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Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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}bk1{Form(cid:160)1.(cid:160)Voluntary(cid:160)Petition}bk{(OfficialForm1)(12/03)FORMB1UnitedStatesBankruptcyCourtVoluntaryPetitionNameofDebtor(ifindividual,enterLast,First,Middle):NameofJointDebtor(Spouse)(Last,First,Middle):AllOtherNamesusedbytheDebtorinthelast6years(includemarried,maiden,andtradenames):AllOtherNamesusedbytheJointDebtorinthelast6years(includemarried,maiden,andtradenames):LastfourdigitsofSoc.Sec.No./CompleteEINorotherTaxI.D.No.LastfourdigitsofSoc.Sec.No./CompleteEINorotherTaxI.D.No.(ifmorethanone,stateall):(ifmorethanone,stateall):StreetAddressofDebtor(No.&Street,City,State&ZipCode):StreetAddressofJointDebtor(No.&Street,City,State&ZipCode):CountyofResidenceorofthePrincipalPlaceofBusiness:CountyofResidenceorofthePrincipalPlaceofBusiness:MailingAddressofDebtor(ifdifferentfromstreetaddress):MailingAddressofJointDebtor(ifdifferentfromstreetaddress):LocationofPrincipalAssetsofBusinessDebtor(ifdifferentfromstreetaddressabove):InformationRegardingtheDebtor(ChecktheApplicableBoxes)Venue(Checkanyapplicablebox)Debtorhasbeendomiciledorhashadaresidence,principalplaceofbusiness,orprincipalassetsinthisDistrictfor180daysimmediatelyprecedingthedateofthispetitionorforalongerpartofsuch180daysthaninanyotherDistrict.Thereisabankruptcycaseconcerningdebtor'saffiliate,generalpartner,orpartnershippendinginthisDistrict.TypeofDebtor(Checkallboxesthatapply)Individual(s)RailroadCorporationStockbrokerPartnershipCommodityBrokerOtherClearingBankChapterorSectionofBankruptcyCodeUnderWhichthePetitionisFiled(Checkonebox)Chapter7Chapter11Chapter13Chapter9Chapter12Sec.304(cid:173)CaseancillarytoforeignproceedingNatureofDebts(Checkonebox)Consumer/Non(cid:173)BusinessBusinessFilingFee(Checkonebox)FullFilingFeeattachedFilingFeetobepaidininstallments(Applicabletoindividualsonly.)Mustattachsignedapplicationforthecourt'sconsiderationcertifyingthatthedebtorisunabletopayfeeexceptininstallments.Rule1006(b).SeeOfficialFormNo.3.Chapter11SmallBusiness(Checkallboxesthatapply)Debtorisasmallbusinessasdefinedin11U.S.C.§101Debtorisandelectstobeconsideredasmallbusinessunder11U.S.C.§1121(e)(Optional)Statistical/AdministrativeInformation(Estimatesonly)Debtorestimatesthatfundswillbeavailablefordistributiontounsecuredcreditors.Debtorestimatesthat,afteranyexemptpropertyisexcludedandadministrativeexpensespaid,therewillbenofundsavailablefordistributiontounsecuredcreditors.THISSPACEISFORCOURTUSEONLYEstimatedNumberofCreditors1(cid:173)1516(cid:173)4950(cid:173)99100(cid:173)199200(cid:173)9991000(cid:173)overEstimatedAssets$0to$50,001to$100,001to$500,001to$1,000,001to$10,000,001to$50,000,001toMorethan$50,000$100,000$500,000$1million$10million$50million$100million$100millionEstimatedDebts$0to$50,001to$100,001to$500,001to$1,000,001to$10,000,001to$50,000,001toMorethan$50,000$100,000$500,000$1million$10million$50million$100million$100millionSouthernDistrictofOhio***G.TimothyDearfield(OH(cid:173)0039684)***Panning,RogerW.Johnson,TracyK.xxx(cid:173)xx(cid:173)66449230A.HuntersCreekDriveCincinnati,OH45242Hamiltonxxx(cid:173)xx(cid:173)49169230A.HuntersCreekDriveCincinnati,OH45242HamiltonCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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(OfficialForm1)(12/03)VoluntaryPetition(Thispagemustbecompletedandfiledineverycase)NameofDebtor(s):FORMB1,Page2PriorBankruptcyCaseFiledWithinLast6Years(Ifmorethanone,attachadditionalsheet)LocationCaseNumber:DateFiled:WhereFiled:PendingBankruptcyCaseFiledbyanySpouse,Partner,orAffiliateofthisDebtor(Ifmorethanone,attachadditionalsheet)NameofDebtor:CaseNumber:DateFiled:District:Relationship:Judge:SignaturesSignature(s)ofDebtor(s)(Individual/Joint)Ideclareunderpenaltyofperjurythattheinformationprovidedinthispetitionistrueandcorrect.[Ifpetitionerisanindividualwhosedebtsareprimarilyconsumerdebtsandhaschosentofileunderchapter7]IamawarethatImayproceedunderchapter7,11,12,or13oftitle11,UnitedStatesCode,understandthereliefavailableundereachsuchchapter,andchoosetoproceedunderchapter7.Irequestreliefinaccordancewiththechapteroftitle11,UnitedStatesCode,specifiedinthispetition.XSignatureofDebtorXSignatureofJointDebtorTelephoneNumber(Ifnotrepresentedbyattorney)DateSignatureofAttorneyXSignatureofAttorneyforDebtor(s)PrintedNameofAttorneyforDebtor(s)FirmNameAddressTelephoneNumberDateSignatureofDebtor(Corporation/Partnership)Ideclareunderpenaltyofperjurythattheinformationprovidedinthispetitionistrueandcorrect,andthatIhavebeenauthorizedtofilethispetitiononbehalfofthedebtor.Thedebtorrequestsreliefinaccordancewiththechapteroftitle11,UnitedStatesCode,specifiedinthispetition.XSignatureofAuthorizedIndividualPrintedNameofAuthorizedIndividualTitleofAuthorizedIndividualDateExhibitA(Tobecompletedifdebtorisrequiredtofileperiodicreports(e.g.,forms10Kand10Q)withtheSecuritiesandExchangeCommissionpursuanttoSection13or15(d)oftheSecuritiesExchangeActof1934andisrequestingreliefunderchapter11)ExhibitAisattachedandmadeapartofthispetition.ExhibitB(Tobecompletedifdebtorisanindividualwhosedebtsareprimarilyconsumerdebts)I,theattorneyforthepetitionernamedintheforegoingpetition,declarethatIhaveinformedthepetitionerthat[heorshe]mayproceedunderchapter7,11,12,or13oftitle11,UnitedStatesCode,andhaveexplainedthereliefavailableundereachsuchchapter.XSignatureofAttorneyforDebtor(s)DateExhibitCDoesthedebtorownorhavepossessionofanypropertythatposesathreatofimminentandidentifiableharmtopublichealthorsafety?Yes,andExhibitCisattachedandmadeapartofthispetition.NoSignatureofNon(cid:173)AttorneyPetitionPreparerIcertifythatIamabankruptcypetitionpreparerasdefinedin11U.S.C.§110,thatIpreparedthisdocumentforcompensation,andthatIhaveprovidedthedebtorwithacopyofthisdocument.PrintedNameofBankruptcyPetitionPreparerSocialSecurityNumber(Requiredby11U.S.C.§110(c).)AddressNamesandSocialSecuritynumbersofallotherindividualswhopreparedorassistedinpreparingthisdocument:Ifmorethanonepersonpreparedthisdocument,attachadditionalsheetsconformingtotheappropriateofficialformforeachperson.XSignatureofBankruptcyPetitionPreparerDateAbankruptcypetitionpreparer'sfailuretocomplywiththeprovisionsoftitle11andtheFederalRulesofBankruptcyProceduremayresultinfinesorimprisonmentorboth.11U.S.C.§110;18U.S.C.§156.Panning,RogerW.Johnson,TracyK.(cid:173)None(cid:173)(cid:173)None(cid:173)/s/G.TimothyDearfieldG.TimothyDearfield(OH(cid:173)0039684)Dearfield,Kruer&Company,LLC230NorthlandBlvd.Suite230Cincinnati,OH45246Email:[email protected](513)772(cid:173)7213Fax:(513)772(cid:173)6513August6,2005August6,2005/s/G.TimothyDearfieldG.TimothyDearfield(OH(cid:173)0039684)RogerW.Panning/s/RogerW.PanningTracyK.JohnsonAugust6,2005/s/TracyK.JohnsonCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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United(cid:160)States(cid:160)Bankruptcy(cid:160)CourtSouthern(cid:160)District(cid:160)of(cid:160)OhioIn(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)Chapter7DISCLOSURE(cid:160)OF(cid:160)COMPENSATION(cid:160)OF(cid:160)ATTORNEY(cid:160)FOR(cid:160)DEBTOR(S)1.Pursuant(cid:160)to(cid:160)11(cid:160)U.S.C.