Free Exhibit "A" to Voluntary Petition - North Dakota


File Size: 50.0 kB
Pages: 1
Date: January 29, 2008
File Format: PDF
State: North Dakota
Category: Bankruptcy
Word Count: 138 Words, 1,476 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.ndb.uscourts.gov/forms/pro_se/ExhibitA.pdf

Download Exhibit "A" to Voluntary Petition ( 50.0 kB)


Preview Exhibit "A" to Voluntary Petition
Form B1, Exh.A (9/97)

Exhibit "A" to Voluntary Petition

1. If any of the debtor's securities are registered under Section 12 of the Securities Exchange Act of 1934, the SEC file number is _______________. 2. The following financial data is the latest available information and refers to the debtor's condition on ______________. a. b. Total assets Total debts (including debts listed in 2.c., below) $ _____________________________ $ ______________________________ Approximate number of holders c. Debt securities held by more than 500 holders. secured / /
secured / / unsecured / / unsecured / / unsecured / / unsecured / / unsecured / / subordinated / / subordinated / / subordinated / / subordinated / / subordinated / / $ _________________________ $__________________________ $ _________________________ $__________________________ $__________________________ _______________ _______________ _______________ _______________ _______________

secured / /
secured / / secured / /

d. e.

Number of shares of preferred stock Number of shares common stock

_______________________ _______________________

_____________ _____________

Comments, if any: _____________________________________________________________________

3.

Brief description of debtor's business: ____________________________________________________

4. List the names of any person who directly or indirectly owns, controls, or holds, with power to vote, 5% or more of the voting securities of debtor: