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IN THE UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION
IN RE: ) ) CHAPTER 7 RAFAEL CARDONA ) ) CASE NO. 11-54098-JRS Debtor. )
AMENDMENT TO SCHEDULES E and F, SUMMARY OF SCHEDULESAND CREDITOR MATRIX
COMES NOW Rafael Cardona, the Debtor in the above-styled Chapter 7
Bankruptcy Case (“Debtor”), and files this Amendment, and respectfully show the Court
as follows:
(1) Schedules E and F: The Debtor hereby substitutes the Schedules E and
F which are attached hereto in lieu of any such Schedules E and F previously filed.
(2) Summary of Schedules. The Debtor hereby substitutes the Summary of
Schedules which is attached hereto in lieu of any such Summary of Schedules
previously filed.
(3) Creditor Matrix. The Debtor hereby amends the Creditor Matrix to include
the creditors listed below:
Georgia Department of Banking and Finance2990 Brandywine Rd. Suite 200 Atlanta, GA 30341
Gano Excel USA, Inc. 4828 Fourth St. Irwindale, CA 91706
Smoke Rise Country Club 4900 Chedworth Dr. Stone Mountain, GA 30087
Raymond Berrones Jr. 4553 Rivercliff Dr. Lilburn, GA 30047
Melaleuca, Inc. 3910 S. Yellowstone Hwy. Idaho Falls, ID. 83402
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 1 of 22
(4) All other Schedules remain the same.
RESPECTFULLY SUBMITTED THIS 15th DAY OF MARCH, 2011.
JONES & WALDEN, LLC
/s/ Noel J. BartelsNoel J. Bartles Georgia Bar No. 823714 Attorney for Debtor 21 Eighth Street Atlanta, Georgia 30309 (404) 564-9300 [email protected]
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 2 of 22
IN THE UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION
IN RE: ) ) CHAPTER 7 RAFAEL CARDONA ) ) CASE NO. 11-54098-JRS Debtor. )
DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR
I declare under penalty of perjury that I have read the foregoing Amendment and that the same is true and correct to the best of my knowledge, information and belief.
/s/ Rafael CardonaDate: March 15, 2011 Rafael Cardona
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 3 of 22
}bk1{ScheduleE-CreditorsHoldingUnsecuredPriorityClaims}bk{
B6E (Official Form 6E) (4/10)
A complete list of claims entitled to priority, listed separately by type of priority, is to be set forth on the sheets provided. Only holders of unsecured claims entitledto priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name, mailing address, including zip code, and last four digits of theaccount number, if any, of all entities holding priority claims against the debtor or the property of the debtor, as of the date of the filing of the petition. Use a separatecontinuation sheet for each type of priority and label each with the type of priority.
The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to doso. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).
If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriateschedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may beliable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in thecolumn labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled"Disputed." (You may need to place an "X" in more than one of these three columns.)
Report the total of claims listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all claims listed on this Schedule E in the box labeled"Total" on the last sheet of the completed schedule. Report this total also on the Summary of Schedules.
Report the total of amounts entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts entitled to prioritylisted on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.
Report the total of amounts not entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts not entitled topriority listed on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data.
Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.
TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets)
Domestic support obligationsClaims for domestic support that are owed to or recoverable by a spouse, former spouse, or child of the debtor, or the parent, legal guardian, or responsible relative
of such a child, or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in 11 U.S.C. § 507(a)(1).
Extensions of credit in an involuntary caseClaims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the appointment of a
trustee or the order for relief. 11 U.S.C. § 507(a)(3).
Wages, salaries, and commissionsWages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying independent sales
representatives up to $11,725* per person earned within 180 days immediately preceding the filing of the original petition, or the cessation of business, whicheveroccurred first, to the extent provided in 11 U.S.C. § 507(a)(4).
Contributions to employee benefit plansMoney owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the cessation of business,
whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(5).
Certain farmers and fishermenClaims of certain farmers and fishermen, up to $5,775* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(6).
Deposits by individualsClaims of individuals up to $2,600* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that were not
delivered or provided. 11 U.S.C. § 507(a)(7).
Taxes and certain other debts owed to governmental unitsTaxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11 U.S.C. § 507(a)(8).
Commitments to maintain the capital of an insured depository institutionClaims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors of the Federal
Reserve System, or their predecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C. § 507 (a)(9).
Claims for death or personal injury while debtor was intoxicatedClaims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug, or
another substance. 11 U.S.C. § 507(a)(10).