(cid:160)§(cid:160)329(a)(cid:160)and(cid:160)Bankruptcy(cid:160)Rule(cid:160)2016(b),(cid:160)I(cid:160)certify(cid:160)that(cid:160)I(cid:160)am(cid:160)the(cid:160)attorney(cid:160)for(cid:160)the(cid:160)above(cid:173)named(cid:160)debtor(cid:160)and(cid:160)thatcompensation(cid:160)paid(cid:160)to(cid:160)me(cid:160)within(cid:160)one(cid:160)year(cid:160)before(cid:160)the(cid:160)filing(cid:160)of(cid:160)the(cid:160)petition(cid:160)in(cid:160)bankruptcy,(cid:160)or(cid:160)agreed(cid:160)to(cid:160)be(cid:160)paid(cid:160)to(cid:160)me,(cid:160)for(cid:160)services(cid:160)rendered(cid:160)or(cid:160)tobe(cid:160)rendered(cid:160)on(cid:160)behalf(cid:160)of(cid:160)the(cid:160)debtor(s)(cid:160)in(cid:160)contemplation(cid:160)of(cid:160)or(cid:160)in(cid:160)connection(cid:160)with(cid:160)the(cid:160)bankruptcy(cid:160)case(cid:160)is(cid:160)as(cid:160)follows:For(cid:160)legal(cid:160)services,(cid:160)I(cid:160)have(cid:160)agreed(cid:160)to(cid:160)accept$850.00Prior(cid:160)to(cid:160)the(cid:160)filing(cid:160)of(cid:160)this(cid:160)statement(cid:160)I(cid:160)have(cid:160)received$850.00Balance(cid:160)Due$0.002.The(cid:160)source(cid:160)of(cid:160)the(cid:160)compensation(cid:160)paid(cid:160)to(cid:160)me(cid:160)was:nDebtoroOther(cid:160)(specify):3.The(cid:160)source(cid:160)of(cid:160)compensation(cid:160)to(cid:160)be(cid:160)paid(cid:160)to(cid:160)me(cid:160)is:nDebtoroOther(cid:160)(specify):4.nI(cid:160)have(cid:160)not(cid:160)agreed(cid:160)to(cid:160)share(cid:160)the(cid:160)above(cid:173)disclosed(cid:160)compensation(cid:160)with(cid:160)any(cid:160)other(cid:160)person(cid:160)unless(cid:160)they(cid:160)are(cid:160)members(cid:160)and(cid:160)associates(cid:160)of(cid:160)my(cid:160)lawfirm.oI(cid:160)have(cid:160)agreed(cid:160)to(cid:160)share(cid:160)the(cid:160)above(cid:173)disclosed(cid:160)compensation(cid:160)with(cid:160)a(cid:160)person(cid:160)or(cid:160)persons(cid:160)who(cid:160)are(cid:160)not(cid:160)members(cid:160)or(cid:160)associates(cid:160)of(cid:160)my(cid:160)law(cid:160)firm.(cid:160)Acopy(cid:160)of(cid:160)the(cid:160)agreement,(cid:160)together(cid:160)with(cid:160)a(cid:160)list(cid:160)of(cid:160)the(cid:160)names(cid:160)of(cid:160)the(cid:160)people(cid:160)sharing(cid:160)in(cid:160)the(cid:160)compensation(cid:160)is(cid:160)attached.5.In(cid:160)return(cid:160)for(cid:160)the(cid:160)above(cid:173)disclosed(cid:160)fee,(cid:160)I(cid:160)have(cid:160)agreed(cid:160)to(cid:160)render(cid:160)legal(cid:160)service(cid:160)for(cid:160)all(cid:160)aspects(cid:160)of(cid:160)the(cid:160)bankruptcy(cid:160)case,(cid:160)including:a.Analysis(cid:160)of(cid:160)the(cid:160)debtor's(cid:160)financial(cid:160)situation,(cid:160)and(cid:160)rendering(cid:160)advice(cid:160)to(cid:160)the(cid:160)debtor(cid:160)in(cid:160)determining(cid:160)whether(cid:160)to(cid:160)file(cid:160)a(cid:160)petition(cid:160)in(cid:160)bankruptcy;b.Preparation(cid:160)and(cid:160)filing(cid:160)of(cid:160)any(cid:160)petition,(cid:160)schedules,(cid:160)statement(cid:160)of(cid:160)affairs(cid:160)and(cid:160)plan(cid:160)which(cid:160)may(cid:160)be(cid:160)required;c.Representation(cid:160)of(cid:160)the(cid:160)debtor(cid:160)at(cid:160)the(cid:160)meeting(cid:160)of(cid:160)creditors(cid:160)and(cid:160)confirmation(cid:160)hearing,(cid:160)and(cid:160)any(cid:160)adjourned(cid:160)hearings(cid:160)thereof;d.[Other(cid:160)provisions(cid:160)as(cid:160)needed]Negotiations(cid:160)with(cid:160)secured(cid:160)creditors(cid:160)to(cid:160)reduce(cid:160)to(cid:160)market(cid:160)value(cid:160)and(cid:160)exemption(cid:160)planning.6.By(cid:160)agreement(cid:160)with(cid:160)the(cid:160)debtor(s),(cid:160)the(cid:160)above(cid:173)disclosed(cid:160)fee(cid:160)does(cid:160)not(cid:160)include(cid:160)the(cid:160)following(cid:160)service:Representation(cid:160)of(cid:160)the(cid:160)debtors(cid:160)in(cid:160)any(cid:160)dischareability(cid:160)actions,(cid:160)judicial(cid:160)lien(cid:160)avoidances,(cid:160)relief(cid:160)from(cid:160)stay(cid:160)actions,(cid:160)anyother(cid:160)adversary(cid:160)proceedings,(cid:160)contested(cid:160)matter,(cid:160)such(cid:160)as(cid:160)redemption(cid:160)motions(cid:160)in(cid:160)chapter(cid:160)7(cid:160)cases(cid:160)and/orpostconfirmation(cid:160)matters(cid:160)in(cid:160)chapter(cid:160)13(cid:160)case.*Fees(cid:160)stated(cid:160)above(cid:160)are(cid:160)based(cid:160)on(cid:160)attorney(cid:160)rate(cid:160)of(cid:160)$200.00(cid:160)per(cid:160)hour(cid:160)and(cid:160)paralegal(cid:160)rate(cid:160)of(cid:160)$95.00(cid:160)per(cid:160)hour(cid:160)at(cid:160)time(cid:160)offiling(cid:160)but(cid:160)subject(cid:160)to(cid:160)future(cid:160)adjustment.(cid:160)Excluded(cid:160)legal(cid:160)services(cid:160)to(cid:160)be(cid:160)billed(cid:160)at(cid:160)such(cid:160)rates.CERTIFICATIONI(cid:160)certify(cid:160)that(cid:160)the(cid:160)foregoing(cid:160)is(cid:160)a(cid:160)complete(cid:160)statement(cid:160)of(cid:160)any(cid:160)agreement(cid:160)or(cid:160)arrangement(cid:160)for(cid:160)payment(cid:160)to(cid:160)me(cid:160)for(cid:160)representation(cid:160)of(cid:160)the(cid:160)debtor(s)(cid:160)inthis(cid:160)bankruptcy(cid:160)proceeding.Dated:August(cid:160)(cid:160)6,(cid:160)2005/s/(cid:160)G.(cid:160)Timothy(cid:160)DearfieldG.(cid:160)Timothy(cid:160)Dearfield(cid:160)(OH(cid:173)0039684)Dearfield,(cid:160)Kruer(cid:160)&(cid:160)Company,(cid:160)LLC230(cid:160)Northland(cid:160)Blvd.Suite(cid:160)230Cincinnati,(cid:160)OH(cid:160)45246(513)(cid:160)772(cid:173)7213Fax:(513)(cid:160)772(cid:173)[email protected](cid:160)Copyright(cid:160)(c)(cid:160)1996(cid:173)2004(cid:160)Best(cid:160)Case(cid:160)Solutions,(cid:160)Inc.(cid:160)(cid:173)(cid:160)Evanston,(cid:160)IL(cid:160)(cid:173)(cid:160)(800)(cid:160)492(cid:173)8037Best(cid:160)Case(cid:160)BankruptcyCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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}bk1{Form(cid:160)6.(cid:160)Summary(cid:160)of(cid:160)Schedules}bk{UnitedStatesBankruptcyCourtSouthernDistrictofOhioInre,DebtorsCaseNo.Chapter7RogerW.Panning,TracyK.JohnsonIndicateastoeachschedulewhetherthatscheduleisattachedandstatethenumberofpagesineach.ReportthetotalsfromSchedulesA,B,D,E,F,I,andJintheboxesprovided.AddtheamountsfromSchedulesAandBtodeterminethetotalamountofthedebtor'sassets.AddtheamountsfromSchedulesD,E,andFtodeterminethetotalamountofthedebtor'sliabilities.SUMMARYOFSCHEDULESAMOUNTSSCHEDULEDATTACHEDNO.OFNAMEOFSCHEDULEASSETSLIABILITIESOTHER(YES/NO)SHEETSA(cid:173)RealPropertyB(cid:173)PersonalPropertyC(cid:173)PropertyClaimedasExemptD(cid:173)CreditorsHoldingSecuredClaimsE(cid:173)CreditorsHoldingUnsecuredPriorityClaimsF(cid:173)CreditorsHoldingUnsecuredNonpriorityClaimsG(cid:173)ExecutoryContractsandUnexpiredLeasesH(cid:173)CodebtorsI(cid:173)CurrentIncomeofIndividualDebtor(s)J(cid:173)CurrentExpendituresofIndividualDebtor(s)TotalNumberofSheetsofALLSchedulesTotalAssetsTotalLiabilitiesCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyYesYesYesYesYesYesYesYesYesYes10.00412,963.9628,497.6311,333.15228,234.7921112,642.0023,467.631712,963.9638,065.57Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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}bk1{Schedule(cid:160)A.(cid:160)Real(cid:160)Property}bk{Inre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonExceptasdirectedbelow,listallrealpropertyinwhichthedebtorhasanylegal,equitable,orfutureinterest,includingallpropertyownedasacotenant,communityproperty,orinwhichthedebtorhasalifeestate.Includeanypropertyinwhichthedebtorholdsrightsandpowersexercisableforthedebtor'sownbenefit.Ifthedebtorismarried,statewhetherhusband,wife,orbothownthepropertybyplacingan"H,""W,""J,"or"C"inthecolumnlabeled"Husband,Wife,Joint,orCommunity."Ifthedebtorholdsnointerestinrealproperty,write"None"under"DescriptionandLocationofProperty."Donotincludeinterestsinexecutorycontractsandunexpiredleasesonthisschedule.ListtheminScheduleG(cid:173)ExecutoryContractsandUnexpiredLeases.Ifanentityclaimstohavealienorholdasecuredinterestinanyproperty,statetheamountofthesecuredclaim.(SeeScheduleD.)Ifnoentityclaimstoholdasecuredinterestintheproperty,write"None"inthecolumnlabeled"AmountofSecuredClaim."Ifthedebtorisanindividualorifajointpetitionisfiled,statetheamountofanyexemptionclaimedinthepropertyonlyinScheduleC(cid:173)PropertyClaimedasExempt.DescriptionandLocationofPropertyNatureofDebtor'sInterestinPropertyHusband,Wife,Joint,orCommunityCurrentMarketValueofDebtor'sInterestinProperty,withoutDeductinganySecuredClaimorExemptionAmountofSecuredClaimcontinuationsheetsattachedtotheScheduleofRealPropertySCHEDULEA.REALPROPERTYCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcy0NoneSub(cid:173)Total>(Totalofthispage)0.00Total>(ReportalsoonSummaryofSchedules)0.00Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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}bk1{Schedule(cid:160)B.(cid:160)Personal(cid:160)Property}bk{Inre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonExceptasdirectedbelow,listallpersonalpropertyofthedebtorofwhateverkind.Ifthedebtorhasnopropertyinoneormoreofthecategories,placean"x"intheappropriatepositioninthecolumnlabeled"None."Ifadditionalspaceisneededinanycategory,attachaseparatesheetproperlyidentifiedwiththecasename,casenumber,andthenumberofthecategory.Ifthedebtorismarried,statewhetherhusband,wife,orbothownthepropertybyplacingan"H,""W,""J,"or"C"inthecolumnlabeled"Husband,Wife,Joint,orCommunity."Ifthedebtorisanindividualorajointpetitionisfiled,statetheamountofanyexemptionsclaimedonlyinScheduleC(cid:173)PropertyClaimedasExempt.Donotlistinterestsinexecutorycontractsandunexpiredleasesonthisschedule.ListtheminScheduleG(cid:173)ExecutoryContractsandUnexpiredLeases.Ifthepropertyisbeingheldforthedebtorbysomeoneelse,statethatperson'snameandaddressunder"DescriptionandLocationofProperty."TypeofPropertyNONEDescriptionandLocationofPropertyHusband,Wife,Joint,orCommunityCurrentMarketValueofDebtor'sInterestinProperty,withoutDeductinganySecuredClaimorExemptioncontinuationsheetsattachedtotheScheduleofPersonalPropertySCHEDULEB.PERSONALPROPERTYCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcy31.CashonhandcashonhandJ73.002.Checking,savingsorotherfinancialaccounts,certificatesofdeposit,orsharesinbanks,savingsandloan,thrift,buildingandloan,andhomesteadassociations,orcreditunions,brokeragehouses,orcooperatives.checkingaccountNationalCityJ319.00CheckingaccountwithKitsapFederalCreditUnionW100.00CheckingaccountwithKitsapFederalCreditUnionH5.00savingsaccountwithKitsapFederalCreditUnionW5.00savingsaccountwithKitsapFederalCreditUnionH5.003.Securitydepositswithpublicutilities,telephonecompanies,landlords,andothers.securitydepositwithlandlordJ225.004.Householdgoodsandfurnishings,includingaudio,video,andcomputerequipment.couch,loveseat&chair($50),endtables&coffeetable($10),microwave($5),vcr($5),dvdplayers($40),chest&dressers($50),4(cid:173)tvs($310),computer($5),lamps($15),boombox($10),andmischouseholditems($100)J600.00bedsandbeddingsJ10.005.Books,picturesandotherartobjects,antiques,stamp,coin,record,tape,compactdisc,andothercollectionsorcollectibles.books,pictures,cds,vcrtapes,cassettetapes,dvdsJ50.006.Wearingapparel.menandwomenclothingJ20.007.Fursandjewelry.misc.jewelryincludingweddingbands,watches,earrings,necklacesJ300.008.Firearmsandsports,photographic,andotherhobbyequipment.38handgun$50,golfclubs$25,camera$20,J125.00Sub(cid:173)Total>(Totalofthispage)1,837.00Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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TypeofPropertyNONEDescriptionandLocationofPropertyHusband,Wife,Joint,orCommunityCurrentMarketValueofDebtor'sInterestinProperty,withoutDeductinganySecuredClaimorExemptionSheetofcontinuationsheetsattachedtotheScheduleofPersonalPropertySCHEDULEB.PERSONALPROPERTY(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson9.Interestsininsurancepolicies.Nameinsurancecompanyofeachpolicyanditemizesurrenderorrefundvalueofeach.UniversalflexiblepremiumadjustablelifewithDegreeofHonor(cid:173)beneificariesarehusbandanddaughter(cid:173)facevalue$353,000.00;nocsvW0.00FlexiblePremiumAdjustableLifeInsurancewithAllstateLifeInsuranceCo.(cid:173)beneficiaryiswife(cid:173)facevalue$250,000.00;csv$0.00W0.00fexiblepremiummultifundedlifeinsurancewithMetropolitanLifeInsurance(cid:173)beneficiariesaregrandchildrenandsister(cid:173)facevalue$60,000.00;nocsvW0.00AALThrivent(cid:173)termlifeinsurance(cid:173)insuredismother;beneficiaryishusbandH0.0010.Annuities.Itemizeandnameeachissuer.X11.InterestsinIRA,ERISA,Keogh,orotherpensionorprofitsharingplans.Itemize.IRA(cid:173)ThriventFinanicalforLutheransH176.9612.Stockandinterestsinincorporatedandunincorporatedbusinesses.Itemize.AllstateFinancialServices(cid:173)100%soleproprietor(cid:173)closed01/2004(cid:173)norenewalsH0.0013.Interestsinpartnershipsorjointventures.Itemize.X14.Governmentandcorporatebondsandothernegotiableandnonnegotiableinstruments.X15.Accountsreceivable.X16.Alimony,maintenance,support,andpropertysettlementstowhichthedebtorisormaybeentitled.Giveparticulars.X17.Otherliquidateddebtsowingdebtorincludingtaxrefunds.Giveparticulars.XSub(cid:173)Total>(Totalofthispage)176.9613Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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TypeofPropertyNONEDescriptionandLocationofPropertyHusband,Wife,Joint,orCommunityCurrentMarketValueofDebtor'sInterestinProperty,withoutDeductinganySecuredClaimorExemptionSheetofcontinuationsheetsattachedtotheScheduleofPersonalPropertySCHEDULEB.PERSONALPROPERTY(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson18.Equitableorfutureinterests,lifeestates,andrightsorpowersexercisableforthebenefitofthedebtorotherthanthoselistedinScheduleofRealProperty.X19.Contingentandnoncontingentinterestsinestateofadecedent,deathbenefitplan,lifeinsurancepolicy,ortrust.X20.Othercontingentandunliquidatedclaimsofeverynature,includingtaxrefunds,counterclaimsofthedebtor,andrightstosetoffclaims.Giveestimatedvalueofeach.X21.Patents,copyrights,andotherintellectualproperty.Giveparticulars.X22.Licenses,franchises,andothergeneralintangibles.Giveparticulars.X23.Automobiles,trucks,trailers,andothervehiclesandaccessories.2001ToyotaCamry(cid:173)miles31,750(cid:173)insuredwithAllstate;monthlypmts.$325.00,currentJ10,950.0024.Boats,motors,andaccessories.X25.Aircraftandaccessories.X26.Officeequipment,furnishings,andsupplies.X27.Machinery,fixtures,equipment,andsuppliesusedinbusiness.X28.Inventory.X29.Animals.1(cid:173)rabbit,1(cid:173)catJ0.0030.Crops(cid:173)growingorharvested.Giveparticulars.XSub(cid:173)Total>(Totalofthispage)10,950.0023Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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TypeofPropertyNONEDescriptionandLocationofPropertyHusband,Wife,Joint,orCommunityCurrentMarketValueofDebtor'sInterestinProperty,withoutDeductinganySecuredClaimorExemptionSheetofcontinuationsheetsattachedtotheScheduleofPersonalPropertySCHEDULEB.PERSONALPROPERTY(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson31.Farmingequipmentandimplements.X32.Farmsupplies,chemicals,andfeed.X33.Otherpersonalpropertyofanykindnotalreadylisted.XSub(cid:173)Total>(Totalofthispage)0.0033Total>(ReportalsoonSummaryofSchedules)12,963.96Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

