for cause and is limited to a maximum of 15 days. Your case may also be dismissed if the court is not satisfied with your reasons for filing your bankruptcy case without first receiving a credit counseling briefing.

’4. I am not required to receive a credit counseling briefing because of: [Check the applicable statement.] [Must be accompanied by a motion for determination by the court.]

’Incapacity. (Defined in 11 U.S.C. § 109(h)(4) as impaired by reason of mental illness or mental deficiency so as to be incapable of realizing and making rational decisions with respect to financial responsibilities.);

’Disability. (Defined in 11 U.S.C. § 109(h)(4) as physically impaired to the extent of being unable, after reasonable effort, to participate in a credit counseling briefing in person, by telephone, or through the Internet.);

’Active military duty in a military combat zone.

’5. The United States trustee or bankruptcy administrator has determined that the credit counseling requirement of 11 U.S.C. ' 109(h) does not apply in this district.

I certify under penalty of perjury that the information provided above is true and correct.

Signature of Debtor: ________________________

Date: _________________

Get Bankruptcy Cover Sheet Petition PDF Form

Form Characteristics

Fact Name Description
Form Identifier The Bankruptcy Cover Sheet Petition is identified as Local Bankruptcy Form 1002-1.1, used specifically within the United States Bankruptcy Court for the District of Colorado.
Purpose This form serves as a cover sheet to ensure that all necessary documents are included when filing a bankruptcy petition.
Governing Law The form is governed by the Bankruptcy Code and relevant Federal Rules of Bankruptcy Procedure, particularly Section 1006 and 1007.
Filing Fees As of November 1, 2011, the fees to file differ by chapter: $306 for Chapter 7, $1,213 for Chapter 11, $246 for Chapter 12, and $281 for Chapter 13.
Pro Se Filers Debtors without an attorney (pro se) must provide their home address and phone number on the form, ensuring they can be contacted by the court.
Credit Counseling Compliance Individual debtors must include Exhibit D to demonstrate compliance with credit counseling requirements, a mandate under federal law prior to filing bankruptcy.
Required Documents Various official forms must accompany the Petition, including the Voluntary Petition and Statement of Financial Affairs, among others, depending on the chapter filed.
Email Notifications Debtors not represented by an attorney may opt to receive electronic notices of filings related to their case via email, enhancing communication efficiency.

Guidelines on Utilizing Bankruptcy Cover Sheet Petition

The Bankruptcy Cover Sheet Petition form is a crucial document used in the bankruptcy filing process. Properly completing this form ensures that all necessary information and documentation has been included with the bankruptcy petition. This step is vital for the effective processing of your case.

  1. Identify the Debtor's Name: Enter the name(s) of the debtor(s) in the space provided at the top of the form.
  2. Attorney Information: If applicable, fill in the attorney’s firm name, address, telephone number, and registration number. If you do not have an attorney, indicate as “pro se” and provide your home address and telephone number.
  3. Choose the Filing Fee: Check the appropriate box to indicate the chapter under which you are filing and the corresponding filing fee. If any other fee is to be paid, specify the amount.
  4. Attach Required Documents: Check the boxes next to all applicable documents you are attaching, including the Voluntary Petition, Statement of Financial Affairs, Schedules, and any additional forms relevant to your case.
  5. Payment Advices: Provide copies of any payment advices or evidence of income received in the 60 days prior to filing. Ensure these copies include your name on each page.
  6. Consider Additional Items: If you are a chapter 7, 11, or 13 debtor, be sure to include any additional required items listed for your specific chapter.
  7. Date the Form: At the bottom of the form, fill in the date and print your name next to the signature line.
  8. Signature: Sign the form in the designated space, which indicates your acknowledgment and understanding of the information provided.

After filling out the Bankruptcy Cover Sheet Petition form, ensure that all attached documents are complete and accurate. Submit the form along with the petition to the appropriate bankruptcy court. This process establishes your official case and begins the journey through bankruptcy proceedings.

What You Should Know About This Form

What is the Bankruptcy Cover Sheet Petition Form?

