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File Size: 8.6 kB
Pages: 1
Date: July 16, 2007
File Format: PDF
State: All
Category: General Forms
Author: myerss
Word Count: 66 Words, 763 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.uscourts.gov/rules/BK_Forms_1207/B_016A_1207.pdf

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B16A (Official Form 16A) (12/07)

Form 16A. CAPTION (FULL)

United States Bankruptcy Court
_______________ District Of _______________

In re __________________________________________, [Set forth here all names including married, maiden, and trade names used by debtor within last 8 years.] Debtor

) ) ) ) ) Case No. ________________ ) Address ________________________________________ ) ) ________________________________________ ) Chapter ___________ ) Last four digits of Social-Security or Individual TaxPayer-Identification (ITIN) No(s).,(if any): ___________ ) ______________________________________________ ) Employer Tax-Identification (EIN) No(s).(if any): _____ ) _______________________________________________ )

[Designation of Character of Paper]