Official Form 122A 1 PDF Details

Are you looking for official form 122A 1? Whether you are trying to fill out an important governmental or financial document, understanding how to properly and accurately complete this form is essential. You want the information provided on your application to be done precisely; otherwise, it could lead to costly mistakes or even a denied request. This blog post offers insight into the ins and outs of filling out Form 122A 1 and why it's so important that all necessary details are included in each submission.

QuestionAnswer
Form NameOfficial Form 122A 1
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesofficial 122a get, 122a1 7 online, 122a 1, 122a 1 chapter

Form Preview Example

Fill in this information to identify your case:

Debtor 1

__________________________________________________________________

 

First Name

Middle Name

Last Name

Debtor 2

________________________________________________________________

(Spouse, if filing)

First Name

Middle Name

Last Name

 

United States Bankruptcy Court for the:

____________ District of _______________

 

 

 

 

 

 

Case number

___________________________________________

 

 

(If known)

 

 

 

 

Check one box only as directed in this form and in

Form 122A-1Supp:

1. There is no presumption of abuse.

2. The calculation to determine if a presumption of abuse applies will be made under Chapter 7 Means Test Calculation (Official Form 122A–2).

3. The Means Test does not apply now because of qualified military service but it could apply later.

Check if this is an amended filing

Official Form 122A1

 

Chapter 7 Statement of Your Current Monthly Income

10/19

Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for being accurate. If more space is needed, attach a separate sheet to this form. Include the line number to which the additional information applies. On the top of any additional pages, write your name and case number (if known). If you believe that you are exempted from a presumption of abuse because you do not have primarily consumer debts or because of qualifying military service, complete and file Statement of Exemption from Presumption of Abuse Under § 707(b)(2) (Official Form 122A-1Supp) with this form.

Part 1: Calculate Your Current Monthly Income

1.What is your marital and filing status? Check one only.

Not married. Fill out Column A, lines 2-11.

Married and your spouse is filing with you. Fill out both Columns A and B, lines 2-11.

Married and your spouse is NOT filing with you. You and your spouse are:

Living in the same household and are not legally separated. Fill out both Columns A and B, lines 2-11.

Living separately or are legally separated. Fill out Column A, lines 2-11; do not fill out Column B. By checking this box, you declare under penalty of perjury that you and your spouse are legally separated under nonbankruptcy law that applies or that you and your spouse are living apart for reasons that do not include evading the Means Test requirements. 11 U.S.C. § 707(b)(7)(B).

Fill in the average monthly income that you received from all sources, derived during the 6 full months before you file this bankruptcy case. 11 U.S.C. § 101(10A). For example, if you are filing on September 15, the 6-month period would be March 1 through August 31. If the amount of your monthly income varied during the 6 months, add the income for all 6 months and divide the total by 6. Fill in the result. Do not include any income amount more than once. For example, if both spouses own the same rental property, put the income from that property in one column only. If you have nothing to report for any line, write $0 in the space.

2. Your gross wages, salary, tips, bonuses, overtime, and commissions (before all payroll deductions).

3. Alimony and maintenance payments. Do not include payments from a spouse if Column B is filled in.

4. All amounts from any source which are regularly paid for household expenses of you or your dependents, including child support. Include regular contributions from an unmarried partner, members of your household, your dependents, parents, and roommates. Include regular contributions from a spouse only if Column B is not filled in. Do not include payments you listed on line 3.

5. Net income from operating a business, profession,

Debtor 1

 

Debtor 2

or farm

 

 

 

 

 

Column A

 

 

Column B

 

 

 

 

Debtor 1

 

 

Debtor 2 or

 

 

 

 

non-filing spouse

$_________

$__________

$_________

$__________

$_________ $__________

Gross receipts (before all deductions)

Ordinary and necessary operating expenses

Net monthly income from a business, profession, or farm

6.Net income from rental and other real property Gross receipts (before all deductions)

Ordinary and necessary operating expenses

Net monthly income from rental or other real property

7.Interest, dividends, and royalties

$______

$______

 

$______ $______

 

 

 

Copy

$______

$______

here

Debtor 1

Debtor 2

 

$______

$______

 

$______ $______

 

 

 

Copy

$______

$______

here

$_________ $__________

$_________ $__________

$_________ $__________

Official Form 122A-1

Chapter 7 Statement of Your Current Monthly Income

page 1

Debtor 1

_______________________________________________________

Case number (if known)_____________________________________

 

First Name

Middle Name

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Column A

 

Column B

 

 

 

 

 

 

 

Debtor 1

 

Debtor 2 or

 

 

 

 

 

 

 

 

 

non-filing spouse

 

8. Unemployment compensation

 

 

$__________

$___________

 

Do not enter the amount if you contend that the amount received was a benefit

 

 

 

 

 

under the Social Security Act. Instead, list it here:

................................