Document Page 10 of 29

}bk1{Schedule(cid:160)C.(cid:160)Property(cid:160)Claimed(cid:160)as(cid:160)Exempt}bk{Inre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonDebtorelectstheexemptionstowhichdebtorisentitledunder:[Checkonebox]11U.S.C.§522(b)(1):Exemptionsprovidedin11U.S.C.§522(d).Note:Theseexemptionsareavailableonlyincertainstates.11U.S.C.§522(b)(2):Exemptionsavailableunderapplicablenonbankruptcyfederallaws,stateorlocallawwherethedebtor'sdomicilehasbeenlocatedforthe180daysimmediatelyprecedingthefilingofthepetition,orforalongerportionofthe180(cid:173)dayperiodthaninanyotherplace,andthedebtor'sinterestasatenantbytheentiretyorjointtenanttotheextenttheinterestisexemptfromprocessunderapplicablenonbankruptcylaw.DescriptionofPropertySpecifyLawProvidingEachExemptionValueofClaimedExemptionCurrentMarketValueofPropertyWithoutDeductingExemptioncontinuationsheetsattachedtoScheduleofPropertyClaimedasExemptSCHEDULEC.PROPERTYCLAIMEDASEXEMPTCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcy1CashonHandcashonhand73.00OhioRev.CodeAnn.§2329.66(A)(4)(a)73.00Checking,Savings,orOtherFinancialAccounts,CertificatesofDepositcheckingaccountNationalCity319.00OhioRev.CodeAnn.§2329.66(A)(4)(a)319.00CheckingaccountwithKitsapFederalCreditUnion100.00OhioRev.CodeAnn.§2329.66(A)(4)(a)100.00CheckingaccountwithKitsapFederalCreditUnion5.00OhioRev.CodeAnn.§2329.66(A)(18)5.00savingsaccountwithKitsapFederalCreditUnion5.00OhioRev.CodeAnn.§2329.66(A)(18)5.00savingsaccountwithKitsapFederalCreditUnion5.00OhioRev.CodeAnn.§2329.66(A)(18)5.00SecurityDepositswithUtilities,Landlords,andOtherssecuritydepositwithlandlord225.00OhioRev.CodeAnn.§2329.66(A)(18)225.00HouseholdGoodsandFurnishingscouch,loveseat&chair($50),endtables&coffeetable($10),microwave($5),vcr($5),dvdplayers($40),chest&dressers($50),4(cid:173)tvs($310),computer($5),lamps($15),boombox($10),andmischouseholditems($100)600.00OhioRev.CodeAnn.§2329.66(A)(4)(b)600.00bedsandbeddings10.00OhioRev.CodeAnn.§2329.66(A)(3)10.00Books,PicturesandOtherArtObjects;Collectiblesbooks,pictures,cds,vcrtapes,cassettetapes,dvds50.00OhioRev.CodeAnn.§2329.66(A)(4)(b)50.00WearingApparelmenandwomenclothing20.00OhioRev.CodeAnn.§2329.66(A)(3)20.00FursandJewelrymisc.jewelryincludingweddingbands,watches,earrings,necklaces300.00OhioRev.CodeAnn.§2329.66(A)(4)(c)300.00FirearmsandSports,PhotographicandOtherHobbyEquipment38handgun$50,golfclubs$25,camera$20,125.00OhioRev.CodeAnn.§2329.66(A)(4)(b)125.00Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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DescriptionofPropertySpecifyLawProvidingEachExemptionValueofClaimedExemptionCurrentMarketValueofPropertyWithoutDeductingExemptionSheetofcontinuationsheetsattachedtotheScheduleofPropertyClaimedasExemptSCHEDULEC.PROPERTYCLAIMEDASEXEMPT(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonInterestsinIRA,ERISA,Keogh,orOtherPensionorProfitSharingPlansIRA(cid:173)ThriventFinanicalforLutherans176.96OhioRev.CodeAnn.§2329.66(A)(10)(c)176.96Automobiles,Trucks,Trailers,andOtherVehicles2001ToyotaCamry(cid:173)miles31,750(cid:173)insuredwithAllstate;monthlypmts.$325.00,current10,950.00OhioRev.CodeAnn.§2329.66(A)(2)2,000.00OhioRev.CodeAnn.§2329.66(A)(18)400.0011Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

Document Page 12 of 29

}bk1{Schedule(cid:160)D.(cid:160)Creditors(cid:160)Holding(cid:160)Secured(cid:160)Claims}bk{AMOUNTOFCLAIMWITHOUTDEDUCTINGVALUEOFCOLLATERALDATECLAIMWASINCURRED,NATUREOFLIEN,ANDDESCRIPTIONANDMARKETVALUEOFPROPERTYSUBJECTTOLIENCODEBTORCONTINGENTUNLIQUIDATEDDISPUTEDHusband,Wife,Joint,orCommunityHWJCCREDITOR'SNAME,ANDMAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER(Seeinstructionsabove.)AccountNo.Value$AccountNo.Value$AccountNo.Value$AccountNo.Value$Subtotal_____continuationsheetsattached(Totalofthispage)UNSECUREDPORTIONIFANYFormB6D(12/03)Statethename,mailingaddress,includingzipcodeandlastfourdigitsofanyaccountnumberofallentitiesholdingclaimssecuredbypropertyofthedebtorasofthedateoffilingofthepetition.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.Listcreditorsholdingalltypesofsecuredinterestssuchasjudgmentliens,garnishments,statutoryliens,mortgages,deedsoftrust,andothersecurityinterests.Listcreditorsinalphabeticalordertotheextentpracticable.Ifallsecuredcreditorswillnotfitonthispage,usethecontinuationsheetprovided.Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean"X"inthecolumnlabeled"Codebtor",includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH(cid:173)Codebtors.Ifajointpetitionisfiled,statewhetherhusband,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.ReportthistotalalsoontheSummaryofSchedules.CheckthisboxifdebtorhasnocreditorsholdingsecuredclaimstoreportonthisScheduleD.SCHEDULED.CREDITORSHOLDINGSECUREDCLAIMSCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson0xxxx30(cid:173)502001consensuallien(cid:173)autoloan2001ToyotaCamry(cid:173)miles31,750(cid:173)insuredwithAllstate;monthlypmts.$325.00,currentKitsapCreditUnion1025BurwellStreetBremerton,WA98337J8,497.630.0010,950.008,497.638,497.63Total(ReportonSummaryofSchedules)Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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}bk1{Schedule(cid:160)E.(cid:160)Creditors(cid:160)Holding(cid:160)Unsecured(cid:160)Priority(cid:160)Claims}bk{FormB6E(04/04)Acompletelistofclaimsentitledtopriority,listedseparatelybytypeofpriority,istobesetforthonthesheetsprovided.Onlyholdersofunsecuredclaimsentitledtopriorityshouldbelistedinthisschedule.Intheboxesprovidedontheattachedsheets,statethename,mailingaddress,includingzipcode,andlastfourdigitsoftheaccountnumber,ifany,ofallentitiesholdingpriorityclaimsagainstthedebtororthepropertyofthedebtor,asofthedateofthefilingofthepetition.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean"X"inthecolumnlabeled"Codebtor",includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH(cid:173)Codebtors.Ifajointpetitionisfiled,statewhetherhusband,wife,bothofthemorthemaritalcommunitymaybeliableoneachclaimbyplacingan"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"Subtotal"oneachsheet.ReportthetotalofallclaimslistedonthisScheduleEintheboxlabeled"Total"onthelastsheetofthecompletedschedule.RepeatthistotalalsoontheSummaryofSchedules.CheckthisboxifdebtorhasnocreditorsholdingunsecuredpriorityclaimstoreportonthisScheduleE.TYPESOFPRIORITYCLAIMS(Checktheappropriatebox(es)belowifclaimsinthatcategoryarelistedontheattachedsheets.)ExtensionsofcreditinaninvoluntarycaseClaimsarisingintheordinarycourseofthedebtor'sbusinessorfinancialaffairsafterthecommencementofthecasebutbeforetheearlieroftheappointmentofatrusteeortheorderforrelief.11U.S.C.§507(a)(2).Wages,salaries,andcommissionsWages,salaries,andcommissions,includingvacation,severance,andsickleavepayowingtoemployeesandcommissionsowingtoqualifyingindependentsalesrepresentativesupto$4,925*perpersonearnedwithin90daysimmediatelyprecedingthefilingoftheoriginalpetition,orthecessationofbusiness,whicheveroccurredfirst,totheextentprovidedin11U.S.C.