When an individual voluntarily files for bankruptcy, he or she is required to complete a bankruptcy form like one below. Depending on the bankruptcy application type and the country or state where it is applied, the form may vary in details and format.  The fillable bankruptcy form template below is a sample of a typical form.

Bankruptcy form – Voluntary Petition

Debtor Information

United States Bankruptcy Court ________________ district of __________________ State

Debtor Name: ___________________________ Other Name(s) Used: ________________

Tax I.D. Number: _________________________ County of Residence: ________________

Mailing Address: ___________________________________________________________

Street Address: _______________ City: ____________ State: ___________ Zip: _______

Bankruptcy petition details

Debtor type:  Individual _____ Corporation ____ Partnership ____ Railroad ____   Stockbroker _____ Com. Broker _____ clearing bank ____ other ______

Nature of debts: Non-Business/Consumer __________ Business __________

Section or chapter of the bankruptcy code under which bankruptcy is filed under _________

Estimated number of creditors: ______________ Estimated Assets value: ______________

Estimated debts value: ____________________ Bankruptcy notices in the last 6 years ___

Signature of debtor’s attorney: ______________ Signature of debtor: _________________

Name of Attorney: ________________________ Debtor’s name: _____________________

Date: __________________________________ Date: ____________________________

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