VOLUNTARY PETITION FOR CHAPTER 7 RELIEF

United States Bankruptcy Court
[PLACEHOLDER: Northern or Southern District] of Mississippi

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Operative Provisions
IV. Representations & Warranties
V. Covenants & Restrictions
VI. Default & Remedies
VII. Risk Allocation
VIII. Dispute Resolution
IX. General Provisions
X. Execution Block
Exhibit A—Schedule C (Mississippi Exemptions)
Exhibit B—Creditor Matrix
Exhibit C—Trustee-Specific Certifications

[// GUIDANCE: This template is designed to accompany—not replace—the Official Bankruptcy Forms (e.g., 101, 106 series, 107, 122A-1/2). Use it as a consolidated “front-sheet” pleading that (i) memorializes critical representations, (ii) embeds Mississippi-specific exemption elections, and (iii) satisfies local practice requirements before filing through CM/ECF.]

I. DOCUMENT HEADER

1.1 Title. VOLUNTARY PETITION FOR CHAPTER 7 RELIEF (the “Petition”).

1.2 Debtor(s).
• Name(s): [PLACEHOLDER: Full Legal Name(s)]
• All Other Names Used in Past 8 Years: [__]
• EIN/SSN (last 4 digits only): [_]
• Street Address: [_]
• Mailing Address (if different): [______]

1.3 Attorney for Debtor(s).
• Name/Firm: [_]
• MS Bar No.: [_]
• Address/Phone/Email: [__]

1.4 Jurisdiction & Venue. This Court has jurisdiction under 28 U.S.C. §§ 1334(a) & 157(a); venue is proper under 28 U.S.C. § 1408.

1.5 Effective Date. “Petition Date” means the electronic time-stamp generated by CM/ECF upon filing.

1.6 Recitals.
A. Debtor is eligible for relief under 11 U.S.C. § 109.
B. Debtor has received the briefing required by 11 U.S.C. § 109(h) within 180 days pre-petition.
C. Debtor elects chapter 7 liquidation and requests entry of an order for relief.

II. DEFINITIONS

Automatic Stay has the meaning set forth in 11 U.S.C. § 362.
Bankruptcy Code means Title 11 of the United States Code, 11 U.S.C. §§ 101 et seq.
Debtor means each person or entity identified in § 1.2.
Exempt Property means property claimed exempt on Exhibit A.
Petition has the meaning in § 1.1.
Petition Date has the meaning in § 1.5.
Trustee means the chapter 7 trustee appointed under 11 U.S.C. § 701.

[// GUIDANCE: Add or delete defined terms to match schedules; ensure consistency throughout official forms.]

III. OPERATIVE PROVISIONS

3.1 Election of Chapter 7. Debtor hereby commences a case under chapter 7 and seeks an order for relief pursuant to 11 U.S.C. § 301.

3.2 Filing Components. Concurrently with—or within 14 days of—the Petition Date (Fed. R. Bankr. P. 1007(c)), Debtor shall file the following:
a. Official Forms 101, 106A/B–J, 107, 108, 122A-1 & 122A-2;
b. Exhibit A (Schedule C—Mississippi Exemptions);
c. Exhibit B (Creditor Matrix in .txt format);
d. Certificate of Credit Counseling; and
e. Attorney’s Rule 2016(b) Disclosure.

3.3 Payment of Filing Fee. Debtor [select one]:
☐ has paid the full fee; ☐ applies for installment payments (Form 103A); ☐ moves for waiver (Form 103B).

3.4 Duties of Debtor. In addition to the duties under 11 U.S.C. § 521(a):
• Comply with Mississippi Local Bankruptcy Rules (“L.B.R.”) 1002-1 & 1007-1;
• Deliver to Trustee tax returns, payroll stubs, and bank statements at least 7 days before the § 341 meeting (L.B.R. 4002-1);
• Cooperate with Trustee’s asset turnover procedures (L.B.R. 6007-1).

3.5 Automatic Stay. The Automatic Stay is effective as of the Petition Date pursuant to 11 U.S.C. § 362(a).

IV. REPRESENTATIONS & WARRANTIES

4.1 Accuracy. Debtor represents that all information contained in this Petition and the accompanying schedules is true and correct to the best of Debtor’s knowledge, information, and belief, and is made under penalty of perjury as required by 28 U.S.C. § 1746.

4.2 Complete Financial Disclosure. Debtor affirms compliance with the disclosure requirements of 11 U.S.C. §§ 521(a)(1)–(4) and 527(a).

4.3 Consumer Primarily Consumer Debts. [PLACEHOLDER: Yes/No]

4.4 Means Test Statement. Debtor represents that the calculations on Form 122A-2 are accurate and supported by documentation available for Trustee review.

