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© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB1(OfficialForm1)(04/13)NameofDebtor(ifindividual,enterLast,First,Middle):NameofJointDebtor(Spouse)(Last,First,Middle):AllOtherNamesusedbytheDebtorinthelast8years(includemarried,maiden,andtradenames):AllOtherNamesusedbytheJointDebtorinthelast8years(includemarried,maiden,andtradenames):LastfourdigitsofSoc.Sec.orIndividual-TaxpayerI.D.(ITIN)/CompleteEIN(ifmorethanone,stateall):LastfourdigitsofSoc.Sec.orIndividual-TaxpayerI.D.(ITIN)/CompleteEIN(ifmorethanone,stateall):StreetAddressofDebtor(No.&Street,City,State&ZipCode):StreetAddressofJointDebtor(No.&Street,City,State&ZipCode):ZIPCODEZIPCODECountyofResidenceorofthePrincipalPlaceofBusiness:CountyofResidenceorofthePrincipalPlaceofBusiness:MailingAddressofDebtor(ifdifferentfromstreetaddress)MailingAddressofJointDebtor(ifdifferentfromstreetaddress):ZIPCODEZIPCODELocationofPrincipalAssetsofBusinessDebtor(ifdifferentfromstreetaddressabove):ZIPCODETypeofDebtor(FormofOrganization)(Checkonebox.)Individual(includesJointDebtors)SeeExhibitDonpage2ofthisform.Corporation(includesLLCandLLP)PartnershipOther(Ifdebtorisnotoneoftheaboveentities,checkthisboxandstatetypeofentitybelow.)Chapter15DebtorCountryofdebtor’scenterofmaininterests:__________________________________________Eachcountryinwhichaforeignproceedingby,regarding,oragainstdebtorispending:__________________________________________NatureofBusiness(Checkonebox.)HealthCareBusinessSingleAssetRealEstateasdefinedin11U.S.C.§101(51B)RailroadStockbrokerCommodityBrokerClearingBankOtherTax-ExemptEntity(Checkbox,ifapplicable.)Debtorisatax-exemptorganizationunderTitle26oftheUnitedStatesCode(theInternalRevenueCode).ChapterofBankruptcyCodeUnderWhichthePetitionisFiled(Checkonebox.)Chapter7Chapter15PetitionforChapter9RecognitionofaForeignChapter11MainProceedingChapter12Chapter15PetitionforChapter13RecognitionofaForeignNonmainProceedingNatureofDebts(Checkonebox.)DebtsareprimarilyconsumerDebtsareprimarilydebts,definedin11U.S.C.businessdebts.§101(8)as“incurredbyanindividualprimarilyforapersonal,family,orhouse-holdpurpose.”FilingFee(Checkonebox)FullFilingFeeattachedFilingFeetobepaidininstallments(Applicabletoindividualsonly).Mustattachsignedapplicationforthecourt’sconsiderationcertifyingthatthedebtorisunabletopayfeeexceptininstallments.Rule1006(b).SeeOfficialForm3A.FilingFeewaiverrequested(Applicabletochapter7individualsonly).Mustattachsignedapplicationforthecourt’sconsideration.SeeOfficialForm3B.Chapter11DebtorsCheckonebox:Debtorisasmallbusinessdebtorasdefinedin11U.S.C.§101(51D).Debtorisnotasmallbusinessdebtorasdefinedin11U.S.C.§101(51D).Checkif:Debtor’saggregatenoncontingentliquidateddebts(excludingdebtsowedtoinsidersoraffiliates)arelessthan$2,490,925(amountsubjecttoadjustmenton4/01/16andeverythreeyearsthereafter).----------------------------------------------------------------Checkallapplicableboxes:AplanisbeingfiledwiththispetitionAcceptancesoftheplanweresolicitedprepetitionfromoneormoreclassesofcreditors,inaccordancewith11U.S.C.§1126(b).Statistical/AdministrativeInformationDebtorestimatesthatfundswillbeavailablefordistributiontounsecuredcreditors.Debtorestimatesthat,afteranyexemptpropertyisexcludedandadministrativeexpensespaid,therewillbenofundsavailablefordistributiontounsecuredcreditors.THISSPACEISFORCOURTUSEONLYEstimatedNumberofCreditors1-4950-99100-199200-9991,000-5,0005,001-10,00010,001-25,00025,001-50,00050,001-100,000Over100,000EstimatedAssets$0to$50,000$50,001to$100,000$100,001to$500,000$500,001to$1million$1,000,001to$10million$10,000,001to$50million$50,000,001to$100million$100,000,001to$500million$500,000,001to$1billionMorethan$1billionEstimatedLiabilities$0to$50,000$50,001to$100,000$100,001to$500,000$500,001to$1million$1,000,001to$10million$10,000,001to$50million$50,000,001to$100million$100,000,001to$500million$500,000,001to$1billionMorethan$1billionUnited States Bankruptcy CourtSouthern District of FloridaVoluntary PetitionDe La Mata, AnggelaAnggela F De La MataAnggela Fiorella De La MataAnggela Fiorella De La Mata Saez855714273 NW 23rd StPembroke Pines, FL33028-2832Broward(cid:252)(cid:252)(cid:252)(cid:252)(cid:252)(cid:252)(cid:252)(cid:252)Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 2 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB1(OfficialForm1)(04/13)Page2(Thispagemustbecompletedandfiledineverycase)NameofDebtor(s):AllPriorBankruptcyCaseFiledWithinLast8Years(Ifmorethantwo,attachadditionalsheet)LocationWhereFiled:CaseNumber:DateFiled:LocationWhereFiled:CaseNumber:DateFiled:PendingBankruptcyCaseFiledbyanySpouse,PartnerorAffiliateofthisDebtor(Ifmorethanone,attachadditionalsheet)NameofDebtor:CaseNumber:DateFiled:District:Relationship:Judge:ExhibitA(Tobecompletedifdebtorisrequiredtofileperiodicreports(e.g.,forms10Kand10Q)withtheSecuritiesandExchangeCommissionpursuanttoSection13or15(d)oftheSecuritiesExchangeActof1934andisrequestingreliefunderchapter11.)ExhibitAisattachedandmadeapartofthispetition.ExhibitB(Tobecompletedifdebtorisanindividualwhosedebtsareprimarilyconsumerdebts.)I,theattorneyforthepetitionernamedintheforegoingpetition,declarethatIhaveinformedthepetitionerthat[heorshe]mayproceedunderchapter7,11,12,or13oftitle11,UnitedStatesCode,andhaveexplainedthereliefavailableundereachsuchchapter.IfurthercertifythatIdeliveredtothedebtorthenoticerequiredby11U.S.C.§342(b).XSignatureofAttorneyforDebtor(s)DateExhibitCDoesthedebtorownorhavepossessionofanypropertythatposesorisallegedtoposeathreatofimminentandidentifiableharmtopublichealthorsafety?Yes,andExhibitCisattachedandmadeapartofthispetition.NoExhibitD(Tobecompletedbyeveryindividualdebtor.Ifajointpetitionisfiled,eachspousemustcompleteandattachaseparateExhibitD.)ExhibitDcompletedandsignedbythedebtorisattachedandmadeapartofthispetition.Ifthisisajointpetition:ExhibitDalsocompletedandsignedbythejointdebtorisattachedamadeapartofthispetition.InformationRegardingtheDebtor-Venue(Checkanyapplicablebox.)Debtorhasbeendomiciledorhashadaresidence,principalplaceofbusiness,orprincipalassetsinthisDistrictfor180daysimmediatelyprecedingthedateofthispetitionorforalongerpartofsuch180daysthaninanyotherDistrict.Thereisabankruptcycaseconcerningdebtor’saffiliate,generalpartner,orpartnershippendinginthisDistrict.DebtorisadebtorinaforeignproceedingandhasitsprincipalplaceofbusinessorprincipalassetsintheUnitedStatesinthisDistrict,orhasnoprincipalplaceofbusinessorassetsintheUnitedStatesbutisadefendantinanactionorproceeding[inafederalorstatecourt]inthisDistrict,ortheinterestsofthepartieswillbeservedinregardtothereliefsoughtinthisDistrict.CertificationbyaDebtorWhoResidesasaTenantofResidentialProperty(Checkallapplicableboxes.)Landlordhasajudgmentagainstthedebtorforpossessionofdebtor’sresidence.(Ifboxchecked,completethefollowing.)(Nameoflandlordthatobtainedjudgment)(Addressoflandlord)Debtorclaimsthatunderapplicablenonbankruptcylaw,therearecircumstancesunderwhichthedebtorwouldbepermittedtocuretheentiremonetarydefaultthatgaverisetothejudgmentforpossession,afterthejudgmentforpossessionwasentered,andDebtorhasincludedinthispetitionthedepositwiththecourtofanyrentthatwouldbecomedueduringthe30-dayperiodafterthefilingofthepetition.Debtorcertifiesthathe/shehasservedtheLandlordwiththiscertification.(11U.S.C.§362(l)).Voluntary PetitionDe La Mata, AnggelaNoneNone/s/ Timothy S. Kingcade, Esq. 6/28/13(cid:252)(cid:252)(cid:252)Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 3 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB1(OfficialForm1)(04/13)Page3(Thispagemustbecompletedandfiledineverycase)NameofDebtor(s):SignaturesSignature(s)ofDebtor(s)(Individual/Joint)Ideclareunderpenaltyofperjurythattheinformationprovidedinthispetitionistrueandcorrect.[IfpetitionerisanindividualwhosedebtsareprimarilyconsumerdebtsandhaschosentofileunderChapter7]IamawarethatImayproceedunderchapter7,11,12or13oftitle11,UnitedStatesCode,understandthereliefavailableundereachsuchchapter,andchoosetoproceedunderchapter7.[Ifnoattorneyrepresentsmeandnobankruptcypetitionpreparersignsthepetition]Ihaveobtainedandreadthenoticerequiredby11U.S.C.§342(b).Irequestreliefinaccordancewiththechapteroftitle11,UnitedStatesCode,specifiedinthispetition.XSignatureofDebtorXSignatureofJointDebtorTelephoneNumber(Ifnotrepresentedbyattorney)DateSignatureofaForeignRepresentativeIdeclareunderpenaltyofperjurythattheinformationprovidedinthispetitionistrueandcorrect,thatIamtheforeignrepresentativeofadebtorinaforeignproceeding,andthatIamauthorizedtofilethispetition.(Checkonlyonebox.)Irequestreliefinaccordancewithchapter15oftitle11,UnitedStatesCode.Certifiedcopiesofthedocumentsrequiredby11U.S.C.§1515areattached.Pursuantto11U.S.C.§1511,Irequestreliefinaccordancewiththechapteroftitle11specifiedinthispetition.Acertifiedcopyoftheordergrantingrecognitionoftheforeignmainproceedingisattached.XSignatureofForeignRepresentativePrintedNameofForeignRepresentativeDateSignatureofAttorney*XSignatureofAttorneyforDebtor(s)Date*Inacaseinwhich§707(b)(4)(D)applies,thissignaturealsoconstitutesacertificationthattheattorneyhasnoknowledgeafteraninquirythattheinformationintheschedulesisincorrect.SignatureofNon-AttorneyPetitionPreparerIdeclareunderpenaltyofperjurythat:1)Iamabankruptcypetitionpreparerasdefinedin11U.S.C.§110;2)Ipreparedthisdocumentforcompensationandhaveprovidedthedebtorwithacopyofthisdocumentandthenoticesandinformationrequiredunder11U.S.C.§§110(b),110(h)and342(b);and3)ifrulesorguidelineshavebeenpromulgatedpursuantto11U.S.C.§110(h)settingamaximumfeeforserviceschargeablebybankruptcypetitionpreparers,Ihavegiventhedebtornoticeofthemaximumamountbeforepreparinganydocumentforfilingforadebtororacceptinganyfeefromthedebtor,asrequiredinthatsection.OfficialForm19isattached.PrintedNameandtitle,ifany,ofBankruptcyPetitionPreparerSocialSecurityNumber(Ifthebankruptcypetitionpreparerisnotanindividual,statetheSocialSecuritynumberoftheofficer,principal,responsiblepersonorpartnerofthebankruptcypetitionpreparer.)(Requiredby11U.S.C.§110.)AddressXSignatureDateSignatureofBankruptcyPetitionPreparerorofficer,principal,responsibleperson,orpartnerwhosesocialsecuritynumberisprovidedabove.NamesandSocial-Securitynumbersofallotherindividualswhopreparedorassistedinpreparingthisdocumentunlessthebankruptcypetitionpreparerisnotanindividual:Ifmorethanonepersonpreparedthisdocument,attachadditionalsheetsconformingtotheappropriateofficialformforeachperson.Abankruptcypetitionpreparer’sfailuretocomplywiththeprovisionsoftitle11andtheFederalRulesofBankruptcyProceduremayresultinfinesorimprisonmentorboth11U.S.C.§110;18U.S.C.§156.SignatureofDebtor(Corporation/Partnership)Ideclareunderpenaltyofperjurythattheinformationprovidedinthispetitionistrueandcorrect,andthatIhavebeenauthorizedtofilethispetitiononbehalfofthedebtor.Thedebtorrequestsreliefinaccordancewiththechapteroftitle11,UnitedStatesCode,specifiedinthispetition.XSignatureofAuthorizedIndividualPrintedNameofAuthorizedIndividualTitleofAuthorizedIndividualDateVoluntary PetitionDe La Mata, Anggela/s/ Anggela De La MataAnggela De La MataJune 28, 2013/s/ Timothy S. Kingcade, Esq.June 28, 2013Timothy S. Kingcade, Esq. 082309Kingcade & Garcia, P.A.1370 Coral WayMiami, FL 33145-2960Kingcadeserve @bellsouth.netCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 4 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB1D(OfficialForm1,ExhibitD)(12/09)INRE:CaseNo.Debtor(s)ChapterCREDITCOUNSELINGREQUIREMENTWarning:Youmustbeabletochecktruthfullyoneofthefivestatementsregardingcreditcounselinglistedbelow.Ifyoucannotdoso,youarenoteligibletofileabankruptcycase,andthecourtcandismissanycaseyoudofile.Ifthathappens,youwilllosewhateverfilingfeeyoupaid,andyourcreditorswillbeabletoresumecollectionactivitiesagainstyou.Ifyourcaseisdismissedandyoufileanotherbankruptcycaselater,youmayberequiredtopayasecondfilingfeeandyoumayhavetotakeextrastepstostopcreditors’collectionactivities.EveryindividualdebtormustfilethisExhibitD.Ifajointpetitionisfiled,eachspousemustcompleteandfileaseparateExhibitD.Checkoneofthefivestatementsbelowandattachanydocumentsasdirected.1.Withinthe180daysbeforethefilingofmybankruptcycase,IreceivedabriefingfromacreditcounselingagencyapprovedbytheUnitedStatestrusteeorbankruptcyadministratorthatoutlinedtheopportunitiesforavailablecreditcounselingandassistedmeinperformingarelatedbudgetanalysis,andIhaveacertificatefromtheagencydescribingtheservicesprovidedtome.Attachacopyofthecertificateandacopyofanydebtrepaymentplandevelopedthroughtheagency.2.Withinthe180daysbeforethefilingofmybankruptcycase,IreceivedabriefingfromacreditcounselingagencyapprovedbytheUnitedStatestrusteeorbankruptcyadministratorthatoutlinedtheopportunitiesforavailablecreditcounselingandassistedmeinperformingarelatedbudgetanalysis,butIdonothaveacertificatefromtheagencydescribingtheservicesprovidedtome.Youmustfileacopyofacertificatefromtheagencydescribingtheservicesprovidedtoyouandacopyofanydebtrepaymentplandevelopedthroughtheagencynolaterthan14daysafteryourbankruptcycaseisfiled.3.IcertifythatIrequestedcreditcounselingservicesfromanapprovedagencybutwasunabletoobtaintheservicesduringthesevendaysfromthetimeImademyrequest,andthefollowingexigentcircumstancesmeritatemporarywaiverofthecreditcounselingrequirementsoIcanfilemybankruptcycasenow.[Summarizeexigentcircumstanceshere.]Ifyourcertificationissatisfactorytothecourt,youmuststillobtainthecreditcounselingbriefingwithinthefirst30daysafteryoufileyourbankruptcypetitionandpromptlyfileacertificatefromtheagencythatprovidedthecounseling,togetherwithacopyofanydebtmanagementplandevelopedthroughtheagency.Failuretofulfilltheserequirementsmayresultindismissalofyourcase.Anyextensionofthe30-daydeadlinecanbegrantedonlyforcauseandislimitedtoamaximumof15days.Yourcasemayalsobedismissedifthecourtisnotsatisfiedwithyourreasonsforfilingyourbankruptcycasewithoutfirstreceivingacreditcounselingbriefing.4.Iamnotrequiredtoreceiveacreditcounselingbriefingbecauseof:[Checktheapplicablestatement.][Mustbeaccompaniedbyamotionfordeterminationbythecourt.]Incapacity.(Definedin11U.S.C.