Form F 8002-1 - Application For Waiver Of The Appellate Filing Fee In A Chapter 7 Case Page 2

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Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
Part 2:
Tell the Court About Your Monthly Expenses
Estimate your average monthly expenses.
6.
Include amounts paid by any government assistance that you
$___________________
reported on line 2.
If you have already filled out Schedule J, Your Expenses, copy
line 22 from that form.
Do these expenses cover anyone
7.
No
who is not included in your family
Yes. Identify who ........
as reported in line 1?
Does anyone other than you
8.
No
regularly pay any of these
expenses?
Yes. How much do you regularly receive as contributions? $_________ monthly
If you have already filled out
Schedule I: Your Income, copy the
total from line 11.
Do you expect your average
9.
No
monthly expenses to increase or
Yes. Explain ................
decrease by more than 10% during
the next 6 months?
Part 3:
Tell the Court About Your Property
If you have already filled out Schedule A/B: Property (Official Form 106A/B) attach copies to this application and go to Part 4.
How much cash do you have?
10.
Examples: Money you have in
Cash:
$_________________
your wallet, in your home, and on
hand when you file this application
Bank accounts and other deposits
11.
Institution name:
Amount:
of money?
Checking account:
__________________________________________________
$__________________
Examples: Checking, savings,
money market, or other financial
accounts; certificates of deposit;
$__________________
Savings account:
__________________________________________________
shares in banks, credit unions,
brokerage houses, and other
$__________________
Other financial accounts:
__________________________________________________
similar institutions. If you have
more than one account with the
$__________________
Other financial accounts:
__________________________________________________
same institution, list each. Do not
include 401(k) and IRA accounts.
Your home? (if you own it outright or
12.
_______________________________________________________
are purchasing it)
Current value:
$_________________
Number
Street
Examples: House, condominium,
_______________________________________________________
Amount you owe
$_________________
manufactured home, or mobile home
City
State
ZIP Code
on mortgage and
liens:
Other real estate?
13.
_______________________________________________________
Current value:
$_________________
Number
Street
Amount you owe
_______________________________________________________
$_________________
on mortgage and
City
State
ZIP Code
liens:
The vehicles you own?
14.
Make:
_____________________
Current value:
$_________________
Examples: Cars, vans, trucks,
Model:
_____________________
sports utility vehicles, motorcycles,
Year:
____________
Amount you owe
tractors, boats
$_________________
on liens:
Mileage
_____________________
Make:
_____________________
Current value:
$_________________
Model:
_____________________
Year:
____________
Amount you owe
$_________________
Mileage
_____________________
on liens:
_______________________________________________________
This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central Distict of California.
June 2016
Page 2
F 8002-1.APPEAL.FEE.WAIVER.APP

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