Fill in this information to identify your case:
United States Bankruptcy Court for the:
__________ District of __________
__________ District of __________
Case number
_________________________ Chapter you are filing under:
(If known):
Chapter 7
Chapter 11
Chapter 12
Check if this is an
Chapter 13
amended filing
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
12/15
The bankruptcy forms use you and Debtor 1 to refer to a debtor filing alone. A married couple may file a bankruptcy case together—called a
joint case—and in joint cases, these forms use you to ask for information from both debtors. For example, if a form asks, “Do you own a car,”
the answer would be yes if either debtor owns a car. When information is needed about the spouses separately, the form uses Debtor 1 and
Debtor 2 to distinguish between them. In joint cases, one of the spouses must report information as Debtor 1 and the other as Debtor 2. The
same person must be Debtor 1 in all of the forms.
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct
information. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number
(if known). Answer every question.
Part 1:
Identify Yourself
About Debtor 1:
About Debtor 2 (Spouse Only in a Joint Case):
Your full name
1.
Write the name that is on your
__________________________________________________
__________________________________________________
government-issued picture
First name
First name
identification (for example,
your driver’s license or
__________________________________________________
__________________________________________________
passport).
Middle name
Middle name
__________________________________________________
__________________________________________________
Bring your picture
Last name
Last name
identification to your meeting
with the trustee.
___________________________
___________________________
Suffix (Sr., Jr., II, III)
Suffix (Sr., Jr., II, III)
All other names you
2.
__________________________________________________
__________________________________________________
have used in the last 8
First name
First name
years
__________________________________________________
__________________________________________________
Middle name
Middle name
Include your married or
maiden names.
__________________________________________________
__________________________________________________
Last name
Last name
__________________________________________________
__________________________________________________
First name
First name
__________________________________________________
__________________________________________________
Middle name
Middle name
__________________________________________________
__________________________________________________
Last name
Last name
Only the last 4 digits of
3.
xxx
– xx – ____ ____ ____ ____
xxx
– xx – ____ ____ ____ ____
your Social Security
number or federal
OR
OR
Individual Taxpayer
9
9
xx – xx – ____ ____ ____ ____
xx – xx – ____ ____ ____ ____
Identification number
(ITIN)
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 1