Official Form 204 "Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders"

What Is Official Form 204?

This is a legal form that was released by the United States Bankruptcy Court on December 1, 2015 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2015;
  • 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 printable version of Official Form 204 by clicking the link below or browse more documents and templates provided by the United States Bankruptcy Court.

ADVERTISEMENT
ADVERTISEMENT

Download Official Form 204 "Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders"

1125 times
Rate (4.6 / 5) 67 votes
Fill in this information to identify the case:
Debtor name __________________________________________________________________
______________________
_________
United States Bankruptcy Court for the:
District of
(State)
Check if this is an
Case number (If known):
_________________________
amended filing
Official Form 204
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest
Unsecured Claims and Are Not Insiders
12/15
A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor
disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by
secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20
largest unsecured claims.
Name of creditor and complete
Name, telephone number, and
Nature of the claim
Indicate if
Amount of unsecured claim
mailing address, including zip code
email address of creditor
(for example, trade
claim is
If the claim is fully unsecured, fill in only unsecured
contact
debts, bank loans,
contingent,
claim amount. If claim is partially secured, fill in
professional
unliquidated,
total claim amount and deduction for value of
services, and
or disputed
collateral or setoff to calculate unsecured claim.
government
contracts)
Total claim, if
Deduction for
Unsecured
partially
value of
claim
secured
collateral or
setoff
1
2
3
4
5
6
7
8
Official Form 204
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims
page 1
Fill in this information to identify the case:
Debtor name __________________________________________________________________
______________________
_________
United States Bankruptcy Court for the:
District of
(State)
Check if this is an
Case number (If known):
_________________________
amended filing
Official Form 204
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest
Unsecured Claims and Are Not Insiders
12/15
A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor
disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by
secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20
largest unsecured claims.
Name of creditor and complete
Name, telephone number, and
Nature of the claim
Indicate if
Amount of unsecured claim
mailing address, including zip code
email address of creditor
(for example, trade
claim is
If the claim is fully unsecured, fill in only unsecured
contact
debts, bank loans,
contingent,
claim amount. If claim is partially secured, fill in
professional
unliquidated,
total claim amount and deduction for value of
services, and
or disputed
collateral or setoff to calculate unsecured claim.
government
contracts)
Total claim, if
Deduction for
Unsecured
partially
value of
claim
secured
collateral or
setoff
1
2
3
4
5
6
7
8
Official Form 204
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims
page 1
Debtor
_______________________________________________________
Case number
_____________________________________
(if known)
Name
Name of creditor and complete
Name, telephone number, and
Nature of the claim
Indicate if
Amount of unsecured claim
mailing address, including zip code
email address of creditor
(for example, trade
claim is
If the claim is fully unsecured, fill in only unsecured
contact
contingent,
debts, bank loans,
claim amount. If claim is partially secured, fill in
unliquidated,
professional
total claim amount and deduction for value of
or disputed
services, and
collateral or setoff to calculate unsecured claim.
government
contracts)
Total claim, if
Deduction for
Unsecured
partially
value of
claim
secured
collateral or
setoff
9
10
11
12
13
14
15
16
17
18
19
20
Official Form 204
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims
page 2
Page of 2