§507(a)(3).ContributionstoemployeebenefitplansMoneyowedtoemployeebenefitplansforservicesrenderedwithin180daysimmediatelyprecedingthefilingoftheoriginalpetition,orthecessationofbusiness,whicheveroccurredfirst,totheextentprovidedin11U.S.C.§507(a)(4).CertainfarmersandfishermenClaimsofcertainfarmersandfishermen,upto$4,925*perfarmerorfisherman,againstthedebtor,asprovidedin11U.S.C.§507(a)(5).DepositsbyindividualsClaimsofindividualsupto$2,225*fordepositsforthepurchase,lease,orrentalofpropertyorservicesforpersonal,family,orhouseholduse,thatwerenotdeliveredorprovided.11U.S.C.§507(a)(6).Alimony,Maintenance,orSupportClaimsofaspouse,formerspouse,orchildofthedebtorforalimony,maintenance,orsupport,totheextentprovidedin11U.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).*AmountsaresubjecttoadjustmentonApril1,2007,andeverythreeyearsthereafterwithrespecttocasescommencedonorafterthedateofadjustment.continuationsheetsattachedSCHEDULEE.CREDITORSHOLDINGUNSECUREDPRIORITYCLAIMSCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson1Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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FormB6E(cid:173)Cont.(04/04)CODEBTORCONTINGENTUNLIQUIDATEDDISPUTEDHusband,Wife,Joint,orCommunityAMOUNTHWJCCREDITOR'SNAME,ANDMAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER(Seeinstructions.)DATECLAIMWASINCURREDTOTALAMOUNTENTITLEDTOANDCONSIDERATIONFORCLAIMOFCLAIMPRIORITYAccountNo.AccountNo.AccountNo.AccountNo.AccountNo.SubtotalSheet_____of_____continuationsheetsattachedto(Totalofthispage)ScheduleofCreditorsHoldingUnsecuredPriorityClaimsTYPEOFPRIORITYSCHEDULEE.CREDITORSHOLDINGUNSECUREDPRIORITYCLAIMS(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonTaxesandCertainOtherDebtsOwedtoGovernmentalUnitsxxxxxx17002005;personalincometaxesforyear2003InternalRevenueServiceAttn:Chief,SpecialProceduresP.O.Box1579Cincinnati,OH45201H1,333.151,333.15Representing:InternalRevenueServiceInternalRevenueServiceDistrictDirectorInsolvencySection,P.O.Box21125Philadelphia,PA19114Representing:InternalRevenueServiceU.S.Attorney(cid:173)Cincinnati221East4thStreetSuite400Cincinnati,OH45202Representing:InternalRevenueServiceU.S.AttorneyGeneral230E.PennsylvaniaAvenueBenFranklinStationWashington,DC200301,333.15111,333.15Total(ReportonSummaryofSchedules)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

Document Page 15 of 29

}bk1{Schedule(cid:160)F.(cid:160)Creditors(cid:160)Holding(cid:160)Unsecured(cid:160)Nonpriority(cid:160)Claims}bk{CODEBTORCONTINGENTUNLIQUIDATEDDISPUTEDHusband,Wife,Joint,orCommunityHWJCCREDITOR'SNAME,ANDMAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER(Seeinstructionsabove.)AccountNo.AccountNo.AccountNo.AccountNo.Subtotal_____continuationsheetsattached(Totalofthispage)DATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATE.AMOUNTOFCLAIMFormB6F(12/03)Statethename,mailingaddress,includingzipcode,andlastfourdigitsofanyaccountnumber,ofallentitiesholdingunsecuredclaimswithoutpriorityagainstthedebtororthepropertyofthedebtor,asofthedateoffilingofthepetition.Thecompleteaccountnumberofanyaccountthedebtorhaswiththecreditorisusefultothetrusteeandthecreditorandmaybeprovidedifthedebtorchoosestodoso.DonotincludeclaimslistedinSchedulesDandE.Ifallcreditorswillnotfitonthispage,usethecontinuationsheetprovided.Ifanyentityotherthanaspouseinajointcasemaybejointlyliableonaclaim,placean"X"inthecolumnlabeled"Codebtor",includetheentityontheappropriatescheduleofcreditors,andcompleteScheduleH(cid:173)Codebtors.Ifajointpetitionisfiled,statewhetherhusband,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.ReportthistotalalsoontheSummaryofSchedules.CheckthisboxifdebtorhasnocreditorsholdingunsecuredclaimstoreportonthisScheduleF.S/N:28510(cid:173)050630SCHEDULEF.CREDITORSHOLDINGUNSECUREDNONPRIORITYCLAIMSCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnson1xxxx(cid:173)xxxx(cid:173)xxxx(cid:173)61851998(cid:173)07/05;creditcardusedtopurchasefood,gasoline,clothingandmisc.householditems,medicines,physiciansandhospitals(cid:173)lastused03/2005CapitalOnePOBox790216SaintLouis,MO63179W6,332.60xxxxxxxxxxxx520301/2005personalloanusedforlivingexpenses,andmedicationsCapitalOnePOBox790217SaintLouis,MO63179(cid:173)0217W4,248.30xxx737203/2005;medicalexpenseHarborviewMedicalCenterPOBox34001Seattle,WA98124H185.30xxxx(cid:173)xxxx(cid:173)xxxx(cid:173)05971997(cid:173)07/05;creditcardusedtopurchasefood,gasoline,clothingandmisc.householditems,medicines,physiciansandhospitals(cid:173)lastused03/2005ProvidianP.O.Box660487Dallas,TX75266(cid:173)0487W6,915.1117,681.31Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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FormB6F(cid:173)Cont.(12/03)CODEBTORCONTINGENTUNLIQUIDATEDDISPUTEDHusband,Wife,Joint,orCommunityHWJCCREDITOR'SNAME,ANDMAILINGADDRESSINCLUDINGZIPCODE,ANDACCOUNTNUMBER(Seeinstructions.)AccountNo.AccountNo.AccountNo.AccountNo.AccountNo.Sheetno._____of_____sheetsattachedtoScheduleofSubtotalCreditorsHoldingUnsecuredNonpriorityClaims(Totalofthispage)DATECLAIMWASINCURREDANDCONSIDERATIONFORCLAIM.IFCLAIMISSUBJECTTOSETOFF,SOSTATE.AMOUNTOFCLAIMSCHEDULEF.CREDITORSHOLDINGUNSECUREDNONPRIORITYCLAIMS(ContinuationSheet)Copyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcyInre,DebtorsCaseNo.RogerW.Panning,TracyK.Johnsonxxxx(cid:173)xxxx(cid:173)xxxx(cid:173)76131997(cid:173)07/05;creditcardusedtopurchasefood,gasoline,clothingandmisc.householditems,medicines,physiciansandhospitals(cid:173)lastused03/2005ProvidianProcessingServicesPOBocx660487Dallas,TX75266H10,553.4810,553.481128,234.79Total(ReportonSummaryofSchedules)Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

Document Page 17 of 29

}bk1{Schedule(cid:160)G.(cid:160)Executory(cid:160)Contracts(cid:160)and(cid:160)Unexpired(cid:160)Leases}bk{Inre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonDescribeallexecutorycontractsofanynatureandallunexpiredleasesofrealorpersonalproperty.Includeanytimeshareinterests.Statenatureofdebtor'sinterestincontract,i.e.,"Purchaser,""Agent,"etc.Statewhetherdebtoristhelessororlesseeofalease.Providethenamesandcompletemailingaddressesofallotherpartiestoeachleaseorcontractdescribed.NOTE:Apartylistedonthisschedulewillnotreceivenoticeofthefilingofthiscaseunlessthepartyisalsoscheduledintheappropriatescheduleofcreditors.Checkthisboxifdebtorhasnoexecutorycontractsorunexpiredleases.NameandMailingAddress,IncludingZipCode,ofOtherPartiestoLeaseorContractDescriptionofContractorLeaseandNatureofDebtor'sInterest.Statewhetherleaseisfornonresidentialrealproperty.Statecontractnumberofanygovernmentcontract.continuationsheetsattachedtoScheduleofExecutoryContractsandUnexpiredLeasesSCHEDULEG.EXECUTORYCONTRACTSANDUNEXPIREDLEASESCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcy0AimcoIncorporationCincinnati,OH45242residentialrealpropertylease;$637.00/mo.;leasebegan11/30/04;ends11/30/05;debtorsarelesseeCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

Document Page 18 of 29

}bk1{Schedule(cid:160)H.(cid:160)Codebtors}bk{Inre,DebtorsCaseNo.RogerW.Panning,TracyK.JohnsonProvidetheinformationrequestedconcerninganypersonorentity,otherthanaspouseinajointcase,thatisalsoliableonanydebtslistedbydebtorintheschedulesofcreditors.Includeallguarantorsandco(cid:173)signers.Incommunitypropertystates,amarrieddebtornotfilingajointcaseshouldreportthenameandaddressofthenondebtorspouseonthisschedule.Includeallnamesusedbythenondebtorspouseduringthesixyearsimmediatelyprecedingthecommencementofthiscase.Checkthisboxifdebtorhasnocodebtors.NAMEANDADDRESSOFCODEBTORNAMEANDADDRESSOFCREDITORcontinuationsheetsattachedtoScheduleofCodebtorsSCHEDULEH.CODEBTORSCopyright(c)1996(cid:173)2005(cid:173)BestCaseSolutions,Inc.(cid:173)Evanston,IL(cid:173)(800)492(cid:173)8037BestCaseBankruptcy0Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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Form(cid:160)B6I(12/03)In(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)SCHEDULE(cid:160)I.(cid:160)CURRENT(cid:160)INCOME(cid:160)OF(cid:160)INDIVIDUAL(cid:160)DEBTOR(S)The(cid:160)column(cid:160)labeled(cid:160)"Spouse"(cid:160)must(cid:160)be(cid:160)completed(cid:160)in(cid:160)all(cid:160)cases(cid:160)filed(cid:160)by(cid:160)joint(cid:160)debtors(cid:160)and(cid:160)by(cid:160)a(cid:160)married(cid:160)debtor(cid:160)in(cid:160)a(cid:160)chapter(cid:160)12(cid:160)or(cid:160)13(cid:160)casewhether(cid:160)or(cid:160)not(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)not(cid:160)filed.Debtor's(cid:160)Marital(cid:160)Status:DEPENDENTS(cid:160)OF(cid:160)DEBTOR(cid:160)AND(cid:160)SPOUSEMarriedRELATIONSHIPNone.AGEEMPLOYMENTDEBTORSPOUSEOccupationName(cid:160)of(cid:160)EmployerHow(cid:160)long(cid:160)employedAddress(cid:160)of(cid:160)EmployerINCOME:(cid:160)(cid:160)(Estimate(cid:160)of(cid:160)average(cid:160)monthly(cid:160)income)DEBTORSPOUSECurrent(cid:160)monthly(cid:160)gross(cid:160)wages,(cid:160)salary,(cid:160)and(cid:160)commissions(cid:160)(pro(cid:160)rate(cid:160)if(cid:160)not(cid:160)paid(cid:160)monthly)$0.00$0.00Estimated(cid:160)monthly(cid:160)overtime$0.00$0.00SUBTOTAL$0.00$0.00LESS(cid:160)PAYROLL(cid:160)DEDUCTIONSa.(cid:160)(cid:160)Payroll(cid:160)taxes(cid:160)and(cid:160)social(cid:160)security$0.00$0.00b.(cid:160)(cid:160)Insurance$0.00$0.00c.(cid:160)(cid:160)Union(cid:160)dues$0.00$0.00d.(cid:160)(cid:160)Other(cid:160)(Specify)$0.00$0.00$0.00$0.00SUBTOTAL(cid:160)OF(cid:160)PAYROLL(cid:160)DEDUCTIONS$0.00$0.00TOTAL(cid:160)NET(cid:160)MONTHLY(cid:160)TAKE(cid:160)HOME(cid:160)PAY$0.00$0.00Regular(cid:160)income(cid:160)from(cid:160)operation(cid:160)of(cid:160)business(cid:160)or(cid:160)profession(cid:160)or(cid:160)farm(cid:160)(attach(cid:160)detailedstatement)$0.00$0.00Income(cid:160)from(cid:160)real(cid:160)property$0.00$0.00Interest(cid:160)and(cid:160)dividends$0.00$0.00Alimony,(cid:160)maintenance(cid:160)or(cid:160)support(cid:160)payments(cid:160)payable(cid:160)to(cid:160)the(cid:160)debtor(cid:160)for(cid:160)the(cid:160)debtor's(cid:160)use(cid:160)orthat(cid:160)of(cid:160)dependents(cid:160)listed(cid:160)above$0.00$0.00Social(cid:160)security(cid:160)or(cid:160)other(cid:160)government(cid:160)assistance(Specify)social(cid:160)security(cid:160)disablity$1,781.00$0.00private(cid:160)disablity$861.00$0.00Pension(cid:160)or(cid:160)retirement(cid:160)income$0.00$0.00Other(cid:160)monthly(cid:160)income(Specify)$0.00$0.00$0.00$0.00TOTAL(cid:160)MONTHLY(cid:160)INCOME$2,642.00$0.00TOTAL(cid:160)COMBINED(cid:160)MONTHLY(cid:160)INCOME$2,642.00(Report(cid:160)also(cid:160)on(cid:160)Summary(cid:160)ofSchedules)Describe(cid:160)any(cid:160)increase(cid:160)or(cid:160)decrease(cid:160)of(cid:160)more(cid:160)than(cid:160)10%(cid:160)in(cid:160)any(cid:160)of(cid:160)the(cid:160)above(cid:160)categories(cid:160)anticipated(cid:160)to(cid:160)occur(cid:160)within(cid:160)the(cid:160)year(cid:160)following(cid:160)thefiling(cid:160)of(cid:160)this(cid:160)document:debtor/husband(cid:160)on(cid:160)15(cid:160)prescriptions(cid:160)due(cid:160)to(cid:160)infections,(cid:160)heart,(cid:160)blood(cid:160)pressure,(cid:160)etc.(cid:160)(cid:173)(cid:160)no(cid:160)health(cid:160)insurance;(cid:160)no(cid:160)coveragefor(cid:160)medicine(cid:160)for(cid:160)debtor/husband;(cid:160)debtor/wife's(cid:160)disability(cid:160)(mental(cid:160)illness)(cid:160)benefits(cid:160)been(cid:160)denied(cid:160)as(cid:160)is(cid:160)on(cid:160)appeal.Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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In(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)SCHEDULE(cid:160)J.(cid:160)CURRENT(cid:160)EXPENDITURES(cid:160)OF(cid:160)INDIVIDUAL(cid:160)DEBTOR(S)Complete(cid:160)this(cid:160)schedule(cid:160)by(cid:160)estimating(cid:160)the(cid:160)average(cid:160)monthly(cid:160)expenses(cid:160)of(cid:160)the(cid:160)debtor(cid:160)and(cid:160)the(cid:160)debtor's(cid:160)family.(cid:160)(cid:160)Pro(cid:160)rate(cid:160)any(cid:160)paymentsmade(cid:160)bi(cid:173)weekly,(cid:160)quarterly,(cid:160)semi(cid:173)annually,(cid:160)or(cid:160)annually(cid:160)to(cid:160)show(cid:160)monthly(cid:160)rate.oCheck(cid:160)this(cid:160)box(cid:160)if(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed(cid:160)and(cid:160)debtor's(cid:160)spouse(cid:160)maintains(cid:160)a(cid:160)separate(cid:160)household.(cid:160)(cid:160)Complete(cid:160)a(cid:160)separate(cid:160)schedule(cid:160)ofexpenditures(cid:160)labeled(cid:160)"Spouse."Rent(cid:160)or(cid:160)home(cid:160)mortgage(cid:160)payment(cid:160)(include(cid:160)lot(cid:160)rented(cid:160)for(cid:160)mobile(cid:160)home)$637.00Are(cid:160)real(cid:160)estate(cid:160)taxes(cid:160)included?YesNo(cid:160)(cid:160)(cid:160)XIs(cid:160)property(cid:160)insurance(cid:160)included?YesNo(cid:160)(cid:160)(cid:160)XUtilities:Electricity(cid:160)and(cid:160)heating(cid:160)fuel$86.00Water(cid:160)and(cid:160)sewer$38.00Telephone$62.00OtherSee(cid:160)Detailed(cid:160)Expense(cid:160)Attachment$68.95Home(cid:160)maintenance(cid:160)(repairs(cid:160)and(cid:160)upkeep)$0.00Food$360.00Clothing$60.00Laundry(cid:160)and(cid:160)dry(cid:160)cleaning$80.00Medical(cid:160)and(cid:160)dental(cid:160)expenses$1,177.57Transportation(cid:160)(not(cid:160)including(cid:160)car(cid:160)payments)$95.91Recreation,(cid:160)clubs(cid:160)and(cid:160)entertainment,(cid:160)newspapers,(cid:160)magazines,(cid:160)etc.$30.00Charitable(cid:160)contributions$20.00Insurance(cid:160)(not(cid:160)deducted(cid:160)from(cid:160)wages(cid:160)or(cid:160)included(cid:160)in(cid:160)home(cid:160)mortgage(cid:160)payments)Homeowner's(cid:160)or(cid:160)renter's$32.00Life$0.00Health$78.20Auto$54.00Otherlong(cid:160)term(cid:160)care$118.00Taxes(cid:160)(not(cid:160)deducted(cid:160)from(cid:160)wages(cid:160)or(cid:160)included(cid:160)in(cid:160)home(cid:160)mortgage(cid:160)payments)(Specify)IRS$72.00Installment(cid:160)payments:(cid:160)(In(cid:160)chapter(cid:160)12(cid:160)and(cid:160)13(cid:160)cases,(cid:160)do(cid:160)not(cid:160)list(cid:160)payments(cid:160)to(cid:160)be(cid:160)included(cid:160)in(cid:160)the(cid:160)plan.)Auto$325.00Other$0.00Other$0.00Other$0.00Alimony,(cid:160)maintenance,(cid:160)and(cid:160)support(cid:160)paid(cid:160)to(cid:160)others$0.00Payments(cid:160)for(cid:160)support(cid:160)of(cid:160)additional(cid:160)dependents(cid:160)not(cid:160)living(cid:160)at(cid:160)your(cid:160)home$0.00Regular(cid:160)expenses(cid:160)from(cid:160)operation(cid:160)of(cid:160)business,(cid:160)profession,(cid:160)or(cid:160)farm(cid:160)(attach(cid:160)detailed(cid:160)statement)$0.00Otherpersonal(cid:160)care(cid:160)items$25.00Otherpet(cid:160)expense$48.00TOTAL(cid:160)MONTHLY(cid:160)EXPENSES(cid:160)(Report(cid:160)also(cid:160)on(cid:160)Summary(cid:160)of(cid:160)Schedules)$3,467.63[FOR(cid:160)CHAPTER(cid:160)12(cid:160)AND(cid:160)13(cid:160)DEBTORS(cid:160)ONLY]Provide(cid:160)the(cid:160)information(cid:160)requested(cid:160)below,(cid:160)including(cid:160)whether(cid:160)plan(cid:160)payments(cid:160)are(cid:160)to(cid:160)be(cid:160)made(cid:160)bi(cid:173)weekly,(cid:160)monthly,(cid:160)annually,(cid:160)or(cid:160)at(cid:160)someother(cid:160)regular(cid:160)interval.A.Total(cid:160)projected(cid:160)monthly(cid:160)income$N/AB.Total(cid:160)projected(cid:160)monthly(cid:160)expenses$N/AC.Excess(cid:160)income(cid:160)(A(cid:160)minus(cid:160)B)$N/AD.Total(cid:160)amount(cid:160)to(cid:160)be(cid:160)paid(cid:160)into(cid:160)plan(cid:160)each$N/A(interval)Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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In(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)SCHEDULE(cid:160)J.(cid:160)CURRENT(cid:160)EXPENDITURES(cid:160)OF(cid:160)INDIVIDUAL(cid:160)DEBTOR(S)Detailed(cid:160)Expense(cid:160)AttachmentOther(cid:160)Utility(cid:160)Expenditures:basic(cid:160)cable$24.00internet$44.95Total(cid:160)Other(cid:160)Utility(cid:160)Expenditures$68.95Case 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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United(cid:160)States(cid:160)Bankruptcy(cid:160)CourtSouthern(cid:160)District(cid:160)of(cid:160)OhioIn(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)Chapter7DECLARATION(cid:160)CONCERNING(cid:160)DEBTOR'S(cid:160)SCHEDULESDECLARATION(cid:160)UNDER(cid:160)PENALTY(cid:160)OF(cid:160)PERJURYBY(cid:160)INDIVIDUAL(cid:160)DEBTORI(cid:160)declare(cid:160)under(cid:160)penalty(cid:160)of(cid:160)perjury(cid:160)that(cid:160)I(cid:160)have(cid:160)read(cid:160)the(cid:160)foregoing(cid:160)summary(cid:160)and(cid:160)schedules,(cid:160)consisting(cid:160)of(cid:160)(cid:160)(cid:160)(cid:160)18(cid:160)sheets[total(cid:160)shown(cid:160)on(cid:160)summary(cid:160)page(cid:160)plus(cid:160)1],(cid:160)and(cid:160)that(cid:160)they(cid:160)are(cid:160)true(cid:160)and(cid:160)correct(cid:160)to(cid:160)the(cid:160)best(cid:160)of(cid:160)myknowledge,(cid:160)information,(cid:160)and(cid:160)belief.DateAugust(cid:160)(cid:160)6,(cid:160)2005Signature/s/(cid:160)Roger(cid:160)W.(cid:160)PanningRoger(cid:160)W.(cid:160)PanningDebtorDateAugust(cid:160)(cid:160)6,(cid:160)2005Signature/s/(cid:160)Tracy(cid:160)K.(cid:160)JohnsonTracy(cid:160)K.(cid:160)JohnsonJoint(cid:160)DebtorPenalty(cid:160)for(cid:160)making(cid:160)a(cid:160)false(cid:160)statement(cid:160)or(cid:160)concealing(cid:160)property:Fine(cid:160)of(cid:160)up(cid:160)to(cid:160)$500,000(cid:160)or(cid:160)imprisonment(cid:160)for(cid:160)up(cid:160)to(cid:160)5(cid:160)years(cid:160)or(cid:160)both.18(cid:160)U.S.C.(cid:160)§§(cid:160)(cid:160)(cid:160)152(cid:160)and(cid:160)3571.Software(cid:160)Copyright(cid:160)(c)(cid:160)1996(cid:173)2003(cid:160)Best(cid:160)Case(cid:160)Solutions,(cid:160)Inc.(cid:160)(cid:173)(cid:160)Evanston,(cid:160)IL(cid:160)(cid:173)(cid:160)(800)(cid:160)492(cid:173)8037Best(cid:160)Case(cid:160)BankruptcyCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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Form(cid:160)7(12/03)United(cid:160)States(cid:160)Bankruptcy(cid:160)CourtSouthern(cid:160)District(cid:160)of(cid:160)OhioIn(cid:160)reRoger(cid:160)W.(cid:160)PanningTracy(cid:160)K.(cid:160)JohnsonCase(cid:160)No.Debtor(s)Chapter7STATEMENT(cid:160)OF(cid:160)FINANCIAL(cid:160)AFFAIRSThis(cid:160)statement(cid:160)is(cid:160)to(cid:160)be(cid:160)completed(cid:160)by(cid:160)every(cid:160)debtor.(cid:160)Spouses(cid:160)filing(cid:160)a(cid:160)joint(cid:160)petition(cid:160)may(cid:160)file(cid:160)a(cid:160)single(cid:160)statement(cid:160)on(cid:160)which(cid:160)the(cid:160)information(cid:160)forboth(cid:160)spouses(cid:160)is(cid:160)combined.(cid:160)If(cid:160)the(cid:160)case(cid:160)is(cid:160)filed(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13,(cid:160)a(cid:160)married(cid:160)debtor(cid:160)must(cid:160)furnish(cid:160)information(cid:160)for(cid:160)both(cid:160)spouses(cid:160)whether(cid:160)ornot(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)not(cid:160)filed.(cid:160)An(cid:160)individual(cid:160)debtor(cid:160)engaged(cid:160)in(cid:160)business(cid:160)as(cid:160)a(cid:160)soleproprietor,(cid:160)partner,(cid:160)family(cid:160)farmer,(cid:160)or(cid:160)self(cid:173)employed(cid:160)professional,(cid:160)should(cid:160)provide(cid:160)the(cid:160)information(cid:160)requested(cid:160)on(cid:160)this(cid:160)statement(cid:160)concerning(cid:160)all(cid:160)suchactivities(cid:160)as(cid:160)well(cid:160)as(cid:160)the(cid:160)individual's(cid:160)personal(cid:160)affairs.Questions(cid:160)1(cid:160)(cid:173)(cid:160)18(cid:160)are(cid:160)to(cid:160)be(cid:160)completed(cid:160)by(cid:160)all(cid:160)debtors.(cid:160)Debtors(cid:160)that(cid:160)are(cid:160)or(cid:160)have(cid:160)been(cid:160)in(cid:160)business,(cid:160)as(cid:160)defined(cid:160)below,(cid:160)also(cid:160)must(cid:160)completeQuestions(cid:160)19(cid:160)(cid:173)(cid:160)25.If(cid:160)the(cid:160)answer(cid:160)to(cid:160)an(cid:160)applicable(cid:160)question(cid:160)is(cid:160)"None,"(cid:160)mark(cid:160)the(cid:160)box(cid:160)labeled(cid:160)"None."If(cid:160)additional(cid:160)space(cid:160)is(cid:160)needed(cid:160)for(cid:160)the(cid:160)answerto(cid:160)any(cid:160)question,(cid:160)use(cid:160)and(cid:160)attach(cid:160)a(cid:160)separate(cid:160)sheet(cid:160)properly(cid:160)identified(cid:160)with(cid:160)the(cid:160)case(cid:160)name,(cid:160)case(cid:160)number(cid:160)(if(cid:160)known),(cid:160)and(cid:160)the(cid:160)number(cid:160)of(cid:160)the(cid:160)question.DEFINITIONS"In(cid:160)business."A(cid:160)debtor(cid:160)is(cid:160)"in(cid:160)business"(cid:160)for(cid:160)the(cid:160)purpose(cid:160)of(cid:160)this(cid:160)form(cid:160)if(cid:160)the(cid:160)debtor(cid:160)is(cid:160)a(cid:160)corporation(cid:160)or(cid:160)partnership.(cid:160)An(cid:160)individual(cid:160)debtor(cid:160)is(cid:160)"inbusiness"(cid:160)for(cid:160)the(cid:160)purpose(cid:160)of(cid:160)this(cid:160)form(cid:160)if(cid:160)the(cid:160)debtor(cid:160)is(cid:160)or(cid:160)has(cid:160)been,(cid:160)within(cid:160)the(cid:160)six(cid:160)years(cid:160)immediately(cid:160)preceding(cid:160)the(cid:160)filing(cid:160)of(cid:160)this(cid:160)bankruptcy(cid:160)case,(cid:160)anyof(cid:160)the(cid:160)following:(cid:160)an(cid:160)officer,(cid:160)director,(cid:160)managing(cid:160)executive,(cid:160)or(cid:160)owner(cid:160)of(cid:160)5(cid:160)percent(cid:160)or(cid:160)more(cid:160)of(cid:160)the(cid:160)voting(cid:160)or(cid:160)equity(cid:160)securities(cid:160)of(cid:160)a(cid:160)corporation;(cid:160)a(cid:160)partner,other(cid:160)than(cid:160)a(cid:160)limited(cid:160)partner,(cid:160)of(cid:160)a(cid:160)partnership;(cid:160)a(cid:160)sole(cid:160)proprietor(cid:160)or(cid:160)self(cid:173)employed."Insider."The(cid:160)term(cid:160)"insider"(cid:160)includes(cid:160)but(cid:160)is(cid:160)not(cid:160)limited(cid:160)to:(cid:160)relatives(cid:160)of(cid:160)the(cid:160)debtor;(cid:160)general(cid:160)partners(cid:160)of(cid:160)the(cid:160)debtor(cid:160)and(cid:160)their(cid:160)relatives;corporations(cid:160)of(cid:160)which(cid:160)the(cid:160)debtor(cid:160)is(cid:160)an(cid:160)officer,(cid:160)director,(cid:160)or(cid:160)person(cid:160)in(cid:160)control;(cid:160)officers,(cid:160)directors,(cid:160)and(cid:160)any(cid:160)owner(cid:160)of(cid:160)5(cid:160)percent(cid:160)or(cid:160)more(cid:160)of(cid:160)the(cid:160)voting(cid:160)orequity(cid:160)securities(cid:160)of(cid:160)a(cid:160)corporate(cid:160)debtor(cid:160)and(cid:160)their(cid:160)relatives;(cid:160)affiliates(cid:160)of(cid:160)the(cid:160)debtor(cid:160)and(cid:160)insiders(cid:160)of(cid:160)such(cid:160)affiliates;(cid:160)any(cid:160)managing(cid:160)agent(cid:160)of(cid:160)the(cid:160)debtor.(cid:160)11U.S.C.(cid:160)§(cid:160)101.__________________________________________Noneo1.(cid:160)Income(cid:160)from(cid:160)employment(cid:160)or(cid:160)operation(cid:160)of(cid:160)businessState(cid:160)the(cid:160)gross(cid:160)amount(cid:160)of(cid:160)income(cid:160)the(cid:160)debtor(cid:160)has(cid:160)received(cid:160)from(cid:160)employment,(cid:160)trade,(cid:160)or(cid:160)profession,(cid:160)or(cid:160)from(cid:160)operation(cid:160)of(cid:160)the(cid:160)debtor'sbusiness(cid:160)from(cid:160)the(cid:160)beginning(cid:160)of(cid:160)this(cid:160)calendar(cid:160)year(cid:160)to(cid:160)the(cid:160)date(cid:160)this(cid:160)case(cid:160)was(cid:160)commenced.(cid:160)State(cid:160)also(cid:160)the(cid:160)gross(cid:160)amounts(cid:160)received(cid:160)during(cid:160)thetwo(cid:160)yearsimmediately(cid:160)preceding(cid:160)this(cid:160)calendar(cid:160)year.(cid:160)(A(cid:160)debtor(cid:160)that(cid:160)maintains,(cid:160)or(cid:160)has(cid:160)maintained,(cid:160)financial(cid:160)records(cid:160)on(cid:160)the(cid:160)basis(cid:160)of(cid:160)afiscal(cid:160)rather(cid:160)than(cid:160)a(cid:160)calendar(cid:160)year(cid:160)may(cid:160)report(cid:160)fiscal(cid:160)year(cid:160)income.(cid:160)Identify(cid:160)the(cid:160)beginning(cid:160)and(cid:160)ending(cid:160)dates(cid:160)of(cid:160)the(cid:160)debtor's(cid:160)fiscal(cid:160)year.)(cid:160)If(cid:160)ajoint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)state(cid:160)income(cid:160)for(cid:160)each(cid:160)spouse(cid:160)separately.(cid:160)(Married(cid:160)debtors(cid:160)filing(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13(cid:160)must(cid:160)state(cid:160)incomeof(cid:160)both(cid:160)spouses(cid:160)whether(cid:160)or(cid:160)not(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)not(cid:160)filed.)AMOUNTSOURCE(cid:160)(if(cid:160)more(cid:160)than(cid:160)one)$20,093.002003(cid:160)(cid:173)(cid:160)Allstate(cid:160)Insurance(cid:160)(cid:173)(cid:160)husband$106.322004(cid:160)(cid:173)(cid:160)Allstate(cid:160)Insurance(cid:160)(cid:173)(cid:160)husbandNoneo2.(cid:160)Income(cid:160)other(cid:160)than(cid:160)from(cid:160)employment(cid:160)or(cid:160)operation(cid:160)of(cid:160)businessState(cid:160)the(cid:160)amount(cid:160)of(cid:160)income(cid:160)received(cid:160)by(cid:160)the(cid:160)debtor(cid:160)other(cid:160)than(cid:160)from(cid:160)employment,(cid:160)trade,(cid:160)profession,(cid:160)or(cid:160)operation(cid:160)of(cid:160)the(cid:160)debtor's(cid:160)businessduring(cid:160)thetwo(cid:160)yearsimmediately(cid:160)preceding(cid:160)the(cid:160)commencement(cid:160)of(cid:160)this(cid:160)case.(cid:160)Give(cid:160)particulars.(cid:160)If(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)state(cid:160)incomefor(cid:160)each(cid:160)spouse(cid:160)separately.(cid:160)(Married(cid:160)debtors(cid:160)filing(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13(cid:160)must(cid:160)state(cid:160)income(cid:160)for(cid:160)each(cid:160)spouse(cid:160)whether(cid:160)or(cid:160)not(cid:160)ajoint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)not(cid:160)filed.)AMOUNTSOURCE$25,000.002003(cid:160)(cid:173)(cid:160)IRA(cid:160)distributions$8,165.922004(cid:160)(cid:173)(cid:160)retirement(cid:160)income(cid:160)(cid:173)(cid:160)husband$2,853.182004(cid:160)(cid:173)(cid:160)severance(cid:160)pay(cid:160)(cid:173)(cid:160)husbandSoftware(cid:160)Copyright(cid:160)(c)(cid:160)1996(cid:173)2003(cid:160)Best(cid:160)Case(cid:160)Solutions,(cid:160)Inc.(cid:160)(cid:173)(cid:160)Evanston,(cid:160)IL(cid:160)(cid:173)(cid:160)(800)(cid:160)492(cid:173)8037Best(cid:160)Case(cid:160)BankruptcyCase 1:05-bk-16746 Doc 1 Filed 08/06/05 Entered 08/06/05 14:16:45 Desc Main

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2AMOUNTSOURCE$12,467.002005(cid:160)(cid:173)(cid:160)social(cid:160)security(cid:160)disability$6,027.002005(cid:160)(cid:173)(cid:160)private(cid:160)disability(cid:160)income(cid:160)(cid:173)(cid:160)husbandNoneo3.(cid:160)Payments(cid:160)to(cid:160)creditorsa.(cid:160)List(cid:160)all(cid:160)payments(cid:160)on(cid:160)loans,(cid:160)installment(cid:160)purchases(cid:160)of(cid:160)goods(cid:160)or(cid:160)services,(cid:160)and(cid:160)other(cid:160)debts,(cid:160)aggregating(cid:160)more(cid:160)than(cid:160)$600(cid:160)to(cid:160)any(cid:160)creditor,made(cid:160)within90(cid:160)daysimmediately(cid:160)preceding(cid:160)the(cid:160)commencement(cid:160)of(cid:160)this(cid:160)case.(cid:160)(Married(cid:160)debtors(cid:160)filing(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13must(cid:160)include(cid:160)payments(cid:160)by(cid:160)either(cid:160)or(cid:160)both(cid:160)spouses(cid:160)whether(cid:160)or(cid:160)not(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)jointpetition(cid:160)is(cid:160)not(cid:160)filed.)NAME(cid:160)AND(cid:160)ADDRESSOF(cid:160)CREDITORDATES(cid:160)OFPAYMENTSAMOUNT(cid:160)PAIDAMOUNT(cid:160)STILLOWINGKitsap(cid:160)Credit(cid:160)Union1025(cid:160)Burwell(cid:160)StreetBremerton,(cid:160)WA(cid:160)98337May,(cid:160)June(cid:160)&(cid:160)July$975.00$8,497.63Nonenb.(cid:160)List(cid:160)all(cid:160)payments(cid:160)made(cid:160)withinone(cid:160)yearimmediately(cid:160)preceding(cid:160)the(cid:160)commencement(cid:160)of(cid:160)this(cid:160)case(cid:160)to(cid:160)or(cid:160)for(cid:160)the(cid:160)benefit(cid:160)of(cid:160)creditors(cid:160)whoare(cid:160)or(cid:160)were(cid:160)insiders.(cid:160)(Married(cid:160)debtors(cid:160)filing(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13(cid:160)must(cid:160)include(cid:160)payments(cid:160)by(cid:160)either(cid:160)or(cid:160)both(cid:160)spouses(cid:160)whether(cid:160)ornot(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)filed,(cid:160)unless(cid:160)the(cid:160)spouses(cid:160)are(cid:160)separated(cid:160)and(cid:160)a(cid:160)joint(cid:160)petition(cid:160)is(cid:160)not(cid:160)filed.)NAME(cid:160)AND(cid:160)ADDRESS(cid:160)OF(cid:160)CREDITOR(cid:160)ANDRELATIONSHIP(cid:160)TO(cid:160)DEBTORDATE(cid:160)OF(cid:160)PAYMENTAMOUNT(cid:160)PAIDAMOUNT(cid:160)STILLOWINGNonen4.(cid:160)(cid:160)Suits(cid:160)and(cid:160)administrative(cid:160)proceedings,(cid:160)executions,(cid:160)garnishments(cid:160)and(cid:160)attachmentsa.(cid:160)List(cid:160)all(cid:160)suits(cid:160)and(cid:160)administrative(cid:160)proceedings(cid:160)to(cid:160)which(cid:160)the(cid:160)debtor(cid:160)is(cid:160)or(cid:160)was(cid:160)a(cid:160)party(cid:160)withinone(cid:160)yearimmediately(cid:160)preceding(cid:160)the(cid:160)filing(cid:160)ofthis(cid:160)bankruptcy(cid:160)case.(cid:160)(Married(cid:160)debtors(cid:160)filing(cid:160)under(cid:160)chapter(cid:160)12(cid:160)or(cid:160)chapter(cid:160)13(cid:160)must(cid:160)