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IN THE UNITED STATES BANKRUPTCY COURT
FOR THE [MIDDLE / EASTERN / WESTERN] DISTRICT OF TENNESSEE
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In re: ) Chapter 7
)
[YOUR FULL LEGAL NAME], ) Case No.: _______________
)
Debtor. ) (If known)
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VOLUNTARY PETITION
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- NAME OF DEBTOR (if individual, enter Last, First, Middle):
[YOUR FULL LEGAL NAME]
Also known as: [ANY ALIASES OR PRIOR NAMES]
- ALL OTHER NAMES USED BY THE DEBTOR IN THE LAST 8 YEARS:
[LIST ANY OTHER NAMES, INCLUDING MAIDEN NAME, MARRIED NAME,
TRADE NAMES, OR NICKNAMES USED FOR BUSINESS PURPOSES]
- ADDRESS:
Mailing Address: [STREET ADDRESS]
[CITY], TN [ZIP CODE]
Location of Principal Assets (if different): [ADDRESS OR "SAME"]
- TYPE OF DEBTOR:
[X] Individual (includes Joint Debtors)
[ ] Corporation
[ ] Partnership
[ ] Other: _______________
- NATURE OF BUSINESS:
[ ] None (Consumer/Personal)
[X] Healthcare
[ ] Retail
[ ] Real Estate
[ ] Other: _______________
- CHAPTER OF THE BANKRUPTCY CODE UNDER WHICH THE PETITION IS FILED:
[X] Chapter 7
- FILING FEE:
[X] $338.00 filing fee paid with petition
[ ] Application to Pay Filing Fee in Installments attached
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EXHIBIT A/B: ASSETS
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- REAL ESTATE:
[ ] None
Property 1:
- Address: [ADDRESS]
- Type: [SINGLE FAMILY / CONDO / LAND / OTHER]
- Ownership: [FEE SIMPLE / JOINT TENANCY / OTHER]
- Current Value: $[AMOUNT]
- Amount Owed: $[AMOUNT]
- VEHICLES:
Vehicle 1:
- Year/Make/Model: [YEAR MAKE MODEL]
- Current Value: $[AMOUNT]
- Amount Owed: $[AMOUNT]
- PERSONAL PROPERTY:
- Cash on hand: $[AMOUNT]
- Checking accounts: $[AMOUNT] — [BANK NAME]
- Savings accounts: $[AMOUNT] — [BANK NAME]
- Household goods and furnishings: $[AMOUNT]
- Clothing: $[AMOUNT]
- Jewelry: $[AMOUNT]
- Retirement accounts (401k, IRA): $[AMOUNT]
- Other: [DESCRIBE]
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EXHIBIT C: LIABILITIES
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- SECURED CLAIMS:
Creditor 1:
- Name: [CREDITOR NAME]
- Address: [ADDRESS]
- Account Number: [LAST 4 DIGITS]
- Amount Owed: $[AMOUNT]
- Collateral: [PROPERTY SECURING THE DEBT]
- UNSECURED CLAIMS:
Creditor 1:
- Name: [CREDITOR NAME]
- Address: [ADDRESS]
- Account Number: [LAST 4 DIGITS]
- Amount Owed: $[AMOUNT]
- Type: [CREDIT CARD / MEDICAL / PERSONAL LOAN / OTHER]
[LIST ALL UNSECURED CREDITORS]
- TOTAL UNSECURED DEBT: $[TOTAL AMOUNT]
TOTAL SECURED DEBT: $[TOTAL AMOUNT]
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EXHIBIT D: SCHEDULE OF INCOME
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- EMPLOYMENT:
Occupation: [OCCUPATION]
Employer Name: [EMPLOYER NAME]
Employer Address: [ADDRESS]
How long employed: [YEARS/MONTHS]
- CURRENT MONTHLY INCOME:
- Gross wages/salary: $[AMOUNT]
- Net income after payroll deductions: $[AMOUNT]
- Other income (specify): $[AMOUNT]
- Total monthly income: $[AMOUNT]
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EXHIBIT E: SCHEDULE OF EXPENSES
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- CURRENT MONTHLY EXPENSES:
- Rent or mortgage: $[AMOUNT]
- Utilities: $[AMOUNT]
- Food: $[AMOUNT]
- Transportation: $[AMOUNT]
- Insurance: $[AMOUNT]
- Medical/dental: $[AMOUNT]
- Clothing: $[AMOUNT]
- Other: $[AMOUNT]
- Total monthly expenses: $[AMOUNT]
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STATEMENT OF INTENTION
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- INTENTIONS REGARDING SECURED PROPERTY:
[ ] I intend to retain the property and continue payments
[ ] I intend to surrender the property
[ ] I intend to redeem the property
[ ] Not applicable
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MEANS TEST DECLARATION
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- I declare that I have completed the Chapter 7 Statement of Currently
Monthly Income (Official Form 122A-1) and:
[ ] My current monthly income is less than the applicable median family
income for Tennessee, and I am not required to complete the means
test calculation.
[ ] My current monthly income exceeds the applicable median family income
for Tennessee, and I have completed the means test calculation
(Official Form 122A-2), which shows that I qualify for Chapter 7.
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DECLARATION
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I declare under penalty of perjury that the information provided in this
petition is true and correct to the best of my knowledge, information, and
belief.
Executed on: _______________
________________________________
[YOUR FULL LEGAL NAME]
Debtor (Signature)
________________________________
[YOUR FULL LEGAL NAME - PRINTED]
Debtor (Print Name)
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TENNESSEE BANKRUPTCY EXEMPTIONS
(Tenn. Code Ann. § 26-2-101 et seq.)
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Tennessee is an "opt-out" state. You MUST use Tennessee state exemptions,
not federal bankruptcy exemptions.
KEY TENNESSEE EXEMPTIONS:
- HOMESTEAD EXEMPTION (Tenn. Code Ann. § 26-2-301):
- Up to $35,000 in real or personal property used as residence
- Up to $17,500 if owned jointly by spouses
- Unused homestead may be applied to any property (wildcard)
- PERSONAL PROPERTY EXEMPTIONS (Tenn. Code Ann. § 26-2-111):
- Necessary wearing apparel for debtor and dependents
- Up to $10,000 in household furnishings and goods
- Up to $5,000 in tools of the trade
- One motor vehicle up to $10,000 in value
- Up to $1,000 in jewelry
- RETIREMENT ACCOUNTS (Tenn. Code Ann. § 26-2-111(n)):
- ERISA-qualified retirement accounts (401k, pension, profit-sharing)
- IRAs and Roth IRAs
- PUBLIC BENEFITS:
- Workers' compensation
- Unemployment compensation
- Social Security benefits
- Veterans' benefits
- LIFE INSURANCE:
- Proceeds payable to surviving spouse or child
- Cash value up to $25,000
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FILING INSTRUCTIONS
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TENNESSEE BANKRUPTCY COURTS:
MIDDLE DISTRICT OF TENNESSEE:
- U.S. Bankruptcy Court
- 719 Church Street, Suite 2400
- Nashville, TN 37203
- Phone: (615) 695-5835
- Website: http://www.tnmb.uscourts.gov
EASTERN DISTRICT OF TENNESSEE:
- U.S. Bankruptcy Court
- 800 Market Street, Suite 100
- Knoxville, TN 37902
- Phone: (865) 545-4320
- Website: http://www.tneb.uscourts.gov
WESTERN DISTRICT OF TENNESSEE:
- U.S. Bankruptcy Court
- 109 South Highland Street, Suite 150
- Memphis, TN 38111
- Phone: (901) 327-9120
- Website: http://www.tnwb.uscourts.gov
FILING FEES:
- Chapter 7 Filing Fee: $338.00
- Credit Counseling Course: ~$15-50
- Debtor Education Course: ~$15-50
REQUIRED DOCUMENTS:
- Voluntary Petition (Official Form 101)
- Schedules A/B, C, D, E/F, G, H, I, J
- Summary of Schedules (Official Form 106Sum)
- Declaration (Official Form 106Dec)
- Statement of Financial Affairs (Official Form 107)
- Chapter 7 Means Test Forms (122A-1, 122A-1Supp, 122A-2 if applicable)
- Credit Counseling Certificate
- Pay stubs for 60 days prior to filing
- Tax returns for most recent year
CREDIT COUNSELING REQUIREMENT:
You must complete an approved credit counseling course within 180 days
BEFORE filing. Approved providers include:
- Debtorcc.org
- Access Counseling
- Money in Motion
DEBTOR EDUCATION REQUIREMENT:
You must complete a debtor education course AFTER filing but BEFORE
receiving your discharge.
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LEGAL DISCLAIMER
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This document is provided for informational purposes only and does not
constitute legal advice. Bankruptcy law is complex and the consequences of
filing are significant. You should consult with a licensed attorney before
filing for bankruptcy.
Tennessee exemption amounts are subject to change. Verify current exemption
amounts with the Tennessee Code or a qualified attorney.
This template does not replace the need to complete all required Official
Bankruptcy Forms, which are available at www.uscourts.gov/forms.