Official Local Form 3 - Chapter 13 Plan Cover Sheet Page 4
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10D. Leases:
i. The Debtor(s) intend(s) to reject the residential/personal property lease claims of
_______________________________________________________________________; or
ii. The Debtor(s) intend(s) to assume the residential/personal property lease claims of
_______________________________________________________________________.
iii. The arrears under the lease to be paid under the plan are _______________________.
III. PRIORITY CLAIMS:
A. Domestic Support Obligations:
Creditor
Description of Claim
Amount of Claim
__________________
________________________
$______________
__________________
________________________
$______________
B. Other:
Creditor
Description of Claim
Amount of Claim
____________________
___________________________
$______________
____________________
___________________________
$______________
____________________
___________________________
$______________
____________________
___________________________
$______________
Total of Priority Claims to Be Paid Through the Plan:
$______________
155
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