The Bankruptcy Cover Sheet Petition Form, also known as Local Bankruptcy Form 1002-1.1, is a document required to be filed when initiating a bankruptcy case. This form outlines essential information about the debtor(s), the attorney (if applicable), and the documents attached to the petition. It ensures that the court has the necessary details to process the bankruptcy filing effectively.

Who needs to fill out this form?

Both individuals and businesses filing for bankruptcy must complete this form. It is used by debtors with or without legal representation. If you have an attorney, their information will be included; otherwise, you must provide your own details as a "pro se" debtor.

What information must be included in the form?

The form requires information about the debtor(s), including names, addresses, social security numbers or taxpayer IDs, and the details of the attorney (if applicable). You must also select applicable boxes to indicate the documents attached and provide information about the filing fee, if applicable.

What are the filing fees associated with the Bankruptcy Cover Sheet Petition Form?

Filing fees vary depending on the chapter of bankruptcy you are filing under. For chapter 7, the fee is $306; for chapter 11, it is $1,213; for chapter 12, it's $246; and for chapter 13, the cost is $281. There may be provisions for payment in installments or requests for fee waivers for certain individuals, but these must be documented appropriately.

Are there specific attachment requirements?

Yes, various documents must be attached to the form, depending on the type of bankruptcy. Common attachments include the Voluntary Petition, Statement of Financial Affairs, and relevant schedules. Additional items are necessary for different chapters, such as plans for chapter 11 and current monthly income statements for chapters 7 and 13.

What happens if I do not include all required attachments?

If not all required attachments are included, the court may deny your petition for bankruptcy. It's essential to confirm that all necessary documents are completed and submitted with the cover sheet to avoid delays or potential dismissal of your case.

Can I file this form electronically?

Filing electronically is generally not available for individuals representing themselves. You must submit the form and associated documents in paper form to the appropriate bankruptcy court. There are specific programs for qualified creditors, but they do not apply to debtors.

What if my information changes after I have filed?

If your contact information changes, especially your email address, it is crucial to inform the court promptly. You can update your details by submitting a new notice to the bankruptcy court, ensuring they have your most current information for correspondence.

How can I track the progress of my bankruptcy case?

You can track the progress by signing up for electronic notifications. If you are a debtor without an attorney, consider providing your email address to receive instant updates whenever there’s an action in your case. This will allow you to remain informed throughout the bankruptcy process.

What should I do if I have additional questions about this form?

If you have more questions, consult the official website for your bankruptcy court or seek advice from a qualified bankruptcy attorney. They can provide guidance tailored to your situation and ensure you meet all requirements for your bankruptcy filing.

Common mistakes

Completing the Bankruptcy Cover Sheet Petition form can be challenging, and many individuals make mistakes that can delay their filing or cause complications. Here are ten common errors to avoid.

One frequent mistake is not checking the applicable boxes correctly. Ensure each box that corresponds to your situation is marked. Leaving sections unchecked can lead to unnecessary delays as the court may need additional information.

Another issue often arises with debtor information. People sometimes fail to provide accurate names, addresses, and social security numbers. It's critical to double-check this data to prevent any mismatches with court records, which can lead to complications later.

Some individuals incorrectly select the chapter under which they are filing. It’s essential to know whether you should file for Chapter 7, 11, or 13, as each chapter has different requirements and implications for your case.

Missing signatures on the petition is a common oversight. Remember, both individual debtors must sign if a joint petition is submitted. Failing to sign could result in the court rejecting your filing.

Not including the required filing fee is another mistake that can derail the process. Make sure to check and attach the correct fee amount or fill out the necessary application if you qualify for an installment payment or a waiver.

Individuals may also overlook the need for specific supporting documents. For instance, Chapter 7 filers must include a statement of current monthly income, while Chapter 13 filers need a plan. Confirm that all documents requested in the form are attached before submission.

Providing outdated information is problematic. Ensure any financial documents, particularly those pertaining to income and debts, are current. Submitting stale information can mislead the court and harm your case.

