Free PDF - Michigan

Revised 05/08

UNITED STATES BANKRUPTCY COURT
Eastern District of Michigan

In re: Case No. Debtor(s). /

BANKRUPTCY PETITION COVER SHEET

(The debtor must complete and file this form with the petition in every bankruptcy case. Instead of filling in the boxes on the petition requiring information on prior and pending cases, the debtor may refer to this form.)
Part 1 "Companion cases," as defined in L.B.R. 1073-1(b), are cases involving any of the following: (1) The same debtor; (2) A corporation and any majority shareholder thereof; (3) Affiliated corporations; (4) A partnership and any of its general partners; (5) An individual and his or her general partner; (6) An individual and his or her spouse; or (7) Individuals or entities with any substantial identity of financial interest or assets. Has a "companion case" to this case ever been filed at any time in this district or any other district? Yes ____ (If yes, complete Part 2.) Part 2 For each companion case, state in chronological order of cases: (Attach supplemental sheets if necessary.) First Case Name on petition Relationship to this case Case Number Chapter Date filed District Division Judge Status/Disposition Second Case Third Case No ____

(Pending, confirmed & still open, confirmed & closed, dismissed before/after confirmation, discharged, etc.)
If the present case is a Chapter 13 case, state for each companion case: Attorney _______________________ _______________________ _______________________ Legal fee $ $ $ Proposed legal fee in this case $____________________________ Changes in circumstances which lead the debtor to reasonably believe that the current plan will be successful.

Part 3 - In a Chapter 13 Case Only The Debtor(s) certify, re: 11 U.S.C.§ 1328(f): [indicate which]

9 Debtor(s) received a discharge issued in a case filed under Chapter 7, 11, or 12 during the 4-years before filing this case. 9 Debtor(s) did not receive a discharge issued in a case filed under Chapter 7, 11, or 12 during the 4-years before filing this case. 9 Debtor(s) received a discharge in a Chapter 13 case filed during the 2-years before filing this case. 9 Debtor(s) did not receive a discharge in a Chapter 13 case filed during the 2-years before filing this case.
I declare under penalty of perjury that I have read this form and that it is true and correct to the best of my information and belief.. _______________________ Debtor Date: __________________________ Debtor ___________________________ Debtor's Attorney