Official Form 101 "Voluntary Petition for Individuals Filing for Bankruptcy"

What Is Official Form 101?

This is a legal form that was released by the United States Bankruptcy Court on April 1, 2020 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2020;
  • The latest available edition released by the United States Bankruptcy Court;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Official Form 101 by clicking the link below or browse more documents and templates provided by the United States Bankruptcy Court.

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Download Official Form 101 "Voluntary Petition for Individuals Filing for Bankruptcy"

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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
04/20
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.
– xx – ____ ____ ____ ____
– xx – ____ ____ ____ ____
xxx
xxx
your Social Security
number or federal
OR
OR
Individual Taxpayer
xx – xx – ____ ____ ____ ____
xx – xx – ____ ____ ____ ____
9
9
Identification number
(ITIN)
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 1
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
04/20
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.
– xx – ____ ____ ____ ____
– xx – ____ ____ ____ ____
xxx
xxx
your Social Security
number or federal
OR
OR
Individual Taxpayer
xx – xx – ____ ____ ____ ____
xx – xx – ____ ____ ____ ____
9
9
Identification number
(ITIN)
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 1
Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
About Debtor 1:
About Debtor 2 (Spouse Only in a Joint Case):
Any business names
4.
I have not used any business names or EINs.
I have not used any business names or EINs.
and Employer
Identification Numbers
(EIN) you have used in
_________________________________________________
_________________________________________________
the last 8 years
Business name
Business name
Include trade names and
_________________________________________________
_________________________________________________
doing business as names
Business name
Business name
___ ___ – ___ ___ ___ ___ ___ ___ ___
___ ___ – ___ ___ ___ ___ ___ ___ ___
EIN
EIN
___ ___ – ___ ___ ___ ___ ___ ___ ___
___ ___ – ___ ___ ___ ___ ___ ___ ___
EIN
EIN
If Debtor 2 lives at a different address:
Where you live
5.
_________________________________________________
_________________________________________________
Number
Street
Number
Street
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
City
State
ZIP Code
City
State
ZIP Code
_________________________________________________
_________________________________________________
County
County
If Debtor 2’s mailing address is different from
If your mailing address is different from the one
yours, fill it in here. Note that the court will send
above, fill it in here. Note that the court will send
any notices to this mailing address.
any notices to you at this mailing address.
_________________________________________________
_________________________________________________
Number
Street
Number
Street
_________________________________________________
_________________________________________________
P.O. Box
P.O. Box
_________________________________________________
_________________________________________________
City
State
ZIP Code
City
State
ZIP Code
Why you are choosing
Check one:
Check one:
6.
this district to file for
Over the last 180 days before filing this petition,
Over the last 180 days before filing this petition,
bankruptcy
I have lived in this district longer than in any
I have lived in this district longer than in any
other district.
other district.
I have another reason. Explain.
I have another reason. Explain.
(See 28 U.S.C. § 1408.)
(See 28 U.S.C. § 1408.)
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 2
Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
Part 2:
Tell the Court About Your Bankruptcy Case
The chapter of the
Check one. (For a brief description of each, see Notice Required by 11 U.S.C. § 342(b) for Individuals Filing
7.
for Bankruptcy (Form 2010)). Also, go to the top of page 1 and check the appropriate box.
Bankruptcy Code you
are choosing to file
Chapter 7
under
Chapter 11
Chapter 12
Chapter 13
I will pay the entire fee when I file my petition. Please check with the clerk’s office in your
How you will pay the fee
8.
local court for more details about how you may pay. Typically, if you are paying the fee
yourself, you may pay with cash, cashier’s check, or money order. If your attorney is
submitting your payment on your behalf, your attorney may pay with a credit card or check
with a pre-printed address.
I need to pay the fee in installments. If you choose this option, sign and attach the
Application for Individuals to Pay The Filing Fee in Installments (Official Form 103A).
I request that my fee be waived (You may request this option only if you are filing for Chapter 7.
By law, a judge may, but is not required to, waive your fee, and may do so only if your income is
less than 150% of the official poverty line that applies to your family size and you are unable to
pay the fee in installments). If you choose this option, you must fill out the Application to Have the
Chapter 7 Filing Fee Waived (Official Form 103B) and file it with your petition.
Have you filed for
9.
No
bankruptcy within the
Yes.
District __________________________ When
_______________ Case number ___________________________
last 8 years?
MM / DD / YYYY
District __________________________ When
_______________ Case number ___________________________
MM / DD / YYYY
District __________________________ When
_______________ Case number ___________________________
MM / DD / YYYY
Are any bankruptcy
10.
No
cases pending or being
Yes.
Debtor _________________________________________________ Relationship to you
_____________________
filed by a spouse who is
not filing this case with
District __________________________ When
_______________ Case number, if known____________________
you, or by a business
MM / DD / YYYY
partner, or by an
affiliate?
Debtor _________________________________________________ Relationship to you
_____________________
District __________________________ When
_______________ Case number, if known____________________
MM / DD / YYYY
Do you rent your
11.
No.
Go to line 12.
residence?
Yes. Has your landlord obtained an eviction judgment against you?
No. Go to line 12.
Yes. Fill out Initial Statement About an Eviction Judgment Against You (Form 101A) and file it as
part of this bankruptcy petition.
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 3
Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
Part 3:
Report About Any Businesses You Own as a Sole Proprietor
Are you a sole proprietor
12.
No. Go to Part 4.
of any full- or part-time
Yes. Name and location of business
business?
A sole proprietorship is a
_______________________________________________________________________________________
business you operate as an
Name of business, if any
individual, and is not a
separate legal entity such as
_______________________________________________________________________________________
a corporation, partnership, or
Number
Street
LLC.
If you have more than one
_______________________________________________________________________________________
sole proprietorship, use a
separate sheet and attach it
_______________________________________________
_______
__________________________
to this petition.
City
State
ZIP Code
Check the appropriate box to describe your business:
Health Care Business (as defined in 11 U.S.C. § 101(27A))
Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))
Stockbroker (as defined in 11 U.S.C. § 101(53A))
Commodity Broker (as defined in 11 U.S.C. § 101(6))
None of the above
If you are filing under Chapter 11, the court must know whether you are a small business debtor or a debtor
Are you filing under
13.
choosing to proceed under Subchapter V so that it can set appropriate deadlines. If you indicate that you
Chapter 11 of the
are a small business debtor or you are choosing to proceed under Subchapter V, you must attach your
Bankruptcy Code, and
most recent balance sheet, statement of operations, cash-flow statement, and federal income tax return or
are you a small business
if any of these documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B).
debtor or a debtor as
defined by 11 U.S. C. §
No. I am not filing under Chapter 11.
1182(1)?
No. I am filing under Chapter 11, but I am NOT a small business debtor according to the definition in
For a definition of small
the Bankruptcy Code.
business debtor, see
Yes. I am filing under Chapter 11, I am a small business debtor according to the definition in the Bankruptcy
11 U.S.C. § 101(51D).
Code, and I do not choose to proceed under Subchapter V of Chapter 11.
Yes. I am filing under Chapter 11, I am a debtor according to the definition in § 1182(1) of the
Bankruptcy Code, and I choose to proceed under Subchapter V of Chapter 11.
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 4
Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
Part 4:
Report if You Own or Have Any Hazardous Property or Any Property That Needs Immediate Attention
Do you own or have any
14.
No
property that poses or is
Yes. What is the hazard?
alleged to pose a threat
________________________________________________________________________
of imminent and
identifiable hazard to
________________________________________________________________________
public health or safety?
Or do you own any
property that needs
If immediate attention is needed, why is it needed?
_______________________________________________
immediate attention?
For example, do you own
________________________________________________________________________
perishable goods, or livestock
that must be fed, or a building
that needs urgent repairs?
Where is the property?
________________________________________________________________________
Number
Street
________________________________________________________________________
________________________________________ _______
____________________
City
State
ZIP Code
Official Form 101
Voluntary Petition for Individuals Filing for Bankruptcy
page 5
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