Official Form 101, Voluntary Petition for Individuals Filing for Bankruptcy Completed Form Examples and Samples
Explore completed examples and samples of Official Form 101, the Voluntary Petition for Individuals Filing for Bankruptcy. See how to correctly fill out a petition for Chapter 7 or Chapter 13, with detailed guidance on assets, liabilities, and credit counseling.
Official Form 101 Example – Joint Chapter 7 Bankruptcy Petition
How this form was filled:
This example shows a completed Voluntary Petition for Individuals Filing for Bankruptcy (Official Form 101) for a married couple, John and Jane Smith, filing a joint Chapter 7 case. It demonstrates how to fill out debtor information, specify the chapter of bankruptcy, estimate assets and liabilities, and declare completion of the required credit counseling.
Information used to fill out the document:
- Debtor 1 Name: John A. Smith
- Debtor 2 Name: Jane B. Smith
- Address: 123 Oak Avenue, Anytown, CA 90210
- County: Los Angeles
- Debtor 1 SSN (last 4): 5678
- Debtor 2 SSN (last 4): 1234
- Chapter of Bankruptcy Code: Chapter 7
- Nature of Debts: Debts are primarily consumer debts
- Estimated Number of Creditors: 50–99
- Estimated Assets: $1 to $50,000
- Estimated Liabilities: $100,001 to $500,000
- Prior Filings: No prior filings within the last 8 years
- Credit Counseling Agency: Approved Credit Counselors, Inc.
- Date Counseling Completed: 01/15/2026
- Attorney Name: Laura Chen
- Attorney Bar Number: 987654
- Law Firm: Chen & Associates, LLP
- Firm Address: 456 Financial Plaza, Anytown, CA 90211
- Filing Date: 02/28/2026
What this filled form sample shows:
- Illustrates a joint petition filed by a married couple.
- Specifies a Chapter 7 bankruptcy, indicating a request for liquidation of non-exempt assets to pay debts.
- Provides checkbox selections for estimated assets, liabilities, and number of creditors.
- Includes confirmation that the required credit counseling was completed within 180 days before filing.
- Shows properly filled debtor signatures and attorney information to validate the petition.
Form specifications and details:
| Form Name: | Official Form 101, Voluntary Petition for Individuals Filing for Bankruptcy |
| Use Case: | Joint Chapter 7 filing for a married couple with primarily consumer debts. |
| Filing Year: | 2026 |
| Jurisdiction: | United States Bankruptcy Court, Central District of California |
Created: February 03, 2026 04:44 PM
