UNITED STATES BANKRUPTCY COURT

DISTRICT OF CONNECTICUT – [BRIDGEPORT / HARTFORD / NEW HAVEN] DIVISION

---------------------------------------------------------------

VOLUNTARY PETITION & CHAPTER 13 PLAN PACKAGE

(Official Forms 101, 113 & Related Schedules—Customizable Template)

[// GUIDANCE: This master template tracks the mandatory Official Bankruptcy Forms, integrates District-of-Connecticut local requirements, and adds practitioner-facing commentary to expedite completion. Replace every bracketed variable (“[_____ ]”) with client-specific information and delete GUIDANCE boxes before filing.]

TABLE OF CONTENTS

1. Document Header & Case Caption
2. Definitions
3. Form 101 – Voluntary Petition (core data fields)
4. Form 121 – Statement About Social Security Numbers
5. Credit Counseling Certificate
6. Schedules A/B through J & Declaration (Forms 106A/B–J, 106Dec)
7. Statement of Financial Affairs (Form 107)
8. Chapter 13 Current Monthly Income & Disposable Income (Forms 122C-1 & 122C-2)
9. Chapter 13 Plan (Official Form 113 – CT-Modified)
10. Creditor Matrix & Verification
11. Representations, Covenants, Default & Remedies (Practitioner Addendum)
12. Execution Block & Notarial Acknowledgments
13. Appendices (Optional Exhibits/Supplements)

1. DOCUMENT HEADER & CASE CAPTION

text
UNITED STATES BANKRUPTCY COURT
DISTRICT OF CONNECTICUT
[Bridgeport/Hartford/New Haven] Division

In re: ) Chapter 13
)
[Debtor 1 Full Legal Name] ) Case No. -__ (XXX)
[Last 4 SSN: _] )
)
[Joint Debtor Full Legal Name] (if any) )
[Last 4 SSN: _] )
)
Debtor(s). )
Effective Date of Petition: [MM/DD/YYYY]

Recitals: The above-captioned individual(s) (the “Debtor” or “Debtors”) file this Voluntary Petition under chapter 13 of title 11 of the United States Code (11 U.S.C. §§ 101 et seq., the “Bankruptcy Code”) for the purpose of proposing a plan to adjust their debts in accordance with 11 U.S.C. §§ 1322 & 1325 and the Local Rules of the United States Bankruptcy Court for the District of Connecticut (the “Local Rules”).

2. DEFINITIONS

Alphabetical listing (used consistently throughout all forms and addenda):

• “Automatic Stay” – the injunction arising upon filing under 11 U.S.C. § 362.
• “Code” – the Bankruptcy Code, 11 U.S.C. §§ 101–1532.
• “Court” – the United States Bankruptcy Court for the District of Connecticut.
• “Disposable Income” – as calculated on Official Form 122C-2.
• “Plan” – the Chapter 13 repayment plan attached hereto (§ 9).
• “Standing Trustee” – [Molly T. Whiton / Suzanne V. Reed] as applicable under Local Rule 13-2.
• “Trustee Procedures” – the written guidelines published by the applicable Standing Trustee, as amended.

3. OFFICIAL FORM 101 – VOLUNTARY PETITION (CORE DATA FIELDS)

[// GUIDANCE: Re-key the exact language of Form 101 where indicated. Only principal fields and CT-specific pointers are displayed below; retain full form for filing.]

1. Debtor’s Full Name: [Debtor 1]
2. All Other Names used in 8 years: [Aliases]
3. Address: [Street Address, City, CT ZIP] (County: [Fairfield/Hartford/New Haven])
4. Joint Debtor: [If none, state “N/A”]
5. Chapter you are filing under: ☑ Chapter 13

6. Statistical/Administrative Information:
   • Estimated number of creditors: [ ] 1–49 [ ] 50–99 […]
   • Estimated assets: [ ] $0–$50k […]
   • Estimated liabilities: […]

7. Attorneys/Pro Se information:
   Attorney Name, Firm, Bar No., Address, Tel, Email.

8. Signature blocks: see §12 below.

4. OFFICIAL FORM 121 – STATEMENT ABOUT SOCIAL SECURITY NUMBERS

Debtor 1 SSN: [-_-__]
Joint Debtor SSN: [If applicable]

[// GUIDANCE: File Form 121 as a non-public document per Fed. R. Bankr. P. 1007(f).]

