Schedule I - Current Income Of Individual Debtor
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1RESET FORM
B6I (Official Form 6I) (12/07)
In re
,
Case No.
Debtor
(if known)
SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)
The column labeled “Spouse” must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petition is
filed, unless the spouses are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthly income
calculated on this form may differ from the current monthly income calculated on From 22A, 22B, or 22C.
Debtor’s Marital
DEPENDENTS OF DEBTOR AND SPOUSE
Status:
RELATIONSHIP(S):
AGE(S):
Employment:
DEBTOR
SPOUSE
Occupation
Name of Employer
How long employed
Address of Employer
INCOME: (Estimate of average or projected monthly income at time
DEBTOR
SPOUSE
case filed)
$________________
$______________
1. Monthly gross wages, salary, and commissions
(Prorate if not paid monthly)
$________________
$______________
2. Estimate monthly overtime
3. SUBTOTAL
$_______________
$_____________
4. LESS PAYROLL DEDUCTIONS
$
$
a. Payroll taxes and social security
$
$
b. Insurance
$
$
c. Union dues
$
$
d. Other (Specify):
5. SUBTOTAL OF PAYROLL DEDUCTIONS
$
$
6. TOTAL NET MONTHLY TAKE HOME PAY
$
$
7. Regular income from operation of business or profession or farm
$
$
(Attach detailed statement)
$
$
8. Income from real property
9. Interest and dividends
$
$
10. Alimony, maintenance or support payments payable to the debtor for
$
$
the debtor’s use or that of dependents listed above
11. Social security or government assistance
(Specify):
$
$
12. Pension or retirement income
$
$
13. Other monthly income
(Specify):
$
$
$
$
14. SUBTOTAL OF LINES 7 THROUGH 13
$
$
15. AVERAGE MONTHLY INCOME (Add amounts on lines 6 and 14)
$
16. COMBINED AVERAGE MONTHLY INCOME: (Combine column
totals from line 15)
(Report also on Summary of Schedules and, if applicable,
on Statistical Summary of Certain Liabilities and Related Data)
17. Describe any increase or decrease in income reasonably anticipated to occur within the year following the filing of this document:
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