Court filing
Form 106 — USA v. Harun (Dkt. 19.2)
Filed August 31, 2023 in USA v. Harun; one of 89 filings from this case.
Record facts
| Court | U.S. District Court for the Southern District of Georgia |
|---|---|
| Filed | 2023-08-31 |
U.S. District Court for the Southern District of Georgia · No. 3:23-cr-00003-DHB-BKE · Doc. 19-2 · 2023-08-31 · Docket on CourtListener
Full text
Official Form 106A/B Schedule A/B: Property page 1 2IILFLDO)RUP 106A/B Schedule A/B: Property 12/15 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? 1.1. _________________________________________ Street address, if available, or other description _________________________________________ _________________________________________ City State ZIP Code _________________________________________ County 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 __________________________________ 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. 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) Other information you wish to add about this item, such as local property identification number: _______________________________ If you own or have more than one, list here: 1.2. ________________________________________ Street address, if available, or other description ________________________________________ ________________________________________ City State ZIP Code ________________________________________ County 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 __________________________________ 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? $_________________ Describe the nature of your ownership interest (such as fee simple, tenancy by the entireties, or a life estate), if known. Who has an interest in the property? Check one. Debtor 1 only Debtor 2 only Debtor 1 and Debtor 2 only At least one of the debtors and another __________________________________________ Check if this is community property (see instructions) Other information you wish to add about this item, such as local property identification number: _______________________________ Debtor 1 __________________________________________________________________ First Name Middle Name Last Name Debtor 2 ________________________________________________________________ (Spouse, if filing) First Name Middle Name Last Name United States Bankruptcy Court for the: __________ District of ___________ Case number ___________________________________________ Fill in this information to identify your case and this filing: Check if this is an amended filing __________ District of __________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 1 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 2 1.3. ________________________________________ Street address, if available, or other description ________________________________________ ________________________________________ City State ZIP Code ________________________________________ County 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 __________________________________ 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. 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) 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. ...................................................................................... Î $_________________ 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 3.1. Make: ______________ Model: ______________ Year: ____________ Approximate mileage: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ If you own or have more than one, describe here: 3.2. Make: ______________ Model: ______________ Year: ____________ Approximate mileage: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 2 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 3 3.3. Make: ______________ Model: ______________ Year: ____________ Approximate mileage: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ 3.4. Make: ______________ Model: ______________ Year: ____________ Approximate mileage: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ 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 4.1. Make: ____________________ Model: ____________________ Year: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ If you own or have more than one, list here: 4.2. Make: ____________________ Model: ____________________ Year: ____________ Other information: 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? $________________ Current value of the portion you own? $________________ 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 ........................................................................................................................ Î $_________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 3 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 4 Part 3: Describe Your Personal and Household Items 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. 6. Household goods and furnishings Examples: Major appliances, furniture, linens, china, kitchenware No Yes. Describe. ........ $___________________ 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 No Yes. Describe. ......... $___________________ 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 No Yes. Describe. ......... $___________________ 9. 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 No Yes. Describe. ......... $___________________ 10.Firearms Examples: Pistols, rifles, shotguns, ammunition, and related equipment No Yes. Describe. .......... $___________________ 11.Clothes Examples: Everyday clothes, furs, leather coats, designer wear, shoes, accessories No Yes. Describe. .......... $___________________ 12.Jewelry Examples: Everyday jewelry, costume jewelry, engagement rings, wedding rings, heirloom jewelry, watches, gems, gold, silver No Yes. Describe. .......... $___________________ 13.Non-farm animals Examples: Dogs, cats, birds, horses No Yes. Describe. .......... $___________________ 14.Any other personal and household items you did not already list, including any health aids you did not list No Yes. Give specific information. .............. $___________________ 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 .................................................................................................................................................... Î $______________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 4 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 5 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: ....................... $__________________ 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. Checking account: _________________________________________________________ 17.2. Checking account: _________________________________________________________ 17.3. Savings account: _________________________________________________________ 17.4. Savings account: _________________________________________________________ 17.5. Certificates of deposit: _________________________________________________________ 17.6. Other financial account: _________________________________________________________ 17.7. Other financial account: _________________________________________________________ 17.8. Other financial account: _________________________________________________________ 17.9. Other financial account: _________________________________________________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ 18.Bonds, mutual funds, or publicly traded stocks Examples: Bond funds, investment accounts with brokerage firms, money market accounts No Yes ................. Institution or issuer name: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ $__________________ $__________________ $__________________ 19. Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in an LLC, partnership, and joint venture No Yes. Give specific information about them......................... Name of entity: % of ownership: _____________________________________________________________________ ___________% _____________________________________________________________________ ___________% _____________________________________________________________________ ___________% $__________________ $__________________ $__________________ 0% 0% 0% Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 5 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 6 20. 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. No Yes. Give specific information about them....................... Issuer name: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ $__________________ $__________________ $__________________ 21. Retirement or pension accounts Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sharing plans No Yes. List each account separately. Type of account: Institution name: 401(k) or similar plan: ___________________________________________________________________ Pension plan: ___________________________________________________________________ IRA: ___________________________________________________________________ Retirement account: ___________________________________________________________________ Keogh: ___________________________________________________________________ Additional account: ___________________________________________________________________ Additional account: ___________________________________________________________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ $__________________ 22.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 No Yes .......................... Institution name or individual: Electric: ______________________________________________________________________ Gas: ______________________________________________________________________ Heating oil: ______________________________________________________________________ Security deposit on rental unit: _____________________________________________________________ Prepaid rent: ______________________________________________________________________ Telephone: ______________________________________________________________________ Water: ______________________________________________________________________ Rented furniture: ______________________________________________________________________ Other: ______________________________________________________________________ $___________________ $___________________ $___________________ $___________________ $___________________ $___________________ $___________________ $___________________ $___________________ 23.Annuities (A contract for a periodic payment of money to you, either for life or for a number of years) No Yes .......................... Issuer name and description: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ $__________________ $__________________ $__________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 6 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 7 24.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). No Yes .................................... Institution name and description. Separately file the records of any interests.11 U.S.C. § 521(c): ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ $_________________ $_________________ $_________________ 25.Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers exercisable for your benefit No Yes. Give specific information about them. ... $__________________ 26. Patents, copyrights, trademarks, trade secrets, and other intellectual property Examples: Internet domain names, websites, proceeds from royalties and licensing agreements No Yes. Give specific information about them. ... $__________________ 27. Licenses, franchises, and other general intangibles Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses, professional licenses No Yes. Give specific information about them. ... $__________________ Money or property owed to you? Current value of the portion you own? Do not deduct secured claims or exemptions. 28.Tax refunds owed to you No Yes. Give specific information about them, including whether you already filed the returns and the tax years. ....................... Federal: $_________________ State: $_________________ Local: $_________________ 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. 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 No Yes. Give specific information. .............. $______________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 7 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 8 31. Interests in insurance policies Examples: Health, disability, or life insurance; health savings account (HSA); credit, homeowner’s, or renter’s insurance No Yes. Name the insurance company of each policy and list its value. ... Company name: Beneficiary: ___________________________________________ ____________________________ ___________________________________________ ____________________________ ___________________________________________ ____________________________ Surrender or refund value: $__________________ $__________________ $__________________ 32. 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. No Yes. Give specific information. ............. $_____________________ 33. 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 No Yes. Describe each claim. .................... $______________________ 34.Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights to set off claims No Yes. Describe each claim. .................... $_____________________ 35.Any financial assets you did not already list No Yes. Give specific information............ $_____________________ 36. 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 .................................................................................................................................................... Î $_____________________ 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. Current value of the portion you own? Do not deduct secured claims or exemptions. 38.Accounts receivable or commissions you already earned No Yes. Describe ....... $_____________________ 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 ....... $_____________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 8 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 9 40.Machinery, fixtures, equipment, supplies you use in business, and tools of your trade No Yes. Describe ....... $_____________________ 41.Inventory No Yes. Describe ....... $_____________________ 42.Interests in partnerships or joint ventures No Yes. Describe ....... Name of entity: % of ownership: ______________________________________________________________________ ________% ______________________________________________________________________ ________% ______________________________________________________________________ ________% $_____________________ $_____________________ $_____________________ 43.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))? No Yes. Describe. ....... $____________________ 44.Any business-related property you did not already list No Yes. Give specific information ......... ______________________________________________________________________________________ $____________________ ______________________________________________________________________________________ $____________________ ______________________________________________________________________________________ $____________________ ______________________________________________________________________________________ $____________________ ______________________________________________________________________________________ $____________________ ______________________________________________________________________________________ $____________________ 45. 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 .................................................................................................................................................... Î $____________________ 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. 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. Farm animals Examples: Livestock, poultry, farm-raised fish No Yes .......................... $___________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 9 of 10 Debtor 1 _______________________________________________________ Case number (if known)_____________________________________ First Name Middle Name Last Name 2IILFLDO)RUP$% Schedule A/B: Property page 10 48.Crops—either growing or harvested No Yes. Give specific information. ............ $___________________ 49.Farm and fishing equipment, implements, machinery, fixtures, and tools of trade No Yes .......................... $___________________ 50.Farm and fishing supplies, chemicals, and feed No Yes .......................... $___________________ 51.Any farm- and commercial fishing-related property you did not already list No Yes. Give specific information. ............ $___________________ 52. 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 .................................................................................................................................................... Î $___________________ Part 7: Describe All Property You Own or Have an Interest in That You Did Not List Above 53. Do you have other property of any kind you did not already list? Examples: Season tickets, country club membership No Yes. Give specific information. ............ $________________ $________________ $________________ 54.Add the dollar value of all of your entries from Part 7. Write that number here ................................................................. Î $________________ Part 8: List the Totals of Each Part of this Form 55.Part 1: Total real estate, line 2 ..............................................................................................................................................................Î $________________ 56.Part 2: Total vehicles, line 5 $________________ 57.Part 3: Total personal and household items, line 15 $________________ 58.Part 4: Total financial assets, line 36 $________________ 59.Part 5: Total business-related property, line 45 $________________ 60.Part 6: Total farm- and fishing-related property, line 52 $________________ 61.Part 7: Total other property not listed, line 54 + $________________ 62.Total personal property. Add lines 56 through 61. .................... $________________ Copy personal property total Î + $_________________ 63.Total of all property on Schedule A/B. Add line 55 + line 62. ......................................................................................... $_________________ Case 3:23-cr-00003-DHB-BKE Document 19-2 Filed 08/31/23 Page 10 of 10
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