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Application For Waiver Of The Chapter 7 Filing Fee Form. This is a New Mexico form and can be use in Bankruptcy Court Federal.
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Tags: Application For Waiver Of The Chapter 7 Filing Fee, 3B, New Mexico Federal, Bankruptcy Court
UNITED STATES BANKRUPTCY COURT
DISTRICT OF NEW MEXICO
In re
Debtor.
Case No. 7-_______________
APPLICATION FOR WAIVER
OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS
WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS
Part A. Family Size and Income
1. Including yourself, your spouse, and dependents you have listed or will list on Schedule I,
Current Income of Individual Debtors, how many people are in your family? (Do not include
your spouse if you are separated AND are not filing a joint petition.)
2. Restate the following information that you provided, or will provide, on Line 16 of
Schedule I. Attach a completed copy of Schedule I, if it is available.
$
3. State the monthly net income, if any, of dependents included in Question 1 above. Do not
include any income already reported in Question 2. If none, enter $ 0.
$
4. Add the “Total combined monthly income” reported in Question 2 to your dependents*
monthly net income from Question 3.
$
5. Do you expect the amount in Question 4 to increase or decrease by more than 10% during the
next 6 months? Yes
No
If yes, explain:
Part B. Monthly Expenses
6. EITHER (a) attach a completed copy of Schedule J, Current Expenditures of Individual
Debtor, and state your total monthly expenses reported on Line 18 of that Schedule, OR (b) if
you have not yet completed Schedule J, provide an estimate of your total monthly expenses.
Total monthly expenses from Schedule J or estimate:
$
7. Do you expect the amount in Question 6 to increase or decrease by more than 10% during
No
If yes, explain:
the next 6 months? Yes
Part C. Real and Personal Property EITHER (I) attach completed copies of Schedules A
(Real Property) and Schedule B (Personal Property) OR (2) if you have not yet completed those
schedules, answer the following questions.
8. State the amount of cash you have on hand:
$
9. State below any money you have in savings, checking, or other accounts in a bank or other
financial institution.
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Name of Financial Institution
Type of account such as
checking, savings, CD
Amount
$
$
10. State assets owned by you. Do not list ordinary household furnishings and clothing.
Address
Value: $
Home
Amount owed on
mortgages/liens: $
Address
Other real
Value: $
estate
Amount owed on
mortgages/liens: $
Motor vehicle
model/year:
Value:
Amount owed:
$
$
Motor vehicle
model/year:
Value:
Amount owed:
$
$
Other (Describe):
Value: $
Amount owed: $
11. State below any person, business, organization, or governmental unit that owes you money
and the amount that is owed.
Name of Person, Business, or Organization that Owes You Money
Amount Owed:
$
$
Part D. Additional Information
12. Have you paid an attorney any money for services in connection with this case, including
No
If yes,
the completion of this form, the bankruptcy petition, or schedules? Yes
how much have you paid?
$
13. Have you promised to pay or do you anticipate paying an attorney in connection with your
bankruptcy case? Yes
No
If yes, how much have you promised to pay or do you
anticipate paying?
$
14. Have you paid anyone other than an attorney (such as a bankruptcy petition preparer,
paralegal, typing service, or another person) any money for services in connection with this case,
including the completion of this form, the bankruptcy petition, or schedules? Yes
No
If yes, how much have you paid?
$
15. Have you promised to pay or do you anticipate paying anyone other than an attorney
(such as a bankruptcy petition preparer, paralegal, typing service, or another person) any money
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for services in connection with this case, including the completion of this form, the bankruptcy
petition, or schedules? Yes
No
If yes, how much have you promised to pay or do you
anticipate paying?
$
16. Has anyone paid an attorney or other person or service in connection with this case, on your
No
If yes, explain:
behalf? Yes
17. Have you filed for bankruptcy relief during the past eight years? Yes
Case Number (if known)
Year filed
Location of filing
No
Did you obtain a discharge?
Yes
Yes
No
No
Don*t know
Don*t know
18. Please provide any other information that helps to explain why you are unable to pay the
filing fee in installments.
Part E. Alternative to Waiver If the application for waiver of the filing fee is DENIED, the
Court may allow you to pay the filing fee in installments. Please propose a payment schedule:
1st payment of $
on or before
2nd payment of $
on or before
rd
3 payment of $
on or before
4th payment of $
on or before
Total: $
Until the filing fee is paid in full, I will not make any additional payment or transfer any
additional property to an attorney or any other person for services in connection with this case.
I understand that the filing fee must be paid within 120 days of the petition filing date
and in a maximum of four installments. For cause shown, the court may extend the time of any
installment, provided the last installment is paid not later than 180 days after the filing date of
the petition. Fed. R. Bankr. P. 1006(b)(2). I also understand that if I fail to pay any
installment when due, my bankruptcy case may be dismissed, I may not receive a discharge of
my debts, and I will still owe the fee to the Bankruptcy Court.
I declare under penalty of perjury that I cannot currently afford to pay the filing fee in
full or in installments and that the foregoing information is true and correct.
Signature of Debtor
Date
Signature of Joint Debtor
Date
Signature of Attorney
Date
Typed name, address, and telephone number
of attorney:
____________________________________
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