B 8 (Official Form 8) (12/08) UNITED STATES BANKRUPTCY COURT __________ District of __________ In re ____________________________, Case No. ___________________ Debtor Chapter 7 CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION PART A – Debts secured by property of the estate. (Part A must be fully completed for EACH debt which is secured by property of the estate. Attach additional pages if necessary.) Property No. 1 Creditor's Name: Property will be (check one): ’ Surrendered Describe Property Securing Debt: ’ Retained If retaining the property, I intend to (check at least one): ’ Redeem the property ’ Reaffirm the debt ’ Other. Explain ________________________________ (for example, avoid lien using 11 U.S.C. § 522(f)). Property is (check one): ’ Claimed as exempt ’ Not claimed as exempt Property No. 2 (if necessary) Creditor's Name: Property will be (check one): ’ Surrendered Describe Property Securing Debt: ’ Retained If retaining the property, I intend to (check at least one): ’ Redeem the property ’ Reaffirm the debt ’ Other. Explain ________________________________ (for example, avoid lien using 11 U.S.C. § 522(f)). Property is (check one): ’ Claimed as exempt ’ Not claimed as exempt American LegalNet, Inc. www.FormsWorkflow.com Page 2 B 8 (Official Form 8) (12/08) PART B – Personal property subject to unexpired leases. (All three columns of Part B must be completed for each unexpired lease. Attach additional pages if necessary.) Property No. 1 Lessor’s Name: Describe Leased Property: Lease will be Assumed pursuant to 11 U.S.C. § 365(p)(2): ’ YES ’ NO Describe Leased Property: Lease will be Assumed pursuant to 11 U.S.C. § 365(p)(2): ’ YES ’ NO Describe Leased Property: Lease will be Assumed pursuant to 11 U.S.C. § 365(p)(2): ’ YES ’ NO Property No. 2 (if necessary) Lessor’s Name: Property No. 3 (if necessary) Lessor’s Name: _____ continuation sheets attached (if any) I declare under penalty of perjury that the above indicates my intention as to any property of my estate securing a debt and/or personal property subject to an unexpired lease. Date: ____________________ ___________________________________________ Signature of Debtor ___________________________________________ Signature of Joint Debtor American LegalNet, Inc. www.FormsWorkflow.com Page 3 B 8 (Official Form 8) (12/08) CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION (Continuation Sheet) PART A - Continuation Property No. Creditor's Name: Property will be (check one): ’ Surrendered Describe Property Securing Debt: ’ Retained If retaining the property, I intend to (check at least one): ’ Redeem the property ’ Reaffirm the debt ’ Other. Explain ________________________________ (for example, avoid lien using 11 U.S.C. § 522(f)). Property is (check one): ’ Claimed as exempt ’ Not claimed as exempt PART B - Continuation Property No. Lessor’s Name: Describe Leased Property: Lease will be Assumed pursuant to 11 U.S.C. § 365(p)(2): ’ YES ’ NO Describe Leased Property: Lease will be Assumed pursuant to 11 U.S.C. § 365(p)(2): ’ YES ’ NO Property No. Lessor’s Name: American LegalNet, Inc. www.FormsWorkflow.com