 

 

 

 

 

 

For you

 

$______________

 

 

 

 

 

 

For your spouse

 

$______________

 

 

 

 

 

9.Pension or retirement income. Do not include any amount received that was a benefit under the Social Security Act. Also, except as stated in the next sentence, do not include any compensation, pension, pay, annuity, or allowance paid by the United States Government in connection with a disability, combat-related injury or disability, or death of a member of the uniformed services. If you received any retired pay paid under chapter 61 of title 10, then include that pay only to the extent that it does not exceed the amount of retired pay to which you would otherwise be entitled if retired under any provision of title 10 other than chapter 61 of that title.

10.Income from all other sources not listed above. Specify the source and amount. Do not include any benefits received under the Social Security Act; payments received as a victim of a war crime, a crime against humanity, or international or domestic terrorism; or compensation, pension, pay, annuity, or allowance paid by the United States Government in connection with a disability, combat-related injury or disability, or death of a member of the uniformed services. If necessary, list other sources on a separate page and put the total below.

______________________________________

______________________________________

Total amounts from separate pages, if any.

11.Calculate your total current monthly income. Add lines 2 through 10 for each column. Then add the total for Column A to the total for Column B.

Part 2: Determine Whether the Means Test Applies to You

$__________

$_________

$_________

+$_________

$_________

+

$___________

$___________

$___________

+$___________

$___________

=$__________

Total current monthly income

12.Calculate your current monthly income for the year. Follow these steps:

12a.

Copy your total current monthly income from line 11

Copy line 11 here

$__________

 

 

 

 

 

Multiply by 12 (the number of months in a year).

 

x 12

 

 

 

 

12b.

The result is your annual income for this part of the form.

12b.

$__________

 

 

 

 

13.Calculate the median family income that applies to you. Follow these steps:

Fill in the state in which you live.

Fill in the number of people in your household.

 

 

 

 

 

 

 

 

 

Fill in the median family income for your state and size of household

13.

$__________

To find a list of applicable median income amounts, go online using the link specified in the separate

 

 

 

 

instructions for this form. This list may also be available at the bankruptcy clerk’s office.

 

 

14.How do the lines compare?

14a. Line 12b is less than or equal to line 13. On the top of page 1, check box 1, There is no presumption of abuse. Go to Part 3.

14b. Line 12b is more than line 13. On the top of page 1, check box 2, The presumption of abuse is determined by Form 122A-2. Go to Part 3 and fill out Form 122A–2.

Official Form 122A-1

Chapter 7 Statement of Your Current Monthly Income

page 2

Debtor 1

_______________________________________________________

Case number (if known)_____________________________________

 

First Name

Middle Name

Last Name

 

Part 3: Sign Below

By signing here, I declare under penalty of perjury that the information on this statement and in any attachments is true and correct.

__________________________________________________________

______________________________________

Signature of Debtor 1

Signature of Debtor 2

Date _________________

Date _________________

MM / DD / YYYY

MM / DD / YYYY

If you checked line 14a, do NOT fill out or file Form 122A–2.

If you checked line 14b, fill out Form 122A–2 and file it with this form.

Official Form 122A-1

Chapter 7 Statement of Your Current Monthly Income

page 3

How to Edit Official Form 122A 1 Online for Free

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With regards to the fields of this particular PDF, here is what you need to know:

1. First of all, while completing the 7 statement, start in the section containing subsequent blank fields:

A way to complete 122a 1 step 1

2. Immediately after the first section is completed, go on to type in the relevant details in all these - Living in the same household and, under penalty of perjury that you, Fill in the average monthly income, Your gross wages salary tips, before all payroll deductions, Column A Debtor, Column B Debtor or nonfiling, Alimony and maintenance payments, Column B is filled in, All amounts from any source which, Net income from operating a, or farm Gross receipts before all, Ordinary and necessary operating, Debtor, and Debtor.

Debtor, Living in the same household and, and Column B Debtor  or nonfiling inside 122a 1

3. In this specific step, examine Gross receipts before all, Ordinary and necessary operating, Net monthly income from rental or, Interest dividends and royalties, Copy here, Official Form A, Chapter Statement of Your Current, and page. All of these will need to be filled in with highest attention to detail.

Ordinary and necessary operating, page, and Official Form A of 122a 1

When it comes to Ordinary and necessary operating and page, be sure you don't make any errors here. Both these are certainly the key fields in this document.

4. The following part requires your involvement in the subsequent parts: Unemployment compensation, Do not enter the amount if you, For you, For your spouse, Pension or retirement income Do, benefit under the Social Security, Income from all other sources not, Do not include any benefits, Column B Debtor or nonfiling, Column A Debtor, First Name, Middle Name, Last Name, Case number if known, and Debtor. Just remember to enter all required information to go further.

For your spouse, Case number if known, and Last Name inside 122a 1

5. This last step to conclude this document is pivotal. You'll want to fill in the required form fields, and this includes Do not include any benefits, Total amounts from separate pages, Calculate your total current, column Then add the total for, Part Determine Whether the Means, Total current monthly income, Calculate your current monthly, a Copy your total current monthly, Multiply by the number of months, b The result is your annual income, Calculate the median family, Fill in the state in which you live, Fill in the number of people in, Fill in the median family income, and To find a list of applicable, prior to finalizing. Neglecting to do this may give you an unfinished and possibly nonvalid form!

Step number 5 for filling out 122a 1

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