§109(h)(4)asimpairedbyreasonofmentalillnessormentaldeficiencysoastobeincapableofrealizingandmakingrationaldecisionswithrespecttofinancialresponsibilities.);Disability.(Definedin11U.S.C.§109(h)(4)asphysicallyimpairedtotheextentofbeingunable,afterreasonableeffort,toparticipateinacreditcounselingbriefinginperson,bytelephone,orthroughtheInternet.);Activemilitarydutyinamilitarycombatzone.5.TheUnitedStatestrusteeorbankruptcyadministratorhasdeterminedthatthecreditcounselingrequirementof11U.S.C.§109(h)doesnotapplyinthisdistrict.Icertifyunderpenaltyofperjurythattheinformationprovidedaboveistrueandcorrect.SignatureofDebtor:Date:United States Bankruptcy CourtSouthern District of FloridaEXHIBIT D - INDIVIDUAL DEBTOR'S STATEMENT OF COMPLIANCE7De La Mata, Anggela(cid:252)/s/ Anggela De La MataJune 28, 2013Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 5 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6Summary(Form6-Summary)(12/07)INRE:CaseNo.Debtor(s)ChapterIndicateastoeachschedulewhetherthatscheduleisattachedandstatethenumberofpagesineach.ReportthetotalsfromSchedulesA,B,D,E,F,I,andJintheboxesprovided.AddtheamountsfromSchedulesAandBtodeterminethetotalamountofthedebtor’sassets.AddtheamountsofallclaimsfromSchedulesD,E,andFtodeterminethetotalamountofthedebtor’sliabilities.Individualdebtorsalsomustcompletethe“StatisticalSummaryofCertainLiabilitiesandRelatedData”iftheyfileacaseunderchapter7,11,or13.NAMEOFSCHEDULEATTACHED(YES/NO)NUMBEROFSHEETSASSETSLIABILITIESOTHERA-RealProperty$B-PersonalProperty$C-PropertyClaimedasExemptD-CreditorsHoldingSecuredClaims$E-CreditorsHoldingUnsecuredPriorityClaims(TotalofClaimsonScheduleE)$F-CreditorsHoldingUnsecuredNonpriorityClaims$G-ExecutoryContractsandUnexpiredLeasesH-CodebtorsI-CurrentIncomeofIndividualDebtor(s)$J-CurrentExpendituresofIndividualDebtor(s)$TOTAL$$United States Bankruptcy CourtSouthern District of FloridaSUMMARY OF SCHEDULES7De La Mata, AnggelaYes 1 269,162.00Yes 3 9,381.33Yes 1Yes 1 354,460.56Yes 1 0.00Yes 8 8,859.56Yes 1Yes 1Yes 1 2,100.00Yes 1 3,842.00 19 278,543.33 363,320.12Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 6 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyForm6-StatisticalSummary(12/07)INRE:CaseNo.Debtor(s)ChapterIfyouareanindividualdebtorwhosedebtsareprimarilyconsumerdebts,asdefinedin§101(8)oftheBankruptcyCode(11U.S.C.§101(8)),filingacaseunderchapter7,11or13,youmustreportallinformationrequestedbelow.CheckthisboxifyouareanindividualdebtorwhosedebtsareNOTprimarilyconsumerdebts.Youarenotrequiredtoreportanyinformationhere.Thisinformationisforstatisticalpurposesonlyunder28U.S.C.§159.Summarizethefollowingtypesofliabilities,asreportedintheSchedules,andtotalthem.TypeofLiabilityAmountDomesticSupportObligations(fromScheduleE)$TaxesandCertainOtherDebtsOwedtoGovernmentalUnits(fromScheduleE)$ClaimsforDeathorPersonalInjuryWhileDebtorWasIntoxicated(fromScheduleE)(whetherdisputedorundisputed)$StudentLoanObligations(fromScheduleF)$DomesticSupport,SeparationAgreement,andDivorceDecreeObligationsNotReportedonScheduleE$ObligationstoPensionorProfit-Sharing,andOtherSimilarObligations(fromScheduleF)$TOTAL$Statethefollowing:AverageIncome(fromScheduleI,Line16)$AverageExpenses(fromScheduleJ,Line18)$CurrentMonthlyIncome(fromForm22ALine12;OR,Form22BLine11;OR,Form22CLine20)$Statethefollowing:1.TotalfromScheduleD,“UNSECUREDPORTION,IFANY”column$2.TotalfromScheduleE,“AMOUNTENTITLEDTOPRIORITY”column.$3.TotalfromScheduleE,“AMOUNTNOTENTITLEDTOPRIORITY,IFANY”column$4.TotalfromScheduleF$5.Totalofnon-priorityunsecureddebt(sumof1,3,and4)$United States Bankruptcy CourtSouthern District of FloridaSTATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)7De La Mata, Anggela 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2,100.00 3,842.00 2,100.00 85,298.56 0.00 0.00 8,859.56 94,158.12Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 7 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6A(OfficialForm6A)(12/07)INREDebtor(s)CaseNo.(Ifknown)Exceptasdirectedbelow,listallrealpropertyinwhichthedebtorhasanylegal,equitable,orfutureinterest,includingallpropertyownedasacotenant,communityproperty,orinwhichthedebtorhasalifeestate.Includeanypropertyinwhichthedebtorholdsrightsandpowersexercisableforthedebtor’sownbenefit.Ifthedebtorismarried,statewhetherthehusband,wife,both,orthemaritalcommunityownthepropertybyplacingan“H,”“W,”“J,”or“C”inthecolumnlabeled“Husband,Wife,Joint,orCommunity.”Ifthedebtorholdsnointerestinrealproperty,write“None”under“DescriptionandLocationofProperty.”Donotincludeinterestsinexecutorycontractsandunexpiredleasesonthisschedule.ListtheminScheduleG-ExecutoryContractsandUnexpiredLeases.Ifanentityclaimstohavealienorholdasecuredinterestinanyproperty,statetheamountofthesecuredclaim.SeeScheduleD.Ifnoentityclaimstoholdasecuredinterestintheproperty,write“None”inthecolumnlabeled“AmountofSecuredClaim.”Ifthedebtorisanindividualorifajointpetitionisfiled,statetheamountofanyexemptionclaimedinthepropertyonlyinScheduleC-PropertyClaimedasExempt.DESCRIPTIONANDLOCATIONOFPROPERTYNATUREOFDEBTOR'SINTERESTINPROPERTYHUSBAND,WIFE,JOINT,ORCOMMUNITYCURRENTVALUEOFDEBTOR'SINTERESTINPROPERTYWITHOUTDEDUCTINGANYSECUREDCLAIMOREXEMPTIONAMOUNTOFSECUREDCLAIMTOTAL(ReportalsoonSummaryofSchedules)SCHEDULE A - REAL PROPERTY 269,162.00De La Mata, Anggela14273 NW 23rd St, Pembroke Pines, FL 33028 269,162.00 354,460.56Debtor's Homestead: Single family residencePurchased: November 2007FMV Based on Zillow.comTo Be Reaffirmed if Mortgage Modification is ApprovedCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 8 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6B(OfficialForm6B)(12/07)INREDebtor(s)CaseNo.(Ifknown)Exceptasdirectedbelow,listallpersonalpropertyofthedebtorofwhateverkind.Ifthedebtorhasnopropertyinoneormoreofthecategories,placean“x”intheappropriatepositioninthecolumnlabeled“None.”Ifadditionalspaceisneededinanycategory,attachaseparatesheetproperlyidentifiedwiththecasename,casenumber,andthenumberofthecategory.Ifthedebtorismarried,statewhetherthehusband,wife,both,orthemaritalcommunityownthepropertybyplacingan“H,”“W,”“J,”or“C”inthecolumnlabeled“Husband,Wife,Joint,orCommunity.”Ifthedebtorisanindividualorajointpetitionisfiled,statetheamountofanyexemptionsclaimedonlyinScheduleC-PropertyClaimedasExempt.Donotlistinterestsinexecutorycontractsandunexpiredleasesonthisschedule.ListtheminScheduleG-ExecutoryContractsandUnexpiredLeases.Ifthepropertyisbeingheldforthedebtorbysomeoneelse,statethatperson’snameandaddressunder“DescriptionandLocationofProperty.”Ifthepropertyisbeingheldforaminorchild,simplystatethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).TYPEOFPROPERTYNONEDESCRIPTIONANDLOCATIONOFPROPERTYHUSBAND,WIFE,JOINT,ORCOMMUNITYCURRENTVALUEOFDEBTOR'SINTERESTINPROPERTYWITHOUTDEDUCTINGANYSECUREDCLAIMOREXEMPTIONSCHEDULE B - PERSONAL PROPERTYDe La Mata, Anggela1.Cashonhand.Cash on hand: None 0.002.Checking,savingsorotherfinancialaccounts,certificatesofdepositorsharesinbanks,savingsandloan,thrift,buildingandloan,andhomesteadassociations,orcreditunions,brokeragehouses,orcooperatives.Bank of America Checking Acct #6648 2,281.76Debtor receives child support into this accountChase Checking Acct #3657 3,097.933.Securitydepositswithpublicutilities,telephonecompanies,landlords,andothers.X4.Householdgoodsandfurnishings,includeaudio,video,andcomputerequipment.Misc. Household Goods 670.00Based on Inventory list5.Books,picturesandotherartobjects,antiques,stamp,coin,record,tape,compactdisc,andothercollectionsorcollectibles.X6.Wearingapparel.Misc. Clothing 100.007.Fursandjewelry.Misc. Jewelry 165.00Based on Inventory list8.Firearmsandsports,photographic,andotherhobbyequipment.X9.Interestininsurancepolicies.Nameinsurancecompanyofeachpolicyanditemizesurrenderorrefundvalueofeach.X10.Annuities.Itemizeandnameeachissue.X11.InterestsinaneducationIRAasdefinedin26U.S.C.§530(b)(1)orunderaqualifiedStatetuitionplanasdefinedin26U.S.C.§529(b)(1).Giveparticulars.(Fileseparatelytherecord(s)ofanysuchinterest(s).11U.S.C.§521(c).)X12.InterestsinIRA,ERISA,Keogh,orotherpensionorprofitsharingplans.Giveparticulars.X13.Stockandinterestsinincorporatedandunincorporatedbusinesses.Itemize.XCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 9 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, Anggela14.Interestsinpartnershipsorjointventures.Itemize.X15.Governmentandcorporatebondsandothernegotiableandnon-negotiableinstruments.X16.Accountsreceivable.X17.Alimony,maintenance,support,andpropertysettlementsinwhichthedebtorisormaybeentitled.Giveparticulars.X18.Otherliquidateddebtsowedtodebtorincludingtaxrefunds.Giveparticulars.X19.Equitableorfutureinterest,lifeestates,andrightsorpowersexercisableforthebenefitofthedebtorotherthanthoselistedinScheduleA-RealProperty.X20.Contingentandnoncontingentinterestsinestateofadecedent,deathbenefitplan,lifeinsurancepolicy,ortrust.X21.Othercontingentandunliquidatedclaimsofeverynature,includingtaxrefunds,counterclaimsofthedebtor,andrightstosetoffclaims.Giveestimatedvalueofeach.Debtor has a pending Homeowner's insurance claim lawusuit 3,066.64against Unviersity Property and Casualty Company. Debtor isbeing represented by Alvarez, Carbonell, Feltman, Jimenez &Gomez, PL, 2100 Ponce de Leon Blvd., #800, Coral Gables, FL3313422.Patents,copyrights,andotherintellectualproperty.Giveparticulars.X23.Licenses,franchises,andothergeneralintangibles.Giveparticulars.X24.Customerlistsorothercompilationscontainingpersonallyidentifiableinformation(asdefinedin11U.S.C.§101(41A))providedtothedebtorbyindividualsinconnectionwithobtainingaproductorservicefromthedebtorprimarilyforpersonal,family,orhouseholdpurposes.X25.Automobiles,trucks,trailers,andothervehiclesandaccessories.Automobile: None 0.00Debtor borrows car or takes public transportation26.Boats,motors,andaccessories.X27.Aircraftandaccessories.X28.Officeequipment,furnishings,andsupplies.X29.Machinery,fixtures,equipment,andsuppliesusedinbusiness.X30.Inventory.X31.Animals.X32.Crops-growingorharvested.Giveparticulars.XB6B(OfficialForm6B)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)TYPEOFPROPERTYNONEDESCRIPTIONANDLOCATIONOFPROPERTYHUSBAND,WIFE,JOINT,ORCOMMUNITYCURRENTVALUEOFDEBTOR'SINTERESTINPROPERTYWITHOUTDEDUCTINGANYSECUREDCLAIMOREXEMPTIONSCHEDULE B - PERSONAL PROPERTYCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 10 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, Anggela33.Farmingequipmentandimplements.X34.Farmsupplies,chemicals,andfeed.X35.Otherpersonalpropertyofanykindnotalreadylisted.Itemize.XB6B(OfficialForm6B)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)TYPEOFPROPERTYNONEDESCRIPTIONANDLOCATIONOFPROPERTYHUSBAND,WIFE,JOINT,ORCOMMUNITYCURRENTVALUEOFDEBTOR'SINTERESTINPROPERTYWITHOUTDEDUCTINGANYSECUREDCLAIMOREXEMPTIONTOTAL(Includeamountsfromanycontinuationsheetsattached.ReporttotalalsoonSummaryofSchedules.)continuationsheetsattachedSCHEDULE B - PERSONAL PROPERTY 9,381.33 0Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 11 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6C(OfficialForm6C)(04/13)INREDebtor(s)CaseNo.(Ifknown)Debtorelectstheexemptionstowhichdebtorisentitledunder:Checkifdebtorclaimsahomesteadexemptionthatexceeds$155,675.*(Checkonebox)11U.S.C.§522(b)(2)11U.S.C.§522(b)(3)DESCRIPTIONOFPROPERTYSPECIFYLAWPROVIDINGEACHEXEMPTIONVALUEOFCLAIMEDEXEMPTIONCURRENTVALUEOFPROPERTYWITHOUTDEDUCTINGEXEMPTIONS*Amountsubjecttoadjustmenton4/1/16andeverythreeyearsthereafterwithrespecttocasescommencedonorafterthedateofadjustment.SCHEDULE C - PROPERTY CLAIMED AS EXEMPT(cid:252)De La Mata, AnggelaSCHEDULE A - REAL PROPERTY14273 NW 23rd St, Pembroke Pines, FLArt. X, §4(a)(1), FSA §§ 222.01, 222.02 1.00 269,162.0033028Debtor's Homestead: Single familyresidencePurchased: November 2007FMV Based on Zillow.comTo Be Reaffirmed if Mortgage Modificationis ApprovedSCHEDULE B - PERSONAL PROPERTYBank of America Checking Acct #6648FSA § 222.201 1,800.00 2,281.76Debtor receives child support into thisaccountChase Checking Acct #3657Art X § 4(a)(2) 200.00 3,097.93Misc. Household GoodsArt X § 4(a)(2) 670.00 670.00Based on Inventory listMisc. ClothingArt X § 4(a)(2) 100.00 100.00Misc. JewelryArt X § 4(a)(2) 30.00 165.00Based on Inventory listDebtor has a pending Homeowner'sArt. X, §4(a)(1), FSA §§ 222.01, 222.02 3,066.64 3,066.64insurance claim lawusuit againstUnviersity Property and Casualty Company.Debtor is being represented by Alvarez,Carbonell, Feltman, Jimenez & Gomez, PL,2100 Ponce de Leon Blvd., #800, CoralGables, FL 33134Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 12 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6D(OfficialForm6D)(12/07)INREDebtor(s)CaseNo.(Ifknown)Statethename,mailingaddress,includingzipcode,andlastfourdigitsofanyaccountnumberofallentitiesholdingclaimssecuredbypropertyofthedebtorasofthedateoffilingofthepetition.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.Listcreditorsholdingalltypesofsecuredinterestssuchasjudgmentliens,garnishments,statutoryliens,mortgages,deedsoftrust,andothersecurityinterests.Listcreditorsinalphabeticalordertotheextentpracticable.Ifaminorchildisthecreditor,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).Ifallsecuredcreditorswillnotfitonthispage,usethecontinuationsheetprovided.Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean“X”inthecolumnlabeled“Codebtor,”includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH–Codebtors.Ifajointpetitionisfiled,statewhetherthehusband,wife,bothofthem,orthemaritalcommunitymaybeliableoneachclaimbyplacingan“H,”“W,”“J,”or“C”inthecolumnlabeled“Husband,Wife,Joint,orCommunity.”Iftheclaimiscontingent,placean“X”inthecolumnlabeled“Contingent.”Iftheclaimisunliquidated,placean“X”inthecolumnlabeled“Unliquidated.”Iftheclaimisdisputed,placean“X”inthecolumnlabeled“Disputed.”