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Case 12-31830 Doc 6 Filed 12/06/12 Page 1 of 8

12/06/12 7:17PMB22A (Official Form 22A) (Chapter 7) (12/10)In reErica Latesia HughesAccording to the information required to be entered on this statement(check one box as directed in Part I, III, or VI of this statement):(cid:134)The presumption arises.(cid:132)The presumption does not arise.(cid:134)The presumption is temporarily inapplicable.Debtor(s)Case Number:(If known)CHAPTER 7 STATEMENT OF CURRENT MONTHLY INCOMEAND MEANS-TEST CALCULATIONIn addition to Schedules I and J, this statement must be completed by every individual chapter 7 debtor. If none of the exclusions in Part I applies,joint debtors may complete one statement only. If any of the exclusions in Part I applies, joint debtors should complete separate statements if theybelieve this is required by § 707(b)(2)(C).Part I. MILITARY AND NON-CONSUMER DEBTORS1ADisabled Veterans. If you are a disabled veteran described in the Declaration in this Part IA, (1) check the box at the beginning of theDeclaration, (2) check the box for "The presumption does not arise" at the top of this statement, and (3) complete the verification in PartVIII. Do not complete any of the remaining parts of this statement.(cid:134)Declaration of Disabled Veteran. By checking this box, I declare under penalty of perjury that I am a disabled veteran (as defined in38 U.S.C. § 3741(1)) whose indebtedness occurred primarily during a period in which I was on active duty (as defined in 10 U.S.C. §101(d)(1)) or while I was performing a homeland defense activity (as defined in 32 U.S.C. §901(1)).1BNon-consumer Debtors. If your debts are not primarily consumer debts, check the box below and complete the verification in Part VIII.Do not complete any of the remaining parts of this statement.(cid:134)Declaration of non-consumer debts. By checking this box, I declare that my debts are not primarily consumer debts.1CReservists and National Guard Members; active duty or homeland defense activity. Members of a reserve component of the ArmedForces and members of the National Guard who were called to active duty (as defined in 10 U.S.C. § 101(d)(1)) after September 11,2001, for a period of at least 90 days, or who have performed homeland defense activity (as defined in 32 U.S.C. § 901(1)) for a period ofat least 90 days, are excluded from all forms of means testing during the time of active duty or homeland defense activity and for 540days thereafter (the "exclusion period"). If you qualify for this temporary exclusion, (1) check the appropriate boxes and complete anyrequired information in the Declaration of Reservists and National Guard Members below, (2) check the box for "The presumption istemporarily inapplicable" at the top of this statement, and (3) complete the verification in Part VIII. During your exclusion period youare not required to complete the balance of this form, but you must complete the form no later than 14 days after the date onwhich your exclusion period ends, unless the time for filing a motion raising the means test presumption expires in your casebefore your exclusion period ends.(cid:134)Declaration of Reservists and National Guard Members. By checking this box and making the appropriate entries below, I declarethat I am eligible for a temporary exclusion from means testing because, as a member of a reserve component of the Armed Forces or theNational Guarda. (cid:134) I was called to active duty after September 11, 2001, for a period of at least 90 days and(cid:134) I remain on active duty /or/(cid:134) I was released from active duty on , which is less than 540 days before this bankruptcy case wasfiled;ORb. (cid:134) I am performing homeland defense activity for a period of at least 90 days /or/(cid:134) I performed homeland defense activity for a period of at least 90 days, terminating on , which is less than540 days before this bankruptcy case was filed.Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case BankruptcyCase 12-31830 Doc 6 Filed 12/06/12 Page 2 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)2Part II. CALCULATION OF MONTHLY INCOME FOR § 707(b)(7) EXCLUSION2Marital/filing status. Check the box that applies and complete the balance of this part of this statement as directed.a. (cid:132) Unmarried. Complete only Column A ("Debtor's Income") for Lines 3-11.b.(cid:134) Married, not filing jointly, with declaration of separate households. By checking this box, debtor declares under penalty of perjury:"My spouse and I are legally separated under applicable non-bankruptcy law or my spouse and I are living apart other than for thepurpose of evading the requirements of § 707(b)(2)(A) of the Bankruptcy Code." Complete only column A ("Debtor's Income")for Lines 3-11.c. (cid:134) Married, not filing jointly, without the declaration of separate households set out in Line 2.b above. Complete both Column A("Debtor's Income") and Column B ("Spouse's Income") for Lines 3-11.d.(cid:134) Married, filing jointly. Complete both Column A ("Debtor's Income") and Column B ("Spouse's Income") for Lines 3-11.All figures must reflect average monthly income received from all sources, derived during the sixcalendar months prior to filing the bankruptcy case, ending on the last day of the month beforethe filing. If the amount of monthly income varied during the six months, you must divide thesix-month total by six, and enter the result on the appropriate line.Column ADebtor'sIncomeColumn BSpouse'sIncome3Gross wages, salary, tips, bonuses, overtime, commissions.$109.00$4Income from the operation of a business, profession or farm. Subtract Line b from Line a andenter the difference in the appropriate column(s) of Line 4. If you operate more than onebusiness, profession or farm, enter aggregate numbers and provide details on an attachment. Donot enter a number less than zero. Do not include any part of the business expenses entered onLine b as a deduction in Part V.$0.00$5Rents and other real property income. Subtract Line b from Line a and enter the difference inthe appropriate column(s) of Line 5. Do not enter a number less than zero. Do not include anypart of the operating expenses entered on Line b as a deduction in Part V.$0.00$6Interest, dividends, and royalties.$0.00$7Pension and retirement income.$0.00$8Any amounts paid by another person or entity, on a regular basis, for the householdexpenses of the debtor or the debtor's dependents, including child support paid for thatpurpose. Do not include alimony or separate maintenance payments or amounts paid by yourspouse if Column B is completed. Each regular payment should be reported in only one column;if a payment is listed in Column A, do not report that payment in Column B.$0.00$9Unemployment compensation. Enter the amount in the appropriate column(s) of Line 9.However, if you contend that unemployment compensation received by you or your spouse was abenefit under the Social Security Act, do not list the amount of such compensation in Column Aor B, but instead state the amount in the space below:$0.00$10Income from all other sources. Specify source and amount. If necessary, list additional sourceson a separate page. Do not include alimony or separate maintenance payments paid by yourspouse if Column B is completed, but include all other payments of alimony or separatemaintenance. Do not include any benefits received under the Social Security Act or paymentsreceived as a victim of a war crime, crime against humanity, or as a victim of international ordomestic terrorism.Total and enter on Line 10$0.00$11Subtotal of Current Monthly Income for § 707(b)(7). Add Lines 3 thru 10 in Column A, and, ifColumn B is completed, add Lines 3 through 10 in Column B. Enter the total(s).$109.00$Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcyb.Ordinary and necessary business expenses$0.00$c.Business incomeSubtract Line b from Line aDebtorSpousea.Gross receiptsDebtorSpouseUnemployment compensation claimed tobe a benefit under the Social Security ActDebtor $0.00Spouse $a.Gross receipts$0.00$DebtorSpousea.$$b.$$b.Ordinary and necessary operating expenses$0.00$c.Rent and other real property incomeSubtract Line b from Line a$0.00$Case 12-31830 Doc 6 Filed 12/06/12 Page 3 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)312Total Current Monthly Income for § 707(b)(7). If Column B has been completed, add Line 11,Column A to Line 11, Column B, and enter the total. If Column B has not been completed, enterthe amount from Line 11, Column A.$109.00Part III. APPLICATION OF § 707(b)(7) EXCLUSION13Annualized Current Monthly Income for § 707(b)(7). Multiply the amount from Line 12 by the number 12 andenter the result.$1,308.0014Applicable median family income. Enter the median family income for the applicable state and household size.(This information is available by family size at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)$72,191.0015Application of Section 707(b)(7). Check the applicable box and proceed as directed.(cid:132)The amount on Line 13 is less than or equal to the amount on Line 14. Check the box for "The presumption does not arise" at thetop of page 1 of this statement, and complete Part VIII; do not complete Parts IV, V, VI or VII.(cid:134)The amount on Line 13 is more than the amount on Line 14. Complete the remaining parts of this statement.Complete Parts IV, V, VI, and VII of this statement only if required. (See Line 15.)Part IV. CALCULATION OF CURRENT MONTHLY INCOME FOR § 707(b)(2)16Enter the amount from Line 12.$17Marital adjustment. If you checked the box at Line 2.c, enter on Line 17 the total of any income listed in Line 11,Column B that was NOT paid on a regular basis for the household expenses of the debtor or the debtor'sdependents. Specify in the lines below the basis for excluding the Column B income (such as payment of thespouse's tax liability or the spouse's support of persons other than the debtor or the debtor's dependents) and theamount of income devoted to each purpose. If necessary, list additional adjustments on a separate page. If you didnot check box at Line 2.c, enter zero.Total and enter on Line 17$18Current monthly income for § 707(b)(2). Subtract Line 17 from Line 16 and enter the result.$Part V. CALCULATION OF DEDUCTIONS FROM INCOMESubpart A: Deductions under Standards of the Internal Revenue Service (IRS)19ANational Standards: food, clothing and other items. Enter in Line 19A the "Total" amount from IRS NationalStandards for Food, Clothing and Other Items for the applicable number of persons. (This information is availableat www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.) The applicable number of persons is the numberthat would currently be allowed as exemptions on your federal income tax return, plus the number of anyadditional dependents whom you support.$19BNational Standards: health care. Enter in Line a1 below the amount from IRS National Standards forOut-of-Pocket Health Care for persons under 65 years of age, and in Line a2 the IRS National Standards forOut-of-Pocket Health Care for persons 65 years of age or older. (This information is available atwww.usdoj.gov/ust/ or from the clerk of the bankruptcy court.) Enter in Line b1 the applicable number of personswho are under 65 years of age, and enter in Line b2 the applicable number of persons who are 65 years of age orolder. (The applicable number of persons in each age category is the number in that category that would currentlybe allowed as exemptions on your federal income tax return, plus the number of any additional dependents whomyou support.) Multiply Line a1 by Line b1 to obtain a total amount for persons under 65, and enter the result inLine c1. Multiply Line a2 by Line b2 to obtain a total amount for persons 65 and older, and enter the result in Linec2. Add Lines c1 and c2 to obtain a total health care amount, and enter the result in Line 19B.$20ALocal Standards: housing and utilities; non-mortgage expenses. Enter the amount of the IRS Housing andUtilities Standards; non-mortgage expenses for the applicable county and family size. (This information isavailable at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court). The applicable family size consists ofthe number that would currently be allowed as exemptions on your federal income tax return, plus the number ofany additional dependents whom you support.$Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcy$b.$c.$Persons under 65 years of agePersons 65 years of age or oldera1.Allowance per persona2.Allowance per personb1.Number of personsb2.Number of personsc1.Subtotalc2.Subtotald.$MDb. Enter debtor's household size:2a. Enter debtor's state of residence:a.Case 12-31830 Doc 6 Filed 12/06/12 Page 4 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)420BLocal Standards: housing and utilities; mortgage/rent expense. Enter, in Line a below, the amount of the IRSHousing and Utilities Standards; mortgage/rent expense for your county and family size (this information isavailable at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court) (the applicable family size consists ofthe number that would currently be allowed as exemptions on your federal income tax return, plus the number ofany additional dependents whom you support); enter on Line b the total of the Average Monthly Payments for anydebts secured by your home, as stated in Line 42; subtract Line b from Line a and enter the result in Line 20B. Donot enter an amount less than zero.$21Local Standards: housing and utilities; adjustment. If you contend that the process set out in Lines 20A and20B does not accurately compute the allowance to which you are entitled under the IRS Housing and UtilitiesStandards, enter any additional amount to which you contend you are entitled, and state the basis for yourcontention in the space below:$22ALocal Standards: transportation; vehicle operation/public transportation expense.You are entitled to an expense allowance in this category regardless of whether you pay the expenses of operating avehicle and regardless of whether you use public transportation.Check the number of vehicles for which you pay the operating expenses or for which the operating expenses areincluded as a contribution to your household expenses in Line 8.(cid:134) 0 (cid:134) 1 (cid:134) 2 or more.If you checked 0, enter on Line 22A the "Public Transportation" amount from IRS Local Standards:Transportation. If you checked 1 or 2 or more, enter on Line 22A the "Operating Costs" amount from IRS LocalStandards: Transportation for the applicable number of vehicles in the applicable Metropolitan Statistical Area orCensus Region. (These amounts are available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court.)$22BLocal Standards: transportation; additional public transportation expense. If you pay the operating expensesfor a vehicle and also use public transportation, and you contend that you are entitled to an additional deduction foryou public transportation expenses, enter on Line 22B the "Public Transportation" amount from IRS LocalStandards: Transportation. (This amount is available at www.usdoj.gov/ust/ or from the clerk of the bankruptcycourt.)$23Local Standards: transportation ownership/lease expense; Vehicle 1. Check the number of vehicles for whichyou claim an ownership/lease expense. (You may not claim an ownership/lease expense for more than twovehicles.)(cid:134) 1 (cid:134) 2 or more.Enter, in Line a below, the "Ownership Costs" for "One Car" from the IRS Local Standards: Transportation(available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b the total of the AverageMonthly Payments for any debts secured by Vehicle 1, as stated in Line 42; subtract Line b from Line a and enterthe result in Line 23. Do not enter an amount less than zero.$24Local Standards: transportation ownership/lease expense; Vehicle 2. Complete this Line only if you checkedthe "2 or more" Box in Line 23.Enter, in Line a below, the "Ownership Costs" for "One Car" from the IRS Local Standards: Transportation(available at www.usdoj.gov/ust/ or from the clerk of the bankruptcy court); enter in Line b the total of the AverageMonthly Payments for any debts secured by Vehicle 2, as stated in Line 42; subtract Line b from Line a and enterthe result in Line 24. Do not enter an amount less than zero.$25Other Necessary Expenses: taxes. Enter the total average monthly expense that you actually incur for all federal,state and local taxes, other than real estate and sales taxes, such as income taxes, self employment taxes, socialsecurity taxes, and Medicare taxes. Do not include real estate or sales taxes.$Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcya.IRS Transportation Standards, Ownership Costs$b.Average Monthly Payment for any debts secured by Vehicle1, as stated in Line 42$c.Net ownership/lease expense for Vehicle 1Subtract Line b from Line a.b.Average Monthly Payment for any debts secured by yourhome, if any, as stated in Line 42$a.IRS Transportation Standards, Ownership Costs$b.Average Monthly Payment for any debts secured by Vehicle2, as stated in Line 42$c.Net ownership/lease expense for Vehicle 2Subtract Line b from Line a.c.Net mortgage/rental expenseSubtract Line b from Line a.a.IRS Housing and Utilities Standards; mortgage/rental expense$Case 12-31830 Doc 6 Filed 12/06/12 Page 5 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)526Other Necessary Expenses: involuntary deductions for employment. Enter the total average monthly payrolldeductions that are required for your employment, such as retirement contributions, union dues, and uniform costs.Do not include discretionary amounts, such as voluntary 401(k) contributions.$27Other Necessary Expenses: life insurance. Enter total average monthly premiums that you actually pay for termlife insurance for yourself. Do not include premiums for insurance on your dependents, for whole life or forany other form of insurance.$28Other Necessary Expenses: court-ordered payments. Enter the total monthly amount that you are required topay pursuant to the order of a court or administrative agency, such as spousal or child support payments. Do notinclude payments on past due obligations included in Line 44.$29Other Necessary Expenses: education for employment or for a physically or mentally challenged child. Enterthe total average monthly amount that you actually expend for education that is a condition of employment and foreducation that is required for a physically or mentally challenged dependent child for whom no public educationproviding similar services is available.$30Other Necessary Expenses: childcare. Enter the total average monthly amount that you actually expend onchildcare - such as baby-sitting, day care, nursery and preschool. Do not include other educational payments.$31Other Necessary Expenses: health care. Enter the total average monthly amount that you actually expend onhealth care that is required for the health and welfare of yourself or your dependents, that is not reimbursed byinsurance or paid by a health savings account, and that is in excess of the amount entered in Line 19B. Do notinclude payments for health insurance or health savings accounts listed in Line 34.$32Other Necessary Expenses: telecommunication services. Enter the total average monthly amount that youactually pay for telecommunication services other than your basic home telephone and cell phone service - such aspagers, call waiting, caller id, special long distance, or internet service - to the extent necessary for your health andwelfare or that of your dependents. Do not include any amount previously deducted.$33Total Expenses Allowed under IRS Standards. Enter the total of Lines 19 through 32.$Subpart B: Additional Living Expense DeductionsNote: Do not include any expenses that you have listed in Lines 19-3234Health Insurance, Disability Insurance, and Health Savings Account Expenses. List the monthly expenses inthe categories set out in lines a-c below that are reasonably necessary for yourself, your spouse, or yourdependents.$Total and enter on Line 34.If you do not actually expend this total amount, state your actual total average monthly expenditures in the spacebelow:$35Continued contributions to the care of household or family members. Enter the total average actual monthlyexpenses that you will continue to pay for the reasonable and necessary care and support of an elderly, chronicallyill, or disabled member of your household or member of your immediate family who is unable to pay for suchexpenses.$36Protection against family violence. Enter the total average reasonably necessary monthly expenses that youactually incurred to maintain the safety of your family under the Family Violence Prevention and Services Act orother applicable federal law. The nature of these expenses is required to be kept confidential by the court.$37Home energy costs. Enter the total average monthly amount, in excess of the allowance specified by IRS LocalStandards for Housing and Utilities, that you actually expend for home energy costs. You must provide your casetrustee with documentation of your actual expenses, and you must demonstrate that the additional amountclaimed is reasonable and necessary.$38Education expenses for dependent children less than 18. Enter the total average monthly expenses that youactually incur, not to exceed $147.92* per child, for attendance at a private or public elementary or secondaryschool by your dependent children less than 18 years of age. You must provide your case trustee withdocumentation of your actual expenses, and you must explain why the amount claimed is reasonable andnecessary and not already accounted for in the IRS Standards.$*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.Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcy$b.Disability Insurance$c.Health Savings Account$a.Health InsuranceCase 12-31830 Doc 6 Filed 12/06/12 Page 6 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)639Additional food and clothing expense. Enter the total average monthly amount by which your food and clothingexpenses exceed the combined allowances for food and clothing (apparel and services) in the IRS NationalStandards, not to exceed 5% of those combined allowances. (This information is available at www.usdoj.gov/ust/or from the clerk of the bankruptcy court.) You must demonstrate that the additional amount claimed isreasonable and necessary.$40Continued charitable contributions. Enter the amount that you will continue to contribute in the form of cash orfinancial instruments to a charitable organization as defined in 26 U.S.C. § 170(c)(1)-(2).$41Total Additional Expense Deductions under § 707(b). Enter the total of Lines 34 through 40$Subpart C: Deductions for Debt Payment42Future payments on secured claims. For each of your debts that is secured by an interest in property that youown, list the name of the creditor, identify the property securing the debt, and state the Average Monthly Payment,and check whether the payment includes taxes or insurance. The Average Monthly Payment is the total of allamounts scheduled as contractually due to each Secured Creditor in the 60 months following the filing of thebankruptcy case, divided by 60. If necessary, list additional entries on a separate page. Enter the total of theAverage Monthly Payments on Line 42.Name of CreditorProperty Securing the DebtAverage MonthlyPaymentDoes paymentinclude taxesor insurance?a.$(cid:134)yes (cid:134)noTotal: Add Lines$43Other payments on secured claims. If any of debts listed in Line 42 are secured by your primary residence, amotor vehicle, or other property necessary for your support or the support of your dependents, you may include inyour deduction 1/60th of any amount (the "cure amount") that you must pay the creditor in addition to thepayments listed in Line 42, in order to maintain possession of the property. The cure amount would include anysums in default that must be paid in order to avoid repossession or foreclosure. List and total any such amounts inthe following chart. If necessary, list additional entries on a separate page.Name of CreditorProperty Securing the Debt1/60th of the Cure Amounta.$Total: Add Lines$44Payments on prepetition priority claims. Enter the total amount, divided by 60, of all priority claims, such aspriority tax, child support and alimony claims, for which you were liable at the time of your bankruptcy filing. Donot include current obligations, such as those set out in Line 28.$45Chapter 13 administrative expenses. If you are eligible to file a case under Chapter 13, complete the followingchart, multiply the amount in line a by the amount in line b, and enter the resulting administrative expense.$46Total Deductions for Debt Payment. Enter the total of Lines 42 through 45.$Subpart D: Total Deductions from Income47Total of all deductions allowed under § 707(b)(2). Enter the total of Lines 33, 41, and 46.$Part VI. DETERMINATION OF § 707(b)(2) PRESUMPTION48Enter the amount from Line 18 (Current monthly income for § 707(b)(2))$49Enter the amount from Line 47 (Total of all deductions allowed under § 707(b)(2))$50Monthly disposable income under § 707(b)(2). Subtract Line 49 from Line 48 and enter the result.$5160-month disposable income under § 707(b)(2). Multiply the amount in Line 50 by the number 60 and enter theresult.$Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcya.Projected average monthly Chapter 13 plan payment.$b.Current multiplier for your district as determined under schedulesissued by the Executive Office for United States Trustees. (Thisinformation is available at www.usdoj.gov/ust/ or from the clerk ofthe bankruptcy court.)xc.Average monthly administrative expense of Chapter 13 caseTotal: Multiply Lines a and bCase 12-31830 Doc 6 Filed 12/06/12 Page 7 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)752Initial presumption determination. Check the applicable box and proceed as directed.(cid:134)The amount on Line 51 is less than $7,025*. Check the box for "The presumption does not arise" at the top of page 1 of this statement,and complete the verification in Part VIII. Do not complete the remainder of Part VI.(cid:134)The amount set forth on Line 51 is more than $11,725* Check the box for "The presumption arises" at the top of page 1 of thisstatement, and complete the verification in Part VIII. You may also complete Part VII. Do not complete the remainder of Part VI.(cid:134)The amount on Line 51 is at least $7,025*, but not more than $11,725*. Complete the remainder of Part VI (Lines 53 through 55).53Enter the amount of your total non-priority unsecured debt$54Threshold debt payment amount. Multiply the amount in Line 53 by the number 0.25 and enter the result.$55Secondary presumption determination. Check the applicable box and proceed as directed.(cid:134)The amount on Line 51 is less than the amount on Line 54. Check the box for "The presumption does not arise" at the top of page 1of this statement, and complete the verification in Part VIII.(cid:134)The amount on Line 51 is equal to or greater than the amount on Line 54. Check the box for "The presumption arises" at the top ofpage 1 of this statement, and complete the verification in Part VIII. You may also complete Part VII.Part VII. ADDITIONAL EXPENSE CLAIMS56Other Expenses. List and describe any monthly expenses, not otherwise stated in this form, that are required for the health and welfare ofyou and your family and that you contend should be an additional deduction from your current monthly income under §707(b)(2)(A)(ii)(I). If necessary, list additional sources on a separate page. All figures should reflect your average monthly expense foreach item. Total the expenses.Part VIII. VERIFICATION57I declare under penalty of perjury that the information provided in this statement is true and correct. (If this is a joint case, both debtorsmust sign.)Erica Latesia Hughes(Debtor)*Amounts are subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after the date of adjustment.Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcyc.$d.$Total: Add Lines a, b, c, and d$Expense DescriptionMonthly Amounta.$Date:December 6, 2012Signature:/s/ Erica Latesia Hughesb.$Case 12-31830 Doc 6 Filed 12/06/12 Page 8 of 8

12/06/12 7:17PM B22A (Official Form 22A) (Chapter 7) (12/10)8Current Monthly Income Details for the DebtorDebtor Income Details:Income for the Period 06/01/2012 to 11/30/2012.Line 3 - Gross wages, salary, tips, bonuses, overtime, commissionsSource of Income: EmploymentIncome by Month:6 Months Ago:06/2012$0.005 Months Ago:07/2012$0.004 Months Ago:08/2012$0.003 Months Ago:09/2012$294.002 Months Ago:10/2012$300.00Last Month:11/2012$60.00Average per month:$109.00Software Copyright (c) 1996-2012 CCH INCORPORATED - www.bestcase.comBest Case Bankruptcy