Another common error is not properly formatting documents. Each attachment must adhere to specific guidelines, including size and formatting standards, which are crucial for acceptance by the court.

Additionally, neglecting to update contact information, particularly e-mail addresses, can cause issues in communications with the court. Keep the court informed of any changes so that you receive all important notifications.

Finally, assume responsibility for understanding the entire process. Many individuals attempt to fill out the form without fully grasping every requirement. Consider consulting with a specialist if you have questions. This proactive approach can save time and reduce stress during the bankruptcy process.

Documents used along the form

When filing for bankruptcy, several key documents accompany the Bankruptcy Cover Sheet Petition form. Each of these documents plays a critical role in establishing the details of your bankruptcy case. The following list explains these forms briefly.

  • Voluntary Petition (Official Form 1): This is the main document that initiates a bankruptcy case. It provides essential information about the debtor, including their name, address, and type of bankruptcy being filed.
  • Statement of Financial Affairs (Official Form 7): This form details the debtor's financial history, including income, expenses, assets, and related information to give the court a clear view of the debtor’s financial situation.
  • Summary of Schedules (Official Form 6–Summary): This summary consolidates all the schedules of assets and debts into a single document, making it easier for the court to understand the overall financial landscape of the debtor.
  • Schedules A-J (Official Forms 6A through 6J): These forms provide a comprehensive breakdown of the debtor's financial situation, detailing specific types of assets, liabilities, and income sources.
  • Declaration Concerning Debtor’s Schedules (Official Form 6–Declaration): This is a statement confirming that all required schedules have been completed and filed with the court, affirming the accuracy and completeness of the information provided.
  • Verification of Creditors’ Matrix (L.B. Form 1007-2.1): This document provides a list of all creditors to whom the debtor owes money, ensuring that the court and creditors are aware of all claims against the debtor.
  • Creditors’ Matrix: This is an official list of creditors, including their names and addresses, which allows the court to notify them of the bankruptcy proceedings.
  • Statement of Social Security Number(s) (Official Form 21): This form provides the debtor’s Social Security number, which is necessary for the identification and processing of the bankruptcy case.
  • Statement of Current Monthly Income (Official Form 22): This form calculates the debtor's current monthly income to determine eligibility for various bankruptcy chapters and assists in assessing repayment ability if applicable.

Each of these documents is critical for the successful filing and processing of a bankruptcy case. Ensure that they are completed accurately and submitted alongside the Bankruptcy Cover Sheet Petition form.

Similar forms

  • Voluntary Petition (Official Form 1) – This form is essential for initiating a bankruptcy case, much like the Bankruptcy Cover Sheet. Both documents require details about the debtor, including name, address, and the type of bankruptcy being filed. They both also include information about applicable fees, demonstrating the costs involved in the process.
  • Statement of Financial Affairs (Official Form 7) – Similar in purpose, this statement outlines the debtor's financial history. Just as with the Bankruptcy Cover Sheet, it requires the debtor to provide a comprehensive view of their financial situation, including income sources and expenditures, which helps assess the overall viability of the bankruptcy claim.
  • Summary of Schedules (Official Form 6 – Summary) – This document summarizes all debtor schedules, providing a quick overview of assets and liabilities. Like the Bankruptcy Cover Sheet, it aims to present a concise snapshot of the debtor's financial status to the court.
  • Schedules A - J (Official Forms 6A - 6J) – These schedules provide in-depth detail on various financial aspects, including property, debts, and income. The Bankruptcy Cover Sheet also collects basic information and checks off documents attached, reflecting a similar need for organized financial disclosure.
  • Declaration Concerning Debtor’s Schedules (Official Form 6 – Declaration) – This declaration, like the Bankruptcy Cover Sheet, ensures that the debtor affirms the accuracy of the schedules filed. Both documents hinge on the requirement for truthful and complete representation of the debtor's financial condition.
  • Attorney Fee Disclosure Statement (Director’s Procedural Form B 203) – This form discusses the attorney's fees associated with the bankruptcy filing. It aligns with the Bankruptcy Cover Sheet by addressing financial obligations and costs relating to the debtor’s representation, ensuring transparency in legal fees.
  • Verification of Creditors’ Matrix (L.B. Form 1007-2.1) – This verification assures the court that all creditors are accurately listed. Both the Verification and the Bankruptcy Cover Sheet emphasize the importance of complete and accurate documentation to assist the court in the bankruptcy process.