(Youmayneedtoplacean“X”inmorethanoneofthesethreecolumns.)Totalthecolumnslabeled“AmountofClaimWithoutDeductingValueofCollateral”and“UnsecuredPortion,ifAny”intheboxeslabeled“Total(s)”onthelastsheetofthecompletedschedule.Reportthetotalfromthecolumnlabeled“AmountofClaimWithoutDeductingValueofCollateral”alsoontheSummaryofSchedulesand,ifthedebtorisanindividualwithprimarilyconsumerdebts,reportthetotalfromthecolumnlabeled“UnsecuredPortion,ifAny”ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.CheckthisboxifdebtorhasnocreditorsholdingsecuredclaimstoreportonthisScheduleD.CREDITOR'SNAMEANDMAILINGADDRESSINCLUDINGZIPCODEANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURRED,NATUREOFLIEN,ANDDESCRIPTIONANDVALUEOFPROPERTYSUBJECTTOLIENCONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMWITHOUTDEDUCTINGVALUEOFCOLLATERALUNSECUREDPORTION,IFANYACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.continuationsheetsattachedSubtotal(Totalofthispage)$$Total(Useonlyonlastpage)$$(ReportalsoonSummaryofSchedules.)(Ifapplicable,reportalsoonStatisticalSummaryofCertainLiabilitiesandRelatedData.)SCHEDULE D - CREDITORS HOLDING SECURED CLAIMSDe La Mata, Anggela182067155354,460.5685,298.56269,162.00Bank Of America, N.a.4161 Piedmont PkwyGreensboro, NC 27410Mortgage loan 11/07-03/13ForeclosureCase No. CACE1003639714273 NW 23rd St, Pembroke Pines, FL33028VALUE $VALUE $VALUE $VALUE $ 0354,460.56354,460.5685,298.5685,298.56Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 13 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6E(OfficialForm6E)(04/13)INREDebtor(s)CaseNo.(Ifknown)Acompletelistofclaimsentitledtopriority,listedseparatelybytypeofpriority,istobesetforthonthesheetsprovided.Onlyholdersofunsecuredclaimsentitledtopriorityshouldbelistedinthisschedule.Intheboxesprovidedontheattachedsheets,statethename,mailingaddress,includingzipcode,andlastfourdigitsoftheaccountnumber,ifany,ofallentitiesholdingpriorityclaimsagainstthedebtororthepropertyofthedebtor,asofthedateofthefilingofthepetition.Useaseparatecontinuationsheetforeachtypeofpriorityandlabeleachwiththetypeofpriority.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.Ifaminorchildisacreditor,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean"X"inthecolumnlabeled"Codebtor,"includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH-Codebtors.Ifajointpetitionisfiled,statewhetherthehusband,wife,bothofthem,orthemaritalcommunitymaybeliableoneachclaimbyplacingan"H,""W,""J,"or"C"inthecolumnlabeled"Husband,Wife,Joint,orCommunity."Iftheclaimiscontingent,placean"X"inthecolumnlabeled"Contingent."Iftheclaimisunliquidated,placean"X"inthecolumnlabeled"Unliquidated."Iftheclaimisdisputed,placean"X"inthecolumnlabeled"Disputed."(Youmayneedtoplacean"X"inmorethanoneofthesethreecolumns.)Reportthetotalofclaimslistedoneachsheetintheboxlabeled"Subtotals"oneachsheet.ReportthetotalofallclaimslistedonthisScheduleEintheboxlabeled“Total”onthelastsheetofthecompletedschedule.ReportthistotalalsoontheSummaryofSchedules.Reportthetotalofamountsentitledtoprioritylistedoneachsheetintheboxlabeled"Subtotals"oneachsheet.ReportthetotalofallamountsentitledtoprioritylistedonthisScheduleEintheboxlabeled“Totals”onthelastsheetofthecompletedschedule.IndividualdebtorswithprimarilyconsumerdebtsreportthistotalalsoontheStatisticalSummaryofCertainLiabilitiesandRelatedData.Reportthetotalofamountsnotentitledtoprioritylistedoneachsheetintheboxlabeled“Subtotals”oneachsheet.ReportthetotalofallamountsnotentitledtoprioritylistedonthisScheduleEintheboxlabeled“Totals”onthelastsheetofthecompletedschedule.IndividualdebtorswithprimarilyconsumerdebtsreportthistotalalsoontheStatisticalSummaryofCertainLiabilitiesandRelatedData.CheckthisboxifdebtorhasnocreditorsholdingunsecuredpriorityclaimstoreportonthisScheduleE.TYPESOFPRIORITYCLAIMS(Checktheappropriatebox(es)belowifclaimsinthatcategoryarelistedontheattachedsheets)DomesticSupportObligationsClaimsfordomesticsupportthatareowedtoorrecoverablebyaspouse,formerspouse,orchildofthedebtor,ortheparent,legalguardian,orresponsiblerelativeofsuchachild,oragovernmentalunittowhomsuchadomesticsupportclaimhasbeenassignedtotheextentprovidedin11U.S.C.§507(a)(1).ExtensionsofcreditinaninvoluntarycaseClaimsarisingintheordinarycourseofthedebtor'sbusinessorfinancialaffairsafterthecommencementofthecasebutbeforetheearlieroftheappointmentofatrusteeortheorderforrelief.11U.S.C.§507(a)(3).Wages,salaries,andcommissionsWages,salaries,andcommissions,includingvacation,severance,andsickleavepayowingtoemployeesandcommissionsowingtoqualifyingindependentsalesrepresentativesupto$12,475*perpersonearnedwithin180daysimmediatelyprecedingthefilingoftheoriginalpetition,orthecessationofbusiness,whicheveroccurredfirst,totheextentprovidedin11U.S.C.§507(a)(4).ContributionstoemployeebenefitplansMoneyowedtoemployeebenefitplansforservicesrenderedwithin180daysimmediatelyprecedingthefilingoftheoriginalpetition,orthecessationofbusiness,whicheveroccurredfirst,totheextentprovidedin11U.S.C.§507(a)(5).CertainfarmersandfishermenClaimsofcertainfarmersandfishermen,upto$6,150*perfarmerorfisherman,againstthedebtor,asprovidedin11U.S.C.§507(a)(6).DepositsbyindividualsClaimsofindividualsupto$2,775*fordepositsforthepurchase,lease,orrentalofpropertyorservicesforpersonal,family,orhouseholduse,thatwerenotdeliveredorprovided.11U.S.C.§507(a)(7).TaxesandCertainOtherDebtsOwedtoGovernmentalUnitsTaxes,customsduties,andpenaltiesowingtofederal,state,andlocalgovernmentalunitsassetforthin11U.S.C.§507(a)(8).CommitmentstoMaintaintheCapitalofanInsuredDepositoryInstitutionClaimsbasedoncommitmentstotheFDIC,RTC,DirectoroftheOfficeofThriftSupervision,ComptrolleroftheCurrency,orBoardofGovernorsoftheFederalReserveSystem,ortheirpredecessorsorsuccessors,tomaintainthecapitalofaninsureddepositoryinstitution.11U.S.C.§507(a)(9).ClaimsforDeathorPersonalInjuryWhileDebtorWasIntoxicatedClaimsfordeathorpersonalinjuryresultingfromtheoperationofamotorvehicleorvesselwhilethedebtorwasintoxicatedfromusingalcohol,adrug,oranothersubstance.11U.S.C.§507(a)(10).*Amountsaresubjecttoadjustmenton4/01/16,andeverythreeyearsthereafterwithrespecttocasescommencedonorafterthedateofadjustment.continuationsheetsattachedSCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS(cid:252) 0Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 14 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6F(OfficialForm6F)(12/07)INREDebtor(s)CaseNo.(Ifknown)Statethename,mailingaddress,includingzipcode,andlastfourdigitsofanyaccountnumber,ofallentitiesholdingunsecuredclaimswithoutpriorityagainstthedebtororthepropertyofthedebtor,asofthedateoffilingofthepetition.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.Ifaminorchildisacreditor,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).DonotincludeclaimslistedinSchedulesDandE.Ifallcreditorswillnotfitonthispage,usethecontinuationsheetprovided.Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean“X”inthecolumnlabeled“Codebtor,”includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH-Codebtors.Ifajointpetitionisfiled,statewhetherthehusband,wife,bothofthem,orthemaritalcommunitymaybeliableoneachclaimbyplacingan“H,”“W,”“J,”or“C”inthecolumnlabeled“Husband,Wife,Joint,orCommunity.”Iftheclaimiscontingent,placean“X”inthecolumnlabeled“Contingent.”Iftheclaimisunliquidated,placean“X”inthecolumnlabeled“Unliquidated.”Iftheclaimisdisputed,placean“X”inthecolumnlabeled“Disputed.”(Youmayneedtoplacean“X”inmorethanoneofthesethreecolumns.)Reportthetotalofallclaimslistedonthisscheduleintheboxlabeled“Total”onthelastsheetofthecompletedschedule.ReportthistotalalsoontheSummaryofSchedulesand,ifthedebtorisanindividualwithprimarilyconsumerdebts,reportthistotalalsoontheStatisticalSummaryofCertainLiabilitiesandRelatedData.CheckthisboxifdebtorhasnocreditorsholdingunsecurednonpriorityclaimstoreportonthisScheduleF.CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.continuationsheetsattachedSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedulesand,ifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMSDe La Mata, AnggelaCACE10036397X1.00Aldridge Connors, Llp7000 W Palmetto Park Rd Ste 307Boca Raton, FL 33433Attorney for Plaintiff Bank Of America, N.a. (7155)and BAC Home Loan Servicing, LP 09/10077404831019326332X1.00AmexPo Box 297871Fort Lauderdale, FL 33329Revolving Credit Card 05/04$0 Balance on Credit Report077404831019526332X1.00AmexPo Box 297871Fort Lauderdale, FL 33329Revolving Credit Card 05/04$0 Balance on Credit Report4313-5149-9608-69753,479.67Bank Of AmericaPo Box 982235El Paso, TX 79998Revolving Credit Card 04/13 73,482.67Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 15 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS1337063174218X1.00Bank Of America, N.a.4161 Piedmont PkwyGreensboro, NC 27410Mortgage loan 08/06$0 Balance on Credit Report70010621027782181,045.54Cap1/bstbyPo Box 5253Carol Stream, IL 60197Revolving Credit Card 04/13CACE10036397X1.00Charo Cam1039 Laguna Springs DriveWeston, FL 33326Co Defendant in Lawsuit5401-6830-1940-3259289.00ChasePo Box 15298Wilmington, DE 19850Revolving Credit Card 02/99-03/064266-8411-7237-4603X1.00Chase201 N. Walnut St//de1-1027Wilmington, DE 19801Revolving Credit Card 07/09$0 Balance on Credit Report152300346860X1.00Chase - CcPo Box 15298Wilmington, DE 19850Revolving Credit Card 04/13$0 Balance on Credit Reportxxx-xx-85570.00Child Support EnforcementPO Box 8030Tallahassee, FL 32314-8030Notice Only 1 71,338.54Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 16 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS5466-1600-5825-8748X1.00CitiPo Box 6241Sioux Falls, SD 57117Revolving Credit Card 05/13$0 Balance on Credit Report5424-1803-2867-8302X1.00CitiPo Box 6241Sioux Falls, SD 57117Revolving Credit Card 11/05$0 Balance on Credit Report5424-1808-9970-1889X1.00CitiPo Box 6241Sioux Falls, SD 57117Revolving Credit Card 10/08$0 Balance on Credit Report849575100017452778.85ComcastP.O. Box 530098Atlanta, GA 30353-0098Services Rendered 11/10xxx-xx-85570.00Department Of The TreasuryPO Box 21126Philadelphia, PA 19114-0326Notice Only6011-0042-3060-9162765.00Discover FinPo Box15316Wilmington, DE 19850Revolving Credit Card 11/99-04/136011-2988-1146-0611X1.00Discover FinPo Box15316Wilmington, DE 19850Revolving Credit Card 03/06$0 Balance on Credit Report 2 7847.85Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 17 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS6011-0048-8017-6090X1.00Discover Fin Svcs LlcPo Box15316Wilmington, DE 19850Revolving Credit Card 04/13$0 Balance on Credit Report47626779502201,295.00Dsnb Macys9111 Duke BlvdMason, OH 45040Revolving Credit Card 01/93-10/084780221086420124.00Dsnb Macys9111 Duke BlvdMason, OH 45040Revolving Credit Card 12/02-07/11CACE100363970.00Enrique Alfonso Cam1039 Lagune Springs DrWeston, FL 33326Co Defendant in Lawsuitxxx-xx-85570.00EquifaxPO Box 740241Atlanta, GA 30374-0241Notice Onlyxxx-xx-85570.00ExperianPO Box 2002Allen, TX 75013-2002Notice Only862407632X1.00Fifth Third Bank5050 Kingsley DriveCincinnati, OH 45263Installment loan 06/12$0 Balance on Credit Report 3 71,421.00Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 18 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS441712115744X1.00First Usa Bank N A1001 Jefferson PlazaWilmington, DE 19701Revolving Credit Card 05/03$0 Balance on Credit Reportxxx-xx-85570.00Florida Department Of RevenuePO Box 6668Tallahassee, FL 32314-6668Notice Onlyxxx-xx-8557145.50Florida Home Medical Equipment, Inc3700 Commerce ParkwayMiramar, FL 33025Medical Services6019190202497033X1.00Gecrb/city FurniturePo Box 981439El Paso, TX 79998Revolving Credit Card 04/13$0 Balance on Credit Report6034610600122298X1.00Gecrb/ethan AllenC/o Po Box 965036Orlando, FL 32896Revolving Credit Card 04/13$0 Balance on Credit Report6008892367187826X1.00Gecrb/jcpPo Box 984100El Paso, TX 79998Revolving Credit Card 04/13$0 Balance on Credit Report6034610027801581X1.00Gecrb/scan DesignC/o Po Box 965036Orlando, FL 32896Revolving Credit Card 05/13$0 Balance on Credit Report 4 7150.50Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 19 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS6034610027039307X1.00Gecrb/scan DesignC/o Po Box 965036Orlando, FL 32896Revolving Credit Card 05/13$0 Balance on Credit ReportCACE10036397X1.00Goldman Sachs Mortgage CompC/ O CT Corp System1200 S Pine Island RdPlantation, FL 33324Co Defendant in Lawsuit000000000000000000603.00Inphynet South Broward, Inc.C/ O Ars Account Resolution1801 Nw 66th Ave Ste 200Plantation, FL 33313Medical Services 06/10-12/12xxx-xx-85570.00Internal Revenue ServicePO Box 21126Philadelphia, PA 19114-0326Notice Only8546506954X1.00Midland Funding8875 Aero Dr Ste 200San Diego, CA 92123Collection Agency for T-Mobile (1071) 01/12-04/13740202354X1.00Nco Fin /99Po Box 15636Wilmington, DE 19850Collection Agency for Progressive AmericanInsurance Co (2354) 07/11-07/12CACE10036397X1.00Pembroke Falls HoaC/ O Management Agent, R.A.1651 NW 136th AvePembroke Pines, FL 33028Co Defendant in Lawsuit 5 7608.00Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 20 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMSCACE10036397X1.00Pembroke Falls HoaC/ O Pembroke Falls HOA Bd Of Direc, R.A1651 NW 136th AvePembroke Pines, FL 33028Co Defendant in Lawsuit740202354407.00Progressive American Insurance Co6300 Wilson Mills Rd #W33Cleveland, OH 44143Services Rendered 07/11-07/12Acct in collection65395230X1.00Sears/cbnaPo Box 6282Sioux Falls, SD 57117Revolving Credit Card 03/09$0 Balance on Credit Report777421071308.00T-MobilePO Box 742596Cincinnati, OH 45274-2596Services Rendered 01/12-04/13Acct in collection8760017000658877X1.00Td Rcs/group Usa Inc1000 Macarthur BlvdMahwah, NJ 07430Revolving Credit Card 08/05$0 Balance on Credit Report6035320068200862X1.00Thd/cbnaPo Box 6497Sioux Falls, SD 57117Revolving Credit Card 01/04$0 Balance on Credit Reportxxx-xx-85570.00TransunionPO Box 1000Chester, PA 19022-2001Notice Only 6 7719.00Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 21 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6F(OfficialForm6F)(12/07)-Cont.INREDebtor(s)CaseNo.(Ifknown)(ContinuationSheet)CREDITOR'SNAME,MAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER.(SeeInstructionsAbove.)CODEBTORHUSBAND,WIFE,JOINT,ORCOMMUNITYDATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATECONTINGENTUNLIQUIDATEDDISPUTEDAMOUNTOFCLAIMACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.ACCOUNTNO.Sheetno.ofcontinuationsheetsattachedtoScheduleofCreditorsHoldingUnsecuredNonpriorityClaimsSubtotal(Totalofthispage)$Total(UseonlyonlastpageofthecompletedScheduleF.ReportalsoontheSummaryofSchedules,andifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.)$SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS772163815 -05025291.00Univita Specialty Infusion PhaPO Box 260670Pembroke Pines, FL 33026Medical Service: 11/20104308-5193-0236-6513X1.00Visa DsnbPo Box 8218Mason, OH 45040Revolving Credit Card 04/13$0 Balance on Credit Report 7 7292.008,859.56Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 22 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6G(OfficialForm6G)(12/07)INREDebtor(s)CaseNo.(Ifknown)Describeallexecutorycontractsofanynatureandallunexpiredleasesofrealorpersonalproperty.Includeanytimeshareinterests.Statenatureofdebtor’sinterestincontract,i.e.,“Purchaser,”“Agent,”etc.Statewhetherdebtoristhelessororlesseeofalease.Providethenamesandcompletemailingaddressesofallotherpartiestoeachleaseorcontractdescribed.Ifaminorchildisapartytooneoftheleasesorcontracts,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).Checkthisboxifdebtorhasnoexecutorycontractsorunexpiredleases.NAMEANDMAILINGADDRESS,INCLUDINGZIPCODEOFOTHERPARTIESTOLEASEORCONTRACTDESCRIPTIONOFCONTRACTORLEASEANDNATUREOFDEBTOR’SINTEREST.STATEWHETHERLEASEISFORNONRESIDENTIALREALPROPERTY.STATECONTRACTNUMBEROFANYGOVERNMENTCONTRACT.SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES(cid:252)De La Mata, AnggelaCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 23 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB6H(OfficialForm6H)(12/07)INREDebtor(s)CaseNo.(Ifknown)Providetheinformationrequestedconcerninganypersonorentity,otherthanaspouseinajointcase,thatisalsoliableonanydebtslistedbythedebtorintheschedulesofcreditors.Includeallguarantorsandco-signers.Ifthedebtorresidesorresidedinacommunitypropertystate,commonwealth,orterritory(includingAlaska,Arizona,California,Idaho,Louisiana,Nevada,NewMexico,PuertoRico,Texas,Washington,orWisconsin)withintheeight-yearperiodimmediatelyprecedingthecommencementofthecase,identifythenameofthedebtor’sspouseandofanyformerspousewhoresidesorresidedwiththedebtorinthecommunitypropertystate,commonwealth,orterritory.Includeallnamesusedbythenondebtorspouseduringtheeightyearsimmediatelyprecedingthecommencementofthiscase.Ifaminorchildisacodebtororacreditor,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).Checkthisboxifdebtorhasnocodebtors.NAMEANDADDRESSOFCODEBTORNAMEANDADDRESSOFCREDITORSCHEDULE H - CODEBTORS(cid:252)De La Mata, AnggelaCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 24 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaDisabled Daughter10B6I(OfficialForm6I)(12/07)INREDebtor(s)CaseNo.(Ifknown)Thecolumnlabeled“Spouse”mustbecompletedinallcasesfiledbyjointdebtorsandbyeverymarrieddebtor,whetherornotajointpetitionisfiled,unlessthespousesareseparatedandajointpetitionisnotfiled.Donotstatethenameofanyminorchild.TheaveragemonthlyincomecalculatedonthisformmaydifferfromthecurrentmonthlyincomecalculatedonFrom22A,22B,or22C.Debtor'sMaritalStatusDEPENDENTSOFDEBTORANDSPOUSERELATIONSHIP(S):AGE(S):EMPLOYMENT:DEBTORSPOUSEOccupationNameofEmployerHowlongemployedAddressofEmployerINCOME:(Estimateofaverageorprojectedmonthlyincomeattimecasefiled)DEBTORSPOUSE1.Currentmonthlygrosswages,salary,andcommissions(prorateifnotpaidmonthly)$$2.Estimatedmonthlyovertime$$3.SUBTOTAL$$4.LESSPAYROLLDEDUCTIONSa.PayrolltaxesandSocialSecurity$$b.Insurance$$c.Uniondues$$d.Other(specify)$$$$5.SUBTOTALOFPAYROLLDEDUCTIONS$$6.TOTALNETMONTHLYTAKEHOMEPAY$$7.Regularincomefromoperationofbusinessorprofessionorfarm(attachdetailedstatement)$$8.Incomefromrealproperty$$9.Interestanddividends$$10.Alimony,maintenanceorsupportpaymentspayabletothedebtorforthedebtor’suseorthatofdependentslistedabove$$11.SocialSecurityorothergovernmentassistance(Specify)$$$$12.Pensionorretirementincome$$13.Othermonthlyincome(Specify)$$$$$$14.SUBTOTALOFLINES7THROUGH13$$15.AVERAGEMONTHLYINCOME(Addamountsshownonlines6and14)$$16.COMBINEDAVERAGEMONTHLYINCOME:(Combinecolumntotalsfromline15;ifthereisonlyonedebtorrepeattotalreportedonline15)$(ReportalsoonSummaryofSchedulesand,ifapplicable,onStatisticalSummaryofCertainLiabilitiesandRelatedData)17.Describeanyincreaseordecreaseinincomereasonablyanticipatedtooccurwithintheyearfollowingthefilingofthisdocument:SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)DivorcedClothing SalesSelf-Employed3 years 0.00 0.00 0.00 1,500.00 600.00 2,100.00 2,100.00 2,100.00NoneCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 25 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6J(OfficialForm6J)(12/07)INREDebtor(s)CaseNo.(Ifknown)Completethisschedulebyestimatingtheaverageorprojectedmonthlyexpensesofthedebtorandthedebtor’sfamilyattimecasefiled.Prorateanypaymentsmadebiweekly,quarterly,semi-annually,orannuallytoshowmonthlyrate.TheaveragemonthlyexpensescalculatedonthisformmaydifferfromthedeductionsfromincomeallowedonForm22Aor22C.Checkthisboxifajointpetitionisfiledanddebtor’sspousemaintainsaseparatehousehold.Completeaseparatescheduleofexpenditureslabeled“Spouse.”1.Rentorhomemortgagepayment(includelotrentedformobilehome)$a.Arerealestatetaxesincluded?YesNob.Ispropertyinsuranceincluded?YesNo2.Utilities:a.Electricityandheatingfuel$b.Waterandsewer$c.Telephone$d.Other$$3.Homemaintenance(repairsandupkeep)$4.Food$5.Clothing$6.Laundryanddrycleaning$7.Medicalanddentalexpenses$8.Transportation(notincludingcarpayments)$9.Recreation,clubsandentertainment,newspapers,magazines,etc.$10.Charitablecontributions$11.Insurance(notdeductedfromwagesorincludedinhomemortgagepayments)a.Homeowner’sorrenter’s$b.Life$c.Health$d.Auto$e.Other$$12.Taxes(notdeductedfromwagesorincludedinhomemortgagepayments)(Specify)$$13.Installmentpayments:(inchapter11,12and13cases,donotlistpaymentstobeincludedintheplan)a.Auto$b.Other$$14.Alimony,maintenance,andsupportpaidtoothers$15.Paymentsforsupportofadditionaldependentsnotlivingatyourhome$16.Regularexpensesfromoperationofbusiness,profession,orfarm(attachdetailedstatement)$17.Other$$$18.AVERAGEMONTHLYEXPENSES(Totallines1-17.ReportalsoonSummaryofSchedulesand,ifapplicable,ontheStatisticalSummaryofCertainLiabilitiesandRelatedData.$19.Describeanyincreaseordecreaseinexpendituresanticipatedtooccurwithintheyearfollowingthefilingofthisdocument:20.STATEMENTOFMONTHLYNETINCOMEa.AveragemonthlyincomefromLine15ofScheduleI$b.AveragemonthlyexpensesfromLine18above$c.Monthlynetincome(a.minusb.)$SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S) 2,724.00(cid:252)(cid:252) 150.00 35.00 40.00 500.00 200.00HOA 193.00 3,842.00None 2,100.00 3,842.00 -1,742.00Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 26 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyUnitedStatesBankruptcyCourtINRE:CaseNo.Debtor(s)ChapterFINANCIALREVIEWOFTHEDEBTOR’SBUSINESS(Note:ONLYINCLUDEinformationdirectlyrelatedtothebusinessoperation.)PARTA-GROSSBUSINESSINCOMEFORTHEPREVIOUS12MONTHS:1.GrossIncomeFor12MonthsPriortoFiling:PARTB-ESTIMATEDAVERAGEFUTUREGROSSMONTHLYINCOME:2.GrossMonthlyIncome:PARTC-ESTIMATEDFUTUREMONTHLYEXPENSES:3.NetEmployeePayroll(OtherThanDebtor)4.PayrollTaxes5.UnemploymentTaxes6.Worker’sCompensation7.OtherTaxes8.InventoryPurchases(Includingrawmaterials)9.PurchaseofFeed/Fertilizer/Seed/Spray10.Rent(Otherthandebtor’sprincipalresidence)11.Utilities12.OfficeExpensesandSupplies13.RepairsandMaintenance14.VehicleExpenses15.TravelandEntertainment16.EquipmentRentalandLeases17.Legal/Accounting/OtherProfessionalFees18.Insurance19.EmployeeBenefits(e.g.,pension,medical,etc.)20.PaymentstobeMadeDirectlybyDebtortoSecuredCreditorsforPre-PetitionBusinessDebts(Specify):21.Other(Specify):22.TotalMonthlyExpenses(Additems3-21)PARTD-ESTIMATEDAVERAGENETMONTHLYINCOME23.AVERAGENETMONTHLYINCOME(SubtractItem22fromItem2)$$$$$$$$$$$$$$$$$$$$$$$Southern District of FloridaBUSINESS INCOME AND EXPENSES7De La Mata, Anggela 1,500.00 1,500.00Case 13-25343-JKO Doc 1 Filed 06/28/13 Page 27 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyDe La Mata, AnggelaB6Declaration(OfficialForm6-Declaration)(12/07)INREDebtor(s)CaseNo.(Ifknown)DECLARATIONUNDERPENALTYOFPERJURYBYINDIVIDUALDEBTORIdeclareunderpenaltyofperjurythatIhavereadtheforegoingsummaryandschedules,consistingofsheets,andthattheyaretrueandcorrecttothebestofmyknowledge,information,andbelief.Date:Signature:DebtorDate:Signature:(JointDebtor,ifany)[Ifjointcase,bothspousesmustsign.]DECLARATIONANDSIGNATUREOFNON-ATTORNEYBANKRUPTCYPETITIONPREPARER(See11U.S.C.§110)Ideclareunderpenaltyofperjurythat:(1)Iamabankruptcypetitionpreparerasdefinedin11U.S.C.§110;(2)Ipreparedthisdocumentforcompensationandhaveprovidedthedebtorwithacopyofthisdocumentandthenoticesandinformationrequiredunder11U.S.C.§§110(b),110(h),and342(b);and,(3)ifrulesorguidelineshavebeenpromulgatedpursuantto11U.S.C.§110(h)settingamaximumfeeforserviceschargeablebybankruptcypetitionpreparers,Ihavegiventhedebtornoticeofthemaximumamountbeforepreparinganydocumentforfilingforadebtororacceptinganyfeefromthedebtor,asrequiredbythatsection.PrintedorTypedNameandTitle,ifany,ofBankruptcyPetitionPreparerSocialSecurityNo.(Requiredby11U.S.C.§110.)Ifthebankruptcypetitionpreparerisnotanindividual,statethename,title(ifany),address,andsocialsecuritynumberoftheofficer,principal,responsibleperson,orpartnerwhosignsthedocument.AddressSignatureofBankruptcyPetitionPreparerDateNamesandSocialSecuritynumbersofallotherindividualswhopreparedorassistedinpreparingthisdocument,unlessthebankruptcypetitionpreparerisnotanindividual:Ifmorethanonepersonpreparedthisdocument,attachadditionalsignedsheetsconformingtotheappropriateOfficialFormforeachperson.Abankruptcypetitionpreparer'sfailuretocomplywiththeprovisionoftitle11andtheFederalRulesofBankruptcyProceduremayresultinfinesorimprisonmentorboth.11U.S.C.§110;18U.S.C.§156.DECLARATIONUNDERPENALTYOFPERJURYONBEHALFOFCORPORATIONORPARTNERSHIPI,the(thepresidentorotherofficeroranauthorizedagentofthecorporationoramemberoranauthorizedagentofthepartnership)ofthe(corporationorpartnership)namedasdebtorinthiscase,declareunderpenaltyofperjurythatIhavereadtheforegoingsummaryandschedules,consistingofsheets(totalshownonsummarypageplus1),andthattheyaretrueandcorrecttothebestofmyknowledge,information,andbelief.Date:Signature:(Printortypenameofindividualsigningonbehalfofdebtor)[Anindividualsigningonbehalfofapartnershiporcorporationmustindicatepositionorrelationshiptodebtor.]Penaltyformakingafalsestatementorconcealingproperty:Fineofupto$500,000orimprisonmentforupto5yearsorboth.18U.S.C.§§152and3571.DECLARATION CONCERNING DEBTOR'S SCHEDULES 21June 28, 2013/s/ Anggela De La MataAnggela De La MataCase 13-25343-JKO Doc 1 Filed 06/28/13 Page 28 of 42

© 1993-2011 EZ-Filing, Inc. [1-800-998-2424] - Forms Software OnlyB7(OfficialForm7)(04/13)INRE:CaseNo.Debtor(s)ChapterThisstatementistobecompletedbyeverydebtor.Spousesfilingajointpetitionmayfileasinglestatementonwhichtheinformationforbothspousesiscombined.Ifthecaseisfiledunderchapter12orchapter13,amarrieddebtormustfurnishinformationforbothspouseswhetherornotajointpetitionisfiled,unlessthespousesareseparatedandajointpetitionisnotfiled.Anindividualdebtorengagedinbusinessasasoleproprietor,partner,familyfarmer,orself-employedprofessional,shouldprovidetheinformationrequestedonthisstatementconcerningallsuchactivitiesaswellastheindividual'spersonalaffairs.Toindicatepayments,transfersandtheliketominorchildren,statethechild'sinitialsandthenameandaddressofthechild'sparentorguardian,suchas"A.B.,aminorchild,byJohnDoe,guardian."Donotdisclosethechild'sname.See,11U.S.C.§112andFed.R.Bankr.P.1007(m).Questions1-18aretobecompletedbyalldebtors.Debtorsthatareorhavebeeninbusiness,asdefinedbelow,alsomustcompleteQuestions19-25.Iftheanswertoanapplicablequestionis"None,"marktheboxlabeled"None."Ifadditionalspaceisneededfortheanswertoanyquestion,useandattachaseparatesheetproperlyidentifiedwiththecasename,casenumber(ifknown),andthenumberofthequestion.DEFINITIONS"Inbusiness."Adebtoris"inbusiness"forthepurposeofthisformifthedebtorisacorporationorpartnership.Anindividualdebtoris"inbusiness"forthepurposeofthisformifthedebtorisorhasbeen,withinsixyearsimmediatelyprecedingthefilingofthisbankruptcycase,anyofthefollowing:anofficer,director,managingexecutive,orownerof5percentormoreofthevotingorequitysecuritiesofacorporation;apartner,otherthanalimitedpartner,ofapartnership;asoleproprietororself-employedfull-timeorpart-time.Anindividualdebtoralsomaybe“inbusiness”forthepurposeofthisformifthedebtorengagesinatrade,business,orotheractivity,otherthanasanemployee,tosupplementincomefromthedebtor’sprimaryemployment."Insider."Theterm"insider"includesbutisnotlimitedto:relativesofthedebtor;generalpartnersofthedebtorandtheirrelatives;corporationsofwhichthedebtorisanofficer,director,orpersonincontrol;officers,directors,andanypersonsincontrolofacorporatedebtorandtheirrelatives;affiliatesofthedebtorandinsidersofsuchaffiliates;anymanagingagentofthedebtor.11U.S.C.§101(2),(31).United States Bankruptcy CourtSouthern District of FloridaSTATEMENT OF FINANCIAL AFFAIRS7De La Mata, Anggela1.IncomefromemploymentoroperationofbusinessNoneStatethegrossamountofincomethedebtorhasreceivedfromemployment,trade,orprofession,orfromoperationofthedebtor'sbusiness,includingpart-timeactivitieseitherasanemployeeorinindependenttradeorbusiness,fromthebeginningofthiscalendaryeartothedatethiscasewascommenced.Statealsothegrossamountsreceivedduringthetwoyearsimmediatelyprecedingthiscalendaryear.(Adebtorthatmaintains,orhasmaintained,financialrecordsonthebasisofafiscalratherthanacalendaryearmayreportfiscalyearincome.Identifythebeginningandendingdatesofthedebtor'sfiscalyear.)Ifajointpetitionisfiled,stateincomeforeachspouseseparately.(Marrieddebtorsfilingunderchapter12orchapter13muststateincomeofbothspouseswhetherornotajointpetitionisfiled,unlessthespousesareseparatedandajointpetitionisnotfiled.)AMOUNTSOURCE 7,500.002013 - Estimated Income YTD 15,000.002012 - Did not file - Estimated gross Income 10,418.002011 - Individual Income Tax Return2.IncomeotherthanfromemploymentoroperationofbusinessNoneStatetheamountofincomereceivedbythedebtorother