Templates Universal Bankruptcy Schedule E/F – Creditors Holding Unsecured Claims Template
Bankruptcy Schedule E/F – Creditors Holding Unsecured Claims Template
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Bankruptcy Schedule E/F – Creditors Holding Unsecured Claims Template

United States Bankruptcy Court
District of [District]

In re: [Debtor Name(s)]
Case No.: [if known]
Chapter: [7/13]

Schedule E/F: Creditors Holding Unsecured Claims

Separate priority and nonpriority unsecured claims. Include co-debtors and notices if required.

Part 1: Priority Unsecured Claims (Schedule E)

Creditor Name Mailing Address Basis for Claim Date Incurred Amount of Claim Type of Priority (e.g., Domestic Support, Taxes) Amount Entitled to Priority Amount Not Entitled
[IRS] [Address] Income taxes [Tax Year] $[Amount] 11 U.S.C. § 507(a)(8) $[Priority Amount] $[Balance]
[State Dept. of Revenue]
[Domestic Support Obligee]

Part 2: Nonpriority Unsecured Claims (Schedule F)

Creditor Name Mailing Address Account No. (last 4) Date Incurred Consideration (e.g., credit card, medical) Amount of Claim Is Claim Contingent, Unliquidated, Disputed?
[Credit Card Company] [Address] [XXXX] [Date] [Credit card purchases] $[Amount]
[Medical Provider] $[Amount]
[Personal loan] $[Amount]

Part 3: Total Claim Summary

  • Total priority unsecured claims: $[Total]
  • Total nonpriority unsecured claims: $[Total]
  • Total unsecured claims: $[Total]

Declaration

I declare under penalty of perjury that the foregoing is true and correct.

Debtor 1 Signature: ____ Date: __

Debtor 2 Signature (if joint case): ____ Date: __

Complete per Official Form 106E/F. Use continuation sheets for additional creditors.

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