Official Form 122C-2 Chapter 13 Calculation of Your Disposable Income page 1 122C-2 Chapter 13 Calculation of Your Disposable Income To fill out this form, you will need your completed copy of Chapter 13 Statement of Your Current Monthly Income and Calculation of Commitment Period (Official Form 122C2261). Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for being accurate. If more space is needed, attach a separate sheet to this form. Include the line number to which the additional information applies. On the top of any additional pages, write your name and case number (if known). Part 1: Calculate Your Deductions from Your Income The Internal Revenue Service (IRS) issues National and Local Standards for certain expense amounts. Use these amounts to answer the questions in lines 6-15. To find the IRS standards, go online using the link specified in the separate instructions for this form. This information may also be available at the bankruptcy clerk222s office. Deduct the expense amounts set out in lines 6-15 regardless of your actual expense. In later parts of the form, you will use some of your actual expenses if they are higher than the standards. Do not include any operating expenses that you subtracted from income in lines 5 and 6 of Form 122C2261, and do not deduct any amounts that you subtracted from your spouse222s income in line 13 of Form 122C2261. If your expenses differ from month to month, enter the average expense. Note: Line numbers 1-4 are not used in this form. These numbers apply to information required by a similar form used in chapter 7 cases. 5. The number of people used in determining your deductions from incomeFill in the number of people who could be claimed as exemptions on your federal income taxreturn, plus the number of any additional dependents whom you support. This number maybe different from the number of people in your household. National Standards You must use the IRS National Standards to answer the questions in lines 6-7. 6. Food, clothing, and other items: Using the number of people you entered in line 5 and the IRS NationalStandards, fill in the dollar amount for food, clothing, and other items.$ 7. Out-of-pocket health care allowance: Using the number of people you entered in line 5 and the IRS NationalStandards, fill in the dollar amount for out-of-pocket health care. The number of people is split into twocategoriespeople who are under 65 and people who are 65 or olderbecause older people have a higher IRSallowance for health care costs. If your actual expenses are higher than this IRS amount, you may deduct theadditional amount on line 22. Debtor 1 First Name Middle Name Last Name Debtor 2 (Spouse, if filing) First Name Middle Name Last Name United States Bankruptcy Court for the: District of Case number (If known) Fill in this information to identify your case: Check if this is an amended filing American LegalNet, Inc. www.FormsWorkFlow.com Debtor 1 Case number (if known) First Name Middle Name Last Name Chapter 13 Calculation of Your Disposable Income page 2 P eople who are under 65 years of age 7a. Out-of-pocket health care allowance per person$ 7b. Number of people who are under 65 X 7c. Subtotal. Multiply line 7a by line 7b. $Copy here $ People who are 65 years of age or older 7d. Out-of-pocket health care allowance per person$ 7e. Number of people who are 65 or older X 7f. Subtotal. Multiply line 7d by line 7e. $Copy here+ $ 7g. Total. Add lines 7c and 7f. ..................................................................................................... . $ Copy here ....... $ Local Standards You must use the IRS Local Standards to answer the questions in lines 8-15. Based on information from the IRS, the U.S. Trustee Program has divided the IRS Local Standard for housing for bankruptcy purposes into two parts: Housing and utilities 226 Insurance and operating expensesHousing and utilities 226 Mortgage or rent expenses To answer the questions in lines 8-9, use the U.S. Trustee Program chart. To find the chart, go online using the link specified in the separate instructions for this form. This chart may also be available at the bankruptcy clerk222s office. 8. Housing and utilities 226 Insurance and operating expenses: Using the number of people you entered in line 5, fillin the dollar amount listed for your county for insurance and operating expenses. $ 9. Housing and utilities 226 Mortgage or rent expenses: 9a. Using the number of people you entered in line 5, fill in the dollar amount listed for your county for mortgage or rent expenses. $ 9b. Total average monthly payment for all mortgages and other debts secured by your home. To calculate the total average monthly payment, add all amounts that are contractually due to each secured creditor in the 60 months after you file for bankruptcy. Next divide by 60. Name of the creditor Average monthly payment $ $ + $ 9b. Total average monthly payment $ Copy here $ Repeat this amount on line 33a. 9c. Net mortgage or rent expense. Subtract line 9b (total average monthly payment) from line 9a (mortgage or rent expense). If this number is less than $0, enter $0. Copy here ....... $ $ 1 0. If you claim that the U.S. Trustee Program222s division of the IRS Local Standard for housing is incorrect and affectsthe calculation of your monthly expenses, fill in any additional amount you claim. $ Explain why: American LegalNet, Inc. www.FormsWorkFlow.com Debtor 1 Case number (if known) First Name Middle Name Last Name Chapter 13 Calculation of Your Disposable Income page 3 1 1. Local transportation expenses: Check the number of vehicles for which you claim an ownership or operating expense. 0. Go to line 14. 1. Go to line 12. 2 or more. Go to line 12. 12. Vehicle operation expense: Using the IRS Local Standards and the number of vehicles for which you claim the operatingexpenses, fill in the Operating Costs that apply for your Census region or metropolitan statistical area. $ 13. Vehicle ownership or lease expense: Using the IRS Local Standards, calculate the net ownership or lease expense foreach vehicle below. You may not claim the expense if you do not make any loan or lease payments on the vehicle. Inaddition, you may not claim the expense for more than two vehicles. Vehicle 1 Describe Vehicle 1: 13a. Ownership or leasing costs using IRS Local Standard ....................................... $ 13b. Average monthly payment for all debts secured by Vehicle 1. Do not include costs for leased vehicles. To calculate the average monthly payment here and on line 13e, add all amounts that are contractually due to each secured creditor in the 60 months after you file for bankruptcy. Then divide by 60. Name of each creditor for Vehicle 1 Average monthly payment $ + $ Total average monthly payment $ Copy here $ Repeat this amount on line 33b. 13c. Net Vehicle 1 ownership or lease expense Subtract line 13b from line 13a. If this number is less than $0, enter $0. ............ $Copy net Vehicle 1 expense here $ Vehicle 2 Describe Vehicle 2: 13d. Ownership or leasing costs using IRS Local Standard ................................... $ 13e. Average monthly payment for all debts secured by Vehicle 2. Do not include costs for leased vehicles. Name of each creditor for Vehicle 2 Average monthly payment $ + $ Total average monthly payment $ Copy here $ Repeat this amount on line 33c. 13f. Net Vehicle 2 ownership or lease expense Subtract line 13e from 13d. If this number is less than $0, enter $0. ................... $ Copy net Vehicle 2 expense here $ 1 4. Public transportation expense: If you claimed 0 vehicles in line 11, using the IRS Local Standards, fill in the PublicTransportation expense allowance regardless of whether you use public transportation. $ 1 5. Additional public transportation expense: If you claimed 1 or more vehicles in line 11 and if you claim that you may alsodeduct a public transportation expense, you may fill in what you believe is the appropriate expense, but you may not claimmore than the IRS Local Standard for Public Transportation. $ American LegalNet, Inc. www.FormsWorkFlow.com