This form contains 379 fields organized into 54 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Amended Filing Checkbox
Amended Filing	Checkbox	Check this box if this is an amended version of a previously filed document.
Case Number
Case Number	Text	Provide the case number for the filing.
Claim Status (First Claim)
First Claim Contingent	Checkbox	Check this box if the first claim is contingent, meaning it depends on a future event that may or may not occur. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Unliquidated	Checkbox	Check this box if the first claim is unliquidated, meaning the exact amount owed has not yet been determined. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Disputed	Checkbox	Check this box if the first claim is disputed, meaning there is disagreement over its validity or amount. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Claim Status (Second Claim)
Second Claim - Contingent	Checkbox	Check this box if the second claim is contingent, meaning it depends on a future event that may or may not happen. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim - Unliquidated	Checkbox	Check this box if the amount of the second claim has not yet been determined or is not fixed. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim - Disputed	Checkbox	Check this box if the second claim is subject to a dispute or disagreement. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Claim Status (Third Claim)
Third Claim Contingent	Checkbox	Check this box if the third claim is contingent as of the date you file. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Unliquidated	Checkbox	Check this box if the third claim is unliquidated as of the date you file. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Disputed	Checkbox	Check this box if the third claim is disputed as of the date you file. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Community Debt Status (First Claim)
First Claim: Community Debt	Checkbox	Check this box if the claim being described is a community debt. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Community Debt Status (Second Claim)
Second Claim Community Debt	Checkbox	Check this box if this second claim is for a community debt. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Creditor Claims Status
No Priority Claims	Checkbox	Check this box if no creditors have priority unsecured claims against you, and proceed to Part 2.
Yes Priority Claims	Checkbox	Check this box if one or more creditors have priority unsecured claims against you.
Creditor Claims Status: No Claims	Checkbox	Check this box if you do not have any nonpriority unsecured claims to report in this part.
Creditor Claims Status: Yes, I Have Claims	Checkbox	Check this box if you have nonpriority unsecured claims against you that need to be reported in this part.
Creditor Information (First Claim)
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First Claim Creditor Name	Text	Provide the full name of the priority creditor for the first claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Creditor Street Number and Name	Text	Enter the street number and name for the first claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Creditor Address Line 2	Text	Provide any additional address information for the first claim creditor, such as an apartment or suite number. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Creditor City	Text	Enter the city for the first claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Creditor State	Text	Enter the two-letter state abbreviation for the first claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Creditor ZIP Code	Text	Enter the ZIP code for the first claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Creditor Information (Second Claim)
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Second Claim Priority Creditor Name	Text	Provide the full name of the priority creditor for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Creditor Address Number	Text	Enter the building number of the priority creditor's address for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Creditor Street	Text	Provide the street name of the priority creditor's address for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Creditor City	Text	Enter the city of the priority creditor's address for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Creditor State	Text	Provide the two-letter state abbreviation for the priority creditor's address for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Creditor ZIP Code	Text	Enter the five or nine-digit ZIP code for the priority creditor's address for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Creditor Information (Third Claim)
Third Claim - Priority Creditor's Name	Text	Enter the full name of the priority creditor for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - Street Number	Text	Enter the street number for the third claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - Street Name	Text	Enter the street name for the third claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - City	Text	Enter the city for the third claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - State	Text	Enter the state for the third claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - ZIP Code	Text	Enter the ZIP code for the third claim creditor's address. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Debt Details (First Claim)
check 3_debtor#201	CheckBox
check 3_debtor#202	CheckBox
check 3_Debtor#201#20and#202	CheckBox
check 3_One#20of#20debtors#20and#20another	CheckBox
Check if this claim relates to a	CheckBox
Debt Details (Second Claim)
Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred the debt for this second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred the debt for this second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred the debt for this second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
At least one of the debtors and another	Checkbox	Check this box if at least one of the debtors incurred the debt along with another party for this second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Check if this claim is for a community debt	Checkbox	Check this box if this second claim is for a community debt. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Debt Details (Third Claim)
Third Claim: Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred this specific debt for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim: Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred this specific debt for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim: Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred this specific debt for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim: At least one of the debtors and another	Checkbox	Check this box if at least one of the debtors and another party incurred this specific debt for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim: Check if this claim is for a community debt	Checkbox	Check this box if the third claim relates to a community debt. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Debt Incurrer (First Claim)
First Claim: Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred this debt for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim: Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred this debt for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim: Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred this debt for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim: At least one of the debtors and another	Checkbox	Check this box if at least one of the debtors and another person or entity incurred this debt for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Debt Incurrer (Second Claim)
check 2_debtor#201	CheckBox	Depends on: Yes Priority Claims
Debtor 2 only (Second Claim)	Checkbox	Check this box if only Debtor 2 incurred this specific debt for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Debtor 1 and Debtor 2 only (Second Claim)	Checkbox	Check this box if both Debtor 1 and Debtor 2 jointly incurred this specific debt for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
At least one of the debtors and another (Second Claim)	Checkbox	Check this box if at least one of the debtors and another party, not listed as a debtor, incurred this specific debt for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Debtor 1 Name
Debtor 1 First Name	Text	Provide the first name of Debtor 1.
Debtor 2 Name
Debtor 2 First Name	Text	Enter the first name of Debtor 2.
Fifth Notified Party Information
Fifth Notified Party Name	Text	Enter the full name of the fifth notified party. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party Street Number	Text	Enter the street number of the fifth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party Original Creditor Line Number	Text	Enter the line number from Part 1 or Part 2 where the original creditor was listed for the fifth notified party. Fill only if 'Fifth Notified Party: Part 1 Creditors with Priority Unsecured Claims', 'Fifth Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Depends on: Fifth Notified Party: Part 1 Creditors with Priority Unsecured Claims, Fifth Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims
Fifth Notified Party: Part 1 Creditors with Priority Unsecured Claims	Checkbox	Check this box if the original creditor for this fifth notified party was listed in Part 1 as having priority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for this fifth notified party was listed in Part 2 as having nonpriority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party Street Name	Text	Enter the street name of the fifth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party City	Text	Enter the city of the fifth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party State	Text	Enter the state of the fifth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party ZIP Code	Text	Enter the ZIP code of the fifth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fifth Notified Party Last 4 Digits of Account Number	Text	Enter the last four digits of the account number associated with the debt for the fifth notified party. Fill only if 'Fifth Notified Party: Part 1 Creditors with Priority Unsecured Claims', 'Fifth Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: Fifth Notified Party: Part 1 Creditors with Priority Unsecured Claims, Fifth Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims
Financial Details (First Claim)
First Claim Last 4 Digits of Account Number	Text	Enter the last four digits of the account number for the first claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Max length: 4 characters Depends on: Yes Priority Claims
First Claim Total Claim Amount	Number	Enter the total amount of the first claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Priority Amount	Number	Enter the priority amount of the first claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Nonpriority Amount	Number	Enter the nonpriority amount of the first claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Date Debt Incurred	Date	Enter the date when the debt for the first claim was incurred. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Financial Details (Second Claim)
Second Claim Last 4 Digits of Account Number	Text	Enter the last four digits of the account number for the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Max length: 4 characters Depends on: Yes Priority Claims
Second Claim Total Claim Amount	Number	Enter the total amount of the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Priority Amount	Number	Enter the priority amount of the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Nonpriority Amount	Number	Enter the nonpriority amount of the second claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Debt Incurred Date	Date	Enter the date when the second claim's debt was incurred. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Financial Details (Third Claim)
Third Claim Account Last 4 Digits	Text	Enter the last four digits of the account number for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Max length: 4 characters Depends on: Yes Priority Claims
Third Claim Total Amount	Number	Provide the total claim amount for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Priority Amount	Number	Enter the priority amount for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Nonpriority Amount	Number	Provide the nonpriority amount for the third claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Debt Incurred Date	Date	Enter the date when the debt for the third claim was incurred. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Amounts
First Claim Total Amount	Number	Enter the total amount for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Priority Amount	Number	Enter the priority amount for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Nonpriority Amount	Number	Enter the nonpriority amount for the first claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Offset Status
First Claim Offset Status No	Checkbox	Check this box if the first claim is not subject to offset. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Offset Status Yes	Checkbox	Check this box if the first claim is subject to offset. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Status
First Claim Status - Contingent	Checkbox	Check this box if the first claim's liability or amount depends on some future event that may or may not happen. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Status - Unliquidated	Checkbox	Check this box if the first claim's amount has not been precisely determined or settled. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Claim Status - Disputed	Checkbox	Check this box if the first claim is currently being challenged or contested. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Nonpriority Unsecured Claim
First Nonpriority Creditor Name	Text	Enter the full legal name of the nonpriority creditor for the first claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Last 4 Digits of Account Number	Text	Provide the last four digits of the account number associated with the first nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Total Amount	Number	Enter the total dollar amount of the first nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor Street Address	Text	Enter the street number and name for the nonpriority creditor's address for the first claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Date Debt Incurred	Date	Provide the date when the debt for the first nonpriority unsecured claim was incurred. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor City	Text	Enter the city for the nonpriority creditor's address for the first claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor State	Text	Enter the state for the nonpriority creditor's address for the first claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor ZIP Code	Text	Enter the ZIP code for the nonpriority creditor's address for the first claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Is Contingent	Checkbox	Check this box if the first nonpriority unsecured claim is contingent. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Is Unliquidated	Checkbox	Check this box if the first nonpriority unsecured claim is unliquidated. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Incurred by Debtor 1 Only	Checkbox	Check this box if only Debtor 1 incurred the first nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Is Disputed	Checkbox	Check this box if the first nonpriority unsecured claim is disputed. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Incurred by Debtor 2 Only	Checkbox	Check this box if only Debtor 2 incurred the first nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Incurred by Debtor 1 and Debtor 2 Only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred the first nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Incurred by At Least One Debtor and Another	Checkbox	Check this box if at least one of the debtors and another party incurred the first nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type Student Loans	Checkbox	Check this box if the first nonpriority unsecured claim is for student loans. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Is Community Debt	Checkbox	Check this box if the first nonpriority unsecured claim is for a community debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type Separation Agreement or Divorce Obligations	Checkbox	Check this box if the first nonpriority unsecured claim is for obligations arising out of a separation agreement or divorce that were not reported as priority claims. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type Debts to Pension or Profit-Sharing Plans	Checkbox	Check this box if the first nonpriority unsecured claim is for debts to pension or profit-sharing plans, and other similar debts. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Not Subject to Offset	Checkbox	Check this box if the first nonpriority unsecured claim is not subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type Other	Checkbox	Check this box if the first nonpriority unsecured claim is of an other type not listed, and specify the type. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Other Unsecured Claim Type Description	Text	If the unsecured claim type is 'Other', describe the type of nonpriority unsecured claim for the first claim. Fill only if 'First Claim Type Other' is 'Yes'. Depends on: First Claim Type Other
First Claim Subject to Offset	Checkbox	Check this box if the first nonpriority unsecured claim is subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
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First Claim Creditor's Name	Text	Provide the full name of the creditor for this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Last 4 Digits of Account Number	Text	Enter the last four digits of the account number associated with this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Total Claim Amount	Number	Enter the total monetary amount of this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor Street Address	Text	Provide the street number and street name for the creditor's address for this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Debt Incurred Date	Date	Specify the date when this first nonpriority unsecured debt was incurred. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor City	Text	Enter the city of the creditor's address for this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor State	Text	Enter the state of the creditor's address for this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Creditor ZIP Code	Text	Provide the ZIP code of the creditor's address for this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Status: Contingent	Checkbox	Check this box if this first nonpriority unsecured claim is contingent as of the date of filing. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Status: Unliquidated	Checkbox	Check this box if this first nonpriority unsecured claim is unliquidated as of the date of filing. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Status: Disputed	Checkbox	Check this box if this first nonpriority unsecured claim is disputed as of the date of filing. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim: Debt incurred by Debtor 1 only	Checkbox	Check this box if Debtor 1 alone incurred this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim: Debt incurred by Debtor 2 only	Checkbox	Check this box if Debtor 2 alone incurred this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim: Debt incurred by Debtor 1 and Debtor 2	Checkbox	Check this box if both Debtor 1 and Debtor 2 jointly incurred this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type: Student loans	Checkbox	Check this box if this first nonpriority unsecured claim is for student loans. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim: Debt incurred by at least one debtor and another	Checkbox	Check this box if at least one of the debtors and another party incurred this first nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type: Obligations from separation/divorce	Checkbox	Check this box if this first nonpriority unsecured claim arises from a separation agreement or divorce and was not reported as a priority claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim: Community debt	Checkbox	Check this box if this first nonpriority unsecured claim is a community debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type: Debts to pension or profit-sharing plans	Checkbox	Check this box if this first nonpriority unsecured claim is for debts to pension, profit-sharing plans, or similar debts. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Type: Other	Checkbox	Check this box if this first nonpriority unsecured claim is of an 'other' type not listed, and specify the type in the provided space. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Other Unsecured Claim Type	Text	Specify the type of other nonpriority unsecured claim if none of the pre-defined options apply. Fill only if 'First Claim Type: Other' is 'Yes'. Depends on: First Claim Type: Other
First Claim Subject to offset: No	Checkbox	Check this box if this first nonpriority unsecured claim is not subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Claim Subject to offset: Yes	Checkbox	Check this box if this first nonpriority unsecured claim is subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party Information
First Notified Party Name Line 1	Text	Enter the first line of the full name for the first party to be notified. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party Name Line 2	Text	Enter the second line of the full name for the first party to be notified, such as a department or attention name. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party Original Creditor Line Number	Text	Enter the line number from Part 1 or Part 2 where the original creditor was listed. Fill only if 'First Notified Party listed in Part 1: Priority Unsecured Claims', 'First Notified Party listed in Part 2: Nonpriority Unsecured Claims' is 'Yes', any. Depends on: First Notified Party listed in Part 1: Priority Unsecured Claims, First Notified Party listed in Part 2: Nonpriority Unsecured Claims
First Notified Party listed in Part 1: Priority Unsecured Claims	Checkbox	Check this box if the original creditor for the debt was listed in Part 1, Creditors with Priority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party listed in Part 2: Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for the debt was listed in Part 2, Creditors with Nonpriority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party Street Address	Text	Enter the street number and street name for the first party to be notified. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party City	Text	Enter the city for the first party to be notified. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party State	Text	Enter the state for the first party to be notified. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party ZIP Code	Text	Enter the ZIP Code for the first party to be notified. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
First Notified Party Last 4 Digits of Account Number	Text	Enter the last four digits of the account number associated with the debt. Fill only if 'First Notified Party listed in Part 1: Priority Unsecured Claims', 'First Notified Party listed in Part 2: Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: First Notified Party listed in Part 1: Priority Unsecured Claims, First Notified Party listed in Part 2: Nonpriority Unsecured Claims
First Priority Creditor Address
First Priority Creditor Name	Text	Enter the full name of the first priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Creditor Street Address	Text	Enter the street number and name for the first priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Creditor City	Text	Enter the city for the first priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Creditor State	Text	Enter the two-letter state abbreviation for the first priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Creditor ZIP Code	Text	Enter the ZIP code for the first priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Creditor Information
First Priority Creditor's Name	Text	Enter the full name of the first priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Last 4 Digits of Account Number	Text	Enter the last four digits of the account number for the first priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Max length: 4 characters Depends on: Yes Priority Claims
First Priority Debt Incurred Date	Date	Enter the date when the debt for the first priority creditor was incurred. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Fourth Notified Party Information
Fourth Notified Party Name	Text	Enter the full name of the fourth party to be notified about the debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party Street Number	Text	Enter the street number of the fourth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party Original Creditor Line Number	Text	Enter the line number where the original creditor was listed in Part 1 or Part 2 for the fourth notified party. Fill only if '4th Part 1: Creditors with Priority Unsecured Claims', '4th Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Depends on: 4th Part 1: Creditors with Priority Unsecured Claims, 4th Part 2: Creditors with Nonpriority Unsecured Claims
4th Part 1: Creditors with Priority Unsecured Claims	Checkbox	Check this box if the original creditor for the fourth notified party was listed in Part 1 as having priority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
4th Part 2: Creditors with Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for the fourth notified party was listed in Part 2 as having nonpriority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party Street Name	Text	Enter the street name of the fourth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party City	Text	Enter the city of the fourth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party State	Text	Enter the state of the fourth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party ZIP Code	Text	Enter the ZIP code of the fourth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Fourth Notified Party Last 4 Digits of Account Number	Text	Enter the last four digits of the account number associated with the debt for the fourth notified party. Fill only if '4th Part 1: Creditors with Priority Unsecured Claims', '4th Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: 4th Part 1: Creditors with Priority Unsecured Claims, 4th Part 2: Creditors with Nonpriority Unsecured Claims
General
Bankruptcy Court	Combobox	Provide the name of the United States Bankruptcy Court. Southern District of Florida Central District of California Western District of New York Southern District of Texas Western District of Pennsylvania Eastern District of Tennessee Eastern District of North Carolina Southern District of New York District of Maine Southern District of California Southern District of Indiana Eastern District of Kentucky District of North Dakota Northern District of West Virginia Northern District of Florida District of New Jersey District of Idaho District of Virgin Islands Southern District of Iowa Southern District of Illinois Middle District of Pennsylvania Middle District of Georgia Eastern District of Texas District of Columbia Northern District of Ohio Northern District of California Southern District of Alabama __________ District of __________ District of New Mexico Central District of Illinois Western District of Louisiana Western District of Tennessee Northern District of Mississippi Western District of Texas District of Nevada District of Maryland Southern District of Mississippi Northern District of Iowa Eastern District of Oklahoma District of Vermont Southern District of Ohio Northern District of Oklahoma Northern District of Alabama Northern District of New York Eastern District of Washington District of Delaware District of South Carolina Western District of Michigan District of Puerto Rico Western District of Washington District of Alaska Northern District of Illinois Eastern District of Pennsylvania Eastern District of Wisconsin Eastern District of California District of Kansas Middle District of Louisiana District of Hawaii District of Oregon District of Minnesota Middle District of Alabama Eastern and Western District of Arkansas Northern District of Georgia Middle District of Tennessee Eastern District of Missouri Eastern District of New York Southern District of Georgia District of Guam Northern District of Indiana Western District of North Carolina Middle District of Florida District of Connecticut Middle District of North Carolina District of Rhode Island District of Nebraska District of New Hampshire Western District of Oklahoma District of South Dakota District of Northern Mariana Islands District of Arizona District of Massachusetts District of Montana District of Wyoming Western District of Kentucky District of Utah Northern District of Texas Western District of Missouri Eastern District of Louisiana Western District of Virginia Southern District of West Virginia Western District of Wisconsin Eastern District of Virginia Eastern District of Michigan District of Colorado
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Offset Status (First Claim)
First Claim Offset Status: No	Checkbox	Check this box if the first claim is not subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Offset Status: Yes	Checkbox	Check this box if the first claim is subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Offset Status (Second Claim)
Second Claim Offset Status: No	Checkbox	Check this box if the second claim is not subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Offset Status: Yes	Checkbox	Check this box if the second claim is subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Offset Status (Third Claim)
Third Claim Offset Status: No	Checkbox	Check this box if the third claim listed is not subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Offset Status: Yes	Checkbox	Check this box if the third claim listed is subject to offset. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Page 6
6a. Domestic Support Obligations Amount	Number	Enter the total amount for domestic support obligations. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
Page Number
Page Number	Text	Enter the current page number of the document.
Current Page Number	Text	Enter the current page number of the form.
Total Pages	Text	Enter the total number of pages in the form.
Page Number	Text	Provide the current page number of the form. Max length: 2 characters
Page Number	Text	Enter the current page number. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Max length: 2 characters Depends on: Creditor Claims Status: Yes, I Have Claims
Page Number	Text	Enter the current page number of this form. Max length: 2 characters
Second Claim Amounts
Second Claim Total Amount	Number	Enter the total amount for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Priority Amount	Number	Enter the priority amount for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Nonpriority Amount	Number	Enter the nonpriority amount for the second claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Offset Status
Second Claim No Offset	Checkbox	Check this box if the second claim is not subject to offset. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Yes Offset	Checkbox	Check this box if the second claim is subject to offset. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Status
Second Claim Status - Contingent	Checkbox	Check this box if the second claim is dependent on some future event or condition, and may or may not become an actual liability. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Status - Unliquidated	Checkbox	Check this box if the exact amount of the second claim has not yet been determined or calculated. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Claim Status - Disputed	Checkbox	Check this box if the second claim is being contested or challenged by the debtor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Nonpriority Unsecured Claim
Second Creditor Name	Text	Enter the full name of the second nonpriority unsecured creditor. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Account Number Last 4 Digits	Text	Provide the last four digits of the account number for the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Total Amount	Number	Enter the total amount of the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Debt Incurred Date	Date	Enter the date when the second nonpriority unsecured debt was incurred. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Creditor Street Number	Text	Enter the street number of the second nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Creditor Street Name	Text	Enter the street name of the second nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Creditor State	Text	Enter the state of the second nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Creditor ZIP Code	Text	Enter the ZIP code of the second nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Contingent	Checkbox	Check this box if the second nonpriority unsecured claim is contingent, meaning it depends on a future event that may or may not happen. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Unliquidated	Checkbox	Check this box if the amount of the second nonpriority unsecured claim has not been determined or is uncertain. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Disputed	Checkbox	Check this box if the second nonpriority unsecured claim is disputed, meaning there is an ongoing disagreement about its validity or amount. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: At least one of the debtors and another	Checkbox	Check this box if at least one of the debtors and another party incurred the second nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Student loans	Checkbox	Check this box if the second nonpriority unsecured claim is a student loan. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Community debt	Checkbox	Check this box if the second nonpriority unsecured claim is considered a community debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Obligations from separation or divorce (non-priority)	Checkbox	Check this box if the second nonpriority unsecured claim is an obligation arising from a separation agreement or divorce that was not reported as a priority claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Debts to pension or profit-sharing plans	Checkbox	Check this box if the second nonpriority unsecured claim is a debt related to a pension or profit-sharing plan, or other similar debts. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Not subject to offset	Checkbox	Check this box if the second nonpriority unsecured claim is not subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Unsecured Claim: Other (specify type)	Checkbox	Check this box if the second nonpriority unsecured claim is of a type not listed above, and provide a specific description in the adjacent text field. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Other Type Description	Text	Describe the type of the second nonpriority unsecured claim if it falls under 'Other'. Fill only if 'Second Nonpriority Unsecured Claim: Other (specify type)' is 'Yes'. Depends on: Second Nonpriority Unsecured Claim: Other (specify type)
Second Nonpriority Unsecured Claim: Subject to offset	Checkbox	Check this box if the second nonpriority unsecured claim is subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
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Second Nonpriority Creditor's Name	Text	Enter the full name of the second nonpriority creditor. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Last 4 Digits of Account Number	Text	Enter the last four digits of the account number for the second nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Amount	Number	Enter the total monetary amount of the second nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Creditor Street Address Number and Street	Text	Enter the street number and street name of the second nonpriority creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Debt Incurred Date	Date	Enter the date when the second nonpriority unsecured debt was incurred. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Creditor City	Text	Enter the city of the second nonpriority creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Creditor State	Text	Enter the state of the second nonpriority creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Creditor ZIP Code	Text	Enter the ZIP code of the second nonpriority creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Contingent	Checkbox	Check this box if the second nonpriority unsecured claim is contingent as of the date you file. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Unliquidated	Checkbox	Check this box if the second nonpriority unsecured claim is unliquidated as of the date you file. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Disputed	Checkbox	Check this box if the second nonpriority unsecured claim is disputed as of the date you file. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred the second nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred the second nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred the second nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: At least one of the debtors and another	Checkbox	Check this box if at least one of the debtors and another party incurred the second nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim Type: Student loans	Checkbox	Check this box if the second nonpriority unsecured claim is for student loans. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim Type: Obligations from separation or divorce	Checkbox	Check this box if the second nonpriority unsecured claim is for obligations arising out of a separation agreement or divorce that you did not report as priority claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim: Community debt	Checkbox	Check this box if the second nonpriority unsecured claim is for a community debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim Type: Debts to pension or profit-sharing plans	Checkbox	Check this box if the second nonpriority unsecured claim is for debts to pension or profit-sharing plans, or other similar debts. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim Type: Other	Checkbox	Check this box if the second nonpriority unsecured claim is of an 'Other' type not listed, and specify the details in the provided field. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Claim Other Type Specify	Text	Specify the other type of nonpriority unsecured claim for the second claim if not listed above. Fill only if 'Second Nonpriority Claim Type: Other' is 'Yes'. Depends on: Second Nonpriority Claim Type: Other
Second Nonpriority Claim Subject to Offset: No	Checkbox	Check this box if the second nonpriority unsecured claim is NOT subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Nonpriority Claim Subject to Offset: Yes	Checkbox	Check this box if the second nonpriority unsecured claim IS subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party Information
Second Notified Party Name	Text	Enter the full name of the second notified party. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party Street Number	Text	Enter the street number component of the second notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party Original Creditor Line Number	Text	Enter the line number from Part 1 or Part 2 where the original creditor for this debt was listed. Fill only if 'Second Notified Party: Part 1 Creditors with Priority Unsecured Claims', 'Second Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Depends on: Second Notified Party: Part 1 Creditors with Priority Unsecured Claims, Second Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims
Second Notified Party: Part 1 Creditors with Priority Unsecured Claims	Checkbox	Check this box if the original creditor for the second notified party was listed in Part 1 as Creditors with Priority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for the second notified party was listed in Part 2 as Creditors with Nonpriority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party Street Name	Text	Enter the street name component of the second notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party City	Text	Enter the city component of the second notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party State	Text	Enter the state component of the second notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party ZIP Code	Text	Enter the ZIP code component of the second notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Second Notified Party Account Number Last 4 Digits	Text	Enter the last 4 digits of the account number associated with this debt for the second notified party. Fill only if 'Second Notified Party: Part 1 Creditors with Priority Unsecured Claims', 'Second Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: Second Notified Party: Part 1 Creditors with Priority Unsecured Claims, Second Notified Party: Part 2 Creditors with Nonpriority Unsecured Claims
Second Priority Creditor Address
Second Priority Creditor Name	Text	Enter the full name of the second priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor Street Address	Text	Enter the street address of the second priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor City	Text	Enter the city of the second priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor State	Text	Enter the state of the second priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor ZIP Code	Text	Enter the ZIP code of the second priority creditor's address. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor Information
Second Priority Creditor's Name	Text	Provide the full name of the second priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Creditor Account Number	Text	Enter the last four digits of the account number for the second priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Max length: 4 characters Depends on: Yes Priority Claims
Second Priority Creditor Debt Incurred Date	Date	Provide the date when the debt was incurred for the second priority creditor. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Seventh Notified Party Information
Seventh Notified Party Name	Text	Enter the name of the seventh notified party. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party Street Number	Text	Enter the street number of the seventh notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party Original Creditor Line Number	Text	Enter the line number from Part 1 or Part 2 where the original creditor was listed. Fill only if 'Seventh Notified Party - Part 1: Creditors with Priority Unsecured Claims', 'Seventh Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Depends on: Seventh Notified Party - Part 1: Creditors with Priority Unsecured Claims, Seventh Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims
Seventh Notified Party - Part 1: Creditors with Priority Unsecured Claims	Checkbox	Check this box if the original creditor for the seventh notified party was listed in Part 1 as a creditor with priority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party Street Name	Text	Enter the street name of the seventh notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for the seventh notified party was listed in Part 2 as a creditor with nonpriority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party City	Text	Enter the city of the seventh notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party State	Text	Enter the state of the seventh notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party ZIP Code	Text	Enter the ZIP code of the seventh notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Seventh Notified Party Account Number Last 4 Digits	Text	Enter the last 4 digits of the account number for the seventh notified party. Fill only if 'Seventh Notified Party - Part 1: Creditors with Priority Unsecured Claims', 'Seventh Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: Seventh Notified Party - Part 1: Creditors with Priority Unsecured Claims, Seventh Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims
Sixth Notified Party Information
Sixth Notified Party Name	Text	Enter the full name of the sixth notified party. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party Street Number	Text	Enter the street number of the sixth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party Original Creditor Line Number	Text	Enter the line number from Part 1 or Part 2 where the original creditor for this debt was listed. Fill only if 'Sixth Notified Party - Part 1: Creditors with Priority Unsecured Claims', 'Sixth Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Depends on: Sixth Notified Party - Part 1: Creditors with Priority Unsecured Claims, Sixth Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims
Sixth Notified Party - Part 1: Creditors with Priority Unsecured Claims	Checkbox	Check this box if the original creditor for this sixth notified party was listed in Part 1 as a Creditor with Priority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for this sixth notified party was listed in Part 2 as a Creditor with Nonpriority Unsecured Claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party Street Name	Text	Enter the street name of the sixth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party City	Text	Enter the city of the sixth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party State	Text	Enter the state of the sixth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party ZIP Code	Text	Enter the ZIP code of the sixth notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Sixth Notified Party Last 4 Digits of Account Number	Text	Enter the last four digits of the account number associated with this debt. Fill only if 'Sixth Notified Party - Part 1: Creditors with Priority Unsecured Claims', 'Sixth Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: Sixth Notified Party - Part 1: Creditors with Priority Unsecured Claims, Sixth Notified Party - Part 2: Creditors with Nonpriority Unsecured Claims
Third Nonpriority Unsecured Claim
Third Nonpriority Creditor's Name	Text	Enter the full name of the creditor for this third nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Last 4 Digits of Account Number	Text	Provide the last four digits of the account number associated with this third nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
Third Total Claim Amount	Number	Enter the total monetary amount of the third nonpriority unsecured claim. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address Number	Text	Enter the street number for the third nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Debt Incurred Date	Date	Provide the date when the debt for the third nonpriority unsecured claim was incurred. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address Street	Text	Enter the street name for the third nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address City	Text	Enter the city for the third nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address ZIP Code	Text	Enter the ZIP code for the third nonpriority unsecured creditor's address. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim - Contingent	Checkbox	Check this box if, as of the date you file, the third nonpriority unsecured claim is contingent. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Incurred by Debtor 1 Only	Checkbox	Check this box if only Debtor 1 incurred the third nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim - Unliquidated	Checkbox	Check this box if, as of the date you file, the third nonpriority unsecured claim is unliquidated. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Incurred by Debtor 2 Only	Checkbox	Check this box if only Debtor 2 incurred the third nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim - Disputed	Checkbox	Check this box if, as of the date you file, the third nonpriority unsecured claim is disputed. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Incurred by Debtor 1 and Debtor 2 Only	Checkbox	Check this box if only Debtor 1 and Debtor 2 together incurred the third nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Incurred by At Least One Debtor and Another	Checkbox	Check this box if at least one of the debtors and another party incurred the third nonpriority unsecured debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Type - Student Loans	Checkbox	Check this box if the third nonpriority unsecured claim is for student loans. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Is for a Community Debt	Checkbox	Check this box if the third nonpriority unsecured claim is for a community debt. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Type - Obligations from Separation/Divorce	Checkbox	Check this box if the third nonpriority unsecured claim is for obligations arising out of a separation agreement or divorce that were not reported as priority claims. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Not Subject to Offset	Checkbox	Check this box if the third nonpriority unsecured claim is not subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Type - Debts to Pension or Profit-Sharing Plans	Checkbox	Check this box if the third nonpriority unsecured claim is for debts to pension or profit-sharing plans, and other similar debts. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Subject to Offset	Checkbox	Check this box if the third nonpriority unsecured claim is subject to offset. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Type - Other	Checkbox	Check this box if the third nonpriority unsecured claim is an 'other' type not specifically listed, and specify the type. Fill only if 'Creditor Claims Status: Yes, I Have Claims' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Other Claim Type Description	Text	Describe the specific type of this third nonpriority unsecured claim if it falls under the 'Other' category. Fill only if 'Third Claim Type - Other' is 'Yes'. Depends on: Third Claim Type - Other
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Third Claim Last 4 Digits Account Number	Text	Enter the last four digits of the account number associated with the third nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Max length: 4 characters Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Total Amount	Number	Enter the total amount of the third nonpriority unsecured claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor's Name	Text	Enter the full name of the nonpriority unsecured creditor for the third claim. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address Number	Text	Enter the street number part of the third creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Date Incurred	Date	Enter the date when the third nonpriority unsecured debt was incurred. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address Street	Text	Enter the street name part of the third creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address State	Text	Enter the two-letter abbreviation for the state of the third creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Creditor Address ZIP Code	Text	Enter the ZIP code for the third creditor's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Contingent	Checkbox	Check this box if the third nonpriority unsecured claim is contingent as of the filing date. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Unliquidated	Checkbox	Check this box if the third nonpriority unsecured claim is unliquidated as of the filing date. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Disputed	Checkbox	Check this box if the third nonpriority unsecured claim is disputed as of the filing date. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Debtor 1 only	Checkbox	Check this box if only Debtor 1 incurred the third nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Debtor 2 only	Checkbox	Check this box if only Debtor 2 incurred the third nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Debtor 1 and Debtor 2 only	Checkbox	Check this box if both Debtor 1 and Debtor 2 incurred the third nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third At least one debtor and another	Checkbox	Check this box if at least one of the debtors and another party incurred the third nonpriority unsecured debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Student Loans	Checkbox	Check this box if the third nonpriority unsecured claim is for student loans. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Obligations from Separation/Divorce	Checkbox	Check this box if the third nonpriority unsecured claim involves obligations arising out of a separation agreement or divorce that were not reported as priority claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Community Debt Claim	Checkbox	Check this box if the third nonpriority unsecured claim is for a community debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Debts to Pension/Profit-Sharing Plans	Checkbox	Check this box if the third nonpriority unsecured claim is for debts to pension or profit-sharing plans, and other similar debts. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Other Claim Type	Checkbox	Check this box if the third nonpriority unsecured claim falls under an 'Other' category and requires specification. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Other Type Specify	Text	If 'Other' was selected as the type of nonpriority unsecured claim for the third claim, specify the nature of the claim here. Fill only if 'Third Other Claim Type' is 'Yes'. Depends on: Third Other Claim Type
Third Claim Not Subject to Offset	Checkbox	Check this box if the third nonpriority unsecured claim is not subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Claim Subject to Offset	Checkbox	Check this box if the third nonpriority unsecured claim is subject to offset. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Information
Third Notified Party Name	Text	Provide the full name of the third party to be notified about the debt. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Street Number	Text	Enter the street number of the third notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Line Number	Text	Specify the line number from Part 1 or Part 2 where the original creditor was listed for this third notified party. Fill only if 'Third Notified Party Part 1: Priority Unsecured Claims', 'Third Notified Party Part 2: Nonpriority Unsecured Claims' is 'Yes', any. Depends on: Third Notified Party Part 1: Priority Unsecured Claims, Third Notified Party Part 2: Nonpriority Unsecured Claims
Third Notified Party Part 1: Priority Unsecured Claims	Checkbox	Check this box if the original creditor for this third notified party entry was listed in Part 1 as having priority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Part 2: Nonpriority Unsecured Claims	Checkbox	Check this box if the original creditor for this third notified party entry was listed in Part 2 as having nonpriority unsecured claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Street Name	Text	Enter the street name of the third notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party City	Text	Provide the city of the third notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party State	Text	Provide the state of the third notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party ZIP Code	Text	Enter the ZIP code of the third notified party's address. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Third Notified Party Last 4 Digits of Account Number	Text	Provide the last four digits of the account number associated with the debt for this third notified party. Fill only if 'Third Notified Party Part 1: Priority Unsecured Claims', 'Third Notified Party Part 2: Nonpriority Unsecured Claims' is 'Yes', any. Max length: 4 characters Depends on: Third Notified Party Part 1: Priority Unsecured Claims, Third Notified Party Part 2: Nonpriority Unsecured Claims
Total Claims from Part 1
6a. Domestic support obligations	Number	Enter the total amount for domestic support obligations. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
6b. Taxes and other government debts	Number	Enter the total amount for taxes and certain other debts owed to the government. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
6c. Claims for injury while intoxicated	Number	Enter the total amount for claims related to death or personal injury caused while intoxicated. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
6d. Other priority unsecured claims	Number	Enter the total amount for all other priority unsecured claims. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
6e. Total claims from 6a-6d	Number	Enter the total sum of amounts from lines 6a through 6d. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes'. Depends on: Yes Priority Claims
Total Claims from Part 2
6f Student Loans	Number	Enter the total amount for student loans. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
6g Obligations from Separation or Divorce	Number	Enter the total amount for obligations arising out of a separation agreement or divorce that were not reported as priority claims. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
6h Debts to Pension or Profit-Sharing Plans	Number	Enter the total amount for debts to pension or profit-sharing plans, and other similar debts. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
6i Other Nonpriority Unsecured Claims	Number	Enter the total amount for all other nonpriority unsecured claims not covered by the preceding categories. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
6j Total Claims from Part 2	Number	Enter the total sum of amounts from fields 6f, 6g, 6h, and 6i. Fill only if 'Do any creditors have nonpriority unsecured claims against you?' is 'Yes'. Depends on: Creditor Claims Status: Yes, I Have Claims
Type of First Priority Unsecured Claim
First Priority Unsecured Claim: Domestic support obligations	Checkbox	Check this box if the priority unsecured claim is for domestic support obligations. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Unsecured Claim: Taxes and certain other debts you owe the government	Checkbox	Check this box if the priority unsecured claim is for taxes or other debts owed to the government. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Unsecured Claim: Claims for death or personal injury while you were intoxicated	Checkbox	Check this box if the priority unsecured claim is for claims related to death or personal injury caused by your intoxication. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Unsecured Claim: Other. Specify	Checkbox	Check this box if the priority unsecured claim is of a type not specified above and provide a description of the claim. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
First Priority Other Claim Type	Text	Provide a detailed description of the first priority unsecured claim if it is not one of the predefined types. Fill only if 'First Priority Unsecured Claim: Other. Specify' is 'Yes'. Depends on: First Priority Unsecured Claim: Other. Specify
Type of Priority (First Claim)
First Claim: Domestic support obligations	Checkbox	Check this box if the priority unsecured claim is for domestic support obligations. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim: Taxes and certain other debts you owe the government	Checkbox	Check this box if the priority unsecured claim is for taxes and certain other debts owed to the government. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim: Claims for death or personal injury while you were intoxicated	Checkbox	Check this box if the priority unsecured claim is for claims related to death or personal injury caused while the debtor was intoxicated. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim: Other type of priority unsecured claim	Checkbox	Check this box if the priority unsecured claim falls into a category other than the ones listed, and specify the type of claim in the adjacent field. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
First Claim Priority Other Specify	Text	Enter the specific nature of the other priority unsecured claim. Fill only if 'First Claim: Other type of priority unsecured claim' is 'Yes'. Depends on: First Claim: Other type of priority unsecured claim
Type of Priority (Second Claim)
Second Claim Domestic support obligations	Checkbox	Check this box if the second claim is for domestic support obligations. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Taxes and certain other debts you owe the government	Checkbox	Check this box if the second claim is for taxes and certain other debts owed to the government. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Claims for death or personal injury while you were intoxicated	Checkbox	Check this box if the second claim is for death or personal injury that occurred while you were intoxicated. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Other Type of Priority Unsecured Claim	Checkbox	Check this box if the second claim is for another type of priority unsecured claim not listed above, and specify the type in the space provided. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Second Claim Other Priority Type	Text	Specify the type of priority unsecured claim if it is not one of the listed options for the second claim. Fill only if 'Second Claim Other Type of Priority Unsecured Claim' is 'Yes'. Depends on: Second Claim Other Type of Priority Unsecured Claim
Type of Priority (Third Claim)
Third Claim - Domestic support obligations	Checkbox	Check this box if the third priority unsecured claim is for domestic support obligations. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - Taxes and other government debts	Checkbox	Check this box if the third priority unsecured claim is for taxes and certain other debts owed to the government. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - Claims for death or personal injury while intoxicated	Checkbox	Check this box if the third priority unsecured claim is for claims for death or personal injury incurred while you were intoxicated. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim - Other priority unsecured claim	Checkbox	Check this box if the third priority unsecured claim falls under another category not listed and then specify the type of claim. Fill only if 'Do any creditors have priority unsecured claims against you?' is 'Yes' Depends on: Yes Priority Claims
Third Claim Other Priority Type	Text	Specify the other type of priority unsecured claim for the third claim. Fill only if 'Third Claim - Other priority unsecured claim' is 'Yes'. Depends on: Third Claim - Other priority unsecured claim
Type of Second Priority Unsecured Claim
Second Priority Domestic Support Obligations	Checkbox	Check this box if the second priority unsecured claim is for domestic support obligations. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Taxes and Other Debts to Government	Checkbox	Check this box if the second priority unsecured claim is for taxes and certain other debts owed to the government. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Claims for Death or Personal Injury	Checkbox	Check this box if the second priority unsecured claim is for claims related to death or personal injury caused by the debtor while intoxicated. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Other Unsecured Claim	Checkbox	Check this box if the second priority unsecured claim does not fall into the other specified categories and provide a brief description in the adjacent text field. Fill only if 'Yes Priority Claims' is 'Yes'. Depends on: Yes Priority Claims
Second Priority Other Claim Type	Text	Enter the specific type of the second priority unsecured claim if it is not among the listed options. Fill only if 'Second Priority Other Unsecured Claim' is 'Yes'. Depends on: Second Priority Other Unsecured Claim

Official Form 106E/F, Schedule E/F: Creditors Who Have Unsecured Claims Instructions