Order - Kservicing Bankruptcy (2022-10-26)
- Date
- 2022-10-26
Summary
Exhibit 1 to a filing in Case 22-10951-CTG, docketed as Doc 161-1 and filed October 26, 2022: a blank Official Form 410 Proof of Claim with its instructions. The form's caption lets a creditor select one of six debtors, Kabbage, Inc. d/b/a KServicing (Case No. 22-10951) and five affiliated debtors each with its own case number, in the United States Bankruptcy Court District of Delaware. Part 1 asks who the current creditor is and whether the claim was acquired or amends an earlier claim; Part 2 asks the amount and basis of the claim, whether it is secured or subject to setoff, and whether any part is entitled to priority under 11 U.S.C. § 507(a); Part 3 is the signature and declaration. The form warns that a person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both, citing 18 U.S.C. §§ 152, 157, and 3571.
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Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 1 of 6
Exhibit 1
Proof of Claim Form
RLF1 28151919v.1
Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 2 of 6
UNITED STATES BANKRUPTCY COURT DISTRICT OF DELAWARE
Fill in the information to identify the case (Select only one Debtor per form):
Kabbage, Inc. d/b/a KServicing (CASE NO. 22-10951) Kabbage Asset Funding 2017-A, LLC (CASE NO. 22-10954)
Kabbage Canada Holdings, LLC (CASE NO. 22-10952) Kabbage Asset Funding 2019-A, LLC (CASE NO. 22-10955)
Kabbage Asset Securitization, LLC (CASE NO. 22-10953) Kabbage Diameter, LLC (CASE NO. 22-10956)
Official Form 410
Proof of Claim 04/22
Read the instructions before filling out this form. This form is for making a claim for payment in a bankruptcy case. Do not use this form to
make a request for payment of an administrative expense. Make such a request according to 11 U.S.C. § 503.
Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents. Attach redacted copies of any
documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements of running accounts, contracts, judgments,
mortgages, and security agreements. Do not send original documents; they may be destroyed after scanning. If the documents are not available,
explain in an attachment.
A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571.
Fill in all the information about the claim as of the date the case was filed. That date is on the notice of bankruptcy (Form 309) that you received.
Carefully read instructions included with this Proof of Claim before completing. In order to have your claim considered for payment and/or voting purposes,
complete ALL applicable questions. The original of this Proof of Claim must be sent to: Kabbage, Inc. dba KServicing, et al., c/o Omni Agent Solutions,
5955 De Soto Avenue, Suite 100, Woodland Hills, CA 91367 by MON DD, YYYY at X:00 pm prevailing Eastern Time or MON DD, YYYY
at X:00 pm prevailing Eastern time for governmental entities.
Part 1: Identify the Claim
1. Who is the current creditor?
Name of the current creditor (the person or entity to be paid for this claim)
Other names the creditor used with the debtor
2. Has this claim been acquired No
from someone else? Yes From whom?
3. Where should notices and Where should notices to the creditor be sent? Where should payments to the creditor be sent? (if
payments to the creditor be different)
sent?
Federal Rule of
Name Name
Bankruptcy Procedure
(FRBP) 2002(g)
Number Street Number Street
City State ZIP Code City State ZIP Code
Contact Phone Contact Phone
Contact email Contact email
Uniform claim identifier for electronic payments in chapter 13 (if you use one)
4. Does this claim amend one No
already filed? Yes Claim Number on court claims registry (if known) Filed On
MM / DD / YYYY
5. Do you know if anyone else
has filed a proof of claim for No
this claim? Yes Who made the earlier filing?
Official Form 410 Proof of Claim Page 1
Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 3 of 6
Part 2: Give Information About the Claim as of the Date the Case Was Filed
6. Do you have any number you No
use to identify the debtor?
Yes Last 4 digits of the debtor's account or any number you use to identify the debtor:
7. How much is the claim? $ Does this amount include interest or other charges?
No
Yes Attach statement itemizing interest, fees, expenses, or other
charges required by Bankruptcy Rule 3001(c)(2)(A).
8. What is the basis of the Examples: Goods sold, money loaned, lease, services performed, personal injury or wrongful death, or credit card.
claim?
Attach redacted copies of any documents supporting the claim required by Bankruptcy Rule 3001(c).
Limit disclosing information that is entitled to privacy, such as health care information
9. Is all or part of the claim No
secured? Yes The claim is secured by a lien on property
Nature of property:
Real Estate If the claim is secured by the debtor's principal residence, file a Mortgage Proof of Claim
Attachment (Official Form 410-A) with this Proof of Claim
Motor Vehicle
Other Describe:
Basis for perfection:
Attach redacted copies of documents, if any, that show evidence of perfection of a security interest (for example,
a mortgage, lien, certificate of title, financing statement, or other document that shows the lien has been filed or
recorded.
Value of Property: $
Amount of the claim that is secured: $
Amount of the claim that is unsecured: $ (The sum of the secured and unsecured
amounts should match the amount in
line 7).
Amount necessary to cure any default as of the date of the petition: $
Annual Interest Rate: (when case was filed) %
Fixed
Variable
10. Is this claim based on a No
lease? Yes Amount necessary to cure any default as of the date of the petition. $
11. Is this claim subject to a No
right of setoff? Yes Identify the property:
12. Is this claim for the value No
of goods received by the Yes Amount of 503(b)(9) Claim: $
debtor within 20 days
before the
commencement date of
this case (11 U.S.C.
§503(b)(9)).?
Official Form 410 Proof of Claim Page 2
Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 4 of 6
13. Is all or part of the claim No
entitled to priority under Amount entitled to priority
Yes Check all that apply
11 U.S.C. § 507(a)?
Domestic support obligations (including alimony and child support) under
11 U.S.C. § 507(a)(1)(A) or (a)(1)(B). $
A claim may be partly
priority and partly
Up to $3,350* of deposits toward purchase, lease, or rental of property or services for
nonpriority. For example,
personal, family, or household use. 11 U.S.C. § 507(a)(7). $
in some categories, the
law limits the amount Wages, salaries, or commissions (up to $15,150*) earned within 180 days before the
entitled to priority. bankruptcy petition is filed or the debtor's business ends, whichever is earlier. 11 $
U.S.C. § 507(a)(4).
Taxes or penalties owed to governmental units. 11 U.S.C. § 507(a)(8). $
Contributions to an employee benefit plan 11 U.S.C. § 507(a)(5). $
Other. Specify subsection of 11 U.S.C. § 507(a)( ) that applies. $
* Amounts are subject to adjustment on 4/01/25 and every 3 years after that for cases begun on or after the date of adjustment.
Part 3: Sign Below
The person completing Check the appropriate box:
this proof of claim must
I am the creditor.
sign and date it.
FRBP 9011(b). I am the creditor's attorney or authorized agent.
I am the trustee, or the debtor, or their authorized agent. Bankruptcy Rule 3004. I
If you file this claim
electronically, FRBP am the guarantor, surety, endorser, or other codebtor. Bankruptcy Rule 3005.
5005(a)(2) authorizes
courts to establish local I understand that an authorized signature on this Proof of Claim serves as an acknowlegment that when calculating the
rules specifying what a
signature is. amount of the claim, the creditor gave the debtor credit for any payments received toward the debt.
I have examined the information in this Proof of Claim and have a reasonable belief that the information is true
A person who files a and correct.
fraudulent claim could be
fined up to $500,000, I declare under penalty of perjury that the foregoing is true and correct.
imprisoned for up to 5
years, or both.
18 U.S.C. §§ 152, 157, and Executed on date
3571. MM / DD / YYYY
Signature
Print the name of the person who is completing and signing this claim:
Name
First Name Middle Name Last Name
Title
Company
Identify the corporate servicer as the company if the authorized agent is a servicer.
Address
Number Street
City State ZIP Code
Contact Phone Email
Official Form 410 Proof of Claim Page 3
Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 5 of 6
Official Form 410
Instructions for Proof of Claim
United States Bankruptcy Court 12/15
These instructions and definitions generally explain the law. In certain circumstances, such as bankruptcy cases that debtors
do not file voluntarily, exceptions to these general rules may apply. You should consider obtaining the advice of an attorney,
especially if you are unfamiliar with the bankruptcy process and privacy regulations.
A person who files a fraudulent claim could be fined up
to $500,000, imprisoned for up to 5 years, or both.
18 U.S.C. §§ 152, 157 and 3571.
How to fill out this form A Proof of Claim form and any attached documents
must show only the last 4 digits of any social security
Fill in all of the information about the claim as of the number, individual’s tax identification number, or
date the case was filed. financial account number, and only the year of any
person’s date of birth. See Bankruptcy Rule 9037.
Fill in the caption at the top of the form.
If any information reflected on the Proof of Claim form For a minor child, fill in only the child’s initials and the
is incorrect or if the Proof of Claim form contains full name and address of the child’s parent or
information that you do not agree with, cross out such guardian. For example, write A.B., a minor child (John
information and write in what you believe to be the correct Doe, parent, 123 Main St., City, State). See Bankruptcy
information. Rule 9037.
If the claim has been acquired from someone else,
then state the identity of the last party who owned the
claim or was the holder of the claim and who transferred Confirmation that the claim has been filed
it to you before the initial claim was filed.
