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B6 Summary (Official Form 6 - Summary) (12/07)

}bk1{Form 6. Summary of Schedules}bk{

In re

Robert Edward Hayner,
Jane E Hayner

United States Bankruptcy Court

Northern District of California

Debtors

,

Case No.

Chapter

7

SUMMARY OF SCHEDULES

Indicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from Schedules A,
B, D, E, F, I, and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor’s assets.
Add the amounts of all claims from Schedules D, E, and F to determine the total amount of the debtor’s liabilities. Individual debtors must
also complete the "Statistical Summary of Certain Liabilities and Related Data" if they file a case under chapter 7, 11, or 13.

NAME OF SCHEDULE

ATTACHED
(YES/NO)

NO. OF
SHEETS

ASSETS

LIABILITIES

OTHER

A - Real Property

B - Personal Property

C - Property Claimed as Exempt

D - Creditors Holding Secured Claims

E - Creditors Holding Unsecured

Priority Claims

(Total of Claims on Schedule E)

F - Creditors Holding Unsecured

Nonpriority Claims

G - Executory Contracts and

Unexpired Leases

H - Codebtors

I - Current Income of Individual

Debtor(s)

J - Current Expenditures of Individual

Debtor(s)

Total Number of Sheets of ALL Schedules

1,230,000.00

123,234.55

2,127,319.00

16,000.00

1,920,596.61

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

1

4

1

2

2

11

1

1

1

2

26

Total Assets

1,353,234.55

Total Liabilities

4,063,915.61

8,590.85

19,117.32

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 1 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

Form 6 - Statistical Summary (12/07)

}bk1{Form 6. Statistical Summary of Certain Liabilities and Related Data}bk{

In re

Robert Edward Hayner,
Jane E Hayner

United States Bankruptcy Court

Northern District of California

Debtors

,

Case No.

Chapter

7

STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)

If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C.§ 101(8)), filing
a case under chapter 7, 11 or 13, you must report all information requested below.

Check this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to
report any information here.

This information is for statistical purposes only under 28 U.S.C. § 159.
Summarize the following types of liabilities, as reported in the Schedules, and total them.



Type of Liability

Domestic Support Obligations (from Schedule E)

Taxes and Certain Other Debts Owed to Governmental Units
(from Schedule E)
Claims for Death or Personal Injury While Debtor Was Intoxicated
(from Schedule E) (whether disputed or undisputed)

Student Loan Obligations (from Schedule F)

Domestic Support, Separation Agreement, and Divorce Decree
Obligations Not Reported on Schedule E
Obligations to Pension or Profit-Sharing, and Other Similar Obligations
(from Schedule F)

Amount

0.00

16,000.00

0.00

0.00

0.00

0.00

TOTAL

16,000.00

State the following:



Average Income (from Schedule I, Line 16)

Average Expenses (from Schedule J, Line 18)

Current Monthly Income (from Form 22A Line 12; OR,
Form 22B Line 11; OR, Form 22C Line 20 )



State the following:
1. Total from Schedule D, "UNSECURED PORTION, IF ANY"

column

2. Total from Schedule E, "AMOUNT ENTITLED TO PRIORITY"

column

3. Total from Schedule E, "AMOUNT NOT ENTITLED TO

PRIORITY, IF ANY" column

4. Total from Schedule F

5. Total of non-priority unsecured debt (sum of 1, 3, and 4)

8,590.85

19,117.32

5,365.00

16,000.00

902,319.00

0.00

1,920,596.61

2,822,915.61

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 2 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6A (Official Form 6A) (12/07)

}bk1{Schedule A - Real Property}bk{

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE A - REAL PROPERTY

Debtors

Case No.

,

Except as directed below, list all real property in which the debtor has any legal, equitable, or future interest, including all property owned as a

cotenant, community property, or in which the debtor has a life estate. Include any property in which the debtor holds rights and powers exercisable for
the debtor's own benefit. If the debtor is married, state whether husband, wife, both, or the marital community own the property by placing an "H," "W,"
"J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the debtor holds no interest in real property, write "None" under
"Description and Location of Property."

Do not include interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - Executory Contracts and

Unexpired Leases.

If an entity claims to have a lien or hold a secured interest in any property, state the amount of the secured claim. See Schedule D. If no entity

claims to hold a secured interest in the property, write "None" in the column labeled "Amount of Secured Claim." If the debtor is an individual or
if a joint petition is filed, state the amount of any exemption claimed in the property only in Schedule C - Property Claimed as Exempt.

Description and Location of Property

Nature of Debtor's
Interest in Property

Location: 4179 Crest Road, Pebble Beach CA 93953

100%

810 Meadow Valley Road, Mt. Shasta, CA

A piece of land in Tahlequah, OK (ID# 4939)

Pinecliff Village HOA, Post Office Box 7716,
Ruidoso, NW 88355 (1 week a year)

100%

100%

100%

Husband,
Wife,
Joint, or
Community

Current Value of
Debtor's Interest in
Property, without
Deducting any Secured
Claim or Exemption

Amount of
Secured Claim

C

C

C

C

875,000.00

350,000.00

3,000.00

2,000.00

1,113,348.00

1,013,971.00

0.00

0.00

Sub-Total >

1,230,000.00

(Total of this page)

Total >

1,230,000.00

0

continuation sheets attached to the Schedule of Real Property

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 3 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

(Report also on Summary of Schedules)

B6B (Official Form 6B) (12/07)

}bk1{Schedule B - Personal Property}bk{

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE B - PERSONAL PROPERTY

Debtors

Case No.

,

Except as directed below, list all personal property of the debtor of whatever kind. If the debtor has no property in one or more of the categories, place
an "x" in the appropriate position in the column labeled "None." If additional space is needed in any category, attach a separate sheet properly identified
with the case name, case number, and the number of the category. If the debtor is married, state whether husband, wife, both, or the marital community
own the property by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the debtor is an individual or a joint
petition is filed, state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt.

Do not list interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - Executory Contracts and

Unexpired Leases.
If the property is being held for the debtor by someone else, state that person's name and address under "Description and Location of Property."
If the property is being held for a minor child, simply state the child's initials and the name and address of the child's parent or guardian, such as
"A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

Description and Location of Property

Husband,
Wife,
Joint, or
Community

Location: 4179 Crest Road, Pebble Beach CA 93953

Checking Acct - Chase Bank

Checking Acct - Comerica Bank

Checking Acct - Monterey Credit Union

Checking Acct - Chase Bank

Location: 4179 Crest Road, Pebble Beach CA 93953

810 Meadow Valley Road, Mt. Shasta, CA

Location: 4179 Crest Road, Pebble Beach CA 93953

Location: 4179 Crest Road, Pebble Beach CA 93953

C

W

W

W

H

C

C

C

C

Type of Property

1. Cash on hand

2. Checking, savings or other financial
accounts, certificates of deposit, or
shares in banks, savings and loan,
thrift, building and loan, and
homestead associations, or credit
unions, brokerage houses, or
cooperatives.

3.

Security deposits with public
utilities, telephone companies,
landlords, and others.

4. Household goods and furnishings,

including audio, video, and
computer equipment.

5. Books, pictures and other art
objects, antiques, stamp, coin,
record, tape, compact disc, and
other collections or collectibles.

6. Wearing apparel.

7.

8.

9.

Furs and jewelry.

Firearms and sports, photographic,
and other hobby equipment.

Interests in insurance policies.
Name insurance company of each
policy and itemize surrender or
refund value of each.

10. Annuities. Itemize and name each

issuer.

N
O
N
E

X

X

X

X

X

Current Value of

Debtor's Interest in Property,
Secured Claim or Exemption

without Deducting any

140.00

0.00

8,914.55

230.00

0.00

3,000.00

3,000.00

2,000.00

2,200.00

3

continuation sheets attached to the Schedule of Personal Property

Sub-Total >

(Total of this page)

19,484.55

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 4 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6B (Official Form 6B) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

Debtors

Case No.

,

N
O
N
E

X

X

X

X

X

X

X

Type of Property

11.

Interests in an education IRA as
defined in 26 U.S.C. § 530(b)(1) or
under a qualified State tuition plan
as defined in 26 U.S.C. § 529(b)(1).
Give particulars. (File separately the
record(s) of any such interest(s).
11 U.S.C. § 521(c).)

12.

Interests in IRA, ERISA, Keogh, or
other pension or profit sharing
plans. Give particulars.

13. Stock and interests in incorporated

and unincorporated businesses.
Itemize.

14.

Interests in partnerships or joint
ventures. Itemize.

15. Government and corporate bonds

and other negotiable and
nonnegotiable instruments.

16. Accounts receivable.

17. Alimony, maintenance, support, and

property settlements to which the
debtor is or may be entitled. Give
particulars.

18. Other liquidated debts owed to debtor
including tax refunds. Give particulars.

19. Equitable or future interests, life

estates, and rights or powers
exercisable for the benefit of the
debtor other than those listed in
Schedule A - Real Property.

20. Contingent and noncontingent

interests in estate of a decedent,
death benefit plan, life insurance
policy, or trust.

Description and Location of Property

Husband,
Wife,
Joint, or
Community

Current Value of

Debtor's Interest in Property,
Secured Claim or Exemption

without Deducting any

Prudential Insurance

SAIC (Qualified IRA in Debtor's Name)

$1,000 US Savings Bond--Current redemption value
is $500.00
Location: 4179 Crest Road, Pebble Beach CA 93953

USAA Term Life Insurance 500K policy - no cash
value

USAA Universal Life 100k policy

ING Term Life Insurance 100k policy - no cash value

C

C

C

H

W

H

45,000.00

20,000.00

500.00

0.00

4,000.00

0.00

Sub-Total >

(Total of this page)

69,500.00

1

3

Sheet
to the Schedule of Personal Property

of

continuation sheets attached

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 5 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6B (Official Form 6B) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

Type of Property

21. Other contingent and unliquidated
claims of every nature, including
tax refunds, counterclaims of the
debtor, and rights to setoff claims.
Give estimated value of each.

22. Patents, copyrights, and other

intellectual property. Give
particulars.

23. Licenses, franchises, and other

general intangibles. Give
particulars.

24. Customer lists or other compilations

containing personally identifiable
information (as defined in 11 U.S.C.
§ 101(41A)) provided to the debtor
by individuals in connection with
obtaining a product or service from
the debtor primarily for personal,
family, or household purposes.

25. Automobiles, trucks, trailers, and

other vehicles and accessories.

26. Boats, motors, and accessories.

27. Aircraft and accessories.

28. Office equipment, furnishings, and

supplies.

29. Machinery, fixtures, equipment, and

supplies used in business.

30.

Inventory.

31. Animals.

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

Debtors

Case No.

,

N
O
N
E

X

X

X

X

X

X

X

X

X

X

Description and Location of Property

Husband,
Wife,
Joint, or
Community

Current Value of

Debtor's Interest in Property,
Secured Claim or Exemption

without Deducting any

1997 GMC Truck - Mileage 91,658
KBB Private Party Value
810 Meadow Valley Road, Mt. Shasta, CA

1997 Mercedes SL320 - Mileage 67,200
KBB Private Party Value
Location: 4179 Crest Road, Pebble Beach CA 93953

2005 BMW x5 - Mileage 61,430
KBB Private Party Value
Location: 4179 Crest Road, Pebble Beach CA 93953

C

C

C

3,200.00

13,285.00

17,665.00

Sub-Total >

(Total of this page)

34,150.00

2

3

Sheet
to the Schedule of Personal Property

of

continuation sheets attached

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 6 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6B (Official Form 6B) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

Debtors

Case No.

,

Type of Property

32. Crops - growing or harvested. Give

particulars.

33. Farming equipment and

implements.

34. Farm supplies, chemicals, and feed.

35. Other personal property of any kind

not already listed. Itemize.

N
O
N
E

X

X

X

Description and Location of Property

Husband,
Wife,
Joint, or
Community

Current Value of

Debtor's Interest in Property,
Secured Claim or Exemption

without Deducting any

34,000 Shares of Biobanc, Inc.

Shares of 1st Capital Bank

5 Units of Shares in Consolidated Leasing
($217,000.00)

1 Unit of Shares in Alliance Sooner Trent
($138,600.00)

Shares in Rembrandt Partners ($71,000.00)

Social Security Benefits for Debtor and Joint Debtor

Military Retirement Benefits

C

C

C

C

C

C

H

100.00

Unknown

0.00

0.00

0.00

Unknown

Unknown

3

3

Sheet
to the Schedule of Personal Property

of

continuation sheets attached

Sub-Total >

(Total of this page)

Total >

100.00

123,234.55

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 7 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

(Report also on Summary of Schedules)

Best Case Bankruptcy

B6C (Official Form 6C) (4/10)

}bk1{Schedule C - Property Claimed as Exempt}bk{

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

Debtors

Case No.

,

Debtor claims the exemptions to which debtor is entitled under:
(Check one box)

11 U.S.C. §522(b)(2)
11 U.S.C. §522(b)(3)

Check if debtor claims a homestead exemption that exceeds
$146,450. (Amount subject to adjustment on 4/1/13, and every three years thereafter

with respect to cases commenced on or after the date of adjustment.)

Description of Property

Real Property
Location: 4179 Crest Road, Pebble Beach CA
93953

Specify Law Providing

Each Exemption

Value of
Claimed
Exemption

Current Value of
Property Without

Deducting Exemption

C.C.P. § 703.140(b)(1)

22,075.00

875,000.00

810 Meadow Valley Road, Mt. Shasta, CA

C.C.P. § 703.140(b)(5)

1,000.00

350,000.00

Cash on Hand
Location: 4179 Crest Road, Pebble Beach CA
93953

C.C.P. § 703.140(b)(5)

140.00

140.00

Checking, Savings, or Other Financial Accounts, Certificates of Deposit
Checking Acct - Chase Bank

C.C.P. § 703.140(b)(5)

Checking Acct - Comerica Bank

C.C.P. § 703.140(b)(5)

Checking Acct - Monterey Credit Union

C.C.P. § 703.140(b)(5)

Household Goods and Furnishings
Location: 4179 Crest Road, Pebble Beach CA
93953

C.C.P. § 703.140(b)(3)

810 Meadow Valley Road, Mt. Shasta, CA

C.C.P. § 703.140(b)(3)

Wearing Apparel
Location: 4179 Crest Road, Pebble Beach CA
93953

C.C.P. § 703.140(b)(3)

Furs and Jewelry
Location: 4179 Crest Road, Pebble Beach CA
93953

C.C.P. § 703.140(b)(4)
C.C.P. § 703.140(b)(5)

Interests in IRA, ERISA, Keogh, or Other Pension or Profit Sharing Plans
Prudential Insurance

C.C.P. § 703.140(b)(10)(E)

SAIC (Qualified IRA in Debtor's Name)

C.C.P. § 703.140(b)(10)(E)

Automobiles, Trucks, Trailers, and Other Vehicles
2005 BMW x5 - Mileage 61,430
KBB Private Party Value
Location: 4179 Crest Road, Pebble Beach CA
93953

C.C.P. § 703.140(b)(2)
C.C.P. § 703.140(b)(5)

Other Personal Property of Any Kind Not Already Listed
34,000 Shares of Biobanc, Inc.

C.C.P. § 703.140(b)(5)

Social Security Benefits for Debtor and Joint
Debtor

C.C.P. § 703.140(b)(10)(A)

Military Retirement Benefits

C.C.P. § 703.140(b)(10)(B)

0.00

6,865.00

230.00

3,000.00

3,000.00

2,000.00

1,425.00
775.00

45,000.00

20,000.00

3,525.00
14,140.00

100.00

0.00

0.00

0.00

8,914.55

230.00

3,000.00

3,000.00

2,000.00

2,200.00

45,000.00

20,000.00

17,665.00

100.00

Unknown

Unknown

Total:

123,275.00

1,327,249.55

0

continuation sheets attached to Schedule of Property Claimed as Exempt

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 8 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6D (Official Form 6D) (12/07)

}bk1{Schedule D - Creditors Holding Secured Claims}bk{

In re

Robert Edward Hayner,
Jane E Hayner

Case No.

,

Debtors

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS



State the name, mailing address, including zip code, and last four digits of any account number of all entities holding claims secured by property of the debtor as of

the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided
if the debtor chooses to do so. List creditors holding all types of secured interests such as judgment liens, garnishments, statutory liens, mortgages, deeds of trust, and
other security interests.

List creditors in alphabetical order to the extent practicable. If a minor child is a creditor, the child's initials and the name and address of the child's parent or

guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). If all secured
creditors will not fit on this page, use the continuation sheet provided.

If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor" ,include the entity on the appropriate

schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be
liable on each claim by placing an "H", "W", "J", or "C" in the column labeled "Husband, Wife, Joint, or Community".

If the claim is contingent, place an "X" in the column labeled "Contingent". If the claim is unliquidated, place an "X" in the column labeled "Unliquidated". If the

claim is disputed, place an "X" in the column labeled "Disputed". (You may need to place an "X" in more than one of these three columns.)

Total the columns labeled "Amount of Claim Without Deducting Value of Collateral" and "Unsecured Portion, if Any" in the boxes labeled "Total(s)" on the last

sheet of the completed schedule. Report the total from the column labeled "Amount of Claim" also on the Summary of Schedules and, if the debtor is an individual with
primarily consumer debts, report the total from the column labeled "Unsecured Portion" on the Statistical Summary of Certain Liabilities and Related Data.

Check this box if debtor has no creditors holding secured claims to report on this Schedule D.

CREDITOR'S NAME

AND MAILING ADDRESS
INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

C
O
D
E
B
T
O
R

Account No.

xxxxxxxxx5103

Chase
9451 Corbin Avenue
Northridge, CA 91328

Account No.

xxxxxxxxx7220

Chase
9451 Corbin Avenue
Northridge, CA 91328

Account No.

xxxxxxxx4583

Chase
N54 W 13600 Woodale Dr
Mennomonee, WI 53051

Account No.

Chase
Home Equity Loan Servicing
Post Office Box 24714
Columbus, OH 43224

1
_____ continuation sheets attached

Husband, Wife, Joint, or Community

DATE CLAIM WAS INCURRED,

NATURE OF LIEN, AND

DESCRIPTION AND VALUE

OF PROPERTY

SUBJECT TO LIEN

Opened 9/01/06 Last Active 7/15/10

1st Deed of Trust

810 Meadow Valley Road, Mt. Shasta, CA

H
W
J
C

C

CLAIM

AMOUNT OF
WITHOUT
DEDUCTING
VALUE OF
COLLATERAL

UNSECURED
PORTION, IF

ANY

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

350,000.00
Value $
Opened 12/01/06 Last Active 9/01/10

First Deed of Trust

Location: 4179 Crest Road, Pebble
Beach CA 93953

C

875,000.00
Value $
Opened 12/01/06 Last Active 9/27/10

Home Equity Lien

Location: 4179 Crest Road, Pebble
Beach CA 93953

C

875,000.00
Value $
DUPLICATE MAILING ADDRESS FOR
HOME EQUITY LINE ON

1,009,959.00

663,971.00

947,041.00

99,786.00

138,562.00

138,562.00

C

Value $

0.00

Subtotal
(Total of this page)

0.00

0.00

2,095,562.00

902,319.00

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 9 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6D (Official Form 6D) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

Case No.

Debtors

,

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

(Continuation Sheet)

C
O
D
E
B
T
O
R

CREDITOR'S NAME

AND MAILING ADDRESS
INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions.)
xxxxxxxxxx4583

Account No.

CHASE
POB 78035
Phoenix, AZ 85062-8035

H
W
J
C

C

Husband, Wife, Joint, or Community

DATE CLAIM WAS INCURRED,

NATURE OF LIEN, AND

DESCRIPTION AND VALUE

OF PROPERTY

SUBJECT TO LIEN

Home Equity Lien

Duplicate Mailing Address for Home
Equity Lien

Account No.

xxxxxxxxxxxxxxxxxxx0610

Monterey County Bank
Po Box 1309
Monterey, CA 93942

0.00
Value $
Opened 6/01/10 Last Active 8/04/10

Lien

Location: 4179 Crest Road, Pebble
Beach CA 93953

H

CLAIM

AMOUNT OF
WITHOUT
DEDUCTING
VALUE OF
COLLATERAL

UNSECURED
PORTION, IF

ANY

C
O
N
T
I
N
G
E
N
T

D
I
S
P
U
T
E
D

U
N
L
I
Q
U
I
D
A
T
E
D

0.00

0.00

Account No.

Monterey County Tax Collector
POB 891
Salinas, CA 93902

Account No.

Siskiyou County Tax Collector
311 Fourth Street, Room 108
Yreka, CA 96097

Account No.

C

C

Value $
Tax Lien

875,000.00

24,900.00

0.00

Location: 4179 Crest Road, Pebble
Beach CA 93953

Value $
Tax Lien

875,000.00

2,845.00

0.00

810 Meadow Valley Road, Mt. Shasta, CA

Value $

350,000.00

4,012.00

0.00

1

1

Sheet _____ of _____ continuation sheets attached to
Schedule of Creditors Holding Secured Claims

Value $

Subtotal
(Total of this page)
Total
(Report on Summary of Schedules)

31,757.00

0.00

2,127,319.00

902,319.00

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 10 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6E (Official Form 6E) (4/10)

}bk1{Schedule E - Creditors Holding Unsecured Priority Claims}bk{

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

Case No.

,

Debtors

A complete list of claims entitled to priority, listed separately by type of priority, is to be set forth on the sheets provided. Only holders of unsecured claims entitled

to priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name, mailing address, including zip code, and last four digits of the
account number, if any, of all entities holding priority claims against the debtor or the property of the debtor, as of the date of the filing of the petition. Use a separate
continuation sheet for each type of priority and label each with the type of priority.

The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do
so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian."
Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriate

schedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be
liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in the
column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled
"Disputed." (You may need to place an "X" in more than one of these three columns.)

Report the total of claims listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all claims listed on this Schedule E in the box labeled

"Total" on the last sheet of the completed schedule. Report this total also on the Summary of Schedules.

Report the total of amounts entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts entitled to priority

listed on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total
also on the Statistical Summary of Certain Liabilities and Related Data.

Report the total of amounts not entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts not entitled to
priority listed on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this
total also on the Statistical Summary of Certain Liabilities and Related Data.

Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.

TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets)

Domestic support obligations
Claims for domestic support that are owed to or recoverable by a spouse, former spouse, or child of the debtor, or the parent, legal guardian, or responsible relative

of such a child, or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in 11 U.S.C. § 507(a)(1).

Extensions of credit in an involuntary case
Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the appointment of a

trustee or the order for relief. 11 U.S.C. § 507(a)(3).

Wages, salaries, and commissions
Wages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying independent sales

representatives up to $11,725* per person earned within 180 days immediately preceding the filing of the original petition, or the cessation of business, whichever
occurred first, to the extent provided in 11 U.S.C. § 507(a)(4).

Contributions to employee benefit plans
Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the cessation of business,

whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(5).

Certain farmers and fishermen
Claims of certain farmers and fishermen, up to $5,775* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(6).
Deposits by individuals
Claims of individuals up to $2,600* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that were not

delivered or provided. 11 U.S.C. § 507(a)(7).

Taxes and certain other debts owed to governmental units
Taxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11 U.S.C. § 507(a)(8).
Commitments to maintain the capital of an insured depository institution
Claims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors of the Federal

Reserve System, or their predecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C. § 507 (a)(9).

Claims for death or personal injury while debtor was intoxicated
Claims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug, or

another substance. 11 U.S.C. § 507(a)(10).

* Amount subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after the date of adjustment.

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 11 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com



Best Case Bankruptcy

1

continuation sheets attached

Case No.

,

Debtors

(Continuation Sheet)

B6E (Official Form 6E) (4/10) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

DATE CLAIM WAS INCURRED

AND CONSIDERATION FOR CLAIM

Unpaid 2005 Taxes

Unpaid 2006 Taxes

Debtors have not filed 2009 Tax Returns
yet

H
W
J
C

C

C

C

Taxes and Certain Other Debts
Owed to Governmental Units

TYPE OF PRIORITY

AMOUNT
OF CLAIM

AMOUNT NOT
ENTITLED TO
PRIORITY, IF ANY

AMOUNT
ENTITLED TO
PRIORITY





C
O
N
T
I
N
G
E
N
T

D
I
S
P
U
T
E
D

U
N
L
I
Q
U
I
D
A
T
E
D

0.00

4,000.00

4,000.00

0.00

12,000.00

12,000.00

0.00

0.00

0.00

CREDITOR'S NAME,

AND MAILING ADDRESS
INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions.)

Account No.

Franchise Tax Board
Bankruptcy Personal Income Tax
Post Office Box 2952
Sacramento, CA 95812

Account No.

Franchise Tax Board
Bankruptcy Personal Income Tax
Post Office Box 2952
Sacramento, CA 95812

Account No.

IRS
Centralized Insolvency Operation
Post Office Box 7346
Philadelphia, PA 19101-7346

Account No.

Account No.

1

Sheet _____ of _____ continuation sheets attached to
Schedule of Creditors Holding Unsecured Priority Claims

1

Subtotal
(Total of this page)
Total
(Report on Summary of Schedules)

16,000.00

0.00

0.00

16,000.00

16,000.00

16,000.00

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 12 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com
Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy
Best Case Bankruptcy

B6F (Official Form 6F) (12/07)

}bk1{Schedule F - Creditors Holding Unsecured Nonpriority Claims}bk{

In re

Robert Edward Hayner,
Jane E Hayner

Case No.

Debtors

,

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

State the name, mailing address, including zip code, and last four digits of any account number, of all entities holding unsecured claims without priority against the
debtor or the property of the debtor, as of the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to the
trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's
parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Do not
include claims listed in Schedules D and E. If all creditors will not fit on this page, use the continuation sheet provided.

If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriate

schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be
liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community."

If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the

claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.)

Report the total of all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedule. Report this total also on the Summary of

Schedules and, if the debtor is an individual with primarily consumer debts, report this total also on the Statistical Summary of Certain Liabilities and Related Data.

Check this box if debtor has no creditors holding unsecured claims to report on this Schedule F.

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xxx0217

ADT Security Services
Post Office Box 650485
Dallas, TX 75265-0485

Account No.

xxxxxxxxxxxxxx8151

American Express
c/o Becket and Lee LLP
Po Box 3001
Malvern, PA 19355

Account No.

xxxxxxxxxxxx7454

Bank Of America
Attn: Bankruptcy NC4-105-03-14
Po Box 26012
Greensboro, NC 27410

Account No.

xxxxxxxxxxxx0942

Bank Of America
Po Box 17054
Wilmington, DE 19850

_____ continuation sheets attached

10

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

UNPAID VENDOR

Opened 8/01/87 Last Active 8/01/06
OPEN ACCOUNT - NOTICE ONLY

Opened 11/01/78 Last Active 5/15/10
CreditCard

Opened 9/01/98 Last Active 5/21/10
CreditCard

H
W
J
C

C

C

C

C

Subtotal
(Total of this page)

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

369.36

0.00

34,279.36

5,099.00

39,747.72

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 13 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

S/N:41459-110104

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

Debtors

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xxxxxxxxxxxx6494

Bank Of America
Attn: Bankruptcy NC4-105-03-14
Po Box 26012
Greensboro, NC 27410

Account No.

5006

Bank Of America
Attn: Bankruptcy NC4-105-03-14
Po Box 26012
Greensboro, NC 27410

Account No.

Birgit Ball Eisner
411 Kaelepulu Drive
Apt 160
Kailua, HI 96734

Account No.

Brian D. Call, Esq.
500 Camino El Estero, Suite 200
Monterey, CA 93940

Account No.

xxxxxxxxxxxx4365

Capital One, N.a.
Bankruptcy Dept
Po Box 5155
Norcross, GA 30091

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

Opened 6/01/90 Last Active 5/13/10
CreditCard

Opened 11/01/78 Last Active 7/29/06
OPEN ACCOUNT - NOTICE ONLY

Personal Guaranty of investment in Biobanc,
Inc.

NOTICE ONLY - Small Claims Case No.:
SC132649

Opened 2/01/08 Last Active 5/04/10
CreditCard

H
W
J
C

H

C

C

C

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

4,135.00

0.00

25,000.00

6,500.00

2,753.24

38,388.24

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

1

Subtotal
(Total of this page)

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 14 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

Debtors

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xxxxxxxxxxxx2488

Chase
Po Box 15298
Wilmington, DE 19850

Account No.

xxxx-xxxx-xxxx-6134

Chase
Po Box 15298
Wilmington, DE 19850

Account No.

xxxxxxxxxxxx5714

Chase
Po Box 15298
Wilmington, DE 19850

Account No.

xxxxxxxxxxxx2975

Chase
Po Box 15298
Wilmington, DE 19850

Account No.

xxxxxxxxxxxx4212

Chase
Po Box 15298
Wilmington, DE 19850

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

Opened 1/01/06 Last Active 5/10/10
CreditCard

Opened 9/21/96 Last Active 12/05/10
CreditCard

Opened 9/01/96 Last Active 12/05/10
CreditCard

Opened 8/01/06 Last Active 10/24/10
CreditCard - Marriott Rewards

Opened 9/01/05 Last Active 12/06/10
CreditCard

H
W
J
C

C

C

C

H

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

21,539.00

11,812.87

11,655.00

1,483.91

1,010.00

47,500.78

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

2

Subtotal
(Total of this page)

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 15 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

Debtors

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xxxxx4583

Chase
3990 S Babcock St
Melbourne, FL 32901

Account No.

xxxxxxxxxxxx5013

Chase
P.o. Box 15298
Wilmington, DE 19850

Account No.

xxxxxxxxxxxx4682

Chase-pier1
Attn: Recovery
Po Box 15298
Wilmington, DE 19850

Account No.

xxxxx4301

Cpu/citi - Conoco Phillips Union
Attn: Centralized Bankruptcy
Po Box 20363
Kansas City, MO 64195

Account No.

xxxxxxxxxxxx4494

Credit One Bank
Po Box 98875
Las Vegas, NV 89193

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

Opened 12/28/06 Last Active 8/17/09
OPEN ACCOUNT - NOTICE ONLY

Opened 4/01/08 Last Active 8/18/10
OPEN ACCOUNT - NOTICE ONLY

Opened 6/01/97 Last Active 8/18/10
OPEN ACCOUNT - NOTICE ONLY

Opened 4/01/99 Last Active 10/31/10
CreditCard

Opened 11/01/09 Last Active 11/16/10
CreditCard

H
W
J
C

C

C

C

C

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

Unknown

0.00

0.00

114.00

5.00

119.00

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

3

Subtotal
(Total of this page)

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 16 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

Debtors

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xxxxxxxxxxxx6344

Discover Fin
Po Box 6103
Carol Stream, IL 60197

Account No.

xxxxxxxxxxxx9878

GEMB / Old Navy
Attention: GEMB
Po Box 103104
Roswell, GA 30076

Account No.

xxxxxxxxxxxx9125

Gemb/care Credit
Attn: Bankruptcy
Po Box 103106
Roswell, GA 30076

Account No.

xxxxxxxxxxxx1491

Gemb/chevron
Attention: Bankruptcy
Po Box 103104
Roswell, GA 30076

Account No.

xxxxxxxxxxxx9018

Hsbc Bank
Po Box 52530
Carol Stream, IL 60196

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

Opened 2/01/87 Last Active 6/04/10
CreditCard

Opened 9/01/09 Last Active 1/17/10
OPEN ACCOUNT - NOTICE ONLY

Opened 2/01/08 Last Active 12/02/10
ChargeAccount

Opened 2/01/79 Last Active 12/02/10
ChargeAccount

Opened 3/01/08 Last Active 10/26/10
OPEN ACCOUNT - NOTICE ONLY

H
W
J
C

C

C

C

C

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

6,075.91

0.00

2,510.00

113.00

0.00

8,698.91

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

4

Subtotal
(Total of this page)

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 17 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

Debtors

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

Hugh Wilson, M.D.
c/o Gerard Rose, Esq.
Post Office Box 6516
Carmel by the Sea, CA 93921

Account No.

Jim and Sharon Swallow
Post Office Box 4975
Carmel by the Sea, CA 93921

Account No.

Jon Giffen, Esq.
Kennedy, Archer & Harray
24591 Silver Cloud Court, Suite 200
Monterey, CA 93940

Account No.

xxx7919

Joseph I. Sussman, P.C.
Attorneys at Law
132 West 31st Street, Suite 1502
New York, NY 10001

Account No.

xxxxxxxx6852

Kohls
Attn: Recovery Dept
Po Box 3120
Milwaukee, WI 53201

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

NOTICE ONLY - M107113

Personal Guaranty of investment in Biobanc,
Inc.

NOTICE ONLY - M106013

Attorney for Principis Capital, LLC

Opened 12/01/09 Last Active 12/02/10
ChargeAccount

H
W
J
C

C

C

C

C

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

55,000.00

50,000.00

54,000.00

120,000.00

107.00

279,107.00

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

5

Subtotal
(Total of this page)

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 18 of 29

Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com

Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

Debtors

(Continuation Sheet)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.

xx-x9193

Law Offices of Patenaude & Felix
A.P.C.
4545 Murphy Canyon Road, 3rd Floor
San Diego, CA 92123

Account No.

xx-xxx-xx-x91-36

Macys/fdsb
Attn: Bankruptcy
Po Box 8053
Mason, OH 45040

Account No.

xx-xxx-xx-x91-20

Macys/fdsb
Attn: Bankruptcy
Po Box 8053
Mason, OH 45040

Account No.

xxxxxxxxx1820

Macys/fdsb
Attn: Bankruptcy
Po Box 8053
Mason, OH 45040

Account No.

xxxxxxxx9140

Macys/fdsb
Attn: Bankruptcy
Po Box 8053
Mason, OH 45040

Sheet no. _____ of _____ sheets attached to Schedule of
Creditors Holding Unsecured Nonpriority Claims

10

6

C
O
D
E
B
T
O
R

Husband, Wife, Joint, or Community

CONSIDERATION FOR CLAIM. IF CLAIM

DATE CLAIM WAS INCURRED AND
IS SUBJECT TO SETOFF, SO STATE.

NOTICE ONLY - Collection Agency for Target
National Bank

Opened 8/01/07 Last Active 5/01/10
ChargeAccount

Opened 7/01/87 Last Active 3/17/10
ChargeAccount

Opened 6/01/06 Last Active 9/21/06
OPEN ACCOUNT - NOTICE ONLY

Opened 12/01/00 Last Active 9/11/01
OPEN ACCOUNT - NOTICE ONLY

H
W
J
C

W

C

C

H

C

D
I
S
P
U
T
E
D

C
O
N
T
I
N
G
E
N
T

U
N
L
I
Q
U
I
D
A
T
E
D

AMOUNT OF CLAIM

0.00

9,971.93

615.00

0.00

Subtotal
(Total of this page)

0.00

10,586.93

Case: 11-51102 Doc# 4 Filed: 02/04/11 Entered: 02/04/11 17:11:31 Page 19 of 29

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Best Case Bankruptcy

B6F (Official Form 6F) (12/07) - Cont.

In re

Robert Edward Hayner,
Jane E Hayner

Debtors

(Continuation Sheet)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

Case No.

,

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,
AND ACCOUNT NUMBER

(See instructions above.)

Account No.