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Case 1:20-bk-12043 Doc 621 Filed 02/24/21 Entered 02/24/21 14:52:42 Desc Main
<br /> Document Page 33 of 40
<br /> __ _ .
<br /> .is all or part of the claim secured? S is this�f aft based on a feast? ti. 4 this claim subject to a right of wtof-s
<br /> No
<br /> No
<br /> 'ers. Amount necessary to cure
<br /> Yea "re-.'_.m is secured by a hei can ft,rpetty_
<br /> any default as of the date of pet=than
<br /> Nature of property:
<br /> F }
<br /> x
<br /> !�€t@;f t3t<3".e, if 4h;ckaFn%+4 secured by the dpbtbr'S tsr'.rtClpol . - >.,-------- _
<br /> esalence,foie a fistoofffolle fire/df Ctsim AtfociPtiecrIf(of#lctat form 12. is all of part of the dafm entfffed to priority n cia_n, rrry bertanry'-fovity and
<br /> �tU h?mr=e:h this�`*ooF f Cry^ under Yt u_S.L 4 507{a{? part,a onva ctv[ta Por ,ecarrtfre. r,
<br /> " No amcle.:2 er`:,Oes to or{`i;t?
<br /> �i j yes. Ctw«rk a,.c
<br /> Amount entitled to Priority
<br /> DOr ebK si;gf,SCrt OtY!giu,xms Uncludoill alimony ant .�. _,�_.....
<br /> Basis for Perfe"%lon: pp
<br /> child su Yt_`t under l'U,5 f,Sit7iaiill(^A)Of(aYWht�
<br /> At
<br /> tack edacred copies of documents if any,that show evidence of
<br /> 0 Up to S3.Q25`of deposits toward purchase,kea§e,or S
<br /> perfection of -unty interest(for example,a mortgage.ten, rental of pr€ppertyor ser'arcesfor personal,famiif,or
<br /> cch,fcate Of Uric,hmanctng statement,or other document that household use.l3 U.S.C.4 St 7Wl 7).
<br /> shows the lien has bin Wed or recorded.(
<br /> 0 Wages,satartes,or fomrrzv5"saGt'+4'top to 523:650*1 5
<br /> Value ofla rgy: earned within ISO days before'he.bansruptcy Freiman is
<br /> filed alme debtor's busmes<_ends,skh,,hever,searlier
<br /> r. Amount of the claim that is secured: 5 j 11 U 5_C.§507¢a((63. �
<br /> taxes or peralhes owed to governme:tat u,�ts --
<br /> Amount of the claim that Is unsecured:S
<br /> f`he sum of tke securee;an unsecured amounts shoaid match the - Y k U.S.C.
<br /> amerant in tine<p i. Corf2r¢bunons to an ernrksyee neht plan.11 U,S C.
<br /> SDtlal(SI
<br /> F Amount neery to cure any
<br /> default as of the date of the petition:
<br /> r CF:at applies.
<br /> (. Annual interest Rate iwhen case was f,ted} _ _ Amounts are sut;,ect to adlustment on 4101122 and eke y 3 Mears After ilia¢for rasps ue, ....
<br /> 0
<br /> fixed Variable
<br /> after thedateof adjustment
<br /> taJ
<br /> _.._, .,.._............_ _w_,..w.__a ._. __. _.M_.__—_ __
<br /> .stfttaclafrn@ualityagartAdministrattvpguptnseurtder2bU.S.C.45433��4F? ._... __..
<br /> No
<br /> C,?yes,AXnOunt that Qualities as an Administrative Expense under IF U.S.C.3 b#{9).5
<br /> The person completint Cheek the opproprtare be.
<br /> is proof of claim must t air the€reddor,
<br /> sls and date h. FR8P
<br /> `. 90E2(b). :�t lam the credoor`s attorney orauthoruedagent.
<br /> acts the trustee,or the debtor,or their authortzed agent. Bankruptcy Rule 3004
<br /> t°ruW ise:hstia€€n �< 1 apt a guarantor,surety,endorser,or other(¢rdetnar.Bankruptcy Ruse 300E
<br /> e4ectron,catly,FRt3P
<br /> St 354af£d)authonres ,i,nders.and that an author zed signature on this 9rersf of Cram;sues as an acknowledgment that when calculat,ng the zmount of the oant,
<br /> courts to establish local the cieditorgatie the debtor credit for any pa teLr,s received"award the debt <
<br /> ru3es spec,Py,rrg what a
<br /> m"gnature is f have examined the Per€osmah"to this ref of Curran and have a reasonable belief that the fn€carnation as true and correct
<br /> i declare under penalty of periury that the foregoingar act- � %
<br /> �person who tills B �2oR ) f /
<br /> fraudulent claim could be e �+ /'� r 0
<br /> i d10
<br /> up to SS{0 . Executed on date i `a ><
<br /> m _
<br /> Imprisoned for up to 5 atria I DD f YYY`r ., a.phe
<br /> years,of both..IS U.S.C.
<br /> §§!SL 151,and 3572< t CY r na€n #cFee persa t who rs erurtp[etu red es thFs eYacrn
<br /> [(
<br /> first name ur ddi",narie roast name
<br /> t
<br /> Title
<br /> C'mitary
<br /> t tiiy he corporate serytce'a$the Company if the authorized agent iZ a servircer
<br /> 4
<br /> City _ State �..ZIP Code `_ .....
<br /> Contact Phortij Email ., r S
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