* Amount subject to adjustment on 4/01/13, and every three years thereafter with respect to cases commenced on or after the date of adjustment.
continuation sheets attached
SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS
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Case No. 11-54098Rafael Agustin Cardona
1
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 4 of 22
B6E (Official Form 6E) (4/10) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,AND MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions.)
DATE CLAIM WAS INCURRED AMOUNTAND CONSIDERATION FOR CLAIM OF CLAIM
Account No.
Account No.
Account No.
Account No.
Account No.
SubtotalSheet _____ of _____ continuation sheets attached to(Total of this page)Schedule of Creditors Holding Unsecured Priority Claims
TYPE OF PRIORITY
AMOUNT NOTENTITLED TOPRIORITY, IF ANY
AMOUNTENTITLED TO
PRIORITY
SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS(Continuation Sheet)
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In re ,Debtor
Case No. 11-54098Rafael Agustin Cardona
Taxes and Certain Other DebtsOwed to Governmental Units
Audit, Fine and Assessment
GA Dept of Banking & Finance2990 Brandywine RoadSuite 200Atlanta, GA 30341 -
9,955.00 9,955.00
0.00
9,955.00 9,955.000.001 1
9,955.00 9,955.000.00Total
(Report on Summary of Schedules)
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Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 5 of 22
}bk1{ScheduleF-CreditorsHoldingUnsecuredNonpriorityClaims}bk{
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Subtotal_____ continuation sheets attached (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
B6F (Official Form 6F) (12/07)
State the name, mailing address, including zip code, and last four digits of any account number, of all entities holding unsecured claims without priority against thedebtor or the property of the debtor, as of the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to thetrustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Do not include claims listed in Schedules D and E. If all creditors will not fit on this page, use the continuation sheet provided.
If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriateschedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may beliable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community."
If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If theclaim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.)
Report the total of all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedule. Report this total also on the Summary ofSchedules and, if the debtor is an individual with primarily consumer debts, report this total also on the Statistical Summary of Certain Liabilities and Related Data.
Check this box if debtor has no creditors holding unsecured claims to report on this Schedule F.
S/N:35745-110218
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS
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In re ,Debtor
Case No. 11-54098Rafael Agustin Cardona
7
xxxx-xxxx-xxxx-9240 Credit Card
Aeromexico Visa800 Nicollet MallMinneapolis, MN 55402
-
10,000.00
xxxx-xxxx-xxxx-3840 Credit Card
Amazon Chase VisaP.O. Box 15299Wilmington, DE 19850
-
7,000.00
xxxx-xxxx-xxxx-4490 Credit Card
Assoc Credit Union Visa6251 Crooked Creed RdNorcross, GA 30092
-
9,048.00
xxxxxxxxxxx0218 Business Debt
AT&T Business Phone ServiceP.O. Box 105262Atlanta, GA 30348
X -
360.00
26,408.00
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 6 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
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Case No. 11-54098Rafael Agustin Cardona
xxxxxxxxx0-001 Business Debt
AT&T Business Phone ServiceP.O. Box 105262Atlanta, GA 30348
X -
375.00
Judgment - Business Debt
Centro NP Northeast Plaza, LLC800 Kennesaw Ave Ste 400Marietta, GA 30060
X -
43,000.00
Business Debt
Chamblee Retail Holdings, LLC2498 Chamblee Tucker RdAtlanta, GA 30341
X -
108,000.00
3390 Business Debt
Crime Free Alarm Service5825 Live Oak Pkwy Ste ANorcross, GA 30093
X -
100.00
xx2978 Business Debt
Crime Free Alarm Service5825 Live Oak Pkwy Ste ANorcross, GA 30093
X -
100.00
151,575.001 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 7 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
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Case No. 11-54098Rafael Agustin Cardona
xxx3365 Business Debt
Dekalb County Water1300 Commerce DrDecatur, GA
X -
500.00
Business Debt
Dennis Matthews2934 Mabry LaneDacula, GA 30019
X -
55,000.00
Business Debt
Dinex188 Bering Dr Ste 420Houston, TX 77057
X -
50,000.00
Business debt
Gano Excel USA, Inc.4828 Fourth St.Baldwin Park, CA 91706
-
210.00
xxxxx-x4049 Business Debt
Georgia Power1841 Cmablee Tucker RdAtlanta, GA 30341
X -
1,000.00
106,710.002 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 