Fillable UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In (US Courts)

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UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In (US Courts)

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LOCAL FORM 1007-3
UNITED STATES BANKRUPTCY COURT
DISTRICT OF MINNESOTA
In re: Case No.
Debtor
(s).
FINANCIAL REVIEW OF THE DEBTOR’S BUSINESS
(NOTE: ONLY INCLUDE
information directly related to one business operation on each form)
Type of business
Business Name
PART A - GROSS BUSINESS INCOME FOR PREVIOUS 12 MONTHS:
1. Gross Income for 12 Months Prior to Filing $
PART B - ESTIMATED AVERAGE FUTURE GROSS MONTHLY INCOME:
2. Gross Monthly Income: $
PART C - ESTIMATED AVERAGE FUTURE MONTHLY EXPENSES:
3. Payroll (paid to others) $
4. Payroll Taxes $
5. Unemployment Taxes $
6. Worker’s Compensation $
7. Employee Benefits $
(e.g., pension, medical, etc.)
8. Other Taxes $
9. Inventory Purchases $
(including raw materials)
10. Purchase of Feed/Fertilizer/ $
Seed/Spray
11. Rent (Other than debtor’s $
principal residence)
12. Utilities $
13. Office Expenses and Supplies $
14. Repairs and Maintenance $
Page 1 of 2
LOCAL FORM 1007-3
15. Vehicle Expenses $
16. Travel and Entertainment $
17. Advertising and Promotion $
18. Equipment Rental and Leases $
19. Legal/Accounting/ $
Other Professional Fees
20. Insurance $
21. Payment to Be Made Directly by $
Debtor to Secured Creditors for $
Pre-Petition Business Debts (specify) $
22. Other (describe) $
23. Total Monthly Expenses (add items 3-22) $
PART D - ESTIMATED AVERAGE NET MONTHLY INCOME:
24. Average Net Monthly Income
(subtract line 22 from line 2) $
Net Monthly Income $
Verification. I, , the debtor(s) named in the foregoing financial review
form, declare under penalty of perjury that the foregoing is true and correct according to the best of my
knowledge, information and belief.
Executed on:
Signed:
Print Name:
Address:
Page 2 of 2
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Completed 24 September 2021

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