Fill in this information to identify your case: Debtor 1 Debtor 2 __________________________________________________________________ First Name Middle Name Last Name (Spouse, if filing) First Name ________________________________________________________________ Middle Name Last Name United States Bankruptcy Court for the: ______________________ District of __________ Case number (If known) ___________________________________________ (State) Check if this is an amended filing Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 If you are an individual filing under chapter 7, you must fill out this form if: creditors have claims secured by your property, or you have leased personal property and the lease has not expired. 12/15 You must file this form with the court within 30 days after you file your bankruptcy petition or by the date set for the meeting of creditors, whichever is earlier, unless the court extends the time for cause. You must also send copies to the creditors and lessors you list on the form. If two married people are filing together in a joint case, both are equally responsible for supplying correct information. Both debtors must sign and date the form. Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write your name and case number (if known). Part 1: List Your Creditors Who Have Secured Claims 1. For any creditors that you listed in Part 1 of Schedule D: Creditors Who Have Claims Secured by Property (Official Form 106D), fill in the information below. Identify the creditor and the property that is collateral What do you intend to do with the property that secures a debt? Did you claim the property as exempt on Schedule C? Creditor's name: Description of property securing debt: Surrender the property. Retain the property and redeem it. Retain the property and enter into a Reaffirmation Agreement. No Yes Retain the property and [explain]: __________ ______________________________________ Creditor's name: Description of property securing debt: Surrender the property. Retain the property and redeem it. Retain the property and enter into a Reaffirmation Agreement. No Yes Retain the property and [explain]: __________ ______________________________________ Creditor's name: Description of property securing debt: Surrender the property. Retain the property and redeem it. Retain the property and enter into a Reaffirmation Agreement. No Yes Retain the property and [explain]: __________ ______________________________________ Creditor's name: Description of property securing debt: Surrender the property. Retain the property and redeem it. Retain the property and enter into a Reaffirmation Agreement. No Yes Retain the property and [explain]: __________ ______________________________________ Statement of Intention for Individuals Filing Under Chapter 7 American LegalNet, Inc. www.FormsWorkFlow.com Official Form 108 page 1 Debtor 1 ______________________________________________________ First Name Middle Name Last Name Case number (If known)_____________________________________ Part 2: List Your Unexpired Personal Property Leases For any unexpired personal property lease that you listed in Schedule G: Executory Contracts and Unexpired Leases (Official Form 106G), fill in the information below. Do not list real estate leases. Unexpired leases are leases that are still in effect; the lease period has not yet ended. You may assume an unexpired personal property lease if the trustee does not assume it. 11 U.S.C. § 365(p)(2). Describe your unexpired personal property leases Will the lease be assumed? Lessor's name: Description of leased property: Lessor's name: Description of leased property: Lessor's name: Description of leased property: Lessor's name: Description of leased property: No Yes No Yes No Yes No Yes Lessor's name: Description of leased property: Lessor's name: Description of leased property: Lessor's name: Description of leased property: No Yes No Yes No Yes Part 3: Sign Below Under penalty of perjury, I declare that I have indicated my intention about any property of my estate that secures a debt and any personal property that is subject to an unexpired lease. ___________________________________________ ___________________________________________ Signature of Debtor 1 Signature of Debtor 2 Date _________________ MM / DD / YYYY Date _________________ MM / DD / YYYY Official Form 108 Statement of Intention for Individuals Filing Under Chapter 7 page 2 American LegalNet, Inc. www.FormsWorkFlow.com