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INSTRUCTIONS FOR
PROOF OF
CLAIM
FORM
The instructions and definitions below are general
explanations of the law. In particular types of cases or circumstances,
such as bankruptcy cases that are not filed voluntarily by a debtor,
there may be exceptions to these general rules.
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–––– DEFINITIONS –––– |
Debtor
The person, corporation, or other entity that has filed a
bankruptcy case is called the debtor.
Creditor
A creditor is any person, corporation, or other entity to whom
the debtor owed a debt on the date that the bankruptcy case was
filed.
Proof of Claim
A form telling the bankruptcy court how much the debtor owed a
creditor at the time the bankruptcy case was filed (the amount
of the creditor’s claim). This form must be filed with the clerk
of the bankruptcy court where the bankruptcy case was filed.
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Secured Claim
A claim is a secured claim to the extent that the creditor has a
lien on property of the debtor (collateral) that gives the
creditor the right to be paid from that property before
creditors who do not have liens on the property.
Examples of liens are a mortgage on real estate and a
security interest in a car, truck, boat, television set, or
other item of property. A lien may have been obtained through a
court proceeding before the bankruptcy case began; in some
states a court judgment is a lien. In addition, to the extent a
creditor also owes money to the debtor (has a right of setoff),
the creditor’s claim may be a secured claim. (See also
Unsecured Claim.) |
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Unsecured
Claim
If a claim is not a secured claim it is an unsecured claim. A
claim may be partly secured and partly unsecured if the property
on which a creditor has a lien is not worth enough to pay the
creditor in full.
Unsecured Priority Claim
Certain types of unsecured claims are given priority, so they
are to be paid in bankruptcy cases before most other unsecured
claims (if there is sufficient money or property available to
pay these claims). The most common types of priority claims are
listed on the proof of claim form. Unsecured claims that are not
specifically given priority status by the bankruptcy laws are
classified as Unsecured Nonpriority Claims. |
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Items
to be completed in Proof of Claim form (if not already filled
in) |
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Court, Name of Debtor,
and Case Number: |
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Fill in the
name of the federal judicial district where the
bankruptcy case was filed (for example, Central District
of California), the name of the debtor in the bankruptcy
case, and the bankruptcy case number. If you received a
notice of the case from the court, all of this
information is near the top of the notice.
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Information about
Creditor: |
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Complete
the section giving the name, address, and telephone
number of the creditor to whom the debtor owes money or
property, and the debtor’s account number, if any. If
anyone else has already filed a proof of claim relating
to this debt, if you never received notices from the
bankruptcy court about this case, if your address
differs from that to which the court sent notice, or if
this proof of claim replaces or changes a proof of claim
that was already filed, check the appropriate box on the
form.
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1. Basis for Claim:
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Check the
type of debt for which the proof of claim is being
filed. If the type of debt is not listed, check “Other”
and briefly describe the type of debt. If you were an
employee of the debtor, fill in the last four digits of
your social security number and the dates of work for
which you were not paid.
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2. Date Debt Incurred:
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Fill in the
date when the debt first was owed by the debtor.
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3. Court Judgments:
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If you have
a court judgment for this debt, state the date the court
entered the judgment.
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4. Total Amount of Claim
at Time Case Filed: |
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Fill in the
applicable amounts, including the total amount of the
entire claim. If interest or other charges in addition
to the principal amount of the claim are included, check
the appropriate place on the form and attach an
itemization of the interest and charges.
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5. Secured Claim:
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Check the
appropriate place if the claim is a secured claim. You
must state the type and value of property that is
collateral for the claim, attach of the documentation of
your lien, and state the amount past copies due on the
claim as of the date the bankruptcy case was filed. A
claim may be partly secured and partly unsecured. (See
DEFINITIONS, above).
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6. Unsecured Nonpriority
Claim: |
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Check the
appropriate place if you have an unsecured nonpriority
claim, sometimes referred to as a “general unsecured
claim”. (See DEFINITIONS, above.) If your claim is
partly secured and partly unsecured, state here the
amount that is unsecured. If part of your claim is
entitled to priority, state here the amount not
entitled to priority.
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7. Unsecured Priority
Claim: |
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Check the
appropriate place if you have an unsecured priority
claim, and state the amount entitled to priority. (See
DEFINITIONS, above). A claim may be partly priority and
partly nonpriority if, for example, the claim is for
more than the amount given priority by the law. Check
the appropriate place to specify the type of priority
claim.
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8. Credits:
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By signing
this proof of claim, you are stating under oath that in
calculating the amount of your claim you have given the
debtor credit for all payments received from the debtor.
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9. Supporting Documents:
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You must
attach to this proof of claim form copies of documents
that show the debtor owes the debt claimed or, if the
documents are too lengthy, a summary of those documents.
If documents are not available, you must attach an
explanation of why they are not available.
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Penalty for
presenting fraudulent claim: Fine of up to $500,000 or imprisonment for
up to 5 years, or both.
18 U.S.C. §§ 152 and 3571.
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