Dos and Don'ts

When filling out the Bankruptcy Cover Sheet Petition form, it is crucial to approach the task with care and attention to detail. Here are ten important dos and don'ts to keep in mind:

  • Do check that all required boxes are marked accurately to reflect your situation.
  • Don’t leave out any essential documents. Ensure you have all forms that may be required for your specific chapter.
  • Do print your name clearly where indicated, ensuring it's legible for all reviewers.
  • Don’t make any unauthorized changes to the form's content; stick to the official guidelines.
  • Do keep a copy of the completed form for your records before submitting it.
  • Don’t forget to attach the required payment advices, checks, or statements as per the instructions.
  • Do include your attorney’s contact information if you are represented.
  • Don’t file the form without double-checking for completion and accuracy; errors can delay the process.
  • Do sign and date the form in the proper sections to validate your petitions.
  • Don’t assume everything is correct; review the instructions thoroughly to avoid misunderstandings.

Attention to these details can streamline the filing process and help prevent complications down the road.

Misconceptions

Misconceptions about the Bankruptcy Cover Sheet Petition form can lead to confusion among debtors navigating the bankruptcy process. Here are seven common misconceptions:

  • Misconception 1: All debtors need an attorney to file the Bankruptcy Cover Sheet Petition.

    • This is false. Debtors can choose to file "pro se," meaning without an attorney. They must still complete all required forms accurately.

  • Misconception 2: The cover sheet can be submitted without any attachments.

    • This is incorrect. The cover sheet must indicate which documents are attached. Failing to provide necessary attachments can delay the process.

  • Misconception 3: The filing fees are the same for all chapters of bankruptcy.

    • This is not true. Each chapter (7, 11, 12, or 13) has a different filing fee. Debtors must verify the correct fee and pay it accordingly.

  • Misconception 4: A debtor does not need to list all income sources on the form.

    • This is misleading. Debtors must fully disclose all sources of income to facilitate an accurate assessment of their financial situation.

  • Misconception 5: Once the cover sheet is filed, the bankruptcy case is automatically approved.

    • This is incorrect. Filing the cover sheet initiates the process, but approval depends on meeting all requirements stipulated by the court.

  • Misconception 6: Debtors do not need to provide proof of credit counseling if they file for Chapter 7 bankruptcy.

    • This is a misconception. Every individual debtor must submit a Statement of Compliance with the Credit Counseling Requirement, regardless of the chapter filed.

  • Misconception 7: The Bankruptcy Cover Sheet Petition form is the only document needed for filing.

    • This is false. The cover sheet is part of a larger set of required documents that must be completed and filed for the bankruptcy case to proceed.

Key takeaways

  • Always ensure you check the relevant boxes on the Bankruptcy Cover Sheet Petition form to indicate which documents are attached. This helps the court process your petition efficiently.

  • Include all required information, such as the names of the debtors, mailing addresses, and attorney details (if applicable). Incomplete information can lead to delays in your case.

  • Be diligent about the filing fees. Know the correct amount based on your chosen bankruptcy chapter. If you're unable to pay the fee upfront, consider applying to pay in installments, but attach the necessary application.

  • Individual debtors must attach important documentation, like proof of income received in the 60 days before filing. Failing to include this may complicate your case.

  • Understand the significance of compliance documents, like the Exhibit D Statement regarding credit counseling. Missing these can lead to court issues.

  • Finally, if you’re not represented by an attorney, consider signing up for e-mail notifications. This service allows you to receive immediate updates about your case electronically, simplifying communication with the court.

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