Official Form 101 — Voluntary Petition for Individuals Filing for Bankruptcy

Worksheet for Preparing Official Bankruptcy Form 101 (04/24)

IMPORTANT: This is a preparation worksheet only. It is NOT the official form. All information must be transferred to Official Form 101 or entered into the court's e-filing software before filing. Filing this petition commences a bankruptcy case and triggers the automatic stay under 11 U.S.C. § 362, which prohibits most collection actions against the debtor. Full SSNs must be filed separately on Official Form 121.

COURT HEADER

UNITED STATES BANKRUPTCY COURT

FOR THE [________________________________] DISTRICT OF [________________________________]

PART 1: IDENTIFY YOURSELF — DEBTOR 1

Line 1: Your Full Legal Name

Line 2: All Other Names Used in the Last 8 Years

Include married/maiden names, trade names, and any other names used within the past 8 years.

Line 3: Social Security Number or Individual Taxpayer Identification Number (ITIN)

CRITICAL PRIVACY NOTE: Do NOT enter the full SSN/ITIN on this form. Enter only the last 4 digits here. The full SSN/ITIN must be provided ONLY on Official Form 121 (Statement of Social Security Number(s)), which is filed separately under seal and not included in the public case file.

Last 4 digits of SSN/ITIN: [____]

Line 4: Employer Identification Number (EIN)

Has the debtor had an EIN within the past 8 years?

☐ No
☐ Yes — EIN (last 4 digits only): [____]

If more than one EIN, list additional (last 4 digits): [____] [____] [____]

PART 1 (CONTINUED): IDENTIFY YOURSELF — DEBTOR 2 (SPOUSE, IF JOINT PETITION)

Note: Complete this section only if filing a joint petition under 11 U.S.C. § 302. Both spouses must meet all eligibility requirements.

Line 1: Debtor 2 Full Legal Name

Line 2: All Other Names Used in the Last 8 Years

Line 3: Social Security Number / ITIN

Last 4 digits of SSN/ITIN: [____]

Line 4: Employer Identification Number

☐ No EIN within the past 8 years
☐ Yes — EIN (last 4 digits only): [____]

PART 2: DEBTOR ADDRESS AND CONTACT INFORMATION

Line 5: Where You Live (Debtor 1)

Mailing Address (if different from street address):

Debtor 2 Address (If Joint Filing)

☐ Same as Debtor 1
☐ Different address:

Contact Information

PART 3: VENUE (WHY YOU ARE FILING IN THIS DISTRICT)

Line 6: Reason for Filing in This District

Check all that apply (28 U.S.C. § 1408):

☐ Debtor has had a domicile (residence) in this district for the greater part of the 180 days immediately preceding the filing of this petition
☐ Debtor has had a principal place of business in this district for the greater part of the 180 days immediately preceding the filing
☐ Debtor's principal assets have been in this district for the greater part of the 180 days immediately preceding the filing
☐ A bankruptcy case concerning debtor's affiliate, general partner, or partnership is pending in this district

PART 4: INFORMATION ABOUT YOUR BANKRUPTCY

Line 7: Chapter Selection

Under which chapter of the Bankruptcy Code are you filing?

☐ Chapter 7 — Liquidation (Filing fee: $338)
☐ Chapter 11 — Reorganization (Filing fee: $1,738 for individuals)
☐ Chapter 12 — Family Farmer or Family Fisherman (Filing fee: $278)
☐ Chapter 13 — Adjustment of Debts of an Individual with Regular Income (Filing fee: $313)

Note: Filing fees are current as of 2026. Verify current fees at uscourts.gov.

Line 8: Filing Fee Payment

How will you pay the filing fee?

☐ Paid in full at time of filing
☐ Request to pay in installments (must file Official Form 103A — Application to Pay Filing Fee in Installments)
☐ Request for waiver of filing fee (Chapter 7 only; must file Official Form 103B — Application to Have the Chapter 7 Filing Fee Waived)

Note: Filing fee waivers are available ONLY in Chapter 7 cases and require proof that the debtor's household income is below 150% of the federal poverty guidelines.