5. CERTIFICATE OF CREDIT COUNSELING

☑ Attached is a certificate describing Debtor’s pre-petition counseling completed on [MM/DD/YYYY] from an approved provider. (11 U.S.C. § 109(h))
[If exigent circumstances apply, insert certification of exigent circumstances.]

6. SCHEDULES (FORMS 106A/B – 106J) & DECLARATION

[// GUIDANCE: Each schedule must be signed and double-checked for internal totals that reconcile to Summary of Assets and Liabilities.]

A/B Property: List real and personal property with current replacement value.
C  Exemptions: Cite Connecticut exemptions (Conn. Gen. Stat. §§ 52-352b et seq.) or federal exemptions (11 U.S.C. § 522(d))—select one scheme only.
D  Secured Claims: Identify collateral, purchase dates, arrearages.
E/F Priority/Unsecured Claims: Flag domestic support obligations as priority.
G  Executory Contracts/Unexpired Leases: Include residential leases, auto leases, etc.
H  Co-Debtors: Name, address, claim description.
I  Income: Current employment & non-employment income.
J  Expenses: Reasonably necessary projected expenses.

Declaration (Form 106Dec) must be signed under penalty of perjury.

7. STATEMENT OF FINANCIAL AFFAIRS (SOFA – FORM 107)

Complete each numbered question thoroughly—including:
• Past 3 yrs. gross income (Q. 1–2)
• Payments to creditors within 90 days/1 yr. (Q. 7–8)
• Lawsuits, garnishments, repossessions (Q. 9–10)
• Prior business interests (Q. 27)

[// GUIDANCE: Cross-check SOFA answers against Schedules and Plan for consistency.]

8. CHAPTER 13 CURRENT MONTHLY INCOME & DISPOSABLE INCOME

(Forms 122C-1 & 122C-2)

• Median Income Comparison: Connecticut median for household size [#] = $[state_median].
• Commitment Period: [☑ 36 months if below-median / ☑ 60 months if above-median]
• Disposable Income: $[calculated amount] (Line 45 of Form 122C-2).

9. CHAPTER 13 PLAN (OFFICIAL FORM 113 – CONNECTICUT MODIFIED)

[// GUIDANCE: The District of Connecticut has adopted Official Form 113 without substantive local alteration; however, two local addenda are customary: (i) Non-Standard Plan Provisions Rider and (ii) Trustee “Plan Payments & Distribution Summary”. Both are included below.]

9.1 Plan Overview

a. Plan Length: [36 / 60] months beginning [next 1st pay‐period date].
b. Payment Amount: $[______] biweekly / monthly to the Standing Trustee.
c. Base Amount: $[total payments] (“Plan Base”).

9.2 Classification & Treatment of Claims

1. Administrative (Trustee fees, debtor’s counsel).
2. Secured Claims:
   • Mortgage Arrearage on [Property Address] – cure $[] @ [0]% interest.
   • Vehicle Loan ([VIN]) – cram-down to $[] @ [___]% over plan term.
3. Priority Claims: IRS § 507(a)(8) taxes $[___] to be paid in full.
4. Unsecured Class: Projected dividend ___ %.
5. Executory Contracts/Leases: [Assume / Reject].

9.3 Non-Standard Provisions Rider

[Insert only if deviating from Official Form language. Example: “Upon successful completion of all payments, title to the 2015 Toyota Camry (VIN ____) shall vest free and clear in the Debtor.”]

9.4 Connecticut Trustee Distribution Summary

[// GUIDANCE: The Standing Trustee will return the Plan if totals or interest rates are omitted.]

9.5 Vesting of Property

♦ Property of the estate revests in the Debtor upon Plan confirmation ☐ / upon discharge ☐.

9.6 Plan Confirmation Requirements Checklist

☑ Feasibility (11 U.S.C. § 1325(a)(6))
☑ Best-interest test satisfied (Liquidation analysis attached)
☑ Disposable income tests passed (§ 1325(b))
☑ Tax returns (past 4 years) furnished to Trustee
☑ Domestic support obligation certifications filed (if applicable)

10. CREDITOR MATRIX & VERIFICATION

Attach a text-only creditor matrix in the exact format required by Local Rule LBR 1007-1(b) (one creditor per line, “Name Address City ST ZIP”).

