Official Form 106E/F, Schedule E/F: Creditors Who Have Unsecured Claims Completed Form Examples and Samples
Explore detailed examples of a completed Official Form 106E/F, Schedule E/F: Creditors Who Have Unsecured Claims. Our filled-out samples provide clear guidance on how to list priority and nonpriority debts, including credit cards, medical bills, and student loans, for Chapter 7 or 13 bankruptcy. Use our free PDF samples to help you accurately complete your bankruptcy paperwork.
Official Form 106E/F, Schedule E/F Example – Individual Chapter 7 Bankruptcy
How this form was filled:
This is an example of a completed Schedule E/F for an individual, Jane M. Smith, filing for Chapter 7 bankruptcy. It demonstrates how to list both priority unsecured claims (a domestic support obligation for child support) and various nonpriority unsecured claims, including credit card debt, medical bills, a personal loan, and student loans. The example correctly indicates a disputed credit card claim and totals all listed debts.
Information used to fill out the document:
- Debtor Name: Jane M. Smith
- Case Number: 26-12345
- Filing Type: Individual Chapter 7 Bankruptcy
- Priority Creditor (Domestic Support): John Smith (for Child Support)
- Priority Claim Amount: $5,000.00
- Nonpriority Creditor 1 (Credit Card): Capital One Bank
- Nonpriority Claim 1 Amount: $8,500.00 (Disputed)
- Nonpriority Creditor 2 (Medical Bill): General Hospital
- Nonpriority Claim 2 Amount: $12,300.00
- Nonpriority Creditor 3 (Personal Loan): Best Bank
- Nonpriority Claim 3 Amount: $15,000.00
- Nonpriority Creditor 4 (Student Loan): Department of Education
- Nonpriority Claim 4 Amount: $45,000.00
- Total Priority Claims: $5,000.00
- Total Nonpriority Claims: $80,800.00
- Date Signed: 03/15/2026
What this filled form sample shows:
- Demonstrates the correct listing of a priority unsecured claim (domestic support obligation) in Part 1.
- Includes a diverse range of common nonpriority unsecured claims like credit cards, medical bills, personal loans, and student loans in Part 2.
- Shows how to indicate the status of a claim, such as marking a credit card balance as disputed.
- Provides a clear example of how to fill in creditor details, when the debt was incurred, and the total amount of the claim.
- Illustrates the final summary page where total priority and nonpriority claims are calculated and reported.
Form specifications and details:
| Form Name: | Official Form 106E/F, Schedule E/F: Creditors Who Have Unsecured Claims |
| Use Case: | Individual Debtor filing for Chapter 7 Bankruptcy with mixed priority and nonpriority unsecured debts. |
| Purpose: | To formally declare all unsecured debts owed by the debtor as part of a bankruptcy filing. |
| Key Sections: | Part 1: Priority Unsecured Claims, Part 2: Nonpriority Unsecured Claims, Part 3: Other Creditors, Part 4: Totals. |
Created: March 07, 2026 01:20 AM