PART 5: PRIOR BANKRUPTCY FILINGS

Line 9: Cases Filed Within the Last 8 Years

Has either debtor filed for bankruptcy within the last 8 years?

☐ No
☐ Yes — Complete the table below for each prior case:

IMPORTANT — Discharge Bars:
- A Chapter 7 discharge bars a subsequent Chapter 7 discharge for 8 years from the prior filing date (11 U.S.C. § 727(a)(8))
- A Chapter 7 discharge bars a subsequent Chapter 13 discharge for 4 years from the prior filing date (11 U.S.C. § 1328(f)(1))
- A Chapter 13 discharge bars a subsequent Chapter 13 discharge for 2 years from the prior filing date (11 U.S.C. § 1328(f)(2))
- A Chapter 13 discharge bars a subsequent Chapter 7 discharge for 6 years from the prior filing date, unless 70% of allowed unsecured claims were paid (11 U.S.C. § 727(a)(9))

Line 10: Pending Bankruptcy Cases

Are any bankruptcy cases pending that were filed by a spouse, partner, or affiliate of the debtor?

☐ No
☐ Yes — Provide details:

PART 6: PROPERTY AND RENTAL STATUS

Line 11: Residential Rental Property

Does the debtor rent the debtor's residence?

☐ No
☐ Yes

Has the landlord obtained a judgment for possession or eviction against the debtor?

☐ No
☐ Yes — If yes, complete Official Form 101A (Initial Statement About an Eviction Judgment Against You)

Note: Under 11 U.S.C. § 362(b)(22), the automatic stay does not apply to an eviction action where the lessor obtained a judgment for possession before the petition was filed, unless the debtor files Form 101A and deposits rent with the court clerk.

PART 7: BUSINESS AND EMPLOYMENT STATUS

Line 12: Business Ownership

Does the debtor own or operate any business as a sole proprietor, partner, member of an LLC, or as a self-employed individual?

☐ No
☐ Yes — Describe each business:

Line 13: Small Business Debtor (Chapter 11 Only)

Does the debtor elect to be treated as a small business debtor under 11 U.S.C. § 101(51D)?

☐ N/A (Not filing Chapter 11)
☐ No
☐ Yes

PART 8: SPECIAL CONDITIONS

Line 14: Hazardous Property

Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to the public health or safety?

☐ No
☐ Yes — Describe: [________________________________]

Note: If Yes, 11 U.S.C. § 362(b)(4) allows governmental units to continue enforcement actions related to public health and safety.

Transfers and Trust Activity

Within the past year, has the debtor made any transfers of property to a self-settled trust or similar device (11 U.S.C. § 548(e))?

☐ No
☐ Yes — Describe: [________________________________]

Within the past year, has the debtor made any transfers to insiders (family members, partners, officers, etc.)?

☐ No
☐ Yes — Describe: [________________________________]

Health Care Business

Is the debtor a health care business as defined in 11 U.S.C. § 101(27A)?

☐ No
☐ Yes — If yes, additional requirements apply regarding patient care and records (11 U.S.C. §§ 351, 704(a)(12))

Single Asset Real Estate

Is the debtor a single asset real estate debtor as defined in 11 U.S.C. § 101(51B)?

☐ No
☐ Yes — If yes, additional requirements and shorter deadlines may apply (11 U.S.C. § 362(d)(3))

PART 9: CREDIT COUNSELING REQUIREMENT

Line 15: Pre-Filing Credit Counseling Briefing

Every individual debtor must receive a briefing from an approved credit counseling agency within 180 days before filing a bankruptcy petition (11 U.S.C. § 109(h)).

Debtor 1:

☐ I received a briefing from an approved credit counseling agency within 180 days before filing this petition. The certificate is attached.

