Voluntary Petition Form PDF Details

Voluntary Petition Form is a form used to file for bankruptcy. This form can be filled out and filed by yourself, or with the help of an attorney. The information on this form will provide the court with all of the necessary information to begin the bankruptcy process. There are many things to consider when filing for bankruptcy, so it's important to understand what this form entails and how it can impact your financial future. Filing for bankruptcy is a big decision, and should not be taken lightly. Make sure you explore all of your options before making a final decision. If you decide that bankruptcy is the best option for you, be sure to fill out the Voluntary Petition Form accurately and completely.

The listing contains information about the voluntary petition form. You may go through it just before filling out the form.

QuestionAnswer
Form NameVoluntary Petition Form
Form Length3 pages
Fillable?Yes
Fillable fields15
Avg. time to fill out3 min 45 sec
Other namesofficial form 1, bankruptcy form petition, bankruptcy voluntary, petition form bankruptcy

Form Preview Example

B1 (Official Form 1) (04/13)

 

 

UNITED STATES BANKRUPTCY COURT

 

 

 

 

 

VOLUNTARY PETITION

 

 

__________ District of __________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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.)

 

 

 

 

Check one box:

Chapter 11 Debtors

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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).

Check if:

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

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:

 

 

Date Filed:

Location

 

Case Number:

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:

 

 

 

Judge:

District:

 

Relationship:

 

 

 

 

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.

 

 

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what official form 106i fields to complete

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