Statement Of Financial Affairs Template Page 7
Download a blank fillable Statement Of Financial Affairs Template in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Statement Of Financial Affairs Template with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
117
16. Spouses and Former Spouses
If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona,
None
California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight
years immediately preceding the commencement of the case, identify the name of the debtor’s spouse and of
any former spouse who resides or resided with the debtor in the community property state.
NAME
______________________________________________________________________________________________________
17. Environmental Information.
For the purpose of this question, the following definitions apply:
"Environmental Law" means any federal, state, or local statute or regulation regulating pollution, contamination,
releases of hazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, or
other medium, including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes,
or material.
"Site" means any location, facility, or property as defined under any Environmental Law, whether or not presently or
formerly owned or operated by the debtor, including, but not limited to, disposal sites.
"Hazardous Material" means anything defined as a hazardous waste, hazardous substance, toxic substance, hazardous
material, pollutant, or contaminant or similar term under an Environmental Law.
________________________________________________________________________________________________
a. List the name and address of every site for which the debtor has received notice in writing by a governmental
None
unit that it may be liable or potentially liable under or in violation of an Environmental Law. Indicate the
governmental unit, the date of the notice, and, if known, the Environmental Law:
SITE NAME
NAME AND ADDRESS
DATE OF
ENVIRONMENTAL
AND ADDRESS
OF GOVERNMENTAL UNIT
NOTICE
LAW
______________________________________________________________________________________________________
b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release
None
of Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice.
SITE NAME
NAME AND ADDRESS
DATE OF
ENVIRONMENTAL
AND ADDRESS
OF GOVERNMENTAL UNIT
NOTICE
LAW
_____________________________________________________________________________________________________
c. List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law with
None
respect to which the debtor is or was a party. Indicate the name and address of the governmental unit that is or was a party
to the proceeding, and the docket number.
NAME AND ADDRESS
DOCKET NUMBER
STATUS OR
OF GOVERNMENTAL UNIT
DISPOSITION
______________________________________________________________________________________________________
18 . Nature, location and name of business
a. If the debtor is an individual, list the names, addresses, taxpayer-identification numbers, nature of the businesses,
None
and beginning and ending dates of all businesses in which the debtor was an officer, director, partner, or managing
executive of a corporation, partner in a partnership, sole proprietor, or was self-employed in a trade, profession, or
other activity either full- or part-time within six years immediately preceding the commencement of this case, or in
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal