Expression, Statement of Intention for Individuals Filing Under Chapter 7

• Legal Form Number: B 108
• Court: United States Federal Court
• Section: United States Federal Court

Official Form 108Statement of Intention for Individuals Filing Under Chapter 7page 1

Official Form 108

Statement of Intention for Individuals Filing Under Chapter 712/15

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.

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 les sors 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 106 D), 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: Surrender the property.

Retainthe property and redeem it.

Retainthe property and enter into a

Reaffirmation Agreement.

Retainthe property and [explain]: __________

______________________________________

No

Yes

Description of

property

securing debt:



Creditor’s

name: Surrender the property.

Retainthe property and redeem it.

Retainthe property and enter into a

Reaffirmation Agreement.

Retainthe property and [explain]: __________

______________________________________

No

Yes

Description of

property

securing debt:



Creditor’s

name: Surrender the property.

Retainthe property and redeem it.

Retainthe property and enter into a

Reaffirmation Agreement.

Retainthe property and [explain]: __________

______________________________________

No

Yes

Description of

property

securing debt:

Creditor’s

name: Surrender the property.

Retainthe property and redeem it.

Retainthe property and enter into a

Reaffirmation Agreement.

Retainthe property and [explain]: __________

______________________________________

No

Yes

Description of

property

securing debt:

Debtor 1 __________________________________________________________________

First Name Middle Name Last Name

Debtor 2 ________________________________________________________________

(Spouse, if filing)First Name Middle Name Last Name

United States Bankruptcy Court for the: __________ District of __________

Case number ___________________________________________

(If known)

Fill in this information to identify your case:

Check if this is an

amended filing

__________ District of __________