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Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 1 of 34

EXHIBIT 3

(Original Filings)





19

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 2 of 34
age 1 of 24

Case:11-6 -369-jrh Doc #:21 Filed: 05/12/11 (cid:9)

)7-

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

United States Bankruptcy Court

Western District of Michigan

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

Chapter (cid:9)

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 also must 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

0.00

872,444.94

0.00

0.00

6.118.358.00

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)

YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

1

3

2

1

2

7

1

1

1

1

TOTAL

20

872,444.94

6,118,358.00

300.00

260.00

(cid:9)
(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 3 of 34
age 2 of 24

Case:11-6 .u69-jrh Doc #:21 Filed: 05/12/11 (cid:9)

Form 6 - Statistical Summary (12/07)

United States Bankruptcy Court

Western District of Michigan

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869
Chapter (cid:9)

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.

1:1 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)

TOTAL

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
228 Line 11; OR, Form 22C Line 20)

Amount

$ (cid:9)

0.00

$ (cid:9)

0.00

$ (cid:9)

$ (cid:9)

0.00

0.00

$ (cid:9)

0.00

$ (cid:9)

$ (cid:9)

0.00

0.00

$ (cid:9)

$ (cid:9)

300.00

260.00

$ (cid:9)

0.00

State the following:

1. Total from Schedule D, "UNSECURED PORTION, IF ANY" column

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

$ (cid:9)

0.00

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)

$ (cid:9)

0.00

$ (cid:9)

$ (cid:9)

$ (cid:9)

0.00

6,118,358.00

6,118,358.00

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 4 of 34
age 3 of 24

Case:11-6-.069-jrh Doc #:21 Filed: 05/12/11 (cid:9)

B6A (Official Form 6A) (12107)

In re: KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE A - REAL PROPERTY

DESCRIPTION AND

LOCATION OF

PROPERTY

NATURE OF DEBTORS
INTEREST IN PROPERTY

CURRENT VALUE

OF DEBTORS
INTEREST IN

PROPERTY, W ITHOUT

DEDUCTING ANY
SECURED CLAIM

OR EXEMPTION

AMOUNT OF

SECURED

CLAIM



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NONE

Total (cid:9)

>

0.00

(Report also on Summary of Schedules.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 5 of 34
Case:11-G -569-jrh Doc #:21 Filed: 05/12/11 . age 4 of 24

B6B (Official Form 6B) (12107)

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE B - PERSONAL PROPERTY



TYPE OF PROPERTY

in
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DESCRIPTION AND LOCATION

OF PROPERTY

CURRENT VALUE OF
DEBTORS INTEREST
IN PROPERTY, WITH-
OUT DEDUCTING ANY

SECURED CLAIM
OR EXEMPTION



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B
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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.

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.

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. Furs and jewelry.

X

X

5. Firearms and sports, photographic, and

x

other hobby equipment.

X

x

9, 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.

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.

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

CASH ON HAND
FIFTH THIRD BANK-CHECKING. JOINT WITH WIFE.
TOTAL VALUE $242. DEBTOR'S 1/2 WORTH $121

0.00
121.00

FIFTH THIRD PASS THROUGH ACCOUNT FOR
HBW INCOME PASSED THROUGH TO BL1UE
DIAMOND ENTERPRISES. JOINT WITH WIFE.
FUNDS BELONG TO BLUE DIAMOND
ENTERPRISES, LLC.
FIFTH THIRD-SAVINGS. JOINT WITH WIFE. TOTAL
VALUE $704. DEBTOR'S 1/2 WORTH $ 352

FURNITURE, FURNISHINGS, APPLIANCES,
HOUSEHOLD TOOLS. JOINT WITH WIFE. TOTAL
VALUE $10,000. DEBTOR'S 1/2 WORTH $5,000

CLOTHING
WEDDING RING, WATCH AND HBW RING

PRIMERICA LIFE INSURANCE TERM POLICY.
DEATH BENEFIT $2,050,000

AVIVA IRA ANNUITY

METLIFE SEP IRA

J

0.00

352.00

5,000.00

500.00
500.00

0.00

41,275.00

261,332.00

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 6 of 34

Case:11-L J69-jrh Doc #:21 Filed: 05/12/11 (cid:9)

.„age 5 of 24

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

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY



E
N
O
N

DESCRIPTION AND LOCATION

OF PROPERTY

CURRENT VALUE OF
DEBTORS INTEREST
IN PROPERTY, WITH-
OUT DEDUCTING ANY

SECURED CLAIM
OR EXEMPTION



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12. Interests in IRA, ERISA, Keogh, or other

pension or profit sharing plans. Give
particulars.

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

13. Stock and interests in incorporated and

unincorporated businesses. Itemize.

Stock and interests in incorporated and
unincorporated businesses. Itemize.

Stock and interests in incorporated and
unincorporated businesses. Itemize.

14. Interests in partnerships or joint

ventures. Itemize.

16. 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.

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.

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.

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.

X

X

X

X

x

x

22. Patents, copyrights, and other

intellectual property. Give particulars.

23. Licenses, franchises, and other general

intangibles. Give particulars.

X

x

PACLIFE SEP IRA

TCA ROTH IRA

BLUE DIAMOND ENTERPRISES, LLC. DEBTOR IS
80% MEMBER
CITIGROUP STOCK.

K & R IMHOFF ENTERPRISES, LLC. DEBTOR IS 5%
MEMBER.

CLAIMS AGAINST PRIM ERICA FINANCIAL
SERVICES.AND RELATED ENTITIES AND
PERSONS. UNKNOWN VALUE.

CONTINGENT BENEFICIARY INTEREST IN RUTH A.
IMHOFF
LIVING TRUST. NO PRESENT RIGHT TO
DISTRIBUTIONS.
POTENTIAL TAX REFUNDS JOINT WITH WIFE
FROM AMENDMENT OF PRIOR YEAR TAX
RETURNS. VALUE UKNOWN.

J

39,825.00

11,776.00

0.00

31.75

0.00

500,000.00

0.00

1.00

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 7 of 34
age 6 of 24

Case:11-G,69-jrh Doc #:21 Filed: 05/12/11 (cid:9)

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

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)



E
N
O
N

X

X
X
X

X

X
X
X

X

X

TYPE OF PROPERTY

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.

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. (cid:9)

Itemize.

Other personal property of any kind not
already listed. Itemize.

Other personal property of any kind not
already listed. Itemize.

DESCRIPTION AND LOCATION

OF PROPERTY



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CURRENT VALUE OF
DEBTOR'S INTEREST
IN PROPERTY, WITH-
OUT DEDUCTING ANY

SECURED CLAIM
OR EXEMPTION

2006 BUICK RAINER.

8,675.00

CONTINGENT INTEREST AS BENEFICIARY OF
WIFE'S TRUST. NO CURRENT VALUE.
HEALTH SAVINGS ACCT-OPTUM HEALTH BANK

INTEREST IN THE KEVIN J. IMHOFF LIVING TRUST

0.00

3,055.19

1.00

2 (cid:9)

continuation sheets attached (cid:9)

Total

>

$ 872,444.94

(Include amounts from any continuation sheets
attached. Report total also on Summary of
Schedules.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 8 of 34
age 7 of 24

Case:11-6-.69-jrh Doc #:21 Filed: 05/12/11

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

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

Debtor claims the exemptions to which debtor is entitled under:

(Check one box)
zj
11 U.S.C. § 522(b)(2)
1:111 U.S.0 . § 522(b)(3)

P Check if debtor claims a homestead exemption that exceeds

$146,450.*

DESCRIPTION OF PROPERTY

SPECIFY LAW

PROVIDING EACH

EXEMPTION

2006 BUICK RAINER.

11 USC § 522(d)(5)

11 USC § 522(d)(2)

AVIVA IRA ANNUITY

11 USC § 522(d)(12)

BLUE DIAMOND
ENTERPRISES, LLC. DEBTOR
IS 80% MEMBER
CASH ON HAND

11 USC § 522(d)(5)

11 USC § 522(d)(5)

CITIGROUP STOCK.

11 USC § 522(d)(5)

CLAIMS AGAINST PRIMERICA
FINANCIAL SERVICES.AND
RELATED ENTITIES AND
PERSONS. UNKNOWN VALUE.
CLOTHING

FIFTH THIRD
BANK-CHECKING. JOINT WITH
WIFE. TOTAL VALUE $242.
DEBTOR'S 1/2 WORTH $121
FIFTH THIRD-SAVINGS. JOINT
WITH WIFE. TOTAL VALUE
$704. DEBTOR'S 1/2 WORTH $
352
FURNITURE, FURNISHINGS,
APPLIANCES, HOUSEHOLD
TOOLS. JOINT WITH WIFE.
TOTAL VALUE $10,000.
DEBTOR'S 1/2 WORTH $5,000
HEALTH SAVINGS
ACCT-OPTUM HEALTH BANK
INTEREST IN THE KEVIN J.
IMHOFF LIVING TRUST
K & R IMHOFF ENTERPRISES,
LLC. DEBTOR IS 5% MEMBER.
METLIFE SEP IRA

11 USC § 522(d)(5)

11 USC § 522(d)(3)

11 USC § 522(d)(5)

11 USC § 522(d)(5)

11 USC § 522(d)(5)

11 USC § 522(d)(5)

11 USC § 522(d)(5)

11 USC § 522(d)(12)

PACLIFE SEP IRA

11 USC § 522(d)(12)

VALUE OF
CLAIMED

EXEMPTION

5,225.00

3,450.00

41,275.00

0.00



0.00

31.75

0.00

500.00

121.00

352.00

CURRENT

VALUE OF PROPERTY
WITHOUT DEDUCTING

'EXEMPTION

8,675.00

41,275.00

0.00

0.00

31.75

500,000.00

500.00

121.00

352.00

3,055.19

3,055.19

1.00

0.00

261,332.00

39,825.00

1.00

0.00

261,332.00

39,825.00

11 USC § 522(d)(3)

5,000.00

5,000.00

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 9 of 34

Case:11-6-.069-jrh Doc #:21 Filed: 05/12/11 . age 8 of 24

B6C (Official Form 6C) (4/10) - Cont.

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

DESCRIPTION OF PROPERTY

POTENTIAL TAX REFUNDS
JOINT WITH WIFE FROM
AMENDMENT OF PRIOR YEAR
TAX RETURNS. VALUE
UKNOWN.
PRIMERICA LIFE INSURANCE
TERM POLICY. DEATH
BENEFIT $2,050,000

11 USC § 522(d)(8)

TCA ROTH IRA

11 USC § 522(d)(12)

WEDDING RING, WATCH AND
HBW RING

11 USC § 522(d)(4)

0.00

11,776.00

1,450.00

* 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.

SPECIFY LAW

PROVIDING EACH

EXEMPTION

VALUE OF

CLAIMED

EXEMPTION

CURRENT

VALUE OF PROPERTY
WITHOUT DEDUCTING

EXEMPTION

11 USC § 522(d)(5)

1.00

11 USC § 522(d)(7)

2,050,000.00

1.00

0.00

11,776.00

500.00

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 10 of 34

Case:11-6,069-jrh Doc #:21 Filed: 05/12/11 . age 9 of 24

B6D (Official Form 6D) (12107)

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

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

AN ACCOUNT NUMBER
(See Instructions, Above.)



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DATE CLAIM WAS
INCURRED, NATURE

OF LIEN, AND

DESCRIPTION AND

VALUE OF PROPERTY

SUBJECT TO LIEN



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AMOUNT OF

CLAIM WITHOUT

DEDUCTING
VALUE OF

COLLATERAL

UNSECURED
PORTION, IF

ANY

ACCOUNT NO.
NONE

VALUE

0 (cid:9)

continuation sheets
attached

Subtotal >
(Total of this page)

Total >
(Use only on last page)

$

$

0.00$

0.00

0.00 $ (cid:9)

0.00

(Report also on Summary of (If applicable, report
Schedules) (cid:9)

also on Statistical
Summary of Certain
Liabilities and
Related Data.)

(cid:9)
(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 11 of 34
Jge 10 of 24

Case:11-0--,39-jrh Doc #:21 Filed: 05/12/11 (cid:9)

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

In re (cid:9)

KEVIN J IMHOFF

Debtor

Case No. (cid:9)

11-04869

(If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

Gal 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).

Li 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).

U 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).

U 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).

U 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).

LI 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).

U 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).

" 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.

1 continuation sheets attached

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 12 of 34

Case:11-0:-.,39-jrh Doc #:21 Filed: 05/12/11 (cid:9)

,ge 11 of 24

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

In re

KEVIN J IMHOFF

Debtor

Case No. (cid:9)

11-04869

(If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet)

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER
(See instructions above.)


1- co tu
0
0

ACCOUNT NO.




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DATE CLAIM WAS
INCURRED AND
CONSIDERATION

FOR CLAIM



1



1



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AMOUNT
OF CLAIM

AMOUNT

ENTITLED TO

PRIORITY

AMOUNT

NOT

ENTITLED TO
PRIORITY, IF

ANY



Sheet no. 1 of 1 continuation sheets attached to Schedule of
Creditors Holding Priority Claims

Subtotals>

(Totals of this page)

(Use only on last page of the completed
Schedule E. Report also on the Summary of
Schedules.)

Total >

Total >

(Use only on last page of the completed
Schedule E. If applicable, report also on the
Statistical Summary of Certain Liabilities
and Related Data. )

$ (cid:9)

$ (cid:9)

0.00 $ (cid:9)

0.00$

0.00

0.00

0.00 $ (cid:9)

0.00

(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 13 of 34

Case:11-04159-jrh Doc #:21 Filed: 05/12/11 (cid:9)

age 12 of 24

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

In re

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NON PRIORITY CLAIMS

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



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X

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

ACCOUNT NO.

BANK OF AMERICA
ATTN: CORRESPONDENCE UNIT
CA6-919-01-41
PO BOX 5170
SIMI VALLEY, CA 93061
ACCESS MORTGAGE
C/O PARISH NATIONAL BANK
13331 US HIGHWAY 98 EAST
DESTIN, FL 32541

COUNTRYWIDE HOME LOANDS
4301 N. BEACH ST.
FVVTX 36
FT. WORTH, TX 76137
ACCOUNT NO.

CHRIS AND KENYATTA PRYOR
4355 SCENIC DR.
SAGINAW, MI 48603

ACCOUNT NO.

DAN AND LORRAINE PUURI
9461 COLEMAN RD
HASLETT MI 48840

DATE CLAIM WAS
INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

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AMOUNT OF

CLAIM

X X X

0.00

POTENTIAL DEFICIENCIES FROM
COUNTRYWIDE MORTGAGES. LOAN
NUMBERS ENDING 9601, 1009, 0161,
1337, 1817, 0906, 9691, 1453, 3025, 1561

DISPUTED CLAIM

NOTICE ONLY

X X X

0.00

X X X

0.00

6 Continuation sheets attached

Subtotal >

Total

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, if applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 14 of 34
age 13 of 24

Case:11-0.,69-jrh Doc #:21 Filed: 05/12/11 (cid:9)

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

In re

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)



R
O
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B
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ACCOUNT NO.

ELIDA SEPULVEDA
501 S HOLMES ST
LANSING MI 48912



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Continuation Sheet)

DATE CLAIM WAS

INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE





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AMOUNT OF

CLAIM


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NOTICE ONLY

X X X

0.00

ACCOUNT NO. (cid:9)

ENDING 7838

X J

79,858.00

FIFTH THIRD BANK
5050 KINGSLEY
1M 0C23
CINCINNATI, OH 45263

ACCOUNT NO.

JOHN AND PAM FLOOD
1392 HOLT ROAD
MASON MI 48854

ACCOUNT NO.

JON AND CELESTE PAGET
5992 SHADOWLAWN CT
EAT LANSING MI 48823

ACCOUNT NO.

KOLYA GAUNA
3524 WEST ST
LANSING MI 48917

PERSONAL CREDIT LINE

NOTICE ONLY

NOTICE ONLY

NOTICE ONLY

X X X

0.00

X X X

0.00

X X X

0.00

Sheet no. 1 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal >

Total

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, If applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 15 of 34
age 14 of 24

Case:11-039-jrh Doc #:21 Filed: 05/12/11 (cid:9)

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

In re (cid:9)

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)


I



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B
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DATE CLAIM WAS
INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE



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AMOUNT OF

CLAIM



1



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CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)



R
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B
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ACCOUNT NO.

MARGARITA GAUNA
701 WATER ST
EATON RAPIDS MI 48827

ACCOUNT NO.

MELVIN PRYOR
3894 CANYON DR.
SAGINAW, MI 48603

ACCOUNT NO.

MS. FELICIA M. FOX, ESQ.
FINRA DISPUTE RESOLUTION
MIDWEST REGIONAL OFFICE
55 WEST MONROE ST., STE 2600
CHICAGO, IL 60603-5104

ACCOUNT NO.

OSCAR AND ROBIN SLATON
1330 S. DUNCAN AVE.
FAYETTEVILLE AR 72701

NOTICE ONLY

DISPUTED CLAIM

NOTICE ONLY

NOTICE ONLY

X X X

0.00

X X X

0.00

0.00

X X X

0.00

Sheet no. 2 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal

Total >

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, if applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

(cid:9)
(cid:9)
(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 16 of 34

Case:11-0 (40d9-jrh Doc #:21 Filed: 05/12/11 t age 15 of 24

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

In re

KEVIN J IMHOFF

Debtor (cid:9)

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS



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Continuation Sheet)

DATE CLAIM WAS

INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE



1



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I

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AMOUNT OF

CLAIM

DISPUTED CLAIMS

X X X

0.00

DISPUTED CLAIMS

X X X

0.00

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)

cc
o

w c:,
o
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ACCOUNT NO.

PFS INVESTMENTS, INC.
CIO MAUREEN MIDDLETON
RESIDENT AGENT
3120 BRECKINGRIDGE BLVD.
DULUTH, GA 30099
PFS INVESTMENTS, INC.
CIO GENERAL COUNSEL
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099

PFS INVESTMENTS, INC
C/O RAYMOND W. HENNEY
HONIGMAN, MILLER SCHWARTZ AND COHN
2290 FIRST NATIONAL BLDG.
DETROIT, MI 48226

ACCOUNT NO.

PRIMERICA FINANCIAL SERVICES
HOME MORTGAGES, INC.
C/O MAUREEN MIDDLETON
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099
PRIMERICAL FINANCIAL SERVICES
HOME MORTGAGES, INC.
C/O RAYMOND W. HENNEY
2290 FIRST NATIONAL BLDG.
DETROIT, MI 48226

Sheet no. 3 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal >

Total

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, if applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 17 of 34

Case:11-0-69-jrh Doc #:21 Filed: 05/12/11 tdge 16 of 24

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

In re

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NON PRIORITY CLAIMS

(Continuation Sheet)



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DATE CLAIM WAS
INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

AMOUNT OF

CLAIM



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N
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X X X

0.00

DISPUTED CLAIM

DISPUTED CLAIMS

X X X

238,500.00

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)



R
O
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B
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C

ACCOUNT NO

PRIMERICA CLIENT SERVICES, INC.
CIO MAUREEN MIDDLETON
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099

PRIMERICA CLIENT SERVICES
CIO RAYMOND W. HENNEY
HONIGMAN, MILLER, SCHWARTZ AND COHN
2290 FIRST NATIONAL BLDG.
DETROIT, MI 48226
ACCOUNT NO

PRIMERICA FINANCIAL SERVICES, INC.
C/O MAUREEN MIDDLETON,
RESIDENT AGENT
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099
PRIMERICA FINANCIAL SERVICES
C/O GENERAL COUNSEL
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099

PRIMERICA FINANCIAL SERVICES
C/O RAYMOND W. HENNEY
HONIGMAN, MILLE SCHWARTZ AND COHN,
2290 FIRST NATIONAL BLDG.
DETROIT, MI 48226

Sheet no. 4 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal >

Total >

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, if applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 18 of 34
Case:11-0'+d9-jrh Doc #:21 Filed: 05/12/11 1 age 17 of 24

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

In re

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER
(See instructions above.)



R
O
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B
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C

ACCOUNT NO.

PRIMERICA LIFE INSURANCE COMPANY
C/O MAUREEN MIDDLETON,
RESIDENT AGENT
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099
PRIMERICA LIFE INSURANCE COMPANY
C/O GENERAL COUNSEL
3120 BRECKINRIDGE BLVD.
DULUTH, GA 30099

PRIMERICA LIFE INSURANCE COMPANY
C/O RAYMOND W. HENNEY
HONIGMAN, MILLER SCHWARTZ AND COHN
2290 FIRST NATIONAL BLDG.
DETROIT, MI 48226

ACCOUNT NO.

ROGER AND TONI SIMINSKI
1981 BRIARCLIFF BLVD.
OWOSSO, MI 48867

JAMES P. DAVEY, ESQ.
KEMP KLEIN LAW FIRM
201 WEST BIG BEAVER RD.
SUITE 600
TROY, MI 48084

ACCOUNT NO.

RUTH PRYOR
37 SAWMILL CREEK TRAIL
SAGINAW, MI 48603



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B
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U
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(Continuation Sheet)

DATE CLAIM WAS
INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

DISPUTED CLAIMS

AMOUNT OF

CLAIM



T
N
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G
N

I
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N
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A
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X X X

0.00

DISPUTED CLAIM

X X X

5,800,000.00

DISPUTED CLAIM

X X X

0.00

Sheet no. 5 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal >

Total >

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, If applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 19 of 34

Case:11-0(,td9-jrh Doc #:21 Filed: 05/12/11 1 dge 18 of 24

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

In re

KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)



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C
R
O

CREDITOR'S NAME,
MAILING ADDRESS

INCLUDING ZIP CODE,

AND ACCOUNT NUMBER

(See instructions above.)



R
O
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B
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C

ACCOUNT NO.

SAMUEL AND DOROTHY DUNCAN
5722 CASTLEBURY CIRCLE
LANSING, MI 48917

ACCOUNT NO.

SCOTT AND LORA BENJAMIN
7673 W. HIDDEN LAKE DR.
PERRY MI 48872

ACCOUNT NO.

TOM AND LINDA STEEPE
2635 STANTON ST.
CANTON MI 48188

DATE CLAIM WAS
INCURRED AND

CONSIDERATION FOR

CLAIM.

IF CLAIM IS SUBJECT TO

SETOFF, SO STATE

AMOUNT OF

CLAIM



T
N
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G
N

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C



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A
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P
S

I

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X X X

0.00

DISPUTED CLAIM

NOTICE ONLY

NOTICE ONLY

X X X

0.00

X X X

0.00

Sheet no. 6 of 6 continuation sheets attached to Schedule of Creditors
Holding Unsecured
Nonpriority Claims

Subtotal

Total >

(Use only on last page of the completed Schedule F.)
(Report also on Summary of Schedules and, if applicable on the Statistical
Summary of Certain Liabilities and Related Data.)

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 20 of 34
age 19 of 24

Case:11-0'+69*h Doc #:21 Filed: 05/12/11 (cid:9)

B6G (Official Form 6G) (12/07)

In re: KEVIN J IMHOFF

Debtor

Case No

11 -04869

(If known)

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

El Check this box if debtor has no executory contracts or unexpired leases.

NAME AND MAILING ADDRESS, INCLUDING ZIP CODE,

OF OTHER PARTIES TO LEASE OR CONTRACT.

HBW ADVISORY SERVICES
PO BOX 2049
SIMI VALLEY, CA 93062

HBW INSURANC & FIN. SVCS. INC.
PO BOX 2049
SIMI VALLEY, CA 93062

HBW Securities, LLC
PO BOX 2049
SIMI VALLEY, CA 93062

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF

DEBTOR'S INTEREST, STATE WHETHER LEASE IS FOR
NONRESIDENTIAL REAL PROPERTY. STATE CONTRACT

NUMBER OF ANY GOVERNMENT CONTRACT.

INVESTMENT ADVISOR REPRESENTATIVE AGREEMENT

HBW AGENT AGREEMENT

Registered Representative Agreement

(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 21 of 34
age 20 of 24

Case:11-04,,d9-jrh Doc #:21 Filed: 05/12/11 (cid:9)

B6H (Official Form 614) (12/07)

In re: KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

SCHEDULE H - CODEBTORS

U Check this box if debtor has no codebtors.

NAME AND ADDRESS OF CODEBTOR

NAME AND ADDRESS OF CREDITOR

RUTH IMHOFF
1534 SETTLERS HILL DR
LANSING, MI 48917

RUTH IMHOFF
1534 SETTLERS HILL DR.
LANSING, MI 48917

BANK OF AMERICA
ATTN: CORRESPONDENCE UNIT
CA6-919-01-41
PO BOX 5170
SIMI VALLEY, CA 93061

FIFTH THIRD BANK
5050 KINGSLEY
1M0C23
CINCINNATI, OH 45263

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 22 of 34

Case:11-04-J9-jrh Doc #:21 Filed: 05/12/11 (cid:9)

ge 21 of 24

B61 (Official Form 61) (12/07)

In re KEVIN J IMHOFF

Debtor

Case No. (cid:9)

11-04869

(If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled "Spouse" must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petition is
filed, unless the spouses are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthly income
calculated on this form may differ from the current monthly income calculated on Form 22A, 22B, or 22C.

Debtor's Marital
Status:

Employment:

Occupation
Name of Employer

How long employed

Address of Employer

DEPENDENTS OF DEBTOR AND SPOUSE

RELATIONSHIP(S): (cid:9)

AGE(S):

DEBTOR

SPOUSE

FINANCIAL ADVISOR
BLUE DIAMOND ENTERPRISES, LLC

924 CENTENNIAL WAY
STE. 400
LANSING, MI 48917

INCOME: (Estimate of average or projected monthly income at time

case filed)

DEBTOR

SPOUSE

1. Monthly gross wages, salary, and commissions

(Prorate if not paid monthly.)

2. Estimate monthly overtime

3. SUBTOTAL
4. LESS PAYROLL DEDUCTIONS

a. Payroll taxes and social security
b. Insurance
c. Union dues

d. Other (Specify)

5. SUBTOTAL OF PAYROLL DEDUCTIONS

6. TOTAL NET MONTHLY TAKE HOME PAY

7. Regular income from operation of business or profession or farm

(Attach detailed statement)

8. Income from real property

9. Interest and dividends
10. Alimony, maintenance or support payments payable to the debtor for the

debtor's use or that of dependents listed above.

11. Social security or other government assistance
(Specify)

12. Pension or retirement income
13. Other monthly income
(Specify) ESTIMATED DISTRIBUTIONS FROM K & R IMHOFF

14. SUBTOTAL OF LINES 7 THROUGH 13

15. AVERAGE MONTHLY INCOME (Add amounts shown on lines 6 and 14)

16. COMBINED AVERAGE MONTHLY INCOME: (Combine column
totals from line 15)

0.00 $

0.00 $

0.00

$

0.00 $
0.00 $
0.00 $

0.00 $

0.00 $

0.00

$

0.00 $

0.00 $
0.00 $

0.00 $

0.00 $
0.00 $

300.00

300.00

$

$

300.00 $

$ 300.00

0 00

(Report also on Summary of Schedules and, if applicable, on
Statistical Summary of Certain Liabilities and Related Data)

17. Describe any increase or decrease in income reasonably anticipated to occur within the year following the filing of this document.:

(cid:9)
(cid:9)
Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 23 of 34
:Age 22 of 24

Case:11-0,,--t59-jrh Doc #:21 Filed: 05/12/11 (cid:9)

B6I (Official Form 61) (12/07) - Cont.
In re KEVIN J IMHOFF (cid:9)

Debtor (cid:9)

Case No. (cid:9)

11 -04869

(If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

NONE

Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 24 of 34
,ge 23 of 24

Case:11-04-j9-jrh Doc #:21 Filed: 05/12/11 (cid:9)

B6J (Official Form 6J) (12/07)

In re KEVIN J IMHOFF

Debtor

Case No.

11-04869
(If known)

SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)

Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor's family at time case filed. Prorate

any payments made biweekly, quarterly, semi-annually, or annually to show monthly rate. The average monthly expenses calculated on this form may
differ from the deductions from income allowed on Form22A or 22C.

Check this box if a joint petition is filed and debtor's spouse maintains a separate household. Complete a separate schedule of
expenditures labeled "Spouse."

1. Rent or home mortgage payment (include lot rented for mobile home) (cid:9)

a. Are real estate taxes included? (cid:9)
b. Is property insurance included? (cid:9)
2. Utilities: a. Electricity and heating fuel (cid:9)

Yes
Yes (cid:9)

No
No



b. Water and sewer (cid:9)
c. Telephone (cid:9)

d. Other (cid:9)

3. Home maintenance (repairs and upkeep) (cid:9)
4. Food (cid:9)
5. Clothing (cid:9)
6. Laundry and dry cleaning (cid:9)
7. Medical and dental expenses (cid:9)
8. Transportation (not including car payments) (cid:9)
9. Recreation, clubs and entertainment, newspapers, magazines, etc. (cid:9)
10. Charitable contributions (cid:9)
11. Insurance (not deducted from wages or included in home mortgage payments)

a. Homeowner's or renter's
b. Life
c. Health
d. Auto
e. Other

12. Taxes (not deducted from wages or included in home mortgage payments)
(Specify)
13. Installment payments: (In chapter 11, 12, and 13 cases, do not list payments to be included in the plan)

a. Auto

b. Other

14. Alimony, maintenance, and support paid to others (cid:9)
15. Payments for support of additional dependents not living at your home (cid:9)
16. Regular expenses from operation of business, profession, or farm (attach detailed statement) (cid:9)
17. Other CONTRIBUTION TO HOUSEHOLD EXPENSES (cid:9)

18. AVERAGE MONTHLY EXPENSES (Total lines 1-17. Report also on Summary of Schedules and,
if applicable, on the Statistical Summary of Certain Liabilities and Related Data.)

19. Describe any increase or decrease in expenditures reasonably anticipated to occur within the year following the filing of this document:

20. STATEMENT OF MONTHLY NET INCOME

a. Average monthly income from Line 15 of Schedule I
b. Average monthly expenses from Line 18 above
c. Monthly net income (a. minus b.)

0.00

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

0.00
0.00
0.00
0.00
0.00

0.00

0.00
0.00
0.00
0.00
0.00
260.00

260.00

300.00
260.00
40.00

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Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 25 of 34
_Age 24 of 24

Case:11-04,,o9-jrh Doc #:21 Filed: 05/12/11 (cid:9)

B6 Declaration (Official Form 6 - Declaration) (12107)

In re KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

DECLARATION CONCERNING DEBTOR'S SCHEDULES

DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of

23



sheets, and that they are true and correct to the best of my knowledge, information, and belief.

Date: 5/12/2011 (cid:9)

Signature:

/s/ KEVIN J IMHOFF
KEVIN J IMHOFF

Debtor

[If joint case, both spouses must sign]

Penalty for making a false statement or concealing property: Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.0 §§ 152 and 3571.

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Case:11-80619-jrh Doc #:1-3 Filed: 12/13/11 Page 26 of 34

Case:11 2‘.. 369-jrh Doc #:22 Filed: 05/12/11 (cid:9)

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B7 (Official Form 7) (4/10)

UNITED STATES BANKRUPTCY COURT

Western District of Michigan

In re: KEVIN J IMHOFF

Debtor

Case No. 11-04869

(If known)

STATEMENT OF FINANCIAL AFFAIRS

1. Income from employment or operation of business

None

State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of the
debtor's business, including part-time activities either as an employee or in independent trade or business, from the
beginning of this calendar year to the date this case was commenced. State also the gross amounts received during the two
years immediately preceding this calendar year. (A debtor that maintains, or has maintained, financial records on the basis
of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning and ending dates of the debtor's
fiscal year.) If a joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or
chapter 13 must state income of both spouses whether or not a joint petition is filed, unless the spouses are separated and a
joint petition is not filed.)

AMOUNT

0.00

40,603.00

845.00

33,320.00

7,520.00

1,195.00

SOURCE

FISCAL YEAR PERIOD

K & R IMHOFF ENTERPRISES, LLC

2009

DISTRIBUTIONS FROM BLUE DIAMOND 2009
ENTERPRISES, LLC

DISTRIBUTIONS FROM K & R IMHOFF
ENTERPRISES, LLC

2010

DISTRIBUTIONS FROM BLUE DIAMOND 2010
ENTERPRISES, LLC

DISTRIBUTIONS FROM BLUE DIAMOND 2011
ENTERPRISES, LLC

DISTRIBUITONS FROM K & R IMHOFF
ENTERPRISES, LLC

2011

None

2. Income other than from employment or operation of business
State the amount of income received by the debtor other than from employment, trade, profession, operation of the debtor's
business during the two years immediately preceding the commencement of this case. Give particulars. If a joint petition is
filed, state income for each spouse separately. (Married debtors filing under chap