Credit counseling agency name: [________________________________]
Date of briefing: [__/__/____]
Certificate number (if any): [________________________________]

☐ I received a briefing from an approved credit counseling agency within 180 days before filing, but I do not have the certificate yet. I will file it within 14 days.

☐ I request a temporary waiver because exigent circumstances merit a waiver and I was unable to obtain the briefing before filing. I will obtain the briefing within 30 days after filing.

Describe the exigent circumstances: [________________________________]

☐ I am not required to receive a briefing because I am:

☐ On active military duty in a military combat zone
☐ Incapacitated or disabled (describe): [________________________________]
☐ The U.S. Trustee has determined that there are insufficient approved agencies in this district

Debtor 2 (if joint filing):

☐ Received briefing — certificate attached. Agency: [________________________________] Date: [__/__/____]
☐ Received briefing — certificate to be filed within 14 days
☐ Request temporary waiver (describe circumstances): [________________________________]
☐ Not required (check applicable reason above)

PART 10: NATURE OF DEBTS

Line 16: Primarily Consumer or Business Debts

The debtor's debts are primarily:

☐ Consumer debts — Debts incurred primarily for personal, family, or household purposes
☐ Business debts — Debts incurred primarily in connection with a business
☐ Both consumer and business debts — Mixed

Note: If primarily consumer debts, the Chapter 7 means test (Official Forms 122A-1 and 122A-2) must be completed unless the debtor qualifies for an exemption under 11 U.S.C. § 707(b)(2)(D) (disabled veteran, active duty, etc.).

PART 11: FILING STATUS AND ASSET INFORMATION

Line 17: Type of Filing (Chapter 7 Only)

If filing under Chapter 7:

☐ No-asset case — The debtor has no assets available to distribute to unsecured creditors after claimed exemptions
☐ Asset case — The debtor has assets that may be available for distribution

PART 12: STATISTICAL/ADMINISTRATIVE INFORMATION

Line 18: Estimated Number of Creditors

☐ 1–49   ☐ 50–99   ☐ 100–199   ☐ 200–999
☐ 1,000–5,000   ☐ 5,001–10,000   ☐ 10,001–25,000
☐ 25,001–50,000   ☐ 50,001–100,000   ☐ More than 100,000

Line 19: Estimated Assets

☐ $0 to $50,000
☐ $50,001 to $100,000
☐ $100,001 to $500,000
☐ $500,001 to $1,000,000
☐ $1,000,001 to $10,000,000
☐ $10,000,001 to $50,000,000
☐ $50,000,001 to $100,000,000
☐ $100,000,001 to $500,000,000
☐ $500,000,001 to $1,000,000,000
☐ More than $1,000,000,000

Line 20: Estimated Liabilities

☐ $0 to $50,000
☐ $50,001 to $100,000
☐ $100,001 to $500,000
☐ $500,001 to $1,000,000
☐ $1,000,001 to $10,000,000
☐ $10,000,001 to $50,000,000
☐ $50,000,001 to $100,000,000
☐ $100,000,001 to $500,000,000
☐ $500,000,001 to $1,000,000,000
☐ More than $1,000,000,000

PART 13: PAYMENTS AND ATTORNEY INFORMATION

Payments to Attorney

Has the debtor paid or agreed to pay an attorney for services in connection with this case?

☐ No
☐ Yes — Complete the following:

Note: Attorney fee disclosure is also required on Official Form 2030 (Disclosure of Compensation of Attorney for Debtor).

Payments to Non-Attorney Preparers

Has the debtor paid anyone other than an attorney to prepare this petition or other documents?

☐ No
☐ Yes — Complete the following:

Bankruptcy Petition Preparer

Is a bankruptcy petition preparer (non-attorney) involved in the preparation of this petition?

☐ No
☐ Yes — The preparer must comply with 11 U.S.C. § 110 and complete Official Form 119

PART 14: SIGNATURES

Debtor 1 Signature

I request relief in accordance with the chapter of Title 11, United States Code, specified in this petition. I declare under penalty of perjury that the information provided in this petition is true and correct.

