Fill in this information to identify the case: United States Bankruptcy Court for the: ____________________ District of _________________ (State) Case number (If known): _________________________ Chapter _____ Check if this is an amended filing Official Form 205 Involuntary Petition Against a Non-Individual 12/15 Use this form to begin a bankruptcy case against a non-individual you allege to be a debtor subject to an involuntary case. If you want to begin a case against an individual, use the Involuntary Petition Against an Individual (Official Form 105). Be as complete and accurate as possible. If more space is needed, attach any additional sheets to this form. On the top of any additional pages, write debtor's name and case number (if known). Part 1: Identify the Chapter of the Bankruptcy Code Under Which Petition Is Filed 1. Chapter of the Bankruptcy Code Check one: Chapter 7 Chapter 11 Part 2: 2. Identify the Debtor ______________________________________________________________________________________________________ Debtor's name 3. Other names you know the debtor has used in the last 8 years Include any assumed names, trade names, or doing business as names. __________________________________________________ __________________________________________________ __________________________________________________ 4. Debtor's federal Employer Identification Number (EIN) Unknown ___ ___ ­ ___ ___ ___ ___ ___ ___ ___ EIN 5. Debtor's address Principal place of business Mailing address, if different ________________________________________________ Number Street _________________________________________________ Number Street _________________________________________________ P.O. Box _____________________________ _______ _________ City State ZIP Code _________________________________________________ ______________________________ City _______ _________ State ZIP Code Location of principal assets, if different from principal place of business _________________________________________________ County _________________________________________________ Number Street _________________________________________________ _____________________________ _______ _________ City State ZIP Code Official Form 205 Involuntary Petition Against a Non-Individual page 1 American LegalNet, Inc. www.FormsWorkFlow.com Debtor _______________________________________________________ Name Case number (if known)_____________________________________ 6. Debtor's website (URL) _____________________________________________________________________________________________________ 7. Type of debtor Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP)) Partnership (excluding LLP) Other type of debtor. Specify: __________________________________________________________________________ 8. Type of debtor's business Check one: Health Care Business (as defined in 11 U.S.C. § 101(27A)) Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B)) Railroad (as defined in 11 U.S.C. § 101(44)) Stockbroker (as defined in 11 U.S.C. § 101(53A)) Commodity Broker (as defined in 11 U.S.C. § 101(6)) Clearing Bank (as defined in 11 U.S.C. § 781(3)) None of the types of business listed. Unknown type of business. 9. To the best of your knowledge, are any bankruptcy cases pending by or against any partner or affiliate of this debtor? No Yes. Debtor _________________________________________________ Relationship __________________________ District __________________________ Date filed _______________ Case number, if known____________________ MM / DD / YYYY Debtor _________________________________________________ Relationship __________________________ District __________________________ Date filed _______________ Case number, if known____________________ MM / DD / YYYY Part 3: 10. Report About the Case Check one: Venue Over the last 180 days before the filing of this bankruptcy, the debtor had a domicile, principal place of business, or principal assets in this district longer than in any other district. A bankruptcy case concerning debtor's affiliates, general partner, or partnership is pending in this district. 11. Allegations Each petitioner is eligible to file this petition under 11 U.S.C. § 303(b). The debtor may be the subject of an involuntary case under 11 U.S.C. § 303(a). At least one box must be checked: The debtor is generally not paying its debts as they become due, unless they are the subject of a bona fide dispute as to liability or amount. Within 120 days before the filing of this petition, a custodian, other than a trustee, receiver, or an agent appointed or authorized to take charge of less than substantially all of the property of the debtor for the purpose of enforcing a lien against such property, was appointed or took possession. 12. Has there been a transfer of any claim against the debtor by or to any petitioner? No Yes. Attach all documents that evidence the transfer and any statements required under Bankruptcy Rule 1003(a). Official Form 205 Involuntary Petition Against a Non-Individual page 2 American LegalNet, Inc. www.FormsWorkFlow.com Debtor _______________________________________________________ Name Case number (if known)_____________________________________ 13. Each petitioner's claim Name of petitioner Nature of petitioner's claim Amount of the claim above the value of any lien ______________________________________ ______________________________________ ______________________________________ _________________________________ _________________________________ _________________________________ $ ________________ $ ________________ $ ________________ Total of petitioners' claims $ ________________ If more space is needed to list petitioners, attach additional sheets. Write the alleged debtor's name and the case number, if known, at the top of each sheet. Following the format of this form, set out the information required in Parts 3 and 4 of the form for each additional petitioning creditor, the petitioner's claim, the petitioner's representative, and the petitioner's attorney. Include the statement under penalty of perjury set out in Part 4 of the form, followed by each additional petitioner's (or representative's) signature, along with the signature of the petitioner's attorney. Part 4: Request for Relief WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up