Matrix Verification:

“I, [Debtor], declare that the attached matrix is true, correct, and complete to the best of my knowledge.”
Signature: ____ Date: //20__

11. PRACTITIONER ADDENDUM

(Representations, Covenants, Default & Remedies)

11.1 Representations & Warranties
• Debtor is an individual eligible for chapter 13 relief under 11 U.S.C. §§ 109(e), 101(30).
• Schedules and SOFA are complete and accurate in all material respects.
• No prior bankruptcy cases were dismissed within the past 180 days for willful failure to appear or comply (11 U.S.C. § 109(g)).

11.2 Covenants
• Debtor shall commence plan payments not later than 30 days after filing (11 U.S.C. § 1326(a)(1)).
• Debtor shall provide annual tax returns to the Trustee (§ 521(f)).
• Debtor shall maintain insurance on all property subject to a security interest.

11.3 Events of Default
a. Failure to make any Plan payment within 30 days of due date.
b. Failure to timely provide requested tax returns or pay post-petition DSO.
c. Post-petition secured debt payment default exceeding 60 days.

11.4 Remedies
Upon written notice of default from the Trustee and a 21-day opportunity to cure, the Trustee or affected creditor may file a motion to dismiss or convert the case to chapter 7 (§ 1307(c)).

11.5 Attorneys’ Fees
If a contested motion is necessary to enforce the Plan, the prevailing party shall be entitled to reasonable attorneys’ fees and costs, subject to Court approval under 11 U.S.C. § 330 and LBR 2016-2.

12. DISPUTE RESOLUTION & GOVERNING LAW

• Governing Law: Bankruptcy Code, Federal Rules of Bankruptcy Procedure, and Local Rules for the District of Connecticut.
• Forum: Exclusive jurisdiction and venue lie in the United States Bankruptcy Court for the District of Connecticut.
• Arbitration: Not available.
• Jury Trial: Only to the extent permitted under applicable bankruptcy and federal law, expressly waived where waiver is enforceable.
• Injunctive Relief: Rights under the Automatic Stay (§ 362) are preserved.

13. GENERAL PROVISIONS

13.1 Amendments & Modifications: Any amendment to the Plan must be in the form prescribed by Official Form 113 and served per Fed. R. Bankr. P. 3015.
13.2 Successors: Obligations herein bind Debtor’s bankruptcy estate and, upon confirmation, the reorganized Debtor.
13.3 Severability: If any provision is unenforceable, the balance shall remain in effect.
13.4 Integration: This Petition, the Schedules, SOFA, and Plan collectively constitute the entire filing package.
13.5 Electronic Signatures: Permitted in accordance with LBR 5005-3 and the Court’s CM/ECF procedures.

14. EXECUTION BLOCK

I declare under penalty of perjury that the information provided in this petition and the documents attached is true and correct.

Debtor 1: ____ Date: //20_
(Print Name): [_____]

Debtor 2 (if any): ___ Date: ___/___/20
(Print Name): [_______]

Attorney for Debtor(s): ___ Date: _//20_
(Print Name & Bar No.): [__]

Address: [Firm Address] Phone: [_] Email: [_]

Notary Acknowledgment (Only if executing paper petition outside presence of attorney):

State of Connecticut, County of _, subscribed and sworn before me on //20_ by ____.
Notary Public: ___ My Comm. Expires: __

APPENDIX A – LIQUIDATION ANALYSIS (BEST-INTEREST TEST)

Total non-exempt equity: $____ → must equal or exceed projected unsecured dividend.

APPENDIX B – TRUSTEE PAYMENT WORKSHEET

[Insert amortization table demonstrating feasibility and compliance with Trustee guidelines.]

[// GUIDANCE: Before filing, run the petition through the most recent “Best Case” or “NextChapter” compliance audit, validate against the CT Standing Trustee checklists, and upload via CM/ECF using event codes “Voluntary Petition (Chapter 13)”, “Plan”, and “Statements/Schedules” in that sequence.]

Copyright © 2025. Prepared by [Your Firm Name]—For Professional Use Only.