Court filing

Chapter 7 voluntary petition — In re Ford

Filed March 30, 2023 in Brandy Ford Bankruptcy, the only filing from this case in the archive.

Record facts

Court	U.S. Bankruptcy Court for the Central District of California
Filed	2023-03-30

U.S. Bankruptcy Court for the Central District of California · No. 2:23-bk-11925-BB · Doc. 1 · 2023-03-30 · Docket on CourtListener

Full text

Fill in this information to identify your case:
United States Bankruptcy Court for the:
Central District of California
Case number (If known):
Chapter you are filing under:
Chapter 7
Chapter 11
Chapter 12
Chapter 13
Check if this is an
amended filing
Official Form 101
The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a joint case—and
in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,” the answer would be yes if
either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 1 and Debtor 2 to distinguish between them. In
joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The same person must be Debtor 1 in all of the forms.
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If more
space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every
question.
Part 1: Identify Yourself
1.
Your full name
Write the name that is on your
government-issued picture
identification (for example, your
driver’s license or passport).
Bring your picture identification
to your meeting with the trustee.
About Debtor 1:
About Debtor 2 (Spouse Only in a Joint Case):
BRANDY
First name
First name
Middle name
Middle name
FORD
Last name
Last name
Suffix (Sr., Jr, II, III)
Suffix (Sr., Jr, II, III)
2.
All other names you have
used in the last 8 years
Include your married or maiden
names and any assumed, trade
names and doing business as
names.
Do NOT list the name of any
separate legal entity such as a
corporation, partnership, or LLC
that is not filing this petition.
Brandy
First name
First name
Middle name
Middle name
Ford-Carey
Last name
Last name
First name
First name
Middle name
Middle name
Last name
Last name
B's Eats & Treats
Business name (if applicable)
Business name (if applicable)
Business name (if applicable)
Business name (if applicable)
3.
Only the last 4 digits of your
Social Security number or
federal Individual Taxpayer
Identification number
(ITIN)
xxx - xx - 7
2
7
8
xxx - xx -
OR
OR
9xx - xx -
9xx - xx -
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 1
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Voluntary Petition for Individuals Filing for Bankruptcy
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
4.
Your Employer Identification
Number (EIN), if any.
About Debtor 1:
About Debtor 2 (Spouse Only in a Joint Case):
-
EIN
-
EIN
-
EIN
-
EIN
5.
Where you live
If Debtor 2 lives at a different address:
154 E 92nd St
Number
Street
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
City
State
ZIP Code
Los Angeles
County
County
If your mailing address is different from the one above,
fill it in here. Note that the court will send any notices to
you at this mailing address.
If Debtor 2's mailing address is different from yours, fill
it in here. Note that the court will send any notices to you
at this mailing address.
Number
Street
Number
Street
P.O. Box
P.O. Box
City
State
ZIP Code
City
State
ZIP Code
6.
Why you are choosing this
district to file for bankruptcy
Check one:
Check one:
Over the last 180 days before filing this petition, I
have lived in this district longer than in any other
district.
Over the last 180 days before filing this petition, I
have lived in this district longer than in any other
district.
I have another reason. Explain.
(See 28 U.S.C. § 1408)
I have another reason. Explain.
(See 28 U.S.C. § 1408)
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 2
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Tell the Court About Your Bankruptcy Case
7.
The chapter of the Bankruptcy
Code you are choosing to file
under
Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing for
Bankruptcy (Form 2010)). Also, go to the top of page 1 and check the appropriate box.
Chapter 7
Chapter 11
Chapter 12
Chapter 13
8.
How you will pay the fee
I will pay the entire fee when I file my petition. Please check with the clerk's office in your local court for more
details about how you may pay. Typically, if you are paying the fee yourself, you may pay with cash, cashier's
check, or money order. If your attorney is submitting your payment on your behalf, your attorney may pay with
a credit card or check with a pre-printed address.
I need to pay the fee in installments. If you choose this option, sign and attach the Application for Individuals
to Pay The Filing Fee in Installments (Official Form 103A).
I request that my fee be waived (You may request this option only if you are filing for Chapter 7. By law, a
judge may, but is not required to, waive your fee, and may do so only if your income is less than 150% of the
official poverty line that applies to your family size and you are unable to pay the fee in installments). If you
choose this option, you must fill out the Application to Have the Chapter 7 Filing Fee Waived (Official Form
103B) and file it with your petition.
9.
Have you filed for bankruptcy
within the last 8 years?
No.
Yes. District
When
MM / DD / YYYY
Case number
District
When
MM / DD / YYYY
Case number
District
When
MM / DD / YYYY
Case number
10. Are any bankruptcy cases
pending or being filed by a
spouse who is not filing this
case with you, or by a
business partner, or by an
affiliate?
No.
Yes. Debtor
Relationship to you
District
When
MM / DD / YYYY
Case number, if known
Debtor
Relationship to you
District
When
MM / DD / YYYY
Case number, if known
11.
Do you rent your residence?
No.
Go to line 12.
Yes. Has your landlord obtained an eviction judgment against you?
No. Go to line 12.
Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) and file it
as part of this bankruptcy petition.
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 3
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 3: Report About Any Businesses You Own as a Sole Proprietor
12. Are you a sole proprietor of
any full- or part-time
business?
A sole proprietorship is a
business you operate as an
individual, and is not a separate
legal entity such as a
corporation, partnership, or LLC.
If you have more than one sole
proprietorship, use a separate
sheet and attach it to this
petition.
No. Go to Part 4.
Yes. Name and location of business
Name of business, if any
Number
Street
City
State
ZIP Code
Check the appropriate box to describe your business:
Health Care Business (as defined in 11 U.S.C. § 101(27A))
Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))
Stockbroker (as defined in 11 U.S.C. § 101(53A))
Commodity Broker (as defined in 11 U.S.C. § 101(6))
None of the above
13. Are you filing under Chapter
11 of the Bankruptcy Code,
and are you a small business
debtor or a debtor as defined
by 11 U.S. C. § 1182(1)?
For a definition of small business
debtor, see 11 U.S.C. §
101(51D).
If you are filing under Chapter 11, the court must know whether you are a small business debtor or a debtor choosing to
proceed under Subchapter V so that it can set appropriate deadlines. If you indicate that you are a small business
debtor or you are choosing to proceed under Subchapter V, you must attach your most recent balance sheet, statement
of operations, cash-flow statement, and federal income tax return or if any of these documents do not exist, follow the
procedure in 11 U.S.C. § 1116(1)(B).
No.
I am not filing under Chapter 11.
No.
I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in the
Bankruptcy Code.
Yes.
I am filing under Chapter 11, I am a small business debtor according to the definition in the
Bankruptcy Code, and I do not choose to proceed under Subchapter V of Chapter 11.
Yes.
I am filing under Chapter 11, I am a debtor according to the definition in § 1182(1) of the Bankruptcy
Code, and I choose to proceed under Subchapter V of Chapter 11.
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 4
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 4: Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention
14. Do you own or have any
property that poses or is
alleged to pose a threat of
imminent and identifiable
hazard to public health or
safety? Or do you own any
property that needs immediate
attention?
For example, do you own
perishable goods, or livestock
that must be fed, or a building
that needs urgent repairs?
No.
Yes.
What is the hazard?
If immediate attention is needed, why is it needed?
Where is the property?
Number
Street
City
State
ZIP Code
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 5
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 5: Explain Your Efforts to Receive a Briefing About Credit Counseling
15. Tell the court whether you
have received a briefing
about credit counseling.
The law requires that you
receive a briefing about credit
counseling before you file for
bankruptcy. You must truthfully
check one of the following
choices. If you cannot do so,
you are not eligible to file.
If you file anyway, the court
can dismiss your case, you will
lose whatever filing fee you
paid, and your creditors can
begin collection activities
again.
About Debtor 1:
About Debtor 2 (Spouse Only in a Joint Case):
You must check one:
You must check one:
I received a briefing from an approved credit counseling
agency within the 180 days before I filed this bankruptcy
petition, and I received a certificate of completion.
Attach a copy of the certificate and the payment plan, if any,
that you developed with the agency.
I received a briefing from an approved credit counseling
agency within the 180 days before I filed this bankruptcy
petition, and I received a certificate of completion.
Attach a copy of the certificate and the payment plan, if any,
that you developed with the agency.
I received a briefing from an approved credit counseling
agency within the 180 days before I filed this bankruptcy
petition, but I do not have a certificate of completion.
Within 14 days after you file this bankruptcy petition, you
MUST file a copy of the certificate and payment plan, if any.
I received a briefing from an approved credit counseling
agency within the 180 days before I filed this bankruptcy
petition, but I do not have a certificate of completion.
Within 14 days after you file this bankruptcy petition, you
MUST file a copy of the certificate and payment plan, if any.
I certify that I asked for credit counseling services from an
approved agency, but was unable to obtain those services
during the 7 days after I made my request, and exigent
circumstances merit a 30-day temporary waiver of the
requirement.
To ask for a 30-day temporary waiver of the requirement,
attach a separate sheet explaining what efforts you made to
obtain the briefing, why you were unable to obtain it before
you filed for bankruptcy, and what exigent circumstances
required you to file this case.
I certify that I asked for credit counseling services from an
approved agency, but was unable to obtain those services
during the 7 days after I made my request, and exigent
circumstances merit a 30-day temporary waiver of the
requirement.
To ask for a 30-day temporary waiver of the requirement,
attach a separate sheet explaining what efforts you made to
obtain the briefing, why you were unable to obtain it before
you filed for bankruptcy, and what exigent circumstances
required you to file this case.
Your case may be dismissed if the court is dissatisfied with
your reasons for not receiving a briefing before you filed for
bankruptcy.
Your case may be dismissed if the court is dissatisfied with
your reasons for not receiving a briefing before you filed for
bankruptcy.
If the court is satisfied with your reasons, you must still
receive a briefing within 30 days after you file.
You must file a certificate from the approved agency, along
with a copy of the payment plan you developed, if any. If you
do not do so, your case may be dismissed.
If the court is satisfied with your reasons, you must still
receive a briefing within 30 days after you file.
You must file a certificate from the approved agency, along
with a copy of the payment plan you developed, if any. If you
do not do so, your case may be dismissed.
Any extension of the 30-day deadline is granted only for
cause and is limited to a maximum of 15 days.
Any extension of the 30-day deadline is granted only for
cause and is limited to a maximum of 15 days.
I am not required to receive a briefing about credit
counseling because of:
Incapacity. I have a mental illness or a mental
deficiency that makes me incapable of
realizing or making rational decisions
about finances.
Disability.
My physical disability causes me to be
unable to participate in a briefing in
person, by phone, or through the
internet, even after I reasonably tried to
do so.
Active duty. I am currently on active military duty in
a military combat zone.
I am not required to receive a briefing about credit
counseling because of:
Incapacity. I have a mental illness or a mental
deficiency that makes me incapable of
realizing or making rational decisions
about finances.
Disability.
My physical disability causes me to be
unable to participate in a briefing in
person, by phone, or through the
internet, even after I reasonably tried to
do so.
Active duty. I am currently on active military duty in
a military combat zone.
If you believe you are not required to receive a briefing
about credit counseling, you must file a motion for waiver of
credit counseling with the court.
If you believe you are not required to receive a briefing
about credit counseling, you must file a motion for waiver of
credit counseling with the court.
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 6
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
For your attorney, if you are
represented by one
If you are not represented by an
attorney, you do not need to file this
page.
I, the attorney for the debtor(s) named in this petition, declare that I have informed the debtor(s) about eligibility to
proceed under Chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under
each chapter for which the person is eligible. I also certify that I have delivered to the debtor(s) the notice required by
11 U.S.C. § 342(b) and, in a case in which § 707(b)(4)(D) applies, certify that I have no knowledge after an inquiry
that the information in the schedules filed with the petition is incorrect.
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Signature of Attorney for Debtor
Date 03/30/2023
MM / DD / YYYY
Misty Wilks
Printed name
WilksLaw
Firm name
3818 Crenshaw Blvd # 445
Number
Street
Los Angeles
City
CA
State
90008-1813
ZIP Code
Contact phone (323) 540-4633
Email address misty@wilkslawoffice.com
196327
Bar number
CA
State
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
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Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 106Sum
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. Fill out all
of your schedules first; then complete the information on this form. If you are filing amended schedules after you file your original forms, you must fill out a
new Summary and check the box at the top of this page.
Part 1: Summarize Your Assets
Your assets
Value of what you own
1. Schedule A/B: Property (Official Form 106A/B)
1a. Copy line 55, Total real estate, from Schedule A/B...........................................................................................................
1b. Copy line 62, Total personal property, from Schedule A/B................................................................................................
1c. Copy line 63, Total of all property on Schedule A/B...........................................................................................................
$0.00
$99,496.95
$99,496.95
Part 2: Summarize Your Liabilities
Your liabilities
Amount you owe
2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D)
2a. Copy the total you listed in Column A, Amount of claim, at the bottom of the last page of Part 1 of Schedule D.......
$20,595.00
3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 106E/F)
3a. Copy the total claims from Part 1 (priority unsecured claims) from line 6e of Schedule E/F......................................
3b. Copy the total claims from Part 2 (nonpriority unsecured claims) from line 6j of Schedule E/F.................................
$0.00
+
$85,122.00
Your total liabilities
$105,717.00
Part 3: Summarize Your Income and Expenses
4. Schedule I: Your Income (Official Form 106I)
Copy your combined monthly income from line 12 of Schedule I..........................................................................................
$4,082.37
5. Schedule J: Your Expenses (Official Form 106J)
Copy your monthly expenses from line 22c of Schedule J..................................................................................
$4,008.79
Official Form 106Sum
Summary of Your Assets and Liabilities and Certain Statistical Information
page 1 of 2
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Summary of Your Assets and Liabilities and Certain Statistical
Information
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 4: Answer These Questions for Administrative and Statistical Records
6. Are you filing for bankruptcy under Chapters 7, 11, or 13?
No. You have nothing to report on this part of the form. Check this box and submit this form to the court with your other schedules.
Yes
7. What kind of debt do you have?
Your debts are primarily consumer debts. Consumer debts are those “incurred by an individual primarily for a personal,
family, or household purpose.” 11 U.S.C. § 101(8). Fill out lines 8-9g for statistical purposes. 28 U.S.C. § 159.
Your debts are not primarily consumer debts. You have nothing to report on this part of the form. Check this box and submit
this form to the court with your other schedules.
8. From the Statement of Your Current Monthly Income: Copy your total current monthly income from Official
Form 122A-1 Line 11; OR, Form 122B Line 11; OR, Form 122C-1 Line 14.
$2,719.86
9. Copy the following special categories of claims from Part 4, line 6 of Schedule E/F:
Total claim
From Part 4 on Schedule E/F, copy the following:
9a. Domestic support obligations (Copy line 6a.)
$0.00
9b. Taxes and certain other debts you owe the government. (Copy line 6b.)
$0.00
9c. Claims for death or personal injury while you were intoxicated. (Copy line 6c.)
$0.00
9d. Student loans. (Copy line 6f.)
$71,410.00
9e.Obligations arising out of a separation agreement or divorce that you did not report as priority
claims. (Copy line 6g.)
$0.00
9f. Debts to pension or profit-sharing plans, and other similar debts. (Copy line 6h.)
+
$0.00
9g. Total. Add lines 9a through 9f.
$71,410.00
Official Form 106Sum
Summary of Your Assets and Liabilities and Certain Statistical Information
page 2 of 2
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Street address, if available, or other description
City
State
ZIP Code
County
Fill in this information to identify your case and this filing:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
Check if this is an
amended filing
Official Form 106A/B
In each category, separately list and describe items. List an asset only once. If an asset fits in more than one category, list the asset in the category where
you think it fits best. Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct
information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known).
Answer every question.
Part 1: Describe Each Residence, Building, Land, or Other Real Estate You Own or Have an Interest In
1.
Do you own or have any legal or equitable interest in any residence, building, land, or similar property?
No. Go to Part 2.
Yes. Where is the property?
What is the property? Check all that apply.
Single-family home
Duplex or multi-unit building
Condominium or cooperative
Manufactured or mobile home
Land
Investment property
Timeshare
Other
Who has an interest in the property? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Do not deduct secured claims or exemptions. Put the
amount of any secured claims on Schedule D: Creditors
Who Have Claims Secured by Property.
Current value of the
entire property?
Current value of the
portion you own?
Describe the nature of your ownership interest
(such as fee simple, tenancy by the entireties, or a
life estate), if known.
Check if this is community property
(see instructions)
Other information you wish to add about this item, such as local
property identification number:
2.
Add the dollar value of the portion you own for all of your entries from Part 1, including any entries for pages
you have attached for Part 1. Write that number here.........................................................................................................
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$0.00
Official Form 106A/B
Schedule A/B: Property
page 1
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Schedule A/B: Property
12/15
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3.1 Make:
Model:
Year:
Approximate mileage:
Lexus
GS
2013
115700
Other information:
Do you own or have any legal or equitable interest in any of the following items?
Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
No
Yes. Describe........
See Attached.
No
Yes. Describe........
Old used cell phone
No
Yes. Describe........

Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Describe Your Vehicles
Do you own, lease, or have legal or equitable interest in any vehicles, whether they are registered or not? Include any vehicles
you own that someone else drives. If you lease a vehicle, also report it on Schedule G: Executory Contracts and Unexpired Leases.
3.
Cars, vans, trucks, tractors, sport utility vehicles, motorcycles
No
Yes
Who has an interest in the property? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this is community property
(see instructions)
Do not deduct secured claims or exemptions. Put the
amount of any secured claims on Schedule D: Creditors
Who Have Claims Secured by Property.
Current value of the
entire property?
$13,250.00
Current value of the
portion you own?
$13,250.00
4.
Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories
Examples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle accessories
No
Yes
5.
Add the dollar value of the portion you own for all of your entries from Part 2, including any entries for pages
you have attached for Part 2. Write that number here.........................................................................................................
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$13,250.00
Part 3: Describe Your Personal and Household Items
6.
Household goods and furnishings
Examples: Major appliances, furniture, linens, china, kitchenware
$2,247.00
7.
Electronics
Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printers, scanners; music
collections; electronic devices including cell phones, cameras, media players, games
$375.00
8.
Collectibles of value
Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art objects;
stamp, coin, or baseball card collections; other collections, memorabilia, collectibles
Official Form 106A/B
Schedule A/B: Property
page 2
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
9.
No
Yes. Describe........
Old used tennis rackets and baseball gloves
Equipment for sports and hobbies
Examples: Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; canoes and
kayaks; carpentry tools; musical instruments
$19.00
10.
No
Yes. Describe........
Firearms
Examples: Pistols, rifles, shotguns, ammunition, and related equipment
11.
No
Yes. Describe........
See Attached.
Clothes
Examples: Everyday clothes, furs, leather coats, designer wear, shoes, accessories
$900.00
12.
No
Yes. Describe........
Jewelry
Examples: Everyday jewelry, costume jewelry, engagement rings, wedding rings, heirloom jewelry, watches, gems, gold,
silver
13.
No
Yes. Describe........
See Attached.
Non-farm animals
Examples: Dogs, cats, birds, horses
unknown
14.
No
Yes. Describe........
Any other personal and household items you did not already list, including any health aids you did not list
15.
Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached
for Part 3. Write that number here........................................................................................................................................➜
$3,541.00
Part 4: Describe Your Financial Assets
Do you own or have any legal or equitable interest in any of the following?
Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
16.
Cash
Examples: Money you have in your wallet, in your home, in a safe deposit box, and on hand when you file your petition
No
Yes........................................................................................................................................................
Cash..............
Official Form 106A/B
Schedule A/B: Property
page 3
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
17.
Deposits of money
Examples: Checking, savings, or other financial accounts; certificates of deposit; shares in credit unions, brokerage houses,
and other similar institutions. If you have multiple accounts with the same institution, list each.
No
Yes..................
Institution name:
17.1. Other financial account:
Dave - Spending Account
$0.34
17.2. Other financial account:
CashApp
$14.24
17.3. Other financial account:
Wells Fargo - Clear Access Banking (held for debtor's son)
$0.00
17.4. Savings account:
University Credit Union
$10.53
17.5. Savings account:
Wells Fargo - Way2Save
$0.00
17.6. Checking account:
University Credit Union
$802.21
17.7. Checking account:
Wells Fargo - Preferred Checking
$1,200.00
17.8. Checking account:
GoBank - Online Checking
$1.19
18.
No
Yes..................
Bonds, mutual funds, or publicly traded stocks
Examples: Bond funds, investment accounts with brokerage firms, money market accounts
Institution or issuer name:
19.
No
Yes. Give specific
information about
them...................
Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in
an LLC, partnership, and joint venture
Name of entity:
% of ownership:
20.
No
Yes. Give specific
information about
them...................
Government and corporate bonds and other negotiable and non-negotiable instruments
Negotiable instruments include personal checks, cashiers’ checks, promissory notes, and money orders.
Non-negotiable instruments are those you cannot transfer to someone by signing or delivering them.
Issuer name:
21.
No
Yes. List each
account separately.
Retirement or pension accounts
Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sharing plans
Type of account:
Institution name:
Official Form 106A/B
Schedule A/B: Property
page 4
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
401(k) or similar plan:
The University of California Retirement Savings Program
$158.44
Retirement account:
The University of California Retirement Savings Program
$15,011.00
22.
No
Yes.....................
Security deposits and prepayments
Your share of all unused deposits you have made so that you may continue service or use from a company
Examples: Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommunications companies,
or others
Institution name or individual:
Electric:
Gas:
Heating oil:
Security deposit on rental unit:
Prepaid rent:
Telephone:
Water:
Rented furniture:
Other:
23.
No
Yes.....................
Annuities (A contract for a periodic payment of money to you, either for life or for a number of years)
Issuer name and description:
24.
No
Yes.....................
Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tuition program.
26 U.S.C. §§ 530(b)(1), 529A(b), and 529(b)(1).
Institution name and description. Separately file the records of any interests. 11 U.S.C. § 521(c):
Official Form 106A/B
Schedule A/B: Property
page 5
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
25.
No
Yes. Give specific
information about them....
Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers exercisable for
your benefit
26.
No
Yes. Give specific
information about them....
Patents, copyrights, trademarks, trade secrets, and other intellectual property
Examples: Internet domain names, websites, proceeds from royalties and licensing agreements
27.
No
Yes. Give specific
information about them....
Phlebotomy license - expiration imminent (Jan)
Licenses, franchises, and other general intangibles
Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses,
professional licenses
unknown
Money or property owed to you?
Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
28.
No
Yes. Give specific information about
them, including whether you
already filed the returns and
the tax years.......................
Federal:
State:
Local:
Tax refunds owed to you
2022 | CA state refund
$508.00
29.
Family support
Examples: Past due or lump sum alimony, spousal support, child support, maintenance, divorce settlement, property settlement
No
Yes. Give specific information..........
Alimony:
Maintenance:
Support:
Divorce settlement:
Property settlement:
30.
No
Yes. Give specific information..........
Other amounts someone owes you
Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers’ compensation,
Social Security benefits; unpaid loans you made to someone else
Official Form 106A/B
Schedule A/B: Property
page 6
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
31.
No
Yes. Name the insurance company
of each policy and list its value....
Company name:
Beneficiary:
Surrender or refund value:
Globe Life Ins
Debtor
$25,000.00
Interests in insurance policies
Examples: Health, disability, or life insurance; health savings account (HSA); credit, homeowner’s, or renter’s insurance
Globe Life Ins
Debtor
$40,000.00
AIG
Debtor
unknown
AIG
Debtor
unknown
32.
No
Yes. Give specific information..........
Any interest in property that is due you from someone who has died
If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receive
property because someone has died.
Debtor inherited gas rights in Louisiana and occassionally receives nominal
distributions. Last received $32 from Aethon Energy LLC in Aug 2022. Debtor
shares these rights with dozens of family members..
unknown
33.
No
Yes. Describe each claim................
Claims against third parties, whether or not you have filed a lawsuit or made a demand for payment
Examples: Accidents, employment disputes, insurance claims, or rights to sue
Pending worker's compensation claim. Value not yet determined.
unknown
34.
No
Yes. Describe each claim................
Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights
to set off claims
35.
No
Yes. Give specific information..........
Any financial assets you did not already list
36.
$82,705.95
Add the dollar value of all of your entries from Part 4, including any entries for pages you have attached
for Part 4. Write that number here..................................................................................................................................➜
Part 5: Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1.
37.
Do you own or have any legal or equitable interest in any business-related property?
No. Go to Part 6.
Yes. Go to line 38.
Official Form 106A/B
Schedule A/B: Property
page 7
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
38.
No
Yes. Describe........
Accounts receivable or commissions you already earned
39.
Office equipment, furnishings, and supplies
Examples: Business-related computers, software, modems, printers, copiers, fax machines, rugs, telephones, desks, chairs, electronic devices
No
Yes. Describe........
40.
No
Yes. Describe........
Machinery, fixtures, equipment, supplies you use in business, and tools of your trade
41.
No
Yes. Describe........
Inventory
42.
No
Yes. Describe........
Interests in partnerships or joint ventures
Name of entity:
% of ownership:
%
43.
No
Yes. Describe........
Customer lists, mailing lists, or other compilations
No
Yes. Do your lists include personally identifiable information (as defined in 11 U.S.C. § 101(41A))?
44.
No
Yes. Give specific
information.........
Any business-related property you did not already list
45.
$0.00
Add the dollar value of all of your entries from Part 5, including any entries for pages you have attached
for Part 5. Write that number here.................................................................................................................................➜
Part 6: Describe Any Farm- and Commercial Fishing-Related Property You Own or Have an Interest In.
If you own or have an interest in farmland, list it in Part 1.
Official Form 106A/B
Schedule A/B: Property
page 8
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
46.
Do you own or have any legal or equitable interest in any farm- or commercial fishing-related property?
No. Go to Part 7.
Yes. Go to line 47.
Current value of the
portion you own?
Do not deduct secured
claims or exemptions.
47.
No
Yes.........................
Farm animals
Examples: Livestock, poultry, farm-raised fish
48.
No
Yes. Give specific
information.............
Crops—either growing or harvested
49.
No
Yes..........................
Farm and fishing equipment, implements, machinery, fixtures, and tools of trade
50.
No
Yes..........................
Farm and fishing supplies, chemicals, and feed
51.
No
Yes. Give specific
information.............
Any farm- and commercial fishing-related property you did not already list
52.
$0.00
Add the dollar value of all of your entries from Part 6, including any entries for pages you have attached
for Part 6. Write that number here...................................................................................................................................➜
Part 7: Describe All Property You Own or Have an Interest in That You Did Not List Above
53.
No
Yes. Give specific
information.............
Do you have other property of any kind you did not already list?
Examples: Season tickets, country club membership
54.
$0.00
Add the dollar value of all of your entries from Part 7. Write that number here.....................................................➜
Part 8: List the Totals of Each Part of this Form
Official Form 106A/B
Schedule A/B: Property
page 9
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
55.
$0.00
Part 1: Total real estate, line 2..........................................................................................................................................➜
56.
Part 2: Total vehicles, line 5
$13,250.00
57.
Part 3: Total personal and household items, line 15
$3,541.00
58.
Part 4: Total financial assets, line 36
$82,705.95
59.
Part 5: Total business-related property, line 45
$0.00
60.
Part 6: Total farm- and fishing-related property, line 52
$0.00
61.
Part 7: Total other property not listed, line 54
+
$0.00
62.
Total personal property. Add lines 56 through 61..............
$99,496.95
Copy personal property total➜
+
$99,496.95
63.
$99,496.95
Total of all property on Schedule A/B. Add line 55 + line 62.................................................................................................
Official Form 106A/B
Schedule A/B: Property
page 10
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
SCHEDULE A/B: PROPERTY
Continuation Page
6.
Household goods and furnishings
Used kitchen appliances
$200.00
Used washer & dryer
$200.00
Used small kitchen appliances & accessories to include air fryer, Foreman grill, cutlery, slow cooker, toaster,
etc.
$438.00
Used dining room furniture & accessories
$316.00
Used living room furniture & accessories
$267.00
Used bathroom accessories, linens, etc
$82.00
Used bedroom furniture, accessories & desk
$279.00
Used furniture, toys, accessories, etc. in son's room
$370.00
Used furniture accessories and equipment for 'work from home' use
$90.00
Glucometer/BP monitor
$5.00
11.
Clothes
Used womens clothing , shoes and accessories
$500.00
Used kids clothing, shoes and accessories
$400.00
13.
Non-farm animals
Blue nose pit bull - priceless family pet
unknown
Turtle - priceless family
unknown
Official Form 106A/B
Schedule A/B: Property
Case 2:23-bk-11925-BB Doc 1 Filed 03/30/23 Entered 03/30/23 21:58:28 Desc
Main Document Page 22 of 66

$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.010
$200.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 106C
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. Using the
property you listed on Schedule A/B: Property (Official Form 106A/B) as your source, list the property that you claim as exempt. If more space is needed, fill
out and attach to this page as many copies of Part 2: Additional Page as necessary. On the top of any additional pages, write your name and case number (if
known).
For each item of property you claim as exempt, you must specify the amount of the exemption you claim. One way of doing so is to state a specific dollar
amount as exempt. Alternatively, you may claim the full fair market value of the property being exempted up to the amount of any applicable statutory limit.
Some exemptions—such as those for health aids, rights to receive certain benefits, and tax-exempt retirement funds—may be unlimited in dollar amount.
However, if you claim an exemption of 100% of fair market value under a law that limits the exemption to a particular dollar amount and the value of the
property is determined to exceed that amount, your exemption would be limited to the applicable statutory amount.
Part 1: Identify the Property You Claim as Exempt
1.
Which set of exemptions are you claiming? Check one only, even if your spouse is filing with you.
You are claiming state and federal nonbankruptcy exemptions. 11 U.S.C. § 522(b)(3)
You are claiming federal exemptions. 11 U.S.C. § 522(b)(2)
2.
For any property you list on Schedule A/B that you claim as exempt, fill in the information below.
Brief description of the property and line on
Schedule A/B that lists this property
Current value of the
portion you own
Copy the value from
Schedule A/B
Amount of the exemption you claim
Check only one box for each exemption.
Specific laws that allow exemption
Brief description:
2013 Lexus GS
Line from
Schedule A/B:
3.1
$13,250.00
Brief description:
Used kitchen appliances
Line from
Schedule A/B:
6
$200.00
3.
Are you claiming a homestead exemption of more than $189,050?
(Subject to adjustment on 4/01/25 and every 3 years after that for cases filed on or after the date of adjustment.)
No
Yes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case?
No
Yes
Official Form 106C
Schedule C: The Property You Claim as Exempt
page 1 of 5
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Schedule C: The Property You Claim as Exempt
04/22
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$200.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$438.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$82.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$370.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$90.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020

Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Additional Page
Brief description of the property and line on
Schedule A/B that lists this property
Current value of the
portion you own
Copy the value from
Schedule A/B
Amount of the exemption you claim
Check only one box for each exemption.
Specific laws that allow exemption
Brief description:
Used washer & dryer
Line from
Schedule A/B:
6
$200.00
Brief description:
Used small kitchen appliances & accessories to
include air fryer, Foreman grill, cutlery, slow
cooker, toaster, etc.
Line from
Schedule A/B:
6
$438.00
Brief description:
Used dining room furniture & accessories
Line from
Schedule A/B:
6
$316.00
Brief description:
Used living room furniture & accessories
Line from
Schedule A/B:
6
$267.00
Brief description:
Used bathroom accessories, linens, etc
Line from
Schedule A/B:
6
$82.00
Brief description:
Used bedroom furniture, accessories & desk
Line from
Schedule A/B:
6
$279.00
Brief description:
Used furniture, toys, accessories, etc. in son's
room
Line from
Schedule A/B:
6
$370.00
Brief description:
Used furniture accessories and equipment for
'work from home' use
Line from
Schedule A/B:
6
$90.00
Official Form 106C
Schedule C: The Property You Claim as Exempt
page 2 of 5
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$5.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$375.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$19.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$500.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$400.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.020
$0.34
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$14.24
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$802.21
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051

Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Additional Page
Brief description of the property and line on
Schedule A/B that lists this property
Current value of the
portion you own
Copy the value from
Schedule A/B
Amount of the exemption you claim
Check only one box for each exemption.
Specific laws that allow exemption
Brief description:
Glucometer/BP monitor
Line from
Schedule A/B:
6
$5.00
Brief description:
Old used cell phone
Line from
Schedule A/B:
7
$375.00
Brief description:
Old used tennis rackets and baseball gloves
Line from
Schedule A/B:
9
$19.00
Brief description:
Used womens clothing , shoes and accessories
Line from
Schedule A/B:
11
$500.00
Brief description:
Used kids clothing, shoes and accessories
Line from
Schedule A/B:
11
$400.00
Brief description:
Dave - Spending Account
Other financial account
Line from
Schedule A/B:
17
$0.34
Brief description:
CashApp
Other financial account
Line from
Schedule A/B:
17
$14.24
Brief description:
University Credit Union
Checking account
Line from
Schedule A/B:
17
$802.21
Official Form 106C
Schedule C: The Property You Claim as Exempt
page 3 of 5
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$10.53
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$0.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$1,200.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$1.19
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$158.44
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.115(b)
$15,011.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.115(b)

Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Additional Page
Brief description of the property and line on
Schedule A/B that lists this property
Current value of the
portion you own
Copy the value from
Schedule A/B
Amount of the exemption you claim
Check only one box for each exemption.
Specific laws that allow exemption
Brief description:
University Credit Union
Savings account
Line from
Schedule A/B:
17
$10.53
Brief description:
Wells Fargo - Clear Access Banking (held for
debtor's son)
Other financial account
Line from
Schedule A/B:
17
$0.00
Brief description:
Wells Fargo - Way2Save
Savings account
Line from
Schedule A/B:
17
$0.00
Brief description:
Wells Fargo - Preferred Checking
Checking account
Line from
Schedule A/B:
17
$1,200.00
Brief description:
GoBank - Online Checking
Checking account
Line from
Schedule A/B:
17
$1.19
Brief description:
The University of California Retirement Savings
Program
Line from
Schedule A/B:
21
$158.44
Brief description:
The University of California Retirement Savings
Program
Line from
Schedule A/B:
21
$15,011.00
Official Form 106C
Schedule C: The Property You Claim as Exempt
page 4 of 5
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$508.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 706.051
$25,000.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.100(a)
$40,000.00
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.100(a)
unknown
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.100(a)
unknown
100% of fair market value, up
to any applicable statutory limit
C.C.P. § 704.100(a)

Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 106D
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If more
space is needed, copy the Additional Page, fill it out, number the entries, and attach it to this form. On the top of any additional pages, write your name and
case number (if known).
1. Do any creditors have claims secured by your property?
No. Check this box and submit this form to the court with your other schedules. You have nothing else to report on this form.
Yes. Fill in all of the information below.
Part 1: List All Secured Claims
2.
List all secured claims. If a creditor has more than one secured claim, list the creditor
separately for each claim. If more than one creditor has a particular claim, list the other
creditors in Part 2. As much as possible, list the claims in alphabetical order according to the
creditor’s name.
Column A
Amount of claim
Do not deduct the
value of
collateral.
Column B
Value of
collateral that
supports this
claim
Column C
Unsecured
portion
If any
2.1
AT&T
Creditor's Name
Po Box 5074
Number
Street
Carol Stream, IL 60197-5074
City
State
ZIP Code
Who owes the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and
another
Check if this claim relates to a
community debt
Date debt was incurred
Describe the property that secures the claim:
Old used cell phone
As of the date you file, the claim is: Check all that
apply.
Contingent
Unliquidated
Disputed
Nature of lien. Check all that apply.
An agreement you made (such as mortgage
or secured car loan)
Statutory lien (such as tax lien, mechanic's
lien)
Judgment lien from a lawsuit
Other (including a right to offset)
Last 4 digits of account number
unknown
$375.00
$0.00
Add the dollar value of your entries in Column A on this page. Write that number here:
$0.00
Official Form 106D
Schedule D: Creditors Who Have Claims Secured by Property
page 1 of 2
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Schedule D: Creditors Who Have Claims Secured by Property
12/15
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Part 1:
Additional Page
After listing any entries on this page, number them beginning with
2.3, followed by 2.4, and so forth.

Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Column A
Amount of claim
Do not deduct the
value of
collateral.
Column B
Value of
collateral that
supports this
claim
Column C
Unsecured
portion
If any
2.2
Synchrony/Ashley Furniture Homestore
Creditor's Name
Attn: Bankruptcy
Po Box 965060
Number
Street
Orlando, FL 32896-5060
City
State
ZIP Code
Who owes the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and
another
Check if this claim relates to a
community debt
Date debt was incurred
2/1/2022
Describe the property that secures the claim:
Used dining room furniture & accessories
Used bedroom furniture, accessories & desk
Used living room furniture & accessories
As of the date you file, the claim is: Check all that
apply.
Contingent
Unliquidated
Disputed
Nature of lien. Check all that apply.
An agreement you made (such as mortgage
or secured car loan)
Statutory lien (such as tax lien, mechanic's
lien)
Judgment lien from a lawsuit
Other (including a right to offset)
Last 4 digits of account number 8
4
3
9
$1,888.00
$862.00
$1,026.00
2.3
University Credit Union
Creditor's Name
Attn: Bankruptcy Dept
P. O. Box 240046
Number
Street
Los Angeles, CA 90024-9146
City
State
ZIP Code
Who owes the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and
another
Check if this claim relates to a
community debt
Date debt was incurred
3/1/2020
Describe the property that secures the claim:
2013 Lexus GS
As of the date you file, the claim is: Check all that
apply.
Contingent
Unliquidated
Disputed
Nature of lien. Check all that apply.
An agreement you made (such as mortgage
or secured car loan)
Statutory lien (such as tax lien, mechanic's
lien)
Judgment lien from a lawsuit
Other (including a right to offset)
Last 4 digits of account number 2
0
0
0
$18,707.00
$13,250.00
$5,457.00
Add the dollar value of your entries in Column A on this page. Write that number here:
$20,595.00
If this is the last page of your form, add the dollar value totals from all pages. Write that number
here:
$20,595.00
Official Form 106D
Additional Page of Schedule D: Creditors Who Have Claims Secured by Property
page 2 of 2
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Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 106E/F
Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY claims and Part 2 for creditors with NONPRIORITY claims. List the other
party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Property (Official Form
106A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G). Do not include any creditors with partially secured claims that
are listed in Schedule D: Creditors Who Hold Claims Secured by Property. If more space is needed, copy the Part you need, fill it out, number the entries in
the boxes on the left. Attach the Continuation Page to this page. On the top of any additional pages, write your name and case number (if known).
Part 1: List All of Your PRIORITY Unsecured Claims
1. Do any creditors have priority unsecured claims against you?
No. Go to Part 2.
Yes.
2. List all of your priority unsecured claims. If a creditor has more than one priority unsecured claim, list the creditor separately for each claim. For each
claim listed, identify what type of claim it is. If a claim has both priority and nonpriority amounts, list that claim here and show both priority and nonpriority
amounts. As much as possible, list the claims in alphabetical order according to the creditor’s name. If you have more than two priority unsecured claims,
fill out the Continuation Page of Part 1. If more than one creditor holds a particular claim, list the other creditors in Part 3.
(For an explanation of each type of claim, see the instructions for this form in the instruction booklet.)
Total
claim
Priority
amount
Nonpriority
amount
Priority Creditor's Name
Number
Street
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number
When was the debt incurred?
As of the date you file, the claim is: Check all that
apply.
Contingent
Unliquidated
Disputed
Type of PRIORITY unsecured claim:
Domestic support obligations
Taxes and certain other debts you owe the
government
Claims for death or person injury while you
were intoxicated
Other. Specify
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 1 of 5
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Schedule E/F: Creditors Who Have Unsecured Claims
12/15
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: List All of Your NONPRIORITY Unsecured Claims
3. Do any creditors have nonpriority unsecured claims against you?
No. You have nothing to report in this part. Submit this form to the court with your other schedules.
Yes.
4. List all of your nonpriority unsecured claims in the alphabetical order of the creditor who holds each claim. If a creditor has more than one nonpriority
unsecured claim, list the creditor separately for each claim. For each claim listed, identify what type of claim it is. Do not list claims already included in Part
1. If more than one creditor holds a particular claim, list the other creditors in Part 3. If you have more than three nonpriority unsecured claims fill out the
Continuation Page of Part 2.
Total claim
4.1
Capital One
Nonpriority Creditor's Name
Attn: Bankruptcy
P.O. Box 30285
Number
Street
Salt Lake City, UT 84130-0285
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 1862
When was the debt incurred?
11/01/2015
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
CreditCard
$4,352.00
4.2
Capital One
Nonpriority Creditor's Name
Attn: Bankruptcy
P.O. Box 30285
Number
Street
Salt Lake City, UT 84130-0285
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 3644
When was the debt incurred?
10/01/2019
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
CreditCard
$2,534.00
4.3
Capital One
Nonpriority Creditor's Name
Attn: Bankruptcy
P.O. Box 30285
Number
Street
Salt Lake City, UT 84130-0285
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 1209
When was the debt incurred?
10/01/2020
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
CreditCard
$1,104.00
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 2 of 5
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Your NONPRIORITY Unsecured Claims - Continuation Page
After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth.
Total claim
4.4
Macys/fdsb
Nonpriority Creditor's Name
Attn: Bankruptcy
9111 Duke Boulevard
Number
Street
Mason, OH 45040
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 9150
When was the debt incurred?
06/01/2022
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
ChargeAccount
$531.00
4.5
Merrick Bank/CCHoldings
Nonpriority Creditor's Name
Attn: Bankruptcy
P.O. Box 9201
Number
Street
Old Bethpage, NY 11804-9001
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 8134
When was the debt incurred?
01/01/2019
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
CreditCard
$1,606.00
4.6
Sallie Mae, Inc
Nonpriority Creditor's Name
Attn: Bankruptcy
PO Box 9500
Number
Street
Wilkes Barre, PA 18773
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 0827
When was the debt incurred?
08/27/2018
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
Educational
$71,410.00
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 3 of 5
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 2: Your NONPRIORITY Unsecured Claims - Continuation Page
After listing any entries on this page, number them beginning with 4.5, followed by 4.6, and so forth.
Total claim
4.7
University Credit Un
Nonpriority Creditor's Name
Attn: Bankruptcy Dept
P. O. Box 240046
Number
Street
Los Angeles, CA 90024-9146
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 9000
When was the debt incurred?
03/01/2020
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
CreditCard
$1,465.00
4.8
Upstart Finance
Nonpriority Creditor's Name
Attn: Bankruptcy
PO Box 1503
Number
Street
San Carlos, CA 94070
City
State
ZIP Code
Who incurred the debt? Check one.
Debtor 1 only
Debtor 2 only
Debtor 1 and Debtor 2 only
At least one of the debtors and another
Check if this claim is for a community debt
Is the claim subject to offset?
No
Yes
Last 4 digits of account number 6145
When was the debt incurred?
05/25/2022
As of the date you file, the claim is: Check all that apply.
Contingent
Unliquidated
Disputed
Type of NONPRIORITY unsecured claim:
Student loans
Obligations arising out of a separation agreement or
divorce that you did not report as priority claims
Debts to pension or profit-sharing plans, and other
similar debts
Other. Specify
Unsecured
$2,120.00
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 4 of 5
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 4: Add the Amounts for Each Type of Unsecured Claim
6. Total the amounts of certain types of unsecured claims. This information is for statistical reporting purposes only. 28 U.S.C. §159. Add the amounts
for each type of unsecured claim.
Total claim
Total claims
from Part 1
6a. Domestic support obligations
6a.
$0.00
6b. Taxes and certain other debts you owe the
government
6b.
$0.00
6c. Claims for death or personal injury while you
were intoxicated
6c.
$0.00
6d. Other. Add all other priority unsecured claims.
Write that amount here.
6d.
+
$0.00
6e. Total. Add lines 6a through 6d.
6e.
$0.00
Total claim
Total claims
from Part 2
6f. Student loans
6f.
$71,410.00
6g. Obligations arising out of a separation
agreement or divorce that you did not report
as priority claims
6g.
$0.00
6h. Debts to pension or profit-sharing plans, and
other similar debts
6h.
$0.00
6i. Other. Add all other nonpriority unsecured
claims. Write that amount here.
6i.
+
$13,712.00
6j. Total. Add lines 6f through 6i.
6j.
$85,122.00
Official Form 106E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 5 of 5
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Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 106H
Codebtors are people or entities who are also liable for any debts you may have. Be as complete and accurate as possible. If two married people are filing
together, both are equally responsible for supplying correct information. If more space is needed, copy the Additional Page, fill it out, and number the entries
in the boxes on the left. Attach the Additional Page to this page. On the top of any Additional Pages, write your name and case number (if known). Answer
every question.
1.
Do you have any codebtors? (If you are filing a joint case, do not list either spouse as a codebtor.)
No
Yes
2.
Within the last 8 years, have you lived in a community property state or territory? (Community property states and territories include Arizona, California,
Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, and Wisconsin.)
No. Go to line 3.
Yes. Did your spouse, former spouse, or legal equivalent live with you at the time?
No
Yes. In which community state or territory did you live? California
. Fill in the name and current address of that person.
Ware, Kyan
Name of your spouse, former spouse, or legal equivalent
1200 W 81st St
Number
Street
Los Angeles, CA 90044-2338
City
State
ZIP Code
3.
In Column 1, list all of your codebtors. Do not include your spouse as a codebtor if your spouse is filing with you. List the person shown in line 2
again as a codebtor only if that person is a guarantor or cosigner. Make sure you have listed the creditor on Schedule D (Official Form 106D),
Schedule E/F (Official Form 106E/F), or Schedule G (Official Form 106G). Use Schedule D, Schedule E/F, or Schedule G to fill out Column 2.
Column 1: Your codebtor
Column 2: The creditor to whom you owe the debt
Check all schedules that apply:
3.1
Name
Number
Street
City
State
ZIP Code
Schedule D, line
Schedule E/F, line
Schedule G, line
Official Form 106H
Schedule H: Your Codebtors
Page 1 of 1
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12/15
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Check if this is:
An amended filing
A supplement showing postpetition
chapter 13 income as of the following date:

MM / DD / YYYY
Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Official Form 106I
Be as complete and accurate as possible. If two married people are filing together (Debtor 1 and Debtor 2), both are equally responsible for supplying correct
information. If you are married and not filing jointly, and your spouse is living with you, include information about your spouse. If you are separated and your
spouse is not filing with you, do not include information about your spouse. If more space is needed, attach a separate sheet to this form. On the top of any
additional pages, write your name and case number (if known). Answer every question.
Part 1: Describe Employment
1.
Fill in your employment
information.
Debtor 1
Debtor 2 or non-filing spouse
If you have more than one job,
attach a separate page with
information about additional
employers.
Include part time, seasonal, or
self-employed work.
Occupation may include student
or homemaker, if it applies.
Employment status
Occupation
Employer's name
Employer's address
Employed
Not Employed
Patient Communication Rep
University of California - Riverside
14350-I Meridian Pkwy
Number Street
March Arb, CA 92518-3035
City
State
Zip Code
Employed
Not Employed
Number Street
City
State
Zip Code
How long employed there?
Part 2: Give Details About Monthly Income
Estimate monthly income as of the date you file this form. If you have nothing to report for any line, write $0 in the space. Include your non-filing spouse
unless you are separated.
If you or your non-filing spouse have more than one employer, combine the information for all employers for that person on the lines below. If you need
more space, attach a separate sheet to this form.
For Debtor 1
For Debtor 2 or
non-filing spouse
2.
List monthly gross wages, salary, and commissions (before all payroll
deductions.) If not paid monthly, calculate what the monthly wage would be.
2.
$5,045.74
$0.00
3.
Estimate and list monthly overtime pay.
3. +
$11.83
+
$0.00
4.
Calculate gross income. Add line 2 + line 3.
4.
$5,057.57
$0.00
Official Form 106I
Schedule I: Your Income
page 1
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Schedule I: Your Income
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
For Debtor 1
For Debtor 2 or
non-filing spouse
Copy line 4 here....................................................................................➔
4.
$5,057.57
$0.00
5.
List all payroll deductions:
5a. Tax, Medicare, and Social Security deductions
5b. Mandatory contributions for retirement plans
5c. Voluntary contributions for retirement plans
5d. Required repayments of retirement fund loans
5e. Insurance
5f. Domestic support obligations
5g. Union dues
5h. Other deductions. Specify:
5a.
5b.
5c.
5d.
5e.
5f.
5g.
5h.
$455.82
$353.21
$46.77
$0.00
$46.76
$0.00
$72.65
+
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
+
$0.00
6.
Add the payroll deductions. Add lines 5a + 5b + 5c + 5d + 5e +5f + 5g + 5h.
6.
$975.21
$0.00
7.
Calculate total monthly take-home pay. Subtract line 6 from line 4.
7.
$4,082.37
$0.00
8.
List all other income regularly received:
8a. Net income from rental property and from operating a business,
profession, or farm
Attach a statement for each property and business showing gross
receipts, ordinary and necessary business expenses, and the total
monthly net income.
8a.
$0.00
$0.00
8b. Interest and dividends
8b.
$0.00
$0.00
8c. Family support payments that you, a non-filing spouse, or a
dependent regularly receive
Include alimony, spousal support, child support, maintenance, divorce
settlement, and property settlement.
8c.
$0.00
$0.00
8d. Unemployment compensation
8d.
$0.00
$0.00
8e. Social Security
8e.
$0.00
$0.00
8f. Other government assistance that you regularly receive
Include cash assistance and the value (if known) of any non-cash
assistance that you receive, such as food stamps (benefits under the
Supplemental Nutrition Assistance Program) or housing subsidies.
Specify:
8f.
$0.00
$0.00
8g. Pension or retirement income
8g.
$0.00
$0.00
8h. Other monthly income. Specify: Temporary Disability
8h. +
$0.00
+
$0.00
9.
Add all other income. Add lines 8a + 8b + 8c + 8d + 8e + 8f +8g + 8h.
9.
$0.00
$0.00
10.
Calculate monthly income. Add line 7 + line 9.
Add the entries in line 10 for Debtor 1 and Debtor 2 or non-filing spouse
10.
$4,082.37
+
$0.00
=
$4,082.37
11.
State all other regular contributions to the expenses that you list in Schedule J.
Include contributions from an unmarried partner, members of your household, your dependents, your roommates, and other
friends or relatives.
Do not include any amounts already included in lines 2-10 or amounts that are not available to pay expenses listed in Schedule J.
Specify:
11. +
$0.00
12.
Add the amount in the last column of line 10 to the amount in line 11. The result is the combined monthly income. Write that
amount on the Summary of Your Assets and Liabilities and Certain Statistical Information, if it applies
12.
$4,082.37
Combined
monthly income
13.
Do you expect an increase or decrease within the year after you file this form?
No.
Yes. Explain:
Official Form 106I
Schedule I: Your Income
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Check if this is:
An amended filing
A supplement showing postpetition chapter 13
expenses as of the following date:
MM / DD / YYYY
Do you have dependents?
Do not list Debtor 1 and
Debtor 2.
Do not state the dependents'
names.
No
Yes. Fill out this information
for each dependent...............
Dependent's relationship to
Debtor 1 or Debtor 2
Dependent's
age
Does dependent live
with you?
Child
15
No.
Yes.
No.
Yes.
No.
Yes.
No.
Yes.
No.
Yes.
Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Official Form 106J
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. If more
space is needed, attach another sheet to this form. On the top of any additional pages, write your name and case number (if known). Answer every question.
Part 1: Describe Your Household
1.
Is this a joint case?
No. Go to line 2.
Yes. Does Debtor 2 live in a separate household?
No
Yes. Debtor 2 must file Official Form 106J-2, Expenses for Separate Household of Debtor 2.
2.
3.
Do your expenses include
expenses of people other than
yourself and your dependents?
No
Yes
Part 2: Estimate Your Ongoing Monthly Expenses
Estimate your expenses as of your bankruptcy filing date unless you are using this form as a supplement in a Chapter 13 case to report expenses as of a
date after the bankruptcy is filed. If this is a supplemental Schedule J, check the box at the top of the form and fill in the applicable date.
Include expenses paid for with non-cash government assistance if you know the value of
such assistance and have included it on Schedule I: Your Income (Official Form 106I.)
Your expenses
4.
The rental or home ownership expenses for your residence. Include first mortgage payments and any rent
for the ground or lot.
If not included in line 4:
4a. Real estate taxes
4b. Property, homeowner's, or renter's insurance
4c. Home maintenance, repair, and upkeep expenses
4d. Homeowner's association or condominium dues
4.
4a.
4b.
4c.
4d.
$672.00
$0.00
$13.00
$0.00
$0.00
Official Form 106J
Schedule J: Your Expenses
page 1
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Your expenses
5.
Additional mortgage payments for your residence, such as home equity loans
5.
$0.00
6.
Utilities:
6a. Electricity, heat, natural gas
6b. Water, sewer, garbage collection
6c. Telephone, cell phone, Internet, satellite, and cable services
6d. Other. Specify:
6a.
6b.
6c.
6d.
$250.00
$0.00
$398.00
$0.00
7.
Food and housekeeping supplies
7.
$800.00
8.
Childcare and children’s education costs
8.
$0.00
9.
Clothing, laundry, and dry cleaning
9.
$70.00
10.
Personal care products and services
10.
$162.00
11.
Medical and dental expenses
11.
$47.00
12.
Transportation. Include gas, maintenance, bus or train fare.
Do not include car payments.
12.
$340.00
13.
Entertainment, clubs, recreation, newspapers, magazines, and books
13.
$100.00
14.
Charitable contributions and religious donations
14.
$40.00
15.
Insurance.
Do not include insurance deducted from your pay or included in lines 4 or 20.
15a. Life insurance
15b. Health insurance
15c. Vehicle insurance
15d. Other insurance. Specify:
15a.
15b.
15c.
15d.
$100.00
$0.00
$378.00
$0.00
16.
Taxes. Do not include taxes deducted from your pay or included in lines 4 or 20.
Specify:
16.
$0.00
17.
Installment or lease payments:
17a. Car payments for Vehicle 1
17b. Car payments for Vehicle 2
17c. Other. Specify:
Ashley's Furniture Rental
17d. Other. Specify:
17a.
17b.
17c.
17d.
$503.79
$0.00
$35.00
$0.00
18.
Your payments of alimony, maintenance, and support that you did not report as deducted
from your pay on line 5, Schedule I, Your Income (Official Form 106I).
18.
$0.00
19.
Other payments you make to support others who do not live with you.
Specify:
19.
$0.00
20.
Other real property expenses not included in lines 4 or 5 of this form or on Schedule I: Your Income.
20a. Mortgages on other property
20b. Real estate taxes
20c. Property, homeowner’s, or renter’s insurance
20d. Maintenance, repair, and upkeep expenses
20e. Homeowner’s association or condominium dues
20a.
20b.
20c.
20d.
20e.
$0.00
$0.00
$0.00
$0.00
$0.00
Official Form 106J
Schedule J: Your Expenses
page 2
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
21.
Other. Specify:
Pet food & supplies
21.
+
$100.00
22.
Calculate your monthly expenses.
22a. Add lines 4 through 21.
22b. Copy line 22 (monthly expenses for Debtor 2), if any, from Official Form 106J-2
22c. Add line 22a and 22b. The result is your monthly expenses.
22a.
22b.
22c.
$4,008.79
$0.00
$4,008.79
23.
Calculate your monthly net income.
23a. Copy line 12 (your combined monthly income) from Schedule I.
23b. Copy your monthly expenses from line 22c above.
23c. Subtract your monthly expenses from your monthly income.
The result is your monthly net income.
23a.
23b.
23c.
$4,082.37
–
$4,008.79
$73.58
24.
Do you expect an increase or decrease in your expenses within the year after you file this form?
For example, do you expect to finish paying for your car loan within the year or do you expect your
mortgage payment to increase or decrease because of a modification to the terms of your mortgage?
No.
Yes.
None
Official Form 106J
Schedule J: Your Expenses
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Amount
6c. Telephone, cell phone, Internet, satellite, and cable services
Telephone
$113.00
Internet
$85.00
Cable
$200.00
10. Personal care products and services
Personal care products and services
$102.00
Gym - 24 Hour Fitness
$60.00
Official Form 106J
Schedule J: Your Expenses
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Part 2: Explain the Sources of Your Income
4. Did you have any income from employment or from operating a business during this year or the two previous calendar years?
Fill in the total amount of income you received from all jobs and all businesses, including part-time activities.
If you are filing a joint case and you have income that you receive together, list it only once under Debtor 1.
No
Yes. Fill in the details.
Debtor 1
Debtor 2
Sources of income
Check all that apply.
Gross Income
(before deductions and
exclusions)
Sources of income
Check all that apply.
Gross Income
(before deductions and
exclusions)
From January 1 of current year until the
date you filed for bankruptcy:
Wages, commissions,
bonuses, tips
Operating a business
$11,794.69
Wages, commissions,
bonuses, tips
Operating a business
For last calendar year:
(January 1 to December 31, 2022
)
YYYY
Wages, commissions,
bonuses, tips
Operating a business
$13,143.00
Wages, commissions,
bonuses, tips
Operating a business
For the calendar year before that:
(January 1 to December 31, 2021
)
YYYY
Wages, commissions,
bonuses, tips
Operating a business
$51,698.00
Wages, commissions,
bonuses, tips
Operating a business
5. Did you receive any other income during this year or the two previous calendar years?
Include income regardless of whether that income is taxable. Examples of other income are alimony; child support; Social Security, unemployment, and other
public benefit payments; pensions; rental income; interest; dividends; money collected from lawsuits; royalties; and gambling and lottery winnings. If you are
filing a joint case and you have income that you received together, list it only once under Debtor 1.
No
Yes. Fill in the details.
Debtor 1
Debtor 2
Sources of income
Describe below.
Gross income from
each source
(before deductions and
exclusions)
Sources of income
Describe below.
Gross Income from
each source
(before deductions and
exclusions)
From January 1 of current year until the
date you filed for bankruptcy:
For last calendar year:
(January 1 to December 31, 2022
)
YYYY
Royalty
$32.00
For the calendar year before that:
(January 1 to December 31, 2021
)
YYYY
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 2
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 3: List Certain Payments You Made Before You Filed for Bankruptcy
6. Are either Debtor 1’s or Debtor 2’s debts primarily consumer debts?
No.
Neither Debtor 1 nor Debtor 2 has primarily consumer debts. Consumer debts are defined in 11 U.S.C. § 101(8) as “incurred by
an individual primarily for a personal, family, or household purpose.”
During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $7,575* or more?
No. Go to line 7.
Yes.
List below each creditor to whom you paid a total of $7,575* or more in one or more payments and the total amount you
paid that creditor. Do not include payments for domestic support obligations, such as child support and alimony. Also, do
not include payments to an attorney for this bankruptcy case.
* Subject to adjustment on 4/01/25 and every 3 years after that for cases filed on or after the date of adjustment.
Yes.
Debtor 1 or Debtor 2 or both have primarily consumer debts.
During the 90 days before you filed for bankruptcy, did you pay any creditor a total of $600 or more?
No. Go to line 7.
Yes.
List below each creditor to whom you paid a total of $600 or more and the total amount you paid that creditor. Do not
include payments for domestic support obligations, such as child support and alimony. Also, do not include payments to
an attorney for this bankruptcy case.
Dates of
payment
Total amount paid
Amount you still owe
Was this payment for…
University Credit Union
Creditor's Name
1500 S Sepulveda Blvd
Number
Street
Los Angeles, CA 90025-3312
City
State
ZIP Code
01/11/2023
02/08/2023
02/23/2023
$1,511.37
$18,708.00
Mortgage
Car
Credit card
Loan repayment
Suppliers or vendors
Other
7. Within 1 year before you filed for bankruptcy, did you make a payment on a debt you owed anyone who was an insider?
Insiders include your relatives; any general partners; relatives of any general partners; partnerships of which you are a general partner; corporations of which
you are an officer, director, person in control, or owner of 20% or more of their voting securities; and any managing agent, including one for a business you
operate as a sole proprietor. 11 U.S.C. § 101. Include payments for domestic support obligations, such as child support and alimony.
No
Yes. List all payments to an insider.
Dates of
payment
Total amount paid
Amount you still
owe
Reason for this payment
Insider's Name
Number
Street
City
State
ZIP Code
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 3
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
8. Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account of a debt that benefited an insider?
Include payments on debts guaranteed or cosigned by an insider.
No
Yes. List all payments that benefited an insider.
Dates of
payment
Total amount paid
Amount you still
owe
Reason for this payment
Include creditor’s name
Insider's Name
Number
Street
City
State
ZIP Code
Part 4: Identify Legal Actions, Repossessions, and Foreclosures