To receive confirmation that the claim has been filed, either
Attach any supporting documents to this form. enclose a stamped self-addressed envelope and a copy of this
Attach redacted copies of any documents that show that the form or go to the court’s PACER system
debt exists, a lien secures the debt, or both. (See the (www.pacer.psc.uscourts.gov) to view the filed form.
definition of redaction on the next page.)
Also attach redacted copies of any documents that show
perfection of any security interest or any assignments or Understand the terms used in this form
transfers of the debt. In addition to the documents, a Administrative expense: Generally, an expense that arises
summary may be added. Federal Rule of Bankruptcy after a bankruptcy case is filed in connection with operating,
Procedure (called “Bankruptcy Rule”) 3001(c) and (d). liquidating, or distributing the bankruptcy estate.
11 U.S.C. § 503.
Do not attach original documents because
attachments may be destroyed after scanning. Claim: A creditor’s right to receive payment for a debt that the
debtor owed on the date the debtor filed for bankruptcy. 11
If the claim is based on delivering health care goods U.S.C. §101 (5). A claim may be secured or unsecured.
or services, do not disclose confidential health care
information. Leave out or redact confidential
information both in the claim and in the attached
documents.
Case 22-10951-CTG Doc 161-1 Filed 10/26/22 Page 6 of 6
Claim Pursuant to 11 U.S.C. §503(b)(9): A claim arising from Secured claim under 11 U.S.C. §506(a): A claim backed by
the value of any goods received by the Debtor within 20 days a lien on particular property of the debtor. A claim is secured
before the date of commencement of the above case, in which to the extent that a creditor has the right to be paid from the
the goods have been sold to the Debtor in the ordinary course
property before other creditors are paid. The amount of a
of the Debtor's business. Attach documentation supporting
secured claim usually cannot be more than the value of the
such claim.
particular property on which the creditor has a lien. Any
amount owed to a creditor that is more than the value of the
Creditor: A person, corporation, or other entity to whom a property normally may be an unsecured claim. But exceptions
debtor owes a debt that was incurred on or before the date the exist; for example, see 11 U.S.C. § 1322(b) and the final
debtor filed for bankruptcy. 11 U.S.C. §101 (10). sentence of 1325(a).
Examples of liens on property include a mortgage on real
Debtor: A person, corporation, or other entity who is in estate or a security interest in a car. A lien may be voluntarily
bankruptcy. Use the debtor’s name and case number as shown granted by a debtor or may be obtained through a court
in the bankruptcy notice you received. 11 U.S.C. § 101 (13). proceeding. In some states, a court judgment may be a lien.
Evidence of perfection: Evidence of perfection of a security Setoff: Occurs when a creditor pays itself with money
interest may include documents showing that a security belonging to the debtor that it is holding, or by canceling a
interest has been filed or recorded, such as a mortgage, lien, debt it owes to the debtor.
certificate of title, or financing statement.
Uniform claim identifier: An optional 24-character identifier
Information that is entitled to privacy: A Proof of Claim that some creditors use to facilitate electronic payment.
form and any attached documents must show only the last 4
digits of any social security number, an individual’s tax
identification number, or a financial account number, only the Unsecured claim: A claim that does not meet the
initials of a minor’s name, and only the year of any person’s requirements of a secured claim. A claim may be unsecured in
date of birth. If a claim is based on delivering health care part to the extent that the amount of the claim is more than the
goods or services, limit the disclosure of the goods or services value of the property on which a creditor has a lien.
to avoid embarrassment or disclosure of confidential health
care information. You may later be required to give more
information if the trustee or someone else in interest objects to Offers to purchase a claim
the claim.
Certain entities purchase claims for an amount that is less than
the face value of the claims. These entities may contact
Priority claim: A claim within a category of unsecured creditors offering to purchase their claims. Some written
claims that is entitled to priority under 11 U.S.C. §507(a). communications from these entities may easily be confused
These claims are paid from the available money or with official court documentation or communications from the
property in a bankruptcy case before other unsecured debtor. These entities do not represent the bankruptcy court,
claims are paid. Common priority unsecured claims the bankruptcy trustee, or the debtor. A creditor has no
include alimony, child support, taxes, and certain unpaid obligation to sell its claim. However, if a creditor decides to
wages. sell its claim, any transfer of that claim is subject to
Bankruptcy Rule 3001(e), any provisions of the Bankruptcy
Proof of claim: A form that shows the amount of debt the Code (11 U.S.C. § 101 et seq.) that apply, and any orders of
debtor owed to a creditor on the date of the bankruptcy filing. the bankruptcy court that apply.
The form must be filed in the district where the case is
pending.
Redaction of information: Masking, editing out, or deleting
certain information to protect privacy. Filers must redact or
leave out information entitled to privacy on the Proof of
Claim form and any attached documents.
Do not file these instructions with your form.
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