Fillable Schedule A/B: Property 12/15 (US Courts)

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Schedule A/B: Property 12/15 (US Courts)

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Official Form 106A/B Schedule A/B: Property page 1

Official Form 106A/B

Schedule A/B: Property 12/15

In each category, separately list and describe items. List an asset only once. If an asset fits in more than one category, list the asset in the

category where you think it fits best. Be as complete and accurate as possible. If two married people are filing together, both are equally

responsible for supplying correct information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,

write your name and case number (if known). Answer every question.

Part 1: Describe Each Residence, Building, Land, or Other Real Estate You Own or Have an Interest In

1. Do you own or have any legal or equitable interest in any residence, building, land, or similar property?

 No. Go to Part 2.

 Yes. Where is the property?

1.1. _________________________________________

Street address, if available, or other description

_________________________________________

City State ZIP Code

_________________________________________

County

What is the property? Check all that apply.

 Single-family home

 Duplex or multi-unit building

 Condominium or cooperative

 Manufactured or mobile home

 Land

 Investment property

 Timeshare

 Other __________________________________

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$_______________

Describe the nature of your ownership

interest (such as fee simple, tenancy by

the entireties, or a life estate), if known.

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

__________________________________________

 Check if this is community property

(see instructions)

her information you wish to add about this item, such as local

property identification number: _______________________________

If you own or have more than one, list here:

1.2. ________________________________________

Street address, if available, or other description

________________________________________

City State

ZIP

Code

________________________________________

County

What is the property? Check all that apply.

 Single-family home

 Duplex or multi-unit building

 Condominium or cooperative

 Manufactured or mobile home

 Land

 Investment property

 Timeshare

 Other __________________________________

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$_________________

Describe the nature of your ownership

interest (such as fee simple, tenancy by

the entireties, or a life estate), if known.

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

__________________________________________

 Check if this is community property

(see instructions)

her information you wish to add about this item, such as local

property identification number: _______________________________

Debtor 1 __________________________________________________________________

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

(Spouse, if filing) First Name Middle Name Last Name

United States Bankruptcy Court for the: __________ District of ___________

Case number ___________________________________________

Fill in this information to identify your case and this filing:

 Check if this is an

amended filing

__________ District of __________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 2

1.3. ________________________________________

Street address, if available, or other description

________________________________________

City State ZIP Code

________________________________________

County

What is the property? Check all that apply.

 Single-family home

 Duplex or multi-unit building

 Condominium or cooperative

 Manufactured or mobile home

 Land

 Investment property

 Timeshare

 Other __________________________________

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$_________________

Describe the nature of your ownership

interest (such as fee simple, tenancy by

the entireties, or a life estate), if known.

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

__________________________________________

 Check if this is community property

(see instructions)

her information you wish to add about this item, such as local

property identification number: _______________________________

2. Add the dollar value of the portion you own for all of your entries from Part 1, including any entries for pages

ou have attached for Part 1. Write that number here.

...................................................................................... 

$_________________

Part 2:

Describe Your Vehicles

Do you own, lease, or have legal or equitable interest in any vehicles, whether they are registered or not? Include any vehicles

you own that someone else drives. If you lease a vehicle, also report it on Schedule G: Executory Contracts and Unexpired Leases.

3. Cars, vans, trucks, tractors, sport utility vehicles, motorcycles

No

 Yes

3.1.

Make: ______________

Model: ______________

Year: ____________

Approximate mileage: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

If you own or have more than one, describe here:

3.2.

Make: ______________

Model: ______________

Year: ____________

Approximate mileage: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 3

3.3.

Make: ______________

Model: ______________

Year: ____________

Approximate mileage: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

3.4.

Make: ______________

Model: ______________

Year: ____________

Approximate mileage: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

4. Watercraft, aircraft, motor homes, ATVs and other recreational vehicles, other vehicles, and accessories

Exam

ples: Boats, trailers, motors, personal watercraft, fishing vessels, snowmobiles, motorcycle

accessories

No

 Yes

4.1.

Make: ____________________

Model: ____________________

Year: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

If you own or have more than one, list here:

4.2.

Make: ____________________

Model: ____________________

Year: ____________

Other information:

Who has an interest in the property? Check one.

