Form 106Sum Worksheet - Summary of Assets and Liabilities and Certain Statistical Information
Worksheet only. Not the official form. Fill out all schedules first, then complete this summary. Transfer totals to the official Form 106Sum or e-filing software.
United States Bankruptcy Court
District of [District]
In re: [Debtor Name(s)]
Case No.: [if known]
Chapter: [7/11/13]
Check if amended filing: [Yes/No]
Part 1: Summarize Your Assets (from Schedule A/B)
1a. Total real estate (Schedule A/B line 55): $[ ]
1b. Total personal property (Schedule A/B line 62): $[ ]
1c. Total of all property (Schedule A/B line 63): $[ ]
Part 2: Summarize Your Liabilities
2a. Total secured claims (Schedule D, Part 1 total of Column A): $[ ]
3a. Priority unsecured claims total (Schedule E/F Part 1 line 6e): $[ ]
3b. Nonpriority unsecured claims total (Schedule E/F Part 2 line 6j): $[ ]
Total liabilities (2a + 3a + 3b): $[ ]
Part 3: Summarize Your Income and Expenses
- Combined monthly income (Schedule I line 12): $[ ]
- Monthly expenses (Schedule J line 22c): $[ ]
Part 4: Administrative and Statistical Records
- Are you filing under Chapter 7, 11, or 13? [No / Yes - Chapter: 7 / 11 / 13]
- What kind of debt do you have?
- [ ] Primarily consumer debts (complete lines 8-9g below).
- [ ] Not primarily consumer debts (skip lines 8-9g). - Total current monthly income (copy one):
- From Form 122A-1 line 11: $[ ]
- From Form 122B line 11: $[ ]
- From Form 122C-1 line 14: $[ ] - Special categories of claims from Schedule E/F Part 4 line 6:
- 9a. Domestic support obligations (line 6a): $[ ]
- 9b. Taxes and certain other government debts (line 6b): $[ ]
- 9c. Claims for death or personal injury while intoxicated (line 6c): $[ ]
- 9d. Student loans (line 6f): $[ ]
- 9e. Separation or divorce obligations not listed as priority (line 6g): $[ ]
- 9f. Debts to pension or profit-sharing plans (line 6h): $[ ]
- 9g. Total (add 9a through 9f): $[ ]
Signatures are provided on Form 106Dec. Verify any district-specific summary addenda.