Official Form 106Dec, Declaration About an Individual Debtor's Schedules Completed Form Examples and Samples
Explore detailed examples and samples of a completed Official Form 106Dec, Declaration About an Individual Debtor's Schedules. Learn how to correctly fill out this essential bankruptcy form for Chapter 7 and Chapter 13 cases by reviewing our filled-in templates.
Official Form 106Dec Example – Joint Chapter 7 Filing
How this form was filled:
This is a sample of a filled Official Form 106Dec for a married couple filing jointly under Chapter 7. Both debtors must sign and date the form, declaring under penalty of perjury that they have reviewed their bankruptcy schedules and that the information provided is true and correct. This declaration is a mandatory component of the initial bankruptcy filing.
Information used to fill out the document:
- Debtor 1 Name: John T. Smith
- Debtor 2 Name: Jane A. Smith
- Case Number: 26-12345
- Bankruptcy Chapter: Chapter 7
- Filing Type: Joint Debtors
- Declaration Statement: Under penalty of perjury, I have read the summary and schedules filed with this declaration and they are true and correct.
- Signature (Debtor 1): John T. Smith
- Signature (Debtor 2): Jane A. Smith
- Execution Date: 03/15/2026
What this filled form sample shows:
- Properly lists both debtors' names at the top of the form for a joint filing.
- Includes a correctly formatted bankruptcy case number.
- Contains the required original signatures from both individual debtors.
- Shows the execution date when the debtors verified their schedules.
- Fulfills the legal requirement of declaring the submitted schedules are true and correct under penalty of perjury.
Form specifications and details:
| Form Name: | Official Form 106Dec, Declaration About an Individual Debtor's Schedules |
| Current Edition: | 12/15 |
| Use Case: | Joint individual debtors filing for Chapter 7 bankruptcy. |
| Purpose: | To declare under penalty of perjury that the debtor(s) have read their bankruptcy schedules and that the information is true and correct. |
| Filing Requirement: | Must be filed with the initial bankruptcy petition and schedules. |
Created: March 07, 2026 01:24 AM