Debtor 1 only

Debtor 2 only

Debtor 1 and Debtor 2 only

At least one of the debtors and another

 Check if this is community property (see

instr

uctions)

Do not deduct secured claims or exemptions. Put

the amount of any secured claims on Schedule D:

Creditors Who Have Claims Secured by Property.

Current value of the

entire property?

$________________

Current value of the

portion you own?

$________________

5. Add the dollar value of the portion you own for all of your entries from Part 2, including any entries for pages

ou have attached for Part 2. Write that number here

........................................................................................................................ 

$_________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 4

Part 3: Describe Your Personal and Household Items

Do you own or have any legal or equitable interest in any of the following items?

Current value of the

portion you own?

Do not deduct secured claims

or exemptions.

6. Household goods and furnishings

Examples: Major appliances, furniture, linens, china, kitchenware

 No

 Yes. Describe. ........

$___________________

7. Electronics

Examples: Televisions and radios; audio, video, stereo, and digital equipment; computers, printe

rs, scanners; music

collections; e

lectronic devices including cell phones, cameras, media players, games

 No

 Yes. Describe. .........

$________

___________

8. Collectibles of value

Examples: Antiques and figurines; paintings, prints, or other artwork; books, pictures, or other art ob

jects;

stamp, coin, or

baseball card collections; other collections, memorabilia, collectibles

 No

 Yes. Describe. .........

$________

___________

9. Equipment for sports and hobbies

Exam

ples: Sports, photographic, exercise, and other hobby equipment; bicycles, pool tables, golf clubs, skis; ca

noes

and ka

yaks; carpentry tools; musical instruments

 No

 Yes. Describe. .........

$________

___________

10. Firearms

Exam

ples: Pistols, rifles, shotguns, ammunition, and related eq

uipment

 No

 Yes. Describe. .........

$________

___________

11. Clothes

Examples: Everyday clothes, furs, leather coats, designer wear, shoe

s, accessories

 No

 Yes. Describe. .........

$________

___________

12. Jewelry

Examples: Everyday jewelry, costume jewelry, engagement rings, wedding rings, heirloom jewelry, watc

hes, gems,

gold, silver

 No

 Yes. Describe. ..........

$________

___________

13. Non-farm animals

Exam

ples: Dogs, cats, birds, horses

 No

 Yes. Describe. ..........

$________

___________

14. Any other personal and household items you did not already list, including any health aids you did not list

 No

 Yes. Give specific

information.

..............

$________

___________

15. Add the dollar value of all of your entries from Part 3, including any entries for pages you have attached

for Part 3. Write that number here

.................................................................................................................................................... 

$______________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 5

Part 4: Describe Your Financial Assets

Do you own or have any legal or equitable interest in any of the following?

Current value of the

portion you own?

Do not deduct secured claims

or exemptions.

16. Cash

Examples: Money you have in your wallet, in your home, in a safe deposit box, and on hand when you file your petition

 No

 Yes ................................................................................................................................................................



Cash: .......................

$__________________

17. Deposits of money

Examples: Checking, savings, or other financial accounts; certificates of deposit; shares in credit unions, brokerag

e houses,

and other similar

institutions. If you have multiple accounts with the same institution, list each.

 No

 Yes .....................

Institution name:

17.1. Checking account: _________________________________________________________

17.2. Checking account: _________________________________________________________

17.3. Savings account: _________________________________________________________

17.4. Savings account: _________________________________________________________

17.5. Certificates of deposit: _________________________________________________________

17.6. Other financial account: _________________________________________________________

17.7. Other financial account: _________________________________________________________

17.8. Other financial account: _________________________________________________________

17.9. Other financial account: _________________________________________________________

$__________________

18. Bonds, mutual funds, or publicly traded stocks

Examples: Bond funds, investment accounts with brokerage firms, money market ac

counts

 No

 Yes .................

Institution or issuer name:

_________________________________________________________________________________________

$__________________

19. Non-publicly traded stock and interests in incorporated and unincorporated businesses, including an interest in

an L

LC, partnership, and joint venture

 No

Yes. Give specific

information abou

them

.........................

Name of entity: % of ownership:

_____________________________________________________________________ ___________%

$________

__________

$__________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 6

20. Government and corporate bonds and other negotiable and non-negotiable instruments

Negotiable instruments include personal checks, cashiers’ checks, promissory notes, and money orders.

Non-negotiable instruments are those you cannot transfer to someone by signing or delivering them.

 No

Yes. Give specific

information about

them

.......................

Issuer name:

______________________________________________________________________________________

$__________________

21. Retirement or pension accounts

Examples: Interests in IRA, ERISA, Keogh, 401(k), 403(b), thrift savings accounts, or other pension or profit-sha

ring plans

 No

 Yes. List each

account separate

ly.

Type of account: Institution name:

401(k) or similar plan: ___________________________________________________________________

Pension plan: ___________________________________________________________________

IRA: ___________________________________________________________________

Retirement account: ___________________________________________________________________

Keogh: ___________________________________________________________________

Additional account: ___________________________________________________________________

$__________________

22. Security deposits and prepayments

Your share of all unused deposits you have made so that you may continue service or use from a compan

Exam

ples: Agreements with landlords, prepaid rent, public utilities (electric, gas, water), telecommuni

cations

companies, or others

 No

 Yes ..........................

Institution name or individual:

Electric: ______________________________________________________________________

Gas: ______________________________________________________________________

Heating oil: ______________________________________________________________________

Security deposit on rental unit: _____________________________________________________________

Prepaid rent: ______________________________________________________________________

Telephone: ______________________________________________________________________

Water: ______________________________________________________________________

Rented furniture: ______________________________________________________________________

Other: ______________________________________________________________________

$___________________

23. Annuities (A contract for a periodic payment of money to you, either for life or for a number of years)

 No

 Yes ..........................

Issuer name and description:

_______________________________________________________________________________________

$__________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 7

24. Interests in an education IRA, in an account in a qualified ABLE program, or under a qualified state tuition program.

26 U.S.C. §§ 530(b)(1), 529A(b), and 529(b)(1).

 No

 Yes ....................................

Institution name and description. Separately file the records of any interests.11 U.S.C. § 521(c)

____________________________________________________________________________________

$_________________

25. Trusts, equitable or future interests in property (other than anything listed in line 1), and rights or powers

exercisable

for your benefit

 No

 Yes. Give specific

information about them

. ...

$__________________

26. Patents, copyrights, trademarks, trade secrets, and other intellectual property

Examples: Internet domain names, websites, proceeds from royalties and licensing agreements

 No

 Yes. Give specific

information about them

. ...

$__________________

27. Licenses, franchises, and other general intangibles

Examples: Building permits, exclusive licenses, cooperative association holdings, liquor licenses, professional licenses

 No

 Yes. Give specific

information about them

. ...

$__________________

Money or property owed to you?

Current value of the

portion you own?

Do not deduct secured

claims or exemptions.

28. Tax refunds owed to you

 No

 Yes. Give specific information

about them, including whether

you alrea

dy filed the returns

and the tax years. .......................

Federal: $_________________

State:

$_________________

Local

: $_________________

29. Family support

Examples: Past due or lump sum alimony, spousal support, child support, maintenance, divorce settlement, property

settlement

 No

 Yes. Give specific information. .............

Alimony

Maintenance:

Support:

Div

orce settlement:

Property settlement:

$________________

30. Other amounts someone owes you

Examples: Unpaid wages, disability insurance payments, disability benefits, sick pay, vacation pay, workers’ compen

sation,

Social Security

benefits; unpaid loans you made to someone else

 No

 Yes. Give specific information. ..............

$______________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 8

31. Interests in insurance policies

Examples: Health, disability, or life insurance; health savings account (HSA); credit, homeowner’s, or renter’s insurance

 No

 Yes. Name the insurance company

of each policy and list its value

. ..

Company name: Beneficiary:

___________________________________________ ____________________________

Surrender or refund value:

$__________________

32. Any interest in property that is due you from someone who has died

If you are the beneficiary of a living trust, expect proceeds from a life insurance policy, or are currently entitled to receiv

propert

y because someone has died.

 No

 Yes. Give specific information. .............

$___________

__________

33. Claims against third parties, whether or not you have filed a lawsuit or made a demand for payment

Exam

ples: Accidents, employment disputes, insurance claims, or rights to sue

 No

 Yes. Describe each claim. ....................

$___________

___________

34. Other contingent and unliquidated claims of every nature, including counterclaims of the debtor and rights

to se

t off claims

 No

 Yes. Describe each claim. ....................

$_____________________

35. Any financial assets you did not already list

 No

 Yes. Give specific information. ...........

$_____________________

36. Add the dollar value of all of your entries from Part 4, including any entries for pages you have attached

for Part 4. Write that number here

.................................................................................................................................................... 

$_____________________

Part 5:

Describe Any Business-Related Property You Own or Have an Interest In. List any real estate in Part 1.

37. Do you own or have any legal or equitable interest in any business-related property?

 No. Go to Part 6.

 Yes. Go to line 38.

Current value of the

portion you own?

Do not deduct secured claims

or exemptions.

38. Accounts receivable or commissions you already earned

 No

 Yes. Describe .......

$_______

_____________

39. Office equipment, furnishings, and supplies

Examples: Business-related computers, software, modems, printers, copiers, fax machines, rugs, telephones, desks, chairs, electronic devices

 No

 Yes. Describe .......

$__________

__________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 9

40. Machinery, fixtures, equipment, supplies you use in business, and tools of your trade

 No

 Yes. Describe .......

$______

______________

41. Inventory

 No

 Yes. Describe .......

_____

_______________

42. Interests in partnerships or joint ventures

 No

 Yes. Describe .......

Name of entity: % of ownership:

______________________________________________________________________ ________%

$________

_____________

$_____________________

43. Customer lists, mailing lists, or other compilations

 No

 Yes. Do your lists include personally identifiable information (as defined in 11 U.S.C. § 101(41A))?

 No

 Yes. Describe. .......

$____________________

44. Any business-related property you did not already list

 No

 Yes. Give specific

information

.........

______________________________________________________________________________________

$____________________

______________________________________________________________________________________

$____________________



______________________________________________________________________________________

$____________________



______________________________________________________________________________________

$____________________



______________________________________________________________________________________

$____________________

______________________________________________________________________________________

$____________________

45. Add the dollar value of all of your entries from Part 5, including any entries for pages you have attached

for Part 5. Write that number here

.................................................................................................................................................... 

$____________________

Part 6: Describe Any Farm- and Commercial Fishing-Related Property You Own or Have an Interest In.

If you own or have an interest in farmland, list it in Part 1.

46. Do you own or have any legal or equitable interest in any farm- or commercial fishing-related property?

 No. Go to Part 7.

 Yes. Go to line 47.



Current value of the

portion you own?

Do not deduct secured claims

or exemptions.

47. Farm animals

Exam

ples: Livestock, poultry, farm

-raised fish

 No

 Yes ..........................

$___________________

Debtor 1 _______________________________________________________ Case number (if known)_____________________________________

First Name Middle Name Last Name

Official Form 106A/B

Schedule A/B: Property page 10

48. Crops—either growing or harvested

 No

 Yes. Give specific

information

. ............

$___________________

49. Farm and fishing equipment, implements, machinery, fixtures, and tools of trade

 No

 Yes ..........................

$___________________

50. Farm and fishing supplies, chemicals, and feed

 No

 Yes ..........................

$___________________

51. Any farm- and commercial fishing-related property you did not already list

 No

 Yes. Give specific

infor

mation

. ............

$___________________

52. Add the dollar value of all of your entries from Part 6, including any entries for pages you have attached

for Part 6. Write that number here

.................................................................................................................................................... 

$___________________

Part 7:

Describe All Property You Own or Have an Interest in That You Did Not List Above

53. Do you have other property of any kind you did not already list?

Examples: Season tickets, country club membership

 No

 Yes. Give specific

infor

mation

. ............

$________________

54. Add the dollar value of all of your entries from Part 7. Write that number here ................................................................. 

$________________

Part 8:

List the Totals of Each Part of this Form

55. Part 1: Total real estate, line 2 .............................................................................................................................................................. 

$________

________

56. Part 2: Total vehicles, line 5 $________________

57. Part 3: Total personal and household items, line 15 $________________

58. Part 4: Total financial assets, line 36 $________________

59. Part 5: Total business-related property, line 45 $________________

60. Part 6: Total farm- and fishing-related property, line 52 $________________

61. Part 7: Total other property not listed, line 54

+ $________________

62. Total personal property. Add lines 56 through 61. .................... $________________

Copy personal property total



+ $_________________

63. Total of all property on Schedule A/B. Add line 55 + line 62. ......................................................................................... $_________________

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Schedule AB: Property 1215 (US Courts)

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Completed 14 September 2020

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