Official Form 122A-2 - Chapter 7 Means Test Calculation

Worksheet only. Complete 122A-1 first. Transfer all data to the official form or e-filing software and confirm current IRS standards and statutory thresholds.

United States Bankruptcy Court
District of [District]

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

Part 1: Adjusted Income

• Current monthly income (from 122A-1): $[CMI]
• Marital adjustment (non-filing spouse expenses not for household): $[ ]
• Other exclusions/adjustments (if applicable): $[ ]
• Adjusted income: $[Adjusted]

Part 1A: IRS Standards Inputs (drives allowances)

• Filing state/county (for Local Standards): [State/County]
• Household size: [ ]
• Vehicles owned/leased (0/1/2): [ ]
• Public transportation instead of vehicle? [Yes/No]
• Filing date (to pick correct IRS tables): [ ]

Part 2: Allowed Deductions (11 U.S.C. §707(b)(2))

Use current IRS National/Local Standards and actual expenses where permitted. List amounts and keep citations/source.

• IRS National Standards (food, clothing, other) — Line [ ]: $[ ]
• IRS Local Standards: Housing/Utilities (standard allowance; do not add mortgage here) — Line [ ]: $[ ]
• IRS Local Standards: Transportation operating (per vehicle/public transit) — Line [ ]: $[ ]
• IRS Local Standards: Transportation ownership costs (Vehicle 1) — Line [ ]: $[ ]; (Vehicle 2) — Line [ ]: $[ ]
• Public transportation allowance (if no ownership) — Line [ ]: $[ ]
• Taxes (federal/state/local/FICA/Medicare): $[ ]
• Involuntary deductions (union dues, mandatory retirement): $[ ]
• Health insurance/disability/HSA: $[ ]
• Additional healthcare (if over standard): $[ ]
• Care for elderly/disabled/dependents: $[ ]
• Court-ordered payments (DSO, etc.): $[ ]
• Education for employment/special needs child: $[ ]
• Charitable contributions (statutory): $[ ]
• Protection from family violence expenses (if applicable): $[ ]
• Home energy adjustment (if applicable): $[ ]
• Telecommunications/other necessary expenses (not already included above; justify necessity): $[ ]

Secured Debt Payments (average over 60 months)

• Secured claim 1 (collateral, creditor, contract payment) — Line [ ]: $[ ] per month
• Secured claim 2 — Line [ ]: $[ ] per month
• Adequate protection/lease payments (if any): $[ ] per month
• Total secured debt average: $[ ]

Priority Claims (average over 60 months)

• Priority claims total: $[ ]
• Priority average (divide by 60): $[ ]

Chapter 13 Administrative Allowance (per statute)

• If required for calculation: $[ ]

Total deductions: $[Total Deductions]

Part 3: Disposable Income & Presumption of Abuse

• Monthly disposable income (Adjusted income − Total deductions): $[MDI]
• 60-month disposable income (MDI × 60): $[MDI60]
• Presumption of abuse arises if 60-month disposable income exceeds the statutory thresholds:
• Lower threshold (updates periodically): $[Lower]
• Upper threshold: $[Upper]
• Threshold source/date: [Citation/date]
• If presumption arises, document special circumstances below.

Part 4: Special Circumstances

Describe and quantify additional expenses/adjustments claimed (with documentation).
[Narrative and amounts]

Signature

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

Debtor 1 Signature: __________________________ Date: __________
Debtor 2 Signature (if joint): __________________________ Date: __________

Keep copies of IRS standard tables, pay evidence, secured debt schedules, and any special-circumstance exhibits for support.