I understand that filing a bankruptcy petition is a serious legal action. I have been informed that bankruptcy fraud is a serious crime; that I could be fined and imprisoned if I have made any false statements in connection with this case; and that all information I provide is subject to audit.

I am aware that I may proceed under Chapter 7, 11, 12, or 13 of Title 11, United States Code, understand the relief available under each such chapter, and choose to proceed under the chapter specified above.

Signature of Debtor 1: ________________________________   Date: [__/__/____]

Printed Name: [________________________________]

Debtor 2 Signature (If Joint Petition)

Signature of Debtor 2: ________________________________   Date: [__/__/____]

Printed Name: [________________________________]

Attorney Signature (If Represented)

I, the attorney for the debtor(s) named in the foregoing petition, declare that I have informed the debtor(s) that [he or she or they] may proceed under Chapter 7, 11, 12, or 13 of Title 11, United States Code, and have explained the relief available under each such chapter.

Attorney Signature: ________________________________   Date: [__/__/____]

Bankruptcy Petition Preparer Signature (If Applicable, 11 U.S.C. § 110)

I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and (3) I have disclosed the fee charged for this service.

Preparer Signature: ________________________________   Date: [__/__/____]

DOCUMENT CHECKLIST — REQUIRED FILINGS

The following documents must be filed with or within the specified time after the petition:

Filed WITH the Petition (Day 0)

☐ Official Form 101 — Voluntary Petition for Individuals
☐ Official Form 121 — Statement of Social Security Number(s) (filed under seal)
☐ Official Form 119 — Bankruptcy Petition Preparer's Notice, Declaration, and Signature (if applicable)
☐ Credit counseling certificate (or request for waiver/extension)
☐ Filing fee (or Form 103A/103B for installments or waiver)

Filed Within 14 Days After Petition

☐ Official Form 106A/B — Schedule A/B: Property
☐ Official Form 106C — Schedule C: Property Claimed as Exempt
☐ Official Form 106D — Schedule D: Creditors Who Hold Claims Secured by Property
☐ Official Form 106E/F — Schedule E/F: Creditors Who Have Unsecured Claims
☐ Official Form 106G — Schedule G: Executory Contracts and Unexpired Leases
☐ Official Form 106H — Schedule H: Your Codebtors
☐ Official Form 106I — Schedule I: Your Income
☐ Official Form 106J — Schedule J: Your Expenses
☐ Official Form 106J-2 — Schedule J-2: Separate Household Expenses (if applicable)
☐ Official Form 106Dec — Declaration About an Individual Debtor's Schedules
☐ Official Form 106Sum — Summary of Assets and Liabilities
☐ Official Form 107 — Statement of Financial Affairs for Individuals
☐ Official Form 108 — Statement of Intention for Individuals Filing Under Chapter 7 (Ch. 7 only)
☐ Official Form 122A-1 — Chapter 7 Statement of Your Current Monthly Income (Ch. 7 only)
☐ Official Form 122A-2 — Chapter 7 Means Test Calculation (if required)
☐ Official Form 122C-1 — Chapter 13 Statement of Your Current Monthly Income (Ch. 13 only)
☐ Official Form 122C-2 — Chapter 13 Calculation of Your Disposable Income (if required)
☐ Official Form 2030 — Disclosure of Compensation of Attorney for Debtor
☐ Pay stubs / payment advices for the 60 days before filing (11 U.S.C. § 521(a)(1)(B)(iv))
☐ Tax returns for the most recent tax year (provided to the trustee at least 7 days before the § 341 meeting)

PRACTITIONER NOTES AND PRACTICE TIPS

Immediate Effects of Filing

• Automatic Stay (11 U.S.C. § 362): The filing triggers an immediate automatic stay that prohibits most creditors from taking collection actions, including lawsuits, garnishments, foreclosures, and repossessions
• Case Number Assignment: The court assigns a case number upon filing
• Section 341 Meeting: The meeting of creditors is typically scheduled 21-40 days after filing (not more than 40 days in Ch. 7/13)
• Creditor Notice: The court sends Official Form 309 to all listed creditors

Emergency / Bare-Bones Filing

Courts permit a bare-minimum filing consisting of:
- Official Form 101 (the petition)
- Official Form 121 (SSN statement)
- Filing fee or fee application
- Credit counseling certificate (or waiver request)

The remaining schedules, statements, and forms must be filed within 14 days. This approach is useful when immediate protection of the automatic stay is needed (e.g., to stop a foreclosure sale or wage garnishment scheduled within days).

Joint Petition Considerations

• Both spouses must sign the petition
• Both must complete credit counseling individually
• Both must provide SSNs on separate copies of Form 121 (or on one form)
• Each debtor's property and debts are administered in the single joint case
• If debtors maintain separate households, Schedule J-2 must be completed

Automatic Stay Limitations

• Serial filers (11 U.S.C. § 362(c)(3)): If the debtor had a case pending within the preceding year that was dismissed, the automatic stay terminates after 30 days unless extended by court order
• Two or more dismissals (11 U.S.C. § 362(c)(4)): If the debtor had two or more cases pending within the preceding year that were dismissed, no automatic stay goes into effect unless the court orders otherwise
• Eviction judgments (§ 362(b)(22)): The stay does not apply to eviction proceedings where the lessor obtained a pre-petition judgment for possession

COMMON PITFALLS AND ERRORS

1. Omitting the credit counseling certificate — Without this certificate (or a valid exemption), the case may be dismissed. There is a strict 180-day window before filing.

2. Entering the full SSN on Form 101 — Only the last 4 digits belong on the petition. The full SSN goes on Form 121, filed under seal. Including the full SSN on public filings is a privacy violation under Fed. R. Bankr. P. 9037.

3. Filing in the wrong district — Venue is proper where the debtor has lived for the greater portion of the past 180 days. Filing in the wrong district may result in dismissal or transfer.

4. Not disclosing prior bankruptcy cases — Failure to disclose prior filings within 8 years is grounds for denial of discharge and may constitute bankruptcy fraud (18 U.S.C. § 152).

5. Missing the 14-day deadline for schedules — If the remaining schedules and statements are not filed within 14 days, the court may dismiss the case without further notice.

6. Incorrect chapter selection — Filing under the wrong chapter can be costly and time-consuming to correct. Evaluate means test results, income levels, and asset exposure before choosing a chapter.

7. Not addressing eviction judgments — If a pre-petition eviction judgment exists, Form 101A must be filed and rent deposited with the clerk, or the stay will not protect the debtor's tenancy.

8. Failing to list all businesses — All sole proprietorships and business interests must be disclosed. Omissions may be grounds for denial of discharge.

9. Ignoring serial-filing consequences — If a prior case was dismissed within the past year, the automatic stay is limited. A motion to extend the stay must be filed promptly.

10. Not paying the filing fee or requesting waiver — The filing fee must be paid, installments requested (Form 103A), or a waiver sought (Form 103B, Chapter 7 only) at the time of filing.

STATE-SPECIFIC VARIATION NOTES

Official Form 101 is a federal form used in all bankruptcy courts nationwide. However, the following state-specific factors affect the filing:

California (CA)

• California is divided into 4 bankruptcy districts (Northern, Eastern, Central, Southern); ensure filing in the correct district based on the 180-day domicile rule
• California exemptions are found in Cal. Code Civ. Proc. § 703.140 (System 1) and § 704 (System 2); debtors must choose one system but cannot mix
• Filing fee: Standard federal amounts apply; some Central District local rules require additional documents (e.g., Local Form F 1015-2.1 for joint administration)

Texas (TX)

• Texas is divided into 4 bankruptcy districts (Northern, Southern, Eastern, Western)
• Texas uses state-specific exemptions only (Tex. Prop. Code § 41.001 et seq.); the federal exemption system under 11 U.S.C. § 522(d) is not available
• Texas homestead exemption is unlimited in value (with acreage limits: 10 acres urban, 100/200 acres rural)
• Some Texas districts require a certificate of credit counseling filed as a separate docket entry

Florida (FL)

• Florida is divided into 3 bankruptcy districts (Northern, Middle, Southern)
• Florida uses state exemptions; federal exemptions under § 522(d) are not available
• Florida homestead exemption (Fla. Const. Art. X, § 4) is unlimited in value with acreage limits (1/2 acre in municipality, 160 acres outside)
• The 2-year residency requirement for the full homestead exemption applies under 11 U.S.C. § 522(b)(3)(A)

New York (NY)

• New York is divided into 4 bankruptcy districts (Southern, Eastern, Northern, Western)
• New York debtors can choose between state exemptions (N.Y. Debt. & Cred. Law § 282 et seq.) and federal exemptions under 11 U.S.C. § 522(d)
• Southern District of New York (SDNY) has specific local rules for individual filings, including requirements for the initial filing checklist
• New York exemption amounts are adjusted periodically; verify current amounts before filing

FILING INSTRUCTIONS

Step 1: Pre-Filing Preparation

☐ Complete credit counseling with an approved agency (verify agency at justice.gov/ust)
☐ Gather all financial records (pay stubs for 60 days, tax returns, bank statements, loan documents)
☐ Determine the correct chapter to file under (run means test if Chapter 7)
☐ Determine the correct bankruptcy district based on 180-day domicile rule
☐ Evaluate exemptions available under applicable state or federal law
☐ Calculate filing fee and determine payment method

Step 2: Complete the Petition and Schedules

☐ Transfer all information from this worksheet to Official Form 101
☐ Complete Official Form 121 (SSN statement) separately
☐ Complete all required schedules (Forms 106A/B through 106J)
☐ Complete Statement of Financial Affairs (Form 107)
☐ Complete means test forms (Forms 122A-1 and 122A-2 for Ch. 7; Forms 122C-1 and 122C-2 for Ch. 13)
☐ Complete attorney fee disclosure (Form 2030)

Step 3: File with the Court

☐ File electronically through the court's CM/ECF system (attorney filing) or PACER
☐ Pro se filers: file in person or by mail at the bankruptcy clerk's office
☐ Pay the filing fee or submit fee application (Form 103A or 103B)
☐ Retain the case number and filing receipt

Step 4: Post-Filing Actions

☐ Serve copies of the petition on creditors as required by local rules
☐ File remaining schedules and statements within 14 days (if not filed with the petition)
☐ Provide pay stubs to the trustee
☐ Provide tax returns to the trustee at least 7 days before the § 341 meeting
☐ Attend the § 341 meeting of creditors
☐ Complete debtor education course (post-filing requirement for discharge under 11 U.S.C. § 727(a)(11) and § 1328(g))

SOURCES AND REFERENCES

• Official Form 101: U.S. Courts — Voluntary Petition for Individuals
• Bankruptcy Forms Index: U.S. Courts — Bankruptcy Forms
• 11 U.S.C. § 109 (Who May Be a Debtor): U.S. Code
• 11 U.S.C. § 301 (Voluntary Cases): U.S. Code
• 11 U.S.C. § 362 (Automatic Stay): U.S. Code
• 28 U.S.C. § 1408 (Venue): U.S. Code
• 28 U.S.C. § 1930 (Filing Fees): U.S. Code
• Fed. R. Bankr. P. 1002 (Commencement of Case): LII — Cornell Law
• NextChapter — Form 101 Instructions: NextChapter Help Center
• Nolo — How to Get and File Bankruptcy Forms: Nolo
• Upsolve — Chapter 7 Bankruptcy Forms: Upsolve