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Debtor 1

_______________________________________________________

Case number

_____________________________________

(if known)

First Name

Middle Name

Last Name

Calculate the median family income that applies to you. Follow these steps:

16.

Fill in the state in which you live.

_________

16a.

Fill in the number of people in your household.

_________

16b.

Fill in the median family income for your state and size of household. .............................................................................

16c.

$___________

To find a list of applicable median income amounts, go online using the link specified in the separate

instructions for this form. This list may also be available at the bankruptcy clerk’s office.

How do the lines compare?

17.



Line 15b is less than or equal to line 16c. On the top of page 1 of this form, check box 1, Disposable income is not determined under 11 U.S.C.

17a.

§ 1325(b)(3). Go to Part 3.

Do NOT fill out Calculation of Disposable Income (Official Form 22C–2).



Line 15b is more than line 16c. On the top of page 1 of this form, check box 2, Disposable income is determined under 11 U.S.C.

17b.

§ 1325(b)(3). Go to Part 3

and fill out Calculation of Disposable Income (Official Form 22C–2). On line 39 of that form, copy

your current monthly income from line 14 above.

Part 3:

Calculate Your Commitment Period Under 11 U.S.C. §1325(b)(4)

Copy your total average monthly income from line 11.

18.

...................................................................................................................... 18.

$__________

Deduct the marital adjustment if it applies. If you are married, your spouse is not filing with you, and you contend

19.

that calculating the commitment period under 11 U.S.C. § 1325(b)(4) allows you to deduct part of your spouse’s

income, copy the amount from line 13d.

─

$__________

If the marital adjustment does not apply, fill in 0 on line 19a.

19a.

Subtract line 19a from line 18.

$__________

19b.

Calculate your current monthly income for the year. Follow these steps:

20.

Copy line 19b.. ...................................................................................................................................................................

20a.

$___________

x 12

Multiply by 12 (the number of months in a year).

. The result is your current monthly income for the year for this part of the form.

$___________

20b

20b.

Copy the median family income for your state and size of household from line 16c. ..........................................................

20c.

$___________

How do the lines compare?

21.



Line 20b is less than line 20c. Unless otherwise ordered by the court, on the top of page 1 of this form, check box 3, The commitment period is

3 years. Go to Part 4.



Line 20b is more than or equal to line 20c. Unless otherwise ordered by the court, on the top of page 1 of this form,

check box 4, The commitment period is 5 years. Go to Part 4.

Part 4:

Sign Below

By signing here, under penalty of perjury I declare that the information on this statement and in any attachments is true and correct.



____________________________________

___________________________________________________

Signature of Debtor 1

Signature of Debtor 2

Date _________________

MM / DD

/ YYYY

MM / DD

/ YYYY

If you checked 17a, do NOT fill out or file Form 22C–2.

If you checked 17b, fill out Form 22C–2 and file it with this form.

On line 39 of that form, copy your current monthly income from line 14 above.

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Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period

page 3

Official Form B 22C1

Official Form B 22c1 - Chapter 13 Statement Of Your Current Monthly Income And Calculation Of Commitment Period Page 4

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