FORM A Page 1 of 3 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF COLUMBIA In re ) ) ) ) Debtor(s). ) Case No. (Chapter 7) SCHEDULE OF UNPAID DEBTS INCURRED AFTER FILING OF ORIGINAL PETITION TO DATE OF CONVERSION CREDITORS HOLDING SECURED CLAIMS HUSBAND, WIFE, OR JOINT DISPUTED CREDITOR'S NAME AND ADDRESS INCLUDING ZIP CODE DATE CLAIM WAS INCURRED, NATURE OF LIEN, AND DESCRIPTION AND MARKET VALUE OF PROPERTY SUBJECT TO LIEN UNLIQUIDATED CONTINGENT AMOUNT OF CLAIM WITHOUT DEDUCTING VALUE OF COLLATERAL CODEBTOR UNSECURED PORTION, IF ANY, OF CLAIM ACCOUNT NO. VALUE $ $ $ ACCOUNT NO. VALUE $ $ $ ACCOUNT NO. VALUE $ $ $ ACCOUNT NO. VALUE $ $ $ ACCOUNT NO. VALUE $ $ $ [ ] No such secured debts were incurred. American LegalNet, Inc. www.USCourtForms.com FORM A Page 2 of 3 SCHEDULE OF UNPAID DEBTS INCURRED AFTER FILING OF ORIGINAL PETITION TO DATE OF CONVERSION (CONT'D) CREDITORS HOLDING UNSECURED CLAIMS (PRIORITY AND/OR NON-PRIORITY) HUSBAND, WIFE, OR JOINT CONTINGENT CODEBTOR PRIORITY CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE DISPUTED DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM. IF CLAIM IS SUBJECT TO SETOFF, SO STATE UNLIQUIDATED AMOUNT OF CLAIM *Account No. $ *Account No. $ *Account No. $ *Account No. $ *Account No. $ *Account No. $ [ ] No such unsecured debts were incurred. * If the claim is a priority claim, the debtor should specify what type of priority claim (the types being listed on the original schedules filed in this case). American LegalNet, Inc. www.USCourtForms.com FORM A Page 3 of 3 DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR I, the undersigned, hereby declare under penalty of perjury that I have read the foregoing schedule and that it is true and correct to the best of my knowledge, information and belief. __________ ___, 20__ ______________________________ Debtor __________ ___, 200__ ______________________________ Joint Debtor CERTIFICATE OF SERVICE I, the undersigned, hereby declare under penalty of perjury that the above Schedule of Unpaid Debts Incurred After Filing of Original Petition to Date of Conversion was served by first class mail this ___ day of __________, 20__ upon the Chapter 7 trustee and the United States Trustee. ________________________________________ Debtor's Attorney [or Debtor if pro se] American LegalNet, Inc. www.USCourtForms.com FORM B Page 1 of 2 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF COLUMBIA In re ) ) ) ) Debtor(s). ) Case No. (Chapter 7) STATEMENT THAT NO DEBTS WERE INCURRED AFTER FILING OF ORIGINAL PETITION TO DATE OF CONVERSION, OR ALTERNATIVELY, THAT DEBTS INCURRED AFTER FILING OF ORIGINAL PETITION TO DATE OF CONVERSION ARE REFLECTED ON ORIGINAL SCHEDULES FILED AFTER CONVERSION OF CASE (Check one of the following.) [] No debts were incurred by the debtor(s) after the filing of the original petition initiating the above-captioned bankruptcy case. All debts incurred by the debtor(s) after the filing of the original petition initiating the above-captioned bankruptcy case are reflected on the original schedules filed after conversion of the case. [] DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR I, the undersigned, hereby declare under penalty of perjury that I have read the foregoing statement and that it is true and correct to the best of my knowledge, information and belief. Executed on: __________ ___, 20__ ________________________________ Debtor Executed on: __________ ___, 20__ ________________________________ Joint Debtor American LegalNet, Inc. www.USCourtForms.com FORM B Page 2 of 2 CERTIFICATE OF SERVICE I, the undersigned, hereby declare under penalty of perjury that the above Statement That No Debts Were Incurred After Filing of Original Petition to Date of Conversion, Or Alternatively, That Debts Incurred After Filing of Original Petition To Date Of Conversion Are Reflected On Original Schedules Filed After Conversion Of Case was served by first class mail this ___ day of __________, 200__ upon the Chapter 7 trustee and the United States Trustee. ________________________________________ Debtor's Attorney [or Debtor if pro se] American LegalNet, Inc. www.USCourtForms.com FORM C Page 1 of 1 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF COLUMBIA In re ) ) ) ) Debtor(s). ) Case No. (Chapter 7) (Check one of the following.) [ ] First Alternative: When the clerk has issued the Notice of Commencement of Case: CERTIFICATE OF SERVICE OF NOTICE OF COMMENCEMENT OF CASE I, the undersigned, hereby declare under penalty of perjury that a copy of the Notice of Commencement of Case issued by the clerk in this Chapter 7 case was served by first class mail this ___ day of __________, 20__ upon each creditor added by the Schedule of Unpaid Debts Incurred After Filing of Original Petition to Date of Conversion and each entity included on the Schedule of Executory Contracts and Unexpired Leases Entered Into or Assumed After Filing of Petition and Before Date of Conversion filed or to be filed contemporaneously herewith. [ ] Second Alternative: When No Notice of Commencement of Case has yet been issued by the clerk: NOTICE BY DEBTOR OF COMMENCEMENT OF CASE I, the undersigned, hereby declare under penalty of perjury that I have served a copy of this Notice by first class mail this ___ day of __________, 20__ upon each creditor added by the Schedule of Unpaid Debts Incurred After Filing of Original Petition to Date of Conversion and each entity included on the Schedule of Executory Contracts and Unexpired Leases Entered Into or Assumed After Filing of Petition and Before Date of Conversion filed or to be filed contemporaneously herewith, so as to notify each such entity of the pendency of this case (in which the clerk has not yet issued a Notice of Commencement of Case received by me) as a Chapter 7 case that was converted to Chapter 7 from Chapter 13 on [Date of Notice of Conversion]. ________________________________________ Debtor's Attorney [or Debtor if pro se] American LegalNet, Inc. www.USCourtForms.com Form D Page 1 of 1 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF COLUMBIA In re ) ) ) ) Debtor(s). ) Case No. (Chapter 7) SUPPLEMENTAL MAILING MATRIX COVER SHEET AND SUPPLEMENTAL LIST OF CREDITORS The attached Supplemental Mailing Matrix and Supplemental List of Creditors in the above-captioned bankruptcy case consists of creditors to be added to the matrix and to the list of creditors. __________ ___, 20__ ______________________________ Debtor __________ ___, 20__ _