9. Within 1 year before you filed for bankruptcy, were you a party in any lawsuit, court action, or administrative proceeding?
List all such matters, including personal injury cases, small claims actions, divorces, collection suits, paternity actions, support or custody modifications, and
contract disputes.
No
Yes. Fill in the details.
Nature of the case
Court or agency
Status of the case
Case title
Brandy Ford
Case number ADJ15655433
Workers Comp
Workers Comp Appeals Board
Court Name
Number
Street
City
State
ZIP Code
Pending
On appeal
Concluded
10. Within 1 year before you filed for bankruptcy, was any of your property repossessed, foreclosed, garnished, attached, seized, or levied?
Check all that apply and fill in the details below.
No. Go to line 11.
Yes. Fill in the information below.
Creditor’s Name
Number
Street
City
State
ZIP Code
Describe the property
Explain what happened
Property was repossessed.
Property was foreclosed.
Property was garnished.
Property was attached, seized, or levied.
Date
Value of the property
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
11. Within 90 days before you filed for bankruptcy, did any creditor, including a bank or financial institution, set off any amounts from your accounts or
refuse to make a payment because you owed a debt?
No
Yes. Fill in the details.
Creditor’s Name
Number
Street
City
State
ZIP Code
Describe the action the creditor took
Last 4 digits of account number: XXXX–
Date action was
taken
Amount
12. Within 1 year before you filed for bankruptcy, was any of your property in the possession of an assignee for the benefit of creditors, a court-
appointed receiver, a custodian, or another official?
No
Yes
Part 5: List Certain Gifts and Contributions
13. Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person?
No
Yes. Fill in the details for each gift.
Gifts with a total value of more than $600
per person
Person to Whom You Gave the Gift
Number
Street
City
State
ZIP Code
Person’s relationship to you
Describe the gifts
Dates you gave
the gifts
Value
14. Within 2 years before you filed for bankruptcy, did you give any gifts or contributions with a total value of more than $600 to any charity?
No
Yes. Fill in the details for each gift or contribution.
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Gifts or contributions to charities
that total more than $600
Charity’s Name
Number
Street
City
State
ZIP Code
Describe what you contributed
Date you
contributed
Value
Part 6: List Certain Losses
15. Within 1 year before you filed for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, fire, other disaster, or
gambling?
No
Yes. Fill in the details.
Describe the property you lost and
how the loss occurred
Describe any insurance coverage for the loss
Include the amount that insurance has paid. List pending
insurance claims on line 33 of Schedule A/B: Property.
Date of your loss
Value of property lost
Part 7: List Certain Payments or Transfers
16. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you consulted
about seeking bankruptcy or preparing a bankruptcy petition?
Include any attorneys, bankruptcy petition preparers, or credit counseling agencies for services required in your bankruptcy.
No
Yes. Fill in the details.
WilksLaw
Person Who Was Paid
3818 Crenshaw Blvd # 445
Number
Street
Los Angeles, CA 90008-1813
City
State
ZIP Code
Email or website address
Person Who Made the Payment, if Not You
Description and value of any property transferred
Attorney’s Fee; Court costs & fees; Attorney’s Fee;
Attorney’s Fee; Attorney’s Fee
Date payment or
transfer was made
03/14/2023
03/28/2023
03/28/2023
03/04/2023
03/04/2023
Amount of payment
$825.00
$338.00
$62.00
$600.00
$600.00
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
17. Within 1 year before you filed for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone who promised to
help you deal with your creditors or to make payments to your creditors?
Do not include any payment or transfer that you listed on line 16.
No
Yes. Fill in the details.
Person Who Was Paid
Number
Street
City
State
ZIP Code
Description and value of any property transferred
Date payment or
transfer was made
Amount of payment
18. Within 2 years before you filed for bankruptcy, did you sell, trade, or otherwise transfer any property to anyone, other than property transferred in the
ordinary course of your business or financial affairs?
Include both outright transfers and transfers made as security (such as the granting of a security interest or mortgage on your property).
Do not include gifts and transfers that you have already listed on this statement.
No
Yes. Fill in the details.
Description and value of property
transferred
Describe any property or payments
received or debts paid in exchange
Date transfer was
made
Person Who Received Transfer
Number
Street
City
State
ZIP Code
Person's relationship to you
19. Within 10 years before you filed for bankruptcy, did you transfer any property to a self-settled trust or similar device of which you are a beneficiary?
(These are often called asset-protection devices.)
No
Yes. Fill in the details.
Name of trust
Description and value of the property transferred
Date transfer was
made
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 8: List Certain Financial Accounts, Instruments, Safe Deposit Boxes, and Storage Units
20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed, sold, moved,
or transferred?
Include checking, savings, money market, or other financial accounts; certificates of deposit; shares in banks, credit unions, brokerage houses, pension
funds, cooperatives, associations, and other financial institutions.
No
Yes. Fill in the details.
Last 4 digits of account number
Type of account or
instrument
Date account was
closed, sold, moved, or
transferred
Last balance
before closing or
transfer
Name of Financial Institution
Number
Street
City
State
ZIP Code
XXXX–
Checking
Savings
Money market
Brokerage
Other
21. Do you now have, or did you have within 1 year before you filed for bankruptcy, any safe deposit box or other depository for securities, cash, or other
valuables?
No
Yes. Fill in the details.
Who else had access to it?
Describe the contents
Do you still have
it?
Name of Financial Institution
Number
Street
City
State
ZIP Code
Name
Number
Street
City
State
ZIP Code
No
Yes
22. Have you stored property in a storage unit or place other than your home within 1 year before you filed for bankruptcy?
No
Yes. Fill in the details.
Who else has or had access to it?
Describe the contents
Do you still have
it?
Name of Storage Facility
Number
Street
City
State
ZIP Code
Name
Number
Street
City
State
ZIP Code
No
Yes
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 8
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 9: Identify Property You Hold or Control for Someone Else
23. Do you hold or control any property that someone else owns? Include any property you borrowed from, are storing for, or hold in trust for someone.
No
Yes. Fill in the details.
Where is the property?
Describe the property
Value
Sister
Owner's Name
Number
Street
City
State
ZIP Code
154 E 92nd St
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
Used sewing machine
$15.00
Ex
Owner's Name
Number
Street
City
State
ZIP Code
154 E 92nd St
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
Sound bar, Samsung TV, 3 XBox games
$113.00
UCLA
Owner's Name
Number
Street
City
State
ZIP Code
154 E 92nd St
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
Computer tower & desk for work from home
$440.00
Part 10: Give Details About Environmental Information
For the purpose of Part 10, the following definitions apply:
Environmental law means any federal, state, or local statute or regulation concerning pollution, contamination, releases of hazardous or toxic
substances, wastes, or material into the air, land, soil, surface water, groundwater, or other medium, including statutes or regulations controlling the
cleanup of these substances, wastes, or material.
Site means any location, facility, or property as defined under any environmental law, whether you now own, operate, or utilize it or used to own, operate,
or utilize it, including disposal sites.
Hazardous material means anything an environmental law defines as a hazardous waste, hazardous substance, toxic substance, hazardous material,
pollutant, contaminant, or similar term.
Report all notices, releases, and proceedings that you know about, regardless of when they occurred.
24. Has any governmental unit notified you that you may be liable or potentially liable under or in violation of an environmental law?
No
Yes. Fill in the details.
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 9
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Governmental unit
Environmental law, if you know it
Date of notice
Name of site
Number
Street
City
State
ZIP Code
Governmental unit
Number
Street
City
State
ZIP Code
25. Have you notified any governmental unit of any release of hazardous material?
No
Yes. Fill in the details.
Governmental unit
Environmental law, if you know it
Date of notice
Name of site
Number
Street
City
State
ZIP Code
Governmental unit
Number
Street
City
State
ZIP Code
26. Have you been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.
No
Yes. Fill in the details.
Court or agency
Nature of the case
Status of the case
Case title
Case number
Court Name
Number
Street
City
State
ZIP Code
Pending
On appeal
Concluded
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 10
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)
Part 11: Give Details About Your Business or Connections to Any Business
27. Within 4 years before you filed for bankruptcy, did you own a business or have any of the following connections to any business?
A sole proprietor or self-employed in a trade, profession, or other activity, either full-time or part-time
A member of a limited liability company (LLC) or limited liability partnership (LLP)
A partner in a partnership
An officer, director, or managing executive of a corporation
An owner of at least 5% of the voting or equity securities of a corporation
No. None of the above applies. Go to Part 12.
Yes. Check all that apply above and fill in the details below for each business.
Hair stylist
Name
154 E 92nd St
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
Describe the nature of the business
Hair stylist
Name of accountant or bookkeeper
Employer Identification number
Do not include Social Security number or ITIN.
EIN:
–
Dates business existed
From 01/01/2019
To 08/01/2020
B's Eats & Treats
Name
154 E 92nd St
Number
Street
Los Angeles, CA 90003-3726
City
State
ZIP Code
Describe the nature of the business
Food
Name of accountant or bookkeeper
Employer Identification number
Do not include Social Security number or ITIN.
EIN:
–
Dates business existed
From 11/03/2020
To 10/01/2022
28. Within 2 years before you filed for bankruptcy, did you give a financial statement to anyone about your business? Include all financial institutions,
creditors, or other parties.
No
Yes. Fill in the details below.
Date issued
Womply
Name
548 Market St # 73871
Number
Street
San Francisco, CA 94104-5401
City
State
ZIP Code
04/29/2021
MM / DD / YYYY
Official Form 107
Statement of Financial Affairs for Individuals Filing for Bankruptcy
page 11
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B2030 (Form 2030) (12/15)
United States Bankruptcy Court
Central District of California
In re
FORD, BRANDY
Debtor
Case No.
Chapter
7
DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR
1.
Pursuant to 11 U .S.C. § 329(a) and Fed. Bankr. P. 2016(b), I certify that I am the attorney for the above named debtor(s) and that
compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered
or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows:
FLAT FEE
For legal services, I have agreed to accept ..............................................................................................
$1,487.00
Prior to the filing of this statement I have received ...................................................................................
$1,825.00
Balance Due .............................................................................................................................................
($338.00)
RETAINER
For legal services, I have agreed to accept and received a retainer of ....................................................
The undersigned shall bill against the retainer at an hourly rate of ..........................................................
[Or attach firm hourly rate schedule.] Debtor(s) have agreed to pay all Court approved fees and
expenses exceeding the amount of the retainer.
2.
$338.00
of the filing fee has been paid.
3.
The source of the compensation paid to me was:
Debtor
Other (specify)
4.
The source of compensation to be paid to me is:
Debtor
Other (specify)
5.
I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my
law firm.
I have agreed to share the above-disclosed compensation with a other person or persons who are not members or associates of my
law firm. A copy of the agreement, together with a list of the names of the people sharing in the compensation, is attached.
6.
In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, including:
a.
Analysis of the debtor' s financial situation, and rendering advice to the debtor in determining whether to file a petition in
bankruptcy;
b.
Preparation and filing of any petition, schedules, statements of affairs and plan which may be required;
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B2030 (Form 2030) (12/15)
c.
Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;
7.
By agreement with the debtor(s), the above-disclosed fee does not include the following services:
Redemption or refinance, multiple 341s
CERTIFICATION
I certify that the foregoing is a complete statement of any agreement or arrangement for payment to
me for representation of the debtor(s) in this bankruptcy proceeding.
03/30/2023
Date
Misty Wilks
Signature of Attorney
Bar Number: 196327
WilksLaw
3818 Crenshaw Blvd # 445
Los Angeles, CA 90008-1813
Phone: (323) 540-4633
WilksLaw
Name of law firm
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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
Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Official Form 122A-1
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 Column 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.
Column A
Debtor 1
Column B
Debtor 2 or
non-filing spouse
2.
Your gross wages, salary, tips, bonuses, overtime, and commissions (before all payroll
deductions).
$0.00
3.
Alimony and maintenance payments. Do not include payments from a spouse if Column B
is filled in.
$0.00
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.
$0.00
5.
Net income from operating a business, profession,
or farm
Debtor 1
Debtor 2
Gross receipts (before all deductions)
$0.00
Ordinary and necessary operating expenses
-
$0.00 -
Net monthly income from a business, profession, or farm
$0.00
Copy
here
→
$0.00
6.
Net income from rental and other real property
Debtor 1
Debtor 2
Gross receipts (before all deductions)
$0.00
Ordinary and necessary operating expenses
-
$0.00 -
Net monthly income from rental or other real property
$0.00
Copy
here
→
$0.00
7.
Interest, dividends, and royalties
$0.00
Official Form 122A-1
Chapter 7 Statement of Your Current Monthly Income
page 1
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Chapter 7 Statement of Your Current Monthly Income
12/19
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3/30/23, 7:01 PM
Form
https://app1.jubileepro.com
2/3
For you....................................................................................
$0.00
For your spouse......................................................................
Copy line 11 here →
12b.
13.
Debtor 1
BRANDY

FORD
First Name

Middle Name

Last Name
Case number (if known)
Column A
Debtor 1
Column B
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: .................................................. ↓
$0.00
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.
$0.00
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.
Temporary Disability
$2,719.86
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.
$2,719.86
+
=
$2,719.86
Total current
monthly income
Part 2: Determine Whether the Means Test Applies to You
12. Calculate your current monthly income for the year. Follow these steps:
12a. Copy your total current monthly income from line 11....................................................................................
$2,719.86
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.
$32,638.32
13. Calculate the median family income that applies to you. Follow these steps:
Fill in the state in which you live.
California
Fill in the number of people in your household.
2
Fill in the median family income for your state and size of household....................................................................................................
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.
$86,271.00
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. Do NOT fill out or file Official Form 122A-2.
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
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AT&T
Po Box 5074
Carol Stream, IL 60197-5074
Capital One
Attn: Bankruptcy
P.O. Box 30285
Salt Lake City, UT 84130-0285
Macys/fdsb
Attn: Bankruptcy 9111 Duke Boulevard
Mason, OH 45040
Merrick Bank/CCHoldings
Attn: Bankruptcy
P.O. Box 9201
Old Bethpage, NY 11804-9001
Sallie Mae, Inc
Attn: Bankruptcy
PO Box 9500
Wilkes Barre, PA 18773
Synchrony
Po Box 965060
Orlando, FL 32896-5060
Synchrony/Ashley Furniture
Homestore
Attn: Bankruptcy
Po Box 965060
Orlando, FL 32896-5060
University Credit Un
Attn: Bankruptcy Dept P. O. Box 240046
Los Angeles, CA 90024-9146
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University Credit Union
Attn: Bankruptcy Dept P. O. Box 240046
Los Angeles, CA 90024-9146
Upstart Finance
Attn: Bankruptcy
PO Box 1503
San Carlos, CA 94070
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Fill in this information to identify your case:
Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Debtor 2
(Spouse, if filing)
First Name
Middle Name
Last Name
United States Bankruptcy Court for the:
Central District of California
Case number
(if known)
Check if this is an
amended filing
Official Form 108
If you are an individual filing under chapter 7, you must fill out this form if:
■creditors have claims secured by your property, or
■you have leased personal property and the lease has not expired.
You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors, whichever is earlier,
unless the court extends the time for cause. You must also send copies to the creditors and lessors you list on the form.
If two married people are filing together in a joint case, both are equally responsible for supplying correct information. Both debtors must sign and date the
form.
Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name
and case number (if known).
Part 1: List Your Creditors Who Have Secured Claims
1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the information
below.
Identify the creditor and the property that is collateral
What do you intend to do with the property that secures
a debt?
Did you claim the property as
exempt on Schedule C?
Creditor’s
name:
University Credit Union
Description of
property
securing debt:
2013 Lexus GS
Surrender the property.
Retain the property and redeem it.
Retain the property and enter into a
Reaffirmation Agreement.
Retain the property and [explain]:
No
Yes
Creditor’s
name:
Synchrony/Ashley Furniture Homestore
Description of
property
securing debt:
Used dining room furniture &
accessories
Used bedroom furniture, accessories
& desk
Used living room furniture &
accessories
Surrender the property.
Retain the property and redeem it.
Retain the property and enter into a
Reaffirmation Agreement.
Retain the property and [explain]:
No
Yes
Official Form 108
Statement of Intention for Individuals Filing Under Chapter 7
page 1
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Statement of Intention for Individuals Filing Under Chapter 7
12/15
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XX
and continue making payments
and continue making payments
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Debtor 1
BRANDY
FORD
First Name
Middle Name
Last Name
Case number (if known)

Additional Page for Part 1
Creditor’s
name:
AT&T
Description of
property
securing debt:
Old used cell phone
Surrender the property.
Retain the property and redeem it.
Retain the property and enter into a
Reaffirmation Agreement.
Retain the property and [explain]:
No
Yes
Official Form 108
Statement of Intention for Individuals Filing Under Chapter 7
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X
X
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AT&T
Cell phone lease & service
X
Synchrony
Furniture
X
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Chapter 7 voluntary petition — In re Ford

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