4.5 Survival. The representations in this Article survive dismissal or conversion of the case.

V. COVENANTS & RESTRICTIONS

5.1 Attendance at Meeting of Creditors. Debtor shall appear in-person (or via approved remote protocol) at the § 341 meeting and any continued meetings.

5.2 Post-Petition Duties.
a. File statement of intention regarding secured property within 30 days of the Petition Date (11 U.S.C. § 521(a)(2)).
b. Complete an approved financial-management course and file Form 423 no later than 60 days after the first date set for the § 341 meeting (Fed. R. Bankr. P. 1007(b)(7)).

5.3 Limitation on Transfers. Except as authorized by 11 U.S.C. §§ 363(b) & (c), Debtor shall not transfer, encumber, or dispose of property of the estate.

VI. DEFAULT & REMEDIES

6.1 Events of Default. Each of the following constitutes a default:
a. Failure to file required documents under § 3.2;
b. Failure to appear at the § 341 meeting;
c. Knowing misrepresentation or omission in any filed document;
d. Violation of § 5.3.

6.2 Remedies. Upon default, the Court may, after notice and hearing:
• Dismiss the case (11 U.S.C. § 707);
• Deny or revoke discharge (11 U.S.C. §§ 727(a)(4), 727(d));
• Impose sanctions under Fed. R. Bankr. P. 9011;
• Order turnover of estate property (11 U.S.C. § 542).

6.3 Cure Period. Unless otherwise ordered, Debtor shall have 14 days after service of a Trustee or creditor notice of default to cure the same.

6.4 Attorney Fees. If the Court finds a willful failure to comply, it may award reasonable attorney’s fees and costs to the moving party (11 U.S.C. § 105(a)).

VII. RISK ALLOCATION

7.1 Indemnification. Not applicable—rights and duties arise under statute.

7.2 Limitation of Liability. Debtor seeks a discharge of pre-petition liabilities under 11 U.S.C. § 727, subject to exceptions enumerated in 11 U.S.C. § 523.

7.3 Force Majeure. Statutory deadlines may be extended only as authorized by the Court (Fed. R. Bankr. P. 9006).

VIII. DISPUTE RESOLUTION

8.1 Governing Law. Federal bankruptcy law (title 11, United States Code) governs all matters arising under or related to this case.

8.2 Forum Selection. Exclusive forum is the United States Bankruptcy Court for the [Northern/Southern] District of Mississippi.

8.3 Arbitration. Not applicable—core bankruptcy matters are non-arbitrable absent Court order.

8.4 Jury Waiver. To the extent a right to jury trial exists in any related proceeding, Debtor knowingly waives it, except as prohibited by 28 U.S.C. § 1411.

8.5 Injunctive Relief. The Automatic Stay preserves the status quo unless modified by Court order.

IX. GENERAL PROVISIONS

9.1 Amendments & Waivers. Amendments require compliance with Fed. R. Bankr. P. 1009; waivers of statutory rights are unenforceable absent Court approval.

9.2 Assignment. Rights and duties hereunder are personal to Debtor and may not be assigned.

9.3 Successors. Obligations bind the Trustee and any successor trustee.

9.4 Severability. If any portion of this Petition is unenforceable, the remainder remains in effect.

9.5 Integration. This Petition, together with the Official Forms and Exhibits, comprises the entire filing.

9.6 Counterparts & E-Signatures. This Petition may be executed in multiple counterparts, including electronic signatures compliant with the Court’s Administrative Procedures for Electronic Case Filing.

X. EXECUTION BLOCK

Executed under penalty of perjury on [DATE].

Debtor

[Debtor Printed Name]

Joint Debtor (if applicable)

[Joint Debtor Printed Name]

Attorney for Debtor(s)

[Attorney Printed Name & MS Bar No.]

[// GUIDANCE: Use Official Form 101’s signature page to ensure compliance with the mandatory certification language.]

EXHIBIT A — SCHEDULE C (MISSISSIPPI EXEMPTIONS)

[// GUIDANCE: Mississippi has opted out of federal exemptions (11 U.S.C. § 522(b)(2)). Tailor this table to each client’s assets and verify dollar caps annually.]

EXHIBIT B — CREDITOR MATRIX

[Paste single-column list of creditor names and full mailing addresses, one per line.]

EXHIBIT C — TRUSTEE-SPECIFIC CERTIFICATIONS

C-1 Tax Returns Delivered: ☐ Yes ☐ N/A
C-2 Bank Statements (90 days): ☐ Yes ☐ N/A
C-3 Domestic Support Obligation Notice (if any): ☐ Provided

[// GUIDANCE: Each Mississippi chapter 7 panel trustee may circulate additional document requests. Insert trustee-specific checklists here to streamline § 341 preparation.]

END OF TEMPLATE