Full text
Official Form 202
Declaration Under Penalty of Perjury for Non-Individual Debtors
Official Form 202
Declaration Under Penalty of Perjury for Non-Individual Debtors
12/15
An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit
this form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document,
and any amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the
document, and the date. Bankruptcy Rules 1008 and 9011.
WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud in
connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341,
1519, and 3571.
Declaration and signature
I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or
another individual serving as a representative of the debtor in this case.
I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:
Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)
Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)
Schedule H: Codebtors (Official Form 206H)
Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)
Amended Schedule ____
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)
Other document that requires a declaration__________________________________________________________________________________
I declare under penalty of perjury that the foregoing is true and correct.
Executed on ______________
_________________________________________________________________________
MM / DD / YYYY
Signature of individual signing on behalf of debtor
________________________________________________________________________
Printed name
______________________________________
Position or relationship to debtor
Debtor Name __________________________________________________________________
United States Bankruptcy Court for the: ________________________________
Case number (If known):
_________________________
Fill in this information to identify the case and this filing:
2:19-bk-00787
✔
✔
✔
Northern District of West Virginia
✔
✔
James Punelli
09/27/2019
✔
/s/ James Punelli
Managing Member
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 1 of 46
Official Form 206Sum
Summary of Assets and Liabilities for Non-Individuals
page 1
Official Form 206Sum
Summary of Assets and Liabilities for Non-Individuals
12/15
Part 1:
Summary of Assets
1. Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)
1a. Real property:
Copy line 88 from Schedule A/B ..........................................................................................................................................
$ __________________
1b. Total personal property:
Copy line 91A from Schedule A/B ........................................................................................................................................
$ __________________
1c. Total of all property:
Copy line 92 from Schedule A/B ..........................................................................................................................................
$ __________________
Part 2:
Summary of Liabilities
2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D ................................................
$ __________________
3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
3a. Total claim amounts of priority unsecured claims:
Copy the total claims from Part 1 from line 6a of Schedule E/F .........................................................................................
$ __________________
3b. Total amount of claims of nonpriority amount of unsecured claims:
Copy the total of the amount of claims from Part 2 from line 6b of Schedule E/F .............................................................
+$ __________________
4. Total liabilities ...........................................................................................................................................................................
Lines 2 + 3a + 3b
$ __________________
Debtor name _________________________________________________________________
United States Bankruptcy Court for the:_______________________ District of ________
(State)
Case number (If known):
_________________________
Fill in this information to identify the case:
Check if this is an
amended filing
1,678,827.29
Northern District of West Virginia
15,050,000.00
Panthera Enterprises, LLC
8,857,337.39
2:19-bk-00787
0.00
11,304,787.74
20,162,125.13
16,728,827.29
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 2 of 46
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 1
Official Form 206A/B
Schedule A/B: Assets — Real and Personal Property
12/15
Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest. Include
all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties which have
no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts or unexpired
leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).
Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write
the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an
additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.
For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset
schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the
debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.
Part 1: Cash and cash equivalents
1. Does the debtor have any cash or cash equivalents?
No. Go to Part 2.
Yes. Fill in the information below.
All cash or cash equivalents owned or controlled by the debtor
Current value of debtor’s
interest
2. Cash on hand
$______________________
3. Checking, savings, money market, or financial brokerage accounts (Identify all)
Name of institution (bank or brokerage firm)
Type of account
Last 4 digits of account number
3.1. _________________________________________________ ______________________
____ ____ ____ ____
3.2. _________________________________________________ ______________________
____ ____ ____ ____
$______________________
$______________________
4. Other cash equivalents (Identify all)
4.1. _____________________________________________________________________________________________________
$______________________
4.2. _____________________________________________________________________________________________________
$______________________
5. Total of Part 1
Add lines 2 through 4 (including amounts on any additional sheets). Copy the total to line 80.
$______________________
Part 2:
Deposits and prepayments
6. Does the debtor have any deposits or prepayments?
No. Go to Part 3.
Yes. Fill in the information below.
Current value of
debtor’s interest
7. Deposits, including security deposits and utility deposits
Description, including name of holder of deposit
7.1. ________________________________________________________________________________________________________
7.2._________________________________________________________________________________________________________
$______________________
$_______________________
Debtor name __________________________________________________________________
United States Bankruptcy Court for the:_______________________________
Case number (If known):
_________________________
Fill in this information to identify the case:
Check if this is an
amended filing
✔
2:19-bk-00787
✔
100.00
0.00
100.00
0.00
Northern District of West Virginia
Old Line Bank
See continuation sheet
0
7
7
9
Panthera Enterprises, LLC
Checking
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 3 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 2
8. Prepayments, including prepayments on executory contracts, leases, insurance, taxes, and rent
Description, including name of holder of prepayment
8.1.___________________________________________________________________________________________________________
8.2.___________________________________________________________________________________________________________
$______________________
$_______________________
9. Total of Part 2.
Add lines 7 through 8. Copy the total to line 81.
$______________________
Part 3: Accounts receivable
10. Does the debtor have any accounts receivable?
No. Go to Part 4.
Yes. Fill in the information below.
Current value of debtor’s
interest
11. Accounts receivable
11a. 90 days old or less:
____________________________ – ___________________________ = ........
face amount
doubtful or uncollectible accounts
$______________________
11b. Over 90 days old:
___________________________ – ___________________________ = ........
face amount
doubtful or uncollectible accounts
$______________________
12. Total of Part 3
Current value on lines 11a + 11b = line 12. Copy the total to line 82.
$______________________
Part 4:
Investments
13. Does the debtor own any investments?
No. Go to Part 5.
Yes. Fill in the information below.
Valuation method
used for current value
Current value of debtor’s
interest
14. Mutual funds or publicly traded stocks not included in Part 1
Name of fund or stock:
14.1. ________________________________________________________________________________
14.2. ________________________________________________________________________________
_____________________
_____________________
$________________________
$________________________
15. Non-publicly traded stock and interests in incorporated and unincorporated businesses,
including any interest in an LLC, partnership, or joint venture
Name of entity:
% of ownership:
15.1._______________________________________________________________
________%
15.2._______________________________________________________________
________%
_____________________
_____________________
$________________________
$________________________
16. Government bonds, corporate bonds, and other negotiable and non-negotiable
instruments not included in Part 1
Describe:
16.1.________________________________________________________________________________
16.2.________________________________________________________________________________
______________________
______________________
$_______________________
$_______________________
17. Total of Part 4
Add lines 14 through 16. Copy the total to line 83.
$______________________
2:19-bk-00787
Panthera Mission Systems LLC
See continuation sheet
100%
777,781.11
0.00
✔
0.00
777,781.11
777,781.11
Unknown
Unknown
0.00
0.00
0.00
✔
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 4 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 3
Part 5:
Inventory, excluding agriculture assets
18. Does the debtor own any inventory (excluding agriculture assets)?
No. Go to Part 6.
Yes. Fill in the information below.
General description
Date of the last
physical inventory
Net book value of
debtor's interest
(Where available)
Valuation method used
for current value
Current value of
debtor’s interest
19. Raw materials
________________________________________
______________
MM / DD / YYYY
$__________________
______________________
$______________________
20. Work in progress
________________________________________
______________
MM / DD / YYYY
$__________________
______________________
$______________________
21. Finished goods, including goods held for resale
________________________________________
______________
MM / DD / YYYY
$__________________
______________________
$______________________
22. Other inventory or supplies
________________________________________
______________
MM / DD / YYYY
$__________________
______________________
$______________________
23. Total of Part 5
Add lines 19 through 22. Copy the total to line 84.
$______________________
24. Is any of the property listed in Part 5 perishable?
No
Yes
25. Has any of the property listed in Part 5 been purchased within 20 days before the bankruptcy was filed?
No
Yes. Book value _______________ Valuation method____________________ Current value______________
26. Has any of the property listed in Part 5 been appraised by a professional within the last year?
No
Yes
Part 6:
Farming and fishing-related assets (other than titled motor vehicles and land)
27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?
No. Go to Part 7.
Yes. Fill in the information below.
General description
Net book value of
debtor's interest
(Where available)
Valuation method used
for current value
Current value of debtor’s
interest
28. Crops—either planted or harvested
______________________________________________________________
$________________
____________________
$______________________
29. Farm animals Examples: Livestock, poultry, farm-raised fish
______________________________________________________________
$________________
____________________
$______________________
30. Farm machinery and equipment (Other than titled motor vehicles)
______________________________________________________________
$________________
____________________
$______________________
31. Farm and fishing supplies, chemicals, and feed
______________________________________________________________
$________________
____________________
$______________________
32. Other farming and fishing-related property not already listed in Part 6
______________________________________________________________
$________________
____________________
$______________________
2:19-bk-00787
✔
✔
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 5 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 4
33. Total of Part 6.
Add lines 28 through 32. Copy the total to line 85.
$______________________
34. Is the debtor a member of an agricultural cooperative?
No
Yes. Is any of the debtor’s property stored at the cooperative?
No
Yes
35. Has any of the property listed in Part 6 been purchased within 20 days before the bankruptcy was filed?
No
Yes. Book value $_______________ Valuation method ____________________ Current value $________________
36. Is a depreciation schedule available for any of the property listed in Part 6?
No
Yes
37. Has any of the property listed in Part 6 been appraised by a professional within the last year?
No
Yes
Part 7:
Office furniture, fixtures, and equipment; and collectibles
38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?
No. Go to Part 8.
Yes. Fill in the information below.
General description
Net book value of
debtor's interest
(Where available)
Valuation method
used for current value
Current value of debtor’s
interest
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$______________________
39. Office furniture
40. Office fixtures
41. Office equipment, including all computer equipment and
communication systems equipment and software
42. Collectibles Examples: Antiques and figurines; paintings, prints, or other
artwork; books, pictures, or other art objects; china and crystal; stamp, coin,
or baseball card collections; other collections, memorabilia, or collectibles
42.1___________________________________________________________
42.2___________________________________________________________
42.3___________________________________________________________
43. Total of Part 7.
Add lines 39 through 42. Copy the total to line 86.
44. Is a depreciation schedule available for any of the property listed in Part 7?
No
Yes
No
Yes
45.
Has any of the property listed in Part 7 been appraised by a professional within the last year?
2:19-bk-00787
✔
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 6 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 5
Part 8: Machinery, equipment, and vehicles
46. Does the debtor own or lease any machinery, equipment, or vehicles?
No. Go to Part 9.
Yes. Fill in the information below.
General description
Include year, make, model, and identification numbers (i.e., VIN,
HIN, or N-number)
Net book value of
debtor's interest
(Where available)
Valuation method used
for current value
Current value of
debtor’s interest
47. Automobiles, vans, trucks, motorcycles, trailers, and titled farm vehicles
47.1___________________________________________________________
$________________
____________________
$______________________
47.2___________________________________________________________
$________________
____________________
$______________________
47.3___________________________________________________________
$________________
____________________
$______________________
47.4___________________________________________________________
$________________
____________________
$______________________
48. Watercraft, trailers, motors, and related accessories Examples: Boats,
trailers, motors, floating homes, personal watercraft, and fishing vessels
48.1__________________________________________________________
$________________
____________________
$______________________
48.2__________________________________________________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$________________
____________________
$______________________
$______________________
53. Has any of the property listed in Part 8 been appraised by a professional within the last year?
49. Aircraft and accessories
49.1__________________________________________________________
49.2__________________________________________________________
50. Other machinery, fixtures, and equipment
______________________________________________________________
51. Total of Part 8.
Add lines 47 through 50. Copy the total to line 87.
52. Is a depreciation schedule available for any of the property listed in Part 8?
No
Yes
No
Yes
(excluding farm machinery and equipment)
2:19-bk-00787
✔
Purchase Price
900,946.18
38 Modular Office Buildings
✔
900,946.18
900,946.18
Panthera Enterprises, LLC
✔
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 7 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 6
Part 9:
Real property
54. Does the debtor own or lease any real property?
No. Go to Part 10.
Yes. Fill in the information below.
55. Any building, other improved real estate, or land which the debtor owns or in which the debtor has an interest
Description and location of property
Include street address or other description such as
Assessor Parcel Number (APN), and type of property
(for example, acreage, factory, warehouse, apartment
or office building), if available.
Nature and extent
of debtor’s interest
in property
Net book value of
debtor's interest
(Where available)
Valuation method used
for current value
Current value of
debtor’s interest
55.1
$_______________
55.2
$_______________
____________________
$_____________________
55.3
$_______________
____________________
$_____________________
____________________
$_____________________
56. Total of Part 9.
Add the current value on lines 55.1 through 55.6 and entries from any additional sheets. Copy the total to line 88.
$_____________________
57. Is a depreciation schedule available for any of the property listed in Part 9?
No
Yes
58. Has any of the property listed in Part 9 been appraised by a professional within the last year?
No
Yes
Part 10: Intangibles and intellectual property
59. Does the debtor have any interests in intangibles or intellectual property?
No. Go to Part 11.
Yes. Fill in the information below.
General description
Net book value of
debtor's interest
(Where available)
Valuation method
used for current value
Current value of
debtor’s interest
60. Patents, copyrights, trademarks, and trade secrets
______________________________________________________________
$_________________
______________________
$____________________
61. Internet domain names and websites
______________________________________________________________
$_________________
______________________
$____________________
62. Licenses, franchises, and royalties
______________________________________________________________
$_________________
______________________
$____________________
63. Customer lists, mailing lists, or other compilations
______________________________________________________________
$_________________
______________________
$____________________
64. Other intangibles, or intellectual property
______________________________________________________________
$________________
_____________________
$____________________
65. Goodwill
______________________________________________________________
$________________
_____________________
$____________________
66. Total of Part 10.
Add lines 60 through 65. Copy the total to line 89.
$____________________
✔
✔
2:19-bk-00787
✔
2506 Fish Pond Road, Old Fields, West Virginia
26845
Appraisal
15,050,000.00
Panthera Enterprises, LLC
✔
15,050,000.00
Owner
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 8 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 7
67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C. §§ 101(41A) and 107)?
No
Yes
68. Is there an amortization or other similar schedule available for any of the property listed in Part 10?
No
Yes
69. Has any of the property listed in Part 10 been appraised by a professional within the last year?
No
Yes
Part 11: All other assets
70. Does the debtor own any other assets that have not yet been reported on this form?
Include all interests in executory contracts and unexpired leases not previously reported on this form.
No. Go to Part 12.
Yes. Fill in the information below.
Current value of
debtor’s interest
71. Notes receivable
Description (include name of obligor)
______________________________________________________
_______________ – __________________________ =
Total face amount
doubtful or uncollectible amount
$_____________________
72. Tax refunds and unused net operating losses (NOLs)
Description (for example, federal, state, local)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Tax year ___________
Tax year ___________
Tax year ___________
$_____________________
$_____________________
$_____________________
73. Interests in insurance policies or annuities
______________________________________________________________
$_______________________
74. Causes of action against third parties (whether or not a lawsuit
has been filed)
______________________________________________________________
$_______________________
Nature of claim
___________________________________
Amount requested
$________________
75. Other contingent and unliquidated claims or causes of action of
every nature, including counterclaims of the debtor and rights to
set off claims
______________________________________________________________
$_______________________
Nature of claim
___________________________________
Amount requested
$________________
76. Trusts, equitable or future interests in property
______________________________________________________________
$_____________________
77. Other property of any kind not already listed Examples: Season tickets,
country club membership
____________________________________________________________
____________________________________________________________
$_____________________
$_____________________
78. Total of Part 11.
Add lines 71 through 77. Copy the total to line 90.
$_____________________
79. Has any of the property listed in Part 11 been appraised by a professional within the last year?
No
Yes
2:19-bk-00787
✔
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 9 of 46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206A/B
Schedule A/B: Assets Real and Personal Property
page 8
Part 12:
Summary
In Part 12 copy all of the totals from the earlier parts of the form.
Type of property
Current value of
personal property
Current value
of real property
80. Cash, cash equivalents, and financial assets. Copy line 5, Part 1.
$_______________
81. Deposits and prepayments. Copy line 9, Part 2.
$_______________
82. Accounts receivable. Copy line 12, Part 3.
$_______________
83. Investments. Copy line 17, Part 4.
$_______________
84. Inventory. Copy line 23, Part 5.
$_______________
85. Farming and fishing-related assets. Copy line 33, Part 6.
$_______________
86. Office furniture, fixtures, and equipment; and collectibles.
Copy line 43, Part 7.
$_______________
87. Machinery, equipment, and vehicles. Copy line 51, Part 8.
$_______________
88. Real property. Copy line 56, Part 9. . ..................................................................................
$________________
89. Intangibles and intellectual property. Copy line 66, Part 10.
$_______________
90. All other assets. Copy line 78, Part 11.
+
$_______________
91. Total. Add lines 80 through 90 for each column. ........................... 91a.
$_______________ +
91b.
$________________
92. Total of all property on Schedule A/B. Lines 91a + 91b = 92. ...........................................................................................
$__________________
15,050,000.00
0.00
0.00
1,678,827.29
15,050,000.00
16,728,827.29
16,728,827.29
2:19-bk-00787
Panthera Enterprises, LLC
100.00
0.00
777,781.11
0.00
0.00
0.00
0.00
900,946.18
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 10 of
46
Schedule A/B: Property
Debtor 1
_
Case number (if known)
First Name
Middle Name
Last Name
Continuation Sheet for Official Form 206 A/B
Official Form 206 A/B
3) Checking, savings, money market, or financial brokerage accounts
Atlantic Union Bank Checking 7398
Balance: 0.00
Atlantic Union Bank Checking 7372
Balance: 0.00
15) Non-publicly traded stock and interests in incorporated and unincorporated businesses,
including any interest in an LLC, partnership, or joint venture
Panthera Worldwide 100%% Unknown
LLC
Panthera Training 80%% Unknown
Center LLC
Panthera Enterprises, LLC
2:19-bk-00787
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46
Official Form 206D
Schedule D: Creditors Who Have Claims Secured by Property
page 1 of ___
Official Form 206D
Schedule D: Creditors Who Have Claims Secured by Property
12/15
Be as complete and accurate as possible.
1. Do any creditors have claims secured by debtor’s property?
No. Check this box and submit page 1 of this form to the court with debtor’s other schedules. Debtor has nothing else to report on this form.
Yes. Fill in all of the information below.
Part 1:
List Creditors Who Have Secured Claims
2. List in alphabetical order all creditors who have secured claims. If a creditor has more than one
secured claim, list the creditor separately for each claim.
Column A
Amount of claim
Do not deduct the value
of collateral.
Column B
Value of collateral
that supports this
claim
2.1 Creditor’s name
Describe debtor’s property that is subject to a lien
$__________________
$_________________
__________________________________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Creditor’s email address, if known
_________________________________________
No
Yes
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
Do multiple creditors have an interest in the
same property?
No
Yes. Specify each creditor, including this creditor,
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
2.2 Creditor’s name
Describe debtor’s property that is subject to a lien
__________________________________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Creditor’s email address, if known
_________________________________________
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Do multiple creditors have an interest in the
same property?
No
Yes. Have you already specified the relative
priority?
No. Specify each creditor, including this
creditor, and its relative priority.
3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional
$________________
Debtor name __________________________________________________________________
United States Bankruptcy Court for the: _______________________________________
Case number (If known):
_________________________
Fill in this information to identify the case:
Check if this is an
amended filing
Describe the lien
_________________________________________________
Is the creditor an insider or related party?
Page, if any.
Yes. The relative priority of creditors is
specified on lines _____
$__________________
$_________________
No
Yes
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
Describe the lien
_________________________________________________
Is the creditor an insider or related party?
15,050,000.00
15,050,000.00
2.1
Judgment
John Good
Note/Mortgage
79 Hyde Street
2:19-bk-00787
JGood@Schockeycompanies.com
✔
✔
Moorefield, WV 26836
P.O. Box 2530, Winchester, VA 22604
8,857,337.39
Central Tie & Lumber, Co., 1st;
Sheriff of Hardy County, 1st; John B.
M C
k
1 t W
t Vi
i i
2506 Fish Pond Road, Old Fields, West
Virginia 26845
2506 Fish Pond Road, Old Fields, West
Virginia 26845
1,700,541.59
3,177.16
✔
✔
Panthera Enterprises, LLC
Northern District of West Virginia
Howard Shockey & Sons, Inc.
Central Tie & Lumber, Co.
✔
4
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 12 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206D
Additional Page of Schedule D: Creditors Who Have Claims Secured by Property
page ___ of ___
Part 1:
Additional Page
Column A
Amount of claim
Do not deduct the value
of collateral.
Column B
Value of collateral
that supports this
claim
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page.
2.__ Creditor’s name
Describe debtor’s property that is subject to a lien
__________________________________________
$__________________
$_________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Creditor’s email address, if known
_________________________________________
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Do multiple creditors have an interest in the
same property?
No
Yes. Have you already specified the relative
priority?
No. Specify each creditor, including this
creditor, and its relative priority.
Yes. The relative priority of creditors is
specified on lines _____
2.__ Creditor’s name
Describe debtor’s property that is subject to a lien
__________________________________________
$__________________
$_________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Describe the lien
__________________________________________________
Creditor’s email address, if known
_________________________________________
Is the creditor an insider or related party?
No
Yes
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
Do multiple creditors have an interest in the
same property?
No
Yes. Have you already specified the relative
priority?
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
No. Specify each creditor, including this
creditor, and its relative priority.
Yes. The relative priority of creditors is
specified on lines _____
Describe the lien
__________________________________________________
Is the creditor an insider or related party?
No
Yes
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
✔
✔
15,050,000.00
15,050,000.00
2.1
2.1
PO Box 643
1900 Kanawha Blvd. East
2017 Tax Lien
Tax Lien
2:19-bk-00787
✔
✔
Building 1, Room W-100, Charleston, WV 2
Moorefield, WV 26836
2017, 2018, 20
2017
4
3
2506 Fish Pond Road, Old Fields, West
Virginia 26845
2506 Fish Pond Road, Old Fields, West
Virginia 26845
79,145.56
Undetermined
2
✔
✔
Panthera Enterprises, LLC
Sheriff of Hardy County
John B. McCuskey
■
✔
4
19
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 13 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206D
Additional Page of Schedule D: Creditors Who Have Claims Secured by Property
page ___ of ___
Part 1:
Additional Page
Column A
Amount of claim
Do not deduct the value
of collateral.
Column B
Value of collateral
that supports this
claim
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page.
2.__ Creditor’s name
Describe debtor’s property that is subject to a lien
__________________________________________
$__________________
$_________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Creditor’s email address, if known
_________________________________________
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Do multiple creditors have an interest in the
same property?
No
Yes. Have you already specified the relative
priority?
No. Specify each creditor, including this
creditor, and its relative priority.
Yes. The relative priority of creditors is
specified on lines _____
2.__ Creditor’s name
Describe debtor’s property that is subject to a lien
__________________________________________
$__________________
$_________________
Creditor’s mailing address
________________________________________________________
________________________________________________________
Describe the lien
__________________________________________________
Creditor’s email address, if known
_________________________________________
Is the creditor an insider or related party?
No
Yes
Date debt was incurred
__________________
Last 4 digits of account
number
_________________
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
Do multiple creditors have an interest in the
same property?
No
Yes. Have you already specified the relative
priority?
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
No. Specify each creditor, including this
creditor, and its relative priority.
Yes. The relative priority of creditors is
specified on lines _____
Describe the lien
__________________________________________________
Is the creditor an insider or related party?
No
Yes
Is anyone else liable on this claim?
No
Yes. Fill out Schedule H: Codebtors (Official Form 206H).
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
✔
✔
15,050,000.00
15,050,000.00
2.1
2.1
2950 Charles Avenue
180 Association Drive
Mortgage
Judgment
2:19-bk-00787
steven.j.webb@wv.gov
✔
✔
NorthGate Business Park, Charleston, WV
Dunbar, WV 25064
6
5
2506 Fish Pond Road, Old Fields, West
Virginia 26845
2506 Fish Pond Road, Old Fields, West
Virginia 26845
640,863.70
6,433,609.38
3
✔
✔
Panthera Enterprises, LLC
West Virginia Paving, Inc.
West Virginia Economic Development
Authority
■
✔
4
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 14 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Form 206D
Official Part 2 of Schedule D: Creditors Who Have Claims Secured by Property
page ___ of ___
Part 2:
List Others to Be Notified for a Debt Already Listed in Part 1
List in alphabetical order any others who must be notified for a debt already listed in Part 1. Examples of entities that may be listed are collection
agencies, assignees of claims listed above, and attorneys for secured creditors.
If no others need to be notified for the debts listed in Part 1, do not fill out or submit this page. If additional pages are needed, copy this page.
Name and address
On which line in Part 1
did you enter the
related creditor?
Last 4 digits of
account number
for this entity
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Line 2. __
_________________
Panthera Enterprises, LLC
4
4
2:19-bk-00787
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 15 of
46
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page 1 of ___
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
12/15
Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY
unsecured 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: Assets - Real and Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases
(Official Form 206G). Number the entries in Parts 1 and 2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach
the Additional Page of that Part included in this form.
Part 1: List All Creditors w ith PRIORITY Unsecured Claims
1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507).
No. Go to Part 2.
Yes. Go to line 2.
2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than
3 creditors with priority unsecured claims, fill out and attach the Additional Page of Part 1.
Total claim
Priority amount
2.1
As of the petition filing date, the claim is:
Check all that apply.
$______________________
$_________________
Contingent
Unliquidated
Disputed
Basis for the claim:
Priority creditor’s name and mailing address
Date or dates debt was incurred
_________________________________
Last 4 digits of account
number
_______________________
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
2.2
As of the petition filing date, the claim is:
Check all that apply.
$______________________
$_________________
Contingent
Unliquidated
Disputed
Basis for the claim:
2.3
As of the petition filing date, the claim is:
Check all that apply.
$______________________
$_________________
Contingent
Unliquidated
Disputed
Basis for the claim:
Debtor
__________________________________________________________________
United States Bankruptcy Court for the: ________________________________
Case number
___________________________________________
(If known)
Fill in this information to identify the case:
Check if this is an
amended filing
Is the claim subject to offset?
No
Yes
Is the claim subject to offset?
No
Yes
Is the claim subject to offset?
No
Yes
Priority creditor’s name and mailing address
Date or dates debt was incurred
_________________________________
Last 4 digits of account
number
_______________________
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
Priority creditor’s name and mailing address
Date or dates debt was incurred
_________________________________
Last 4 digits of account
number
_______________________
Specify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
Panthera Enterprises, LLC
9
2:19-bk-00787
✔
Northern District of West Virginia
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 16 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: List All Creditors w ith NONPRIORITY Unsecured Claims
3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority
Amount of claim
3.1
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
unsecured claims, fill out and attach the Additional Page of Part 2.
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
3.2
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Is the claim subject to offset?
3.3
As of the petition filing date, the claim is:
Check all that apply.
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
3.4
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Is the claim subject to offset?
No
Yes
3.5
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Is the claim subject to offset?
3.6
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Is the claim subject to offset?
No
Yes
Basis for the claim:
Is the claim subject to offset?
Is the claim subject to offset?
Basis for the claim:
Basis for the claim:
Contingent
Unliquidated
Disputed
No
Yes
Basis for the claim:
Basis for the claim:
No
Yes
Basis for the claim:
No
Yes
No
Yes
Arthur J. Gallagher & Co.
4000 Midlantic Drive
Suite 200
Mount Laurel, NJ, 08054
9
ARB Investments Company, LLC
109 Floral Vale Blvd.
Morrisville, PA, 19067
Anthony McIntyre
4000 Midlantic Drive
Suite 200
Mount Laurel, NJ, 08054
ADP, LLC
1851 N. Resler Drive
El Paso, TX, 79912
A.L.L. Construction, Inc.
P.O. Box 232
Mount Storm, WV, 26739
714,842.20
106.24
1,580,000.00
4,050.00
174,879.04
6,013.90
Monies Loaned / Advanced
Services
Monies Loaned / Advanced
2:19-bk-00787
Insurance
Bank Fees
2
✔
✔
✔
✔
✔
✔
Panthera Enterprises, LLC
Atlantic Union Bank
1800 Robert Fulton Drive
Suite 310
Reston, VA, 20191
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 17 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
224,657.00
690,830.90
18,000.00
2:19-bk-00787
✔
✔
Sale Contract
Monies Loaned / Advanced
10
3
11
Bureau of Alcohol Tobacco & Firearms
C2 Logistics USA LLC/Candy Group
9040 Town Centre Parkway
Bradenton, FL, 34202
500.00
2,500.00
✔
✔
✔
9
8
7
Panthera Enterprises, LLC
Brian Riso
138 Woodridge Drive
Morehead City, NC, 28557
Bill Neff Enterprises
3570 North Valley Pike
Harrisonburg, VA, 22802
Azadian Group, LLC
600 Madison Avenue
18th Floor
New York, NY, 10022
✔
P.O. Box 6200-20
Portland, OR 97228-6200
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 18 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
2,500.00
21,247.85
379,231.20
2:19-bk-00787
✔
✔
Services
Services
15
4
16
James Michael Dowty
1477 Seaside Circle
Gulf Breeze, FL, 32566
James Punelli
11654 Plaza America Drive
#320
Reston, VA, 20190
Monies Loaned / Advanced
122,036.11
2,582,637.31
✔
✔
✔
14
13
12
Panthera Enterprises, LLC
Duncan Development Group, LLC
420 Park Street
Charlottesville, VA, 22902
Dinsmore & Shohl, LLP
Accounts Receivable
PO Box 639038
Cincinnati, OH, 45263
Department of State
401 Federal St #4
Dover, DE 19901
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 19 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
4,592.00
1,500.00
2,367.25
2:19-bk-00787
✔
✔
Rent
Services
20
5
21
Michael L. Cranston, CPA, Ltd.
4085 Chain Bridge Road
Suite 400
Fairfax, VA, 22030
Midtown Resources
1518 Walnut Street
Suite 1400
Philadelphia, PA, 19102
Services
54,973.41
273,741.06
✔
✔
✔
19
18
17
Panthera Enterprises, LLC
McGrath & Spielberger, PLLC
6201 Fairview Road
Suite 330
Charlotte, NC, 28210
Live Oaks Consultants, LLC
PO Box 1010
Hampstead, NC, 28443
Leesburg Junction
215 Depot Court SE
Leesburg, VA, 20175
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 20 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
11,525.00
47,806.12
103,580.68
2:19-bk-00787
✔
✔
Services
Services
Monies Loaned / Advanced
25
6
26
Raymond Jones
43787 Bent Creek Terrace
Leesburg, VA, 20176
SMI, LLC
c/o Timothy Kelsey
123 East Main Street, 5th Floor
Charlottesville, VA, 22902
Monies Loaned / Advanced
3,258,323.18
529,199.00
✔
✔
✔
24
23
22
Panthera Enterprises, LLC
Raymond Barbic
26098 Huntwick Glen Square
Aldie, VA, 20105
Parker, Ostovic & Associates
1940 Duke Street
Suite 200
Alexandria, VA, 22314
n8 Consulting LLC
PO Box 651163
Sterling, VA, 20165
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 21 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
31,113.70
5,643.73
3,875.00
2:19-bk-00787
✔
✔
Services
Services
30
7
31
State of West Virginia/State Tax Dept.
397 Mid-Atlantic Pkwy
Suite 2
Martinsburg, WV, 25401
Stratos & Associates, PLLC
8322-A Traford Lane
Springfield, VA, 225152
Income Taxes
170,113.44
3,000.00
✔
✔
✔
29
28
27
Panthera Enterprises, LLC
State of Delaware
Squadron Defense Group
PO Box 1381
Sterling, VA, 20167
Sprectrum Consulting, LLC
11 Canal Center Plaza
Suite 300
Alexandria, VA, 22314
401 Federal St #4
Dover, DE 19901
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 22 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 2: Additional Page
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
Amount of claim
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
Is the claim subject to offset?
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
__________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
___________________
___________________
Basis for the claim:
No
Yes
3.___
As of the petition filing date, the claim is:
Check all that apply.
Contingent
Unliquidated
Disputed
$________________________________
Nonpriority creditor’s name and mailing address
Date or dates debt was incurred
Last 4 digits of account number
____________________
___________________
Basis for the claim:
No
Yes
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
Is the claim subject to offset?
9
4,775.00
151,500.00
26,169.94
2:19-bk-00787
✔
Construction Materials
Monies Loaned / Advanced
Insurance
35
8
Unity Technology Corporation
3001 Ward Kline Road
Myersville, MD, 21773
Services
96,957.48
✔
✔
✔
34
33
32
Panthera Enterprises, LLC
United Health Care
185 Asylum Street
Hartford, CT, 06103
Tim Miller
440 Premier Circle
Suite 200
Charlottesville, VA, 22901
✔
The U Company
453 Mae West Road
Confluence, PA, 15424
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 23 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206E/F
Schedule E/F: Creditors Who Have Unsecured Claims
page __ of ___
Part 4:
Total Amounts of the Priority and Nonpriority Unsecured Claims
5. Add the amounts of priority and nonpriority unsecured claims.
Total of claim amounts
5a. Total claims from Part 1
5a.
$_____________________________
5b. Total claims from Part 2
5b.
+
$_____________________________
5c. Total of Parts 1 and 2
Lines 5a + 5b = 5c.
5c.
$_____________________________
9
11,304,787.74
11,304,787.74
0.00
Panthera Enterprises, LLC
2:19-bk-00787
9
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 24 of
46
Official Form 206G
Schedule G: Executory Contracts and Unexpired Leases
page 1 of ___
Official Form 206G
Schedule G: Executory Contracts and Unexpired Leases
12/15
Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, numbering the entries consecutively.
1. Does the debtor have any executory contracts or unexpired leases?
No. Check this box and file this form with the court with the debtor’s other schedules. There is nothing else to report on this form.
Yes. Fill in all of the information below even if the contracts or leases are listed on Schedule A/B: Assets - Real and Personal Property (Official
Form 206A/B).
2. List all contracts and unexpired leases
State the name and mailing address for all other parties with
whom the debtor has an executory contract or unexpired lease
2.1
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.2
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.3
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.4
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.5
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
Debtor name __________________________________________________________________
United States Bankruptcy Court for the:______________________
Case number (If known):
_________________________
Chapter _____
Fill in this information to identify the case:
Check if this is an
amended filing
Panthera Enterprises, LLC
2
Expires 09/10/2023
15DDHQ18A00000027
Drug Enforcement Administration
Attn: Office of Acq. & Relo Mgmt (FA)
8701 Morrisette Drive
Springfield, VA, 22152
Panthera Training LLC
2464 Plantation Creek
Cape Charles, VA, 23310
Unity Small Business Consortium
5350-A Partners Court
Frederick, MD, 21703
SMI, LLC, c/o Timothy Kelsey
Woods Rogers PLC
123 E. Main Street, 5th Floor
Charlottesville, VA, 22902
Panthera Training LLC
2506 Fish Pond Road
Old Fields, WV, 26845
Subcontract
Timber Agreement
Small Business Consortium
License Agreement
Contract to Provide Training
11
2:19-bk-00787
Northern District of West Virginia
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 25 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 206G
Schedule G: Executory Contracts and Unexpired Leases
page ___ of ___
Additional Page if Debtor Has More Executory Contracts or Unexpired Leases
Copy this page only if more space is needed. Continue numbering the lines sequentially from the previous page.
List all contracts and unexpired leases
State the name and mailing address for all other parties with
whom the debtor has an executory contract or unexpired lease
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number o
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
2.____
State what the contract or
lease is for and the nature
of the debtor’s interest
State the term remaining
List the contract number of
any government contract
Panthera Enterprises, LLC
10
11
12
2
2
6
7
8
9
Indefinite
Amira Security Systems Inc.
Marfaa' 127 Building
Foch Street
Beirut, Lebanon
11 years
Through 07/23/2023
South Branch Inn
1500 YS Hwy 220 North
Moorefield, WV, 26836
Bill Neff Enterprises
3570 North Valley Pike
Harrisonburg, VA, 22802
6 years
Renick C. Williams and Betty P. Williams
PO Box 664
Moorefield, WV, 26836
Indefinite
Real Estate Sales Agreement
Sales Contract
Purchaser
Covenant & Agreement
Joint Venture Agreement
2:19-bk-00787
Joint Venture Agreement
Covenant & Agreement
South Branch Inn
1500 US Hwy 220 North
Moorefield, WV, 26836
Facility Lease Agreement
Lessor
MRW, Inc.
c/o Robert R. Williams
PO Box 122
Moorefield, WV, 26836
Panthera Training LLC
2464 Plantation Creek Lane
Cape Charles, VA, 23310
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 26 of
46
Official Form 206H
Schedule H: Codebtors
page 1 of ___
Official Form 206H
Schedule H: Codebtors
12/15
Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach
the Additional Page to this page.
1. Does the debtor have any codebtors?
No. Check this box and submit this form to the court with the debtor's other schedules. Nothing else needs to be reported on this form.
Yes
2. In Column 1, list as codebtors all of the people or entities who are also liable for any debts listed by the debtor in the schedules of
creditors, Schedules D-G. Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each
schedule on which the creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.
Column 1: Codebtor
Column 2: Creditor
Name
Name
Check all schedules
that apply:
2.1
Mailing address
_____________________
D
E/F
G
2.2
_____________________
D
E/F
G
2.3
_____________________
D
E/F
G
2.4
_____________________
D
E/F
G
2.5
_____________________
D
E/F
G
2.6
_____________________
D
E/F
G
Debtor name __________________________________________________________________
United States Bankruptcy Court for the:_______________________________
Case number (If known):
_________________________
Fill in this information to identify the case:
Check if this is an
amended filing
Panthera Enterprises, LLC
1
✔
2:19-bk-00787
Northern District of West Virginia
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 27 of
46
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 1
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
04/19
The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,
write the debtor’s name and case number (if known).
Part 1:
Income
1. Gross revenue from business
None
Identify the beginning and ending dates of the debtor’s fiscal year, which
may be a calendar year
Sources of revenue
Check all that apply
From the beginning of the
fiscal year to filing date:
From ___________
to
Filing date
MM / DD / YYYY
For prior year:
From ___________
to
___________
MM / DD / YYYY
MM / DD / YYYY
For the year before that:
From ___________
to
___________
MM / DD / YYYY
MM / DD / YYYY
Gross revenue
(before deductions and
exclusions)
$_____________________
$_____________________
$_____________________
2. Non-business revenue
Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected
from lawsuits, and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.
None
Description of sources of revenue
Gross revenue from each
source
(before deductions and
exclusions)
From the beginning of the
fiscal year to filing date:
From ___________
to
Filing date
MM / DD / YYYY
___________________________
$__________________
For prior year:
From ___________
to
___________
MM / DD / YYYY
MM / DD / YYYY
___________________________
$__________________
For the year before that:
From ___________
to
___________
MM / DD / YYYY
MM / DD / YYYY
___________________________
$__________________
Check if this is an
amended filing
Debtor name __________________________________________________________________
United States Bankruptcy Court for the: ______________________ District of _________
(State)
Case number (If known):
_________________________
Fill in this information to identify the case:
Operating a business
Operating a business
Operating a business
Other
Other
Other
✔
2:19-bk-00787
1,507,998.00
1,770,957.00
Panthera Enterprises, LLC
01/01/2018
01/01/2019
12/31/2018
✔
✔
Northern District of West Virginia
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 28 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 2
Part 2:
List Certain Transfers Made Before Filing for Bankruptcy
3. Certain payments or transfers to creditors within 90 days before filing this case
List payments or transfersincluding expense reimbursementsto any creditor, other than regular employee compensation, within 90
days before filing this case unless the aggregate value of all property transferred to that creditor is less than $6,825. (This amount may be
adjusted on 4/01/22 and every 3 years after that with respect to cases filed on or after the date of adjustment.)
None
Dates
Total amount or value
Reasons for payment or transfer
Check all that apply
3.1.
________
________
________
$_________________
Secured debt
Unsecured loan repayments
Suppliers or vendors
Services
Other _______________________________
3.2.
Creditor’s name and address
__________________________________________
Creditor’s name
__________________________________________
Creditor’s name
________
________
________
$_________________
Secured debt
Unsecured loan repayments
Suppliers or vendors
Services
Other _______________________________
4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider
List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or
guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than
$6,825. (This amount may be adjusted on 4/01/22 and every 3 years after that with respect to cases filed on or after the date of adjustment.)
Do not include any payments listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their
relatives; general partners of a partnership debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and any managing
agent of the debtor. 11 U.S.C. § 101(31).
None
Dates
Total amount or value
Reasons for payment or transfer
4.1.
_________
_________
_________
$__________________
4.2.
Insider’s name and address
__________________________________________
Insider’s name
Relationship to debtor
__________________________________________
__________________________________________
Insider’s name
_________
_________
_________
$__________________
Relationship to debtor
__________________________________________
97,782.94
217,464.00
2:19-bk-00787
Iron Horse Consulting, LLC
Panthera Training Center LLC
Raymond Jones
James V. Punelli
2,500.00
5,000.00
Panthera Enterprises, LLC
43787 Bent Creek Ter
Leesburg, VA 20176
215 Depot Court SE
Leesburg, VA 20175
✔
✔
2506 Fish Pond Road
Old Fields, WV 26845
344 Maple Ave. West
Suite 265
Vienna, VA 22180
6/28/19
8/12/19
6/28/19
Garnishment
9/24/18
Reimbursement of Travel Expenses
10/19/18
Reimbursement of Travel Expenses
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 29 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 3
5. Repossessions, foreclosures, and returns
List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor,
sold at a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6.
None
Creditor’s name and address
Description of the property
Date
Value of property
5.1.
______________
$___________
5.2.
__________________________________________
Creditor’s name
__________________________________________
Creditor’s name
_______________
$___________
6. Setoffs
List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account of
the debtor without permission or refused to make a payment at the debtor’s direction from an account of the debtor because the debtor owed a debt.
None
Creditor’s name and address
Description of the action creditor took
Date action was
taken
Amount
__________________________________________
Creditor’s name
_______________
$___________
Last 4 digits of account number: XXXX– ________
Part 3: Legal Actions or Assignments
7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits
List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor
was involved in any capacity—within 1 year before filing this case.
None
7.1.
Case title
Nature of case
Court or agency’s name and address
Status of case
Pending
On appeal
Concluded
Case number
_________________________________
7.2.
Case title
Court or agency’s name and address
Pending
On appeal
Concluded
Case number
_________________________________
2:19-bk-00787
West Virginia Paving, Inc. v. Panthera
Enterprises, f/k/a TenX Group, LLC
Azadian Group LLC v. TenX Group
LLC
Panthera Enterprises, LLC
Alleged Breach of Contract
Garnishment Summons
Charlottesville, VA
✔
Circuit Court of Charlottesville, Virginia
Superior Court of Delaware
✔
✔
N19C-04-235 CLS
CL19-267
✔
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 30 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 4
8. Assignments and receivership
List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the
hands of a receiver, custodian, or other court-appointed officer within 1 year before filing this case.
None
Custodian’s name and address
Description of the property
Value
__________________________________________
Custodian’s name
______________________________________
$_____________
Case title
Court name and address
______________________________________
__________________________________________
Name
Case number
______________________________________
Date of order or assignment
______________________________________
Part 4:
Certain Gifts and Charitable Contributions
9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value
of the gifts to that recipient is less than $1,000
None
9.1.
Recipient’s name and address
Description of the gifts or contributions
Dates given
Value
__________________________________________
Recipient’s name
_________________
$__________
Recipient’s relationship to debtor
__________________________________________
9.2. __________________________________________
Recipient’s name
_________________
$__________
Recipient’s relationship to debtor
__________________________________________
Part 5:
Certain Losses
10. All losses from fire, theft, or other casualty within 1 year before filing this case.
None
Description of the property lost and how the loss
occurred
Amount of payments received for the loss
If you have received payments to cover the loss, for
example, from insurance, government compensation, or
tort liability, list the total received.
List unpaid claims on Official Form 106A/B (Schedule A/B:
Assets – Real and Personal Property).
Date of loss
Value of property
lost
___________________________________________
_________________
$__________
✔
2:19-bk-00787
✔
Panthera Enterprises, LLC
✔
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 31 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 5
Part 6:
Certain Payments or Transfers
11. Payments related to bankruptcy
List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before
the filing of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring,
seeking bankruptcy relief, or filing a bankruptcy case.
None
Who was paid or who received the transfer?
If not money, describe any property transferred
Dates
Total amount or
value
11.1.
______________
$_________
If not money, describe any property transferred
Dates
Total amount or
value
11.2.
______________
$_________
__________________________________________
Address
Email or website address
_________________________________
Who made the payment, if not debtor?
__________________________________________
Who was paid or who received the transfer?
__________________________________________
Address
Email or website address
__________________________________________
Who made the payment, if not debtor?
__________________________________________
12. Self-settled trusts of which the debtor is a beneficiary
List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case to
a self-settled trust or similar device.
Do not include transfers already listed on this statement.
None
Name of trust or device
Describe any property transferred
Dates transfers
were made
Total amount or
value
__________________________________________
______________
$_________
Trustee
__________________________________________
2:19-bk-00787
✔
Panthera Enterprises, LLC
✔
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 32 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 6
13. Transfers not already listed on this statement
List any transfers of money or other propertyby sale, trade, or any other meansmade by the debtor or a person acting on behalf of the debtor
within 2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs.
Include both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.
None
Who received transfer?
Description of property transferred or payments received
or debts paid in exchange
Date transfer
was made
Total amount or
value
13.1.
________________
$_________
________________
$_________
13.2.
__________________________________________
Address
Relationship to debtor
__________________________________________
Who received transfer?
__________________________________________
Address
Relationship to debtor
__________________________________________
Part 7:
Previous Locations
14. Previous addresses
List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.
Does not apply
Address
Dates of occupancy
14.1.
From
____________
To
____________
14.2.
From
____________
To
____________
2:19-bk-00787
✔
✔
Panthera Enterprises, LLC
No. 2:19-bk-00787 Doc 23 Filed 09/27/19 Entered 09/27/19 13:48:04 Page 33 of
46
Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 7
Part 8:
Health Care Bankruptcies
15. Health Care bankruptcies
Is the debtor primarily engaged in offering services and facilities for:
diagnosing or treating injury, deformity, or disease, or
providing any surgical, psychiatric, drug treatment, or obstetric care?
No. Go to Part 9.
Yes. Fill in the information below.
Facility name and address
If debtor provides meals
and housing, number of
patients in debtor’s care
15.1.
____________________
How are records kept?
Nature of the business operation, including type of services the
debtor provides
Location where patient records are maintained (if different from facility
address). If electronic, identify any service provider.
Check all that apply:
Electronically
Paper
If debtor provides meals
and housing, number of
patients in debtor’s care
15.2.
________________________________________
Facility name
Facility name and address
________________________________________
Facility name
____________________
How are records kept?
Nature of the business operation, including type of services the
debtor provides
Location where patient records are maintained (if different from facility
address). If electronic, identify any service provider.
Check all that apply:
Electronically
Paper
Part 9:
Personally Identifiable Information
16. Does the debtor collect and retain personally identifiable information of customers?
No.
Yes. State the nature of the information collected and retained. ___________________________________________________________________
Does the debtor have a privacy policy about that information?
No
Yes
17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other
pension or profit-sharing plan made available by the debtor as an employee benefit?
No. Go to Part 10.
Yes. Does the debtor serve as plan administrator?
No. Go to Part 10.
Yes. Fill in below:
Name of plan
_______________________________________________________________________
Employer identification number of the plan
EIN: ___________________________________
Has the plan been terminated?
No
Yes
2:19-bk-00787
✔
✔
Panthera Enterprises, LLC
✔
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 8
Part 10:
Certain Financial Accounts, Safe Deposit Boxes, and Storage Units
18. Closed financial accounts
Within 1 year before filing this case, were any financial accounts or instruments held in the debtor’s name, or for the debtor’s benefit, closed, sold,
moved, or transferred?
Include checking, savings, money market, or other financial accounts; certificates of deposit; and shares in banks, credit unions,
brokerage houses, cooperatives, associations, and other financial institutions.
None
Last 4 digits of account
number
Type of account
Date account was
closed, sold, moved,
or transferred
Last balance
before closing or
transfer
18.1.
XXXX–__________
Checking
Savings
Money market
Brokerage
Other______________
___________________
$__________
18.2.
Financial institution name and address
______________________________________
Name
______________________________________
Name
XXXX–__________
Checking
Savings
Money market
Brokerage
Other______________
___________________
$__________
19. Safe deposit boxes
List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this case.
None
Names of anyone with access to it
Description of the contents
Does debtor
still have it?
Depository institution name and address
______________________________________
Name
No
Yes
Address
20. Off-premises storage
List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in
which the debtor does business.
None
Facility name and address
Names of anyone with access to it
Description of the contents
Does debtor
still have it?
______________________________________
Name
No
Yes
Address
✔
2:19-bk-00787
✔
7815 Woodmont Avenue
Bethesda, MD 20814
0.00
12/31/2018
2253
Panthera Enterprises, LLC
✔
Eagle Bank
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 9
Part 11:
Property the Debtor Holds or Controls That the Debtor Does Not Own
21. Property held for another
List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in
trust. Do not list leased or rented property.
None
Owner’s name and address
Location of the property
Value
______________________________________
Name
Description of the property
$_________
Part 12:
Details About Environmental Information
For the purpose of Part 12, the following definitions apply:
Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material,
regardless of the medium affected (air, land, water, or any other medium).
Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor
formerly owned, operated, or utilized.
Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant,
or a similarly harmful substance.
Report all notices, releases, and proceedings known, regardless of when they occurred.
22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.
No
Yes. Provide details below.
Case title
Status of case
_________________________________
Court or agency name and address
_____________________________________
Name
Nature of the case
Pending
On appeal
Concluded
Case number
_________________________________
23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an
environmental law?
No
Yes. Provide details below.
Site name and address
Date of notice
__________________________________
Name
Governmental unit name and address
_____________________________________
Name
Environmental law, if known
__________
2:19-bk-00787
Panthera Enterprises, LLC
✔
✔
✔
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 10
24. Has the debtor notified any governmental unit of any release of hazardous material?
No
Yes. Provide details below.
Site name and address
Date of notice
__________________________________
Name
Governmental unit name and address
______________________________________
Name
Environmental law, if known
__________
Part 13:
Details About the Debtor’s Business or Connections to Any Business
25. Other businesses in which the debtor has or has had an interest
List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.
Include this information even if already listed in the Schedules.
None
25.1.
Employer Identification number
Do not include Social Security number or ITIN.
EIN: ________________________
Dates business existed
From ___________
To ____________
25.2.
Employer Identification number
Do not include Social Security number or ITIN.
EIN: ________________________
Dates business existed
25.3.
Business name and address
__________________________________
Name
Business name and address
__________________________________
Name
Business name and address
__________________________________
Name
Describe the nature of the business
Describe the nature of the business
Describe the nature of the business
Employer Identification number
Do not include Social Security number or ITIN.
EIN: ________________________
Dates business existed
From ___________
To ____________
From ___________
To ____________
2:19-bk-00787
Panthera Enterprises, LLC
2506 Fish Pond Road
Old Fields, WV 26845
✔
Panthera Training Center LLC
Panthera Worldwide LLC
Panthera Mission Systems LLC
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 11
26. Books, records, and financial statements
26a. List all accountants and bookkeepers who maintained the debtor’s books and records within 2 years before filing this case.
None
Dates of service
26a.1.
From _______
To _______
Dates of service
26a.2.
Name and address
__________________________________________________________________________________
Name
Name and address
__________________________________________________________________________________
Name
From _______
To _______
26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of account and records or prepared a financial
statement within 2 years before filing this case.
None
Name and address
Dates of service
26b.1.
From _______
To _______
Dates of service
26b.2.
From _______
To _______
______________________________________________________________________________
Name
Name and address
______________________________________________________________________________
Name
26c. List all firms or individuals who were in possession of the debtor’s books of account and records when this case is filed.
None
Name and address
26c.1.
______________________________________________________________________________
Name
If any books of account and records are
unavailable, explain why
James Punelli
2:19-bk-00787
Raymond Barbic
James Punelli
05/01/2018
09/13/2019
05/01/2018
05/01/2018
09/13/2019
09/13/2019
Panthera Enterprises, LLC
11654 Plaza America Drive, #320, Reston, VA 20190
43787 Bent Neck Terrace, Leesburg, VA 20176
Raymond Jones
James Punelli
11654 Plaza America Drive, #320, Reston, VA 20190
05/01/2018
11654 Plaza America Drive, Reston, VA 20190
29098 Huntwick Glen Square, Aldie, VA 20105
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 12
26c.2.
If any books of account and records are
unavailable, explain why
Name and address
______________________________________________________________________________
Name
26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial statement
within 2 years before filing this case.
None
26d.1.
26d.2.
Name and address
______________________________________________________________________________
Name
Name and address
______________________________________________________________________________
Name
27. Inventories
Have any inventories of the debtor’s property been taken within 2 years before filing this case?
No
Yes. Give the details about the two most recent inventories.
Name of the person who supervised the taking of the inventory
Date of
inventory
The dollar amount and basis (cost, market, or
other basis) of each inventory
______________________________________________________________________
_______
$___________________
27.1.
Name and address of the person who has possession of inventory records
______________________________________________________________________
Name
2:19-bk-00787
Raymond Jones
Panthera Enterprises, LLC
✔
✔
43787 Bent Neck Terrace, Leesburg, VA 20176
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 13
Name of the person who supervised the taking of the inventory
Date of
inventory
The dollar amount and basis (cost, market, or
other basis) of each inventory
______________________________________________________________________
_______
$___________________
27.2.
Name and address of the person who has possession of inventory records
______________________________________________________________________
Name
Yes. Identify below.
Address
30.1.
_________________________
_____________
_____________
_____________
______________________________________________________________
Name
Relationship to debtor
_____________
______________________________________________________________
_____________
Position and nature of any
interest
28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other
people in control of the debtor at the time of the filing of this case.
Name
% of interest, if any
Address
Position and nature of any interest
29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in
control of the debtor, or shareholders in control of the debtor who no longer hold these positions?
No
Period during which position
or interest was held
Name
30.
Payments, distributions, or withdrawals credited or given to insiders
Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws,
bonuses, loans, credits on loans, stock redemptions, and options exercised?
No
Yes. Identify below.
Name and address of recipient
Amount of money or description
and value of property
Dates
Reason for providing
the value
_________ To _________
_________ To _________
_________ To _________
_________ To _________
2:19-bk-00787
Managing Member
50%
50%
5,000.00
✔
✔
Panthera Enterprises, LLC
Managing Member
Managing Member
43787 Ben Creek Ter, Leesburg, VA 20176
11654 Plaza America Drive #320, Reston, VA 20190
James Punelli
Raymond Jones
James Punelli
11654 Plaza America Drive #320
Reston, VA
9/24/2018
Travel Expenses
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Debtor
_______________________________________________________
Case number (if known)_____________________________________
Name
Official Form 207
Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy
page 14
__________________________
_____________
30.2
_____________
_____________
_____________
_____________
Name and address of recipient
______________________________________________________________
Name
Relationship to debtor
______________________________________________________________
31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?
No
Yes. Identify below.
Name of the parent corporation
Employer Identification number of the parent
corporation
______________________________________________________________
EIN: ____________________________
32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?
No
Yes. Identify below.
Name of the pension fund
______________________________________________________________
Employer Identification number of the pension fund
EIN: ____________________________
Part 14:
Signature and Declaration
WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by fraud in
connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both.
18 U.S.C. §§ 152, 1341, 1519, and 3571.
I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information
is true and correct.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on _________________
MM / DD / YYYY
___________________________________________________________
Printed name _________________________________________________
Signature of individual signing on behalf of the debtor
Position or relationship to debtor ____________________________________
Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?
No
Yes
/s/ James Punelli
2:19-bk-00787
2,500.00
Panthera Enterprises, LLC
✔
James Punelli
09/27/2019
✔
Ramond Jones
✔
43787 Bent Creek Ter.
Leesburg, VA 20176
Managing Member
10/19/2018
Travel Expense
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Official Form 207
Statement of Financial Affairs for Non-Individuals
Debtor Name
Case number (if known)
Continuation Sheet for Official Form 207
Panthera Enterprises, LLC
2:19-bk-00787
26a) Bookkeepers
Raymond Barbic
26098 Huntwick
05/01/2018
Glen Square,
Aldie, VA 20105
26b) Auditors
Raymond Jones
43787 Bent Neck
05/01/2018
09/13/2019
Terrace, Leesburg,
VA 20176
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B2030 (Form 2030) (12/15)
United States Bankruptcy Court
__________________________________
In re
Case No. _______________
Debtor
Chapter________________
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:
For legal services, I have agreed to accept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________
Prior to the filing of this statement I have received. . . . . . . . . . . . . . . . . . . . . . . . $______________
Balance Due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________
2.
The source of the compensation paid to me was:
Debtor
Other (specify)
3.
The source of compensation to be paid to me is:
Debtor
Other (specify)
4.
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 the compensation is attached.
5.
In return of 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;
c.
Representation of the debtor at the meeting of creditors and confirmation hearing, and any
adjourned hearings thereof;
FLAT FEE
RETAINER
For legal services, I have agreed to accept 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.
Northern District of West Virginia
11
0.00
2:19-bk-00787
0.00
0.00
Panthera Enterprises, LLC
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B2030 (Form 2030) (12/15)
d. [Other provisions as needed]
6. By agreement with the debtor(s), the above-disclosed fee does not include the following services:
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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.
_____________________
Date
_________________________________________
Signature of Attorney
_________________________________________
Name of law firm
707 Grant Street
Suite 2200
Pittsburgh, PA 15219
412-456-8100
rbernstein@bernsteinlaw.com
Bernstein-Burkley, P.C.
09/27/2019
/s/ Robert S. Bernstein, WV ID 4708
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46
United States Bankruptcy Court
IN RE:
Case No.__________________
__________________________________________________________ Chapter __________________
LIST OF EQUITY SECURITY HOLDERS
Registered name and last known address of security holder
Shares
Security Class
(Or Percentage)
(or kind of interest)
Raymond Jones
43787 Ben Creek Ter, Leesburg, VA 20176
2:19-bk-00787
11
Managing member
Managing member
Panthera Enterprises, LLC
50%
James Punelli
11654 Plaza America Drive #320, Reston, VA 20190
50%
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