Form B1 - Voluntary Petition - United States Bankruptcy Court Page 3
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3B1 (Official Form 1) (04/13)
Page 3
Voluntary Petition
Name of Debtor(s):
(This page must be completed and filed in every case.)
Signatures
Signature(s) of Debtor(s) (Individual/Joint)
Signature of a Foreign Representative
I declare under penalty of perjury that the information provided in this petition is true
I declare under penalty of perjury that the information provided in this petition is true
and correct, that I am the foreign representative of a debtor in a foreign proceeding,
and correct.
and that I am authorized to file this petition.
[If petitioner is an individual whose debts are primarily consumer debts and has
chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12
(Check only one box.)
or 13 of title 11, United States Code, understand the relief available under each such
chapter, and choose to proceed under chapter 7.
I request relief in accordance with chapter 15 of title 11, United States Code.
[If no attorney represents me and no bankruptcy petition preparer signs the petition] I
Certified copies of the documents required by 11 U.S.C. § 1515 are attached.
have obtained and read the notice required by 11 U.S.C. § 342(b).
Pursuant to 11 U.S.C. § 1511, I request relief in accordance with the
I request relief in accordance with the chapter of title 11, United States Code,
chapter of title 11 specified in this petition. A certified copy of the
specified in this petition.
order granting recognition of the foreign main proceeding is attached.
X
X
Signature of Debtor
(Signature of Foreign Representative)
X
Signature of Joint Debtor
(Printed Name of Foreign Representative)
Telephone Number (if not represented by attorney)
Date
Date
Signature of Attorney*
Signature of Non-Attorney Bankruptcy Petition Preparer
X
I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as
Signature of Attorney for Debtor(s)
defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have
provided the debtor with a copy of this document and the notices and information
Printed Name of Attorney for Debtor(s)
required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and, (3) if rules or
guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum
Firm Name
fee for services chargeable by bankruptcy petition preparers, I have given the debtor
notice of the maximum amount before preparing any document for filing for a debtor
or accepting any fee from the debtor, as required in that section. Official Form 19 is
attached.
Address
Telephone Number
Printed Name and title, if any, of Bankruptcy Petition Preparer
Date
Social-Security number (If the bankruptcy petition preparer is not an individual,
*In a case in which § 707(b)(4)(D) applies, this signature also constitutes a
state the Social-Security number of the officer, principal, responsible person or
certification that the attorney has no knowledge after an inquiry that the information
partner of the bankruptcy petition preparer.) (Required by 11 U.S.C. § 110.)
in the schedules is incorrect.
Signature of Debtor (Corporation/Partnership)
I declare under penalty of perjury that the information provided in this petition is true
Address
and correct, and that I have been authorized to file this petition on behalf of the
debtor.
X
The debtor requests the relief in accordance with the chapter of title 11, United States
Signature
Code, specified in this petition.
X
Date
Signature of Authorized Individual
Signature of bankruptcy petition preparer or officer, principal, responsible person, or
Printed Name of Authorized Individual
partner whose Social-Security number is provided above.
Title of Authorized Individual
Names and Social-Security numbers of all other individuals who prepared or assisted
in preparing this document unless the bankruptcy petition preparer is not an
Date
individual.
If more than one person prepared this document, attach additional sheets conforming
to the appropriate official form for each person.
A bankruptcy petition preparer’s failure to comply with the provisions of title 11 and
the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or
both. 11 U.S.C. § 110; 18 U.S.C. § 156.
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