(Official Form 1) (9/97)
Voluntary Petition
Location Where Filed: Name of Debtor: District:
Name of Debtor(s):
FORM B1, Page 2
(This page must be completed and filed in every case) Prior Bankruptcy Case Filed Within Last 6 Years (If more than one, attach additional sheet)
Case Number: Date Filed:
Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor (If more than one, attach additional sheet)
Case Number: Relationship: Date Filed: Judge:
Signatures
Signature(s) of Debtor(s) (Individual/Joint)
I declare under penalty of perjury that the information provided in this petition is true and correct. [If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12 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 the chapter of title 11, United States Code, specified in this petition.
Signature of Debtor (Corporation/Partnership)
I declare under penalty of perjury that the information provided in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this petition.
X
Signature of Authorized Individual Printed Name of Authorized Individual
X
Signature of Debtor
X
Signature of Joint Debtor Telephone Number (If not represented by attorney)
Title of Authorized Individual Date Date
Signature of Attorney
Signature of Non-Attorney Petition Preparer
I certify that I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110, that I prepared this document for compensation, and that I have provided the debtor with a copy of this document.
X
Signature of Attorney for Debtor(s) Printed Name of Attorney for Debtor(s)
Printed Name of Bankruptcy Petition Preparer Firm Name Address Social Security Number Address Telephone Number Date Names and Social Security numbers of all other individuals who prepared or assisted in preparing this document:
Exhibit A
(To be completed if debtor is required to file periodic reports (e.g., forms 10K and 10Q) with the Securities and Exchange Commission pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 and is requesting relief under chapter 11) Exhibit A is attached and made a part of this petition. If more than one person prepared this document, attach additional sheets conforming to the appropriate official form for each person.
Exhibit B
(To be completed if debtor is an individual whose debts are primarily consumer debts) 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.
X
Signature of Bankruptcy Petition Preparer Date 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.
X
Signature of Attorney for Debtor(s) Date