Legal BK Petition Form

LEGAL BK PETITION FORM

Petitioning Party: Debtor Name: ; Co‑Debtor (if any): .

Debtor Address: ; Debtor SSN / Tax ID (last 4 digits): .

Case Number (if known): ; Date of Petition: .

RECITALS

WHEREAS, the Debtor is generally unable to pay debts as they mature and believes that relief under the Bankruptcy Code is necessary and appropriate to effect an orderly administration of the Debtor's obligations and estate; and

WHEREAS, the Debtor intends to file a voluntary petition for relief under the provisions of the United States Bankruptcy Code and to file all required Schedules, Statements of Financial Affairs and related filings within the periods required by the Code and applicable rules; and

WHEREAS, the Debtor seeks court recognition of the commencement of a bankruptcy case under the chapter of the Bankruptcy Code selected below and requests the relief described in this Petition.

PETITION

NOW THEREFORE, the Debtor hereby petitions the appropriate United States Bankruptcy Court for an order commencing a bankruptcy case under the Bankruptcy Code. The Debtor requests relief and states under penalty of perjury the following:

1. CHAPTER SELECTION

The Debtor elects to proceed under the following chapter of the Bankruptcy Code (select one):

Chapter 7    Chapter 11    Chapter 13

2. JURISDICTION AND VENUE

The Debtor submits that this Court has jurisdiction pursuant to the Bankruptcy Code and that venue of this case is proper in the judicial district where the Debtor's domicile, residence, principal place of business, or principal assets have been located for the requisite period. The Debtor's principal place of business or residence is: .

3. SCHEDULES AND STATEMENTS

The Debtor acknowledges the obligation to prepare and file all required schedules, statements of financial affairs, and related documents, and certifies that the schedules will be true, complete, and accurate to the best of the Debtor's knowledge. The Debtor will file the required schedules within days of the filing of this Petition.

4. AUTOMATIC STAY AND RELIEF SOUGHT

Upon the filing of this Petition, the Debtor requests the entry of an order recognizing the automatic stay pursuant to the Bankruptcy Code, enjoining creditors from taking collection actions against the Debtor or property of the Debtor's estate, and granting such other relief as is necessary to preserve estate assets and permit administration of the case.

5. ASSETS, LIABILITIES AND FINANCIAL INFORMATION

Estimated aggregate assets: $ ; Estimated aggregate liabilities: $.

6. ATTORNEY INFORMATION

7. FEES, PAYMENTS AND RETENTION

Filing fee: $. The Debtor certifies the fee has been paid in full; certifies the fee will be paid in accordance with the court's rules.

8. NOTICES

All notices and communications to the Debtor should be directed to the following address and contact:

9. VERIFICATION AND CERTIFICATION

I certify under penalty of perjury under the laws of the United States that the information contained in this Petition and the schedules and statements filed in connection with this Petition are true and correct to the best of my knowledge, information and belief. I further certify that the Debtor has provided accurate information concerning assets, liabilities, income and expenditures and understands the duties and penalties for false statements under applicable law.

10. MISCELLANEOUS PROVISIONS

Governing Law: This Petition and any order entered in this case shall be governed by the provisions of the United States Bankruptcy Code and, to the extent applicable, the laws of the state where this petition is filed.

Entire Agreement: This Petition, together with the Schedules and Statements filed concurrently or subsequently, constitutes the entire filing and statement of the Debtor's intent and supersedes any prior written or oral statements concerning the relief requested herein.

Severability: If any provision of this Petition is found to be invalid or unenforceable, the remaining provisions shall continue in full force and effect to the extent permitted by law.

Amendments and Waiver: Any amendment or waiver of provisions of this Petition must be made in writing and executed by the party seeking the amendment or waiver. No course of conduct shall constitute a waiver of any provision unless set forth in a written instrument signed by the party against whom enforcement is sought.

NOTARY / DECLARATION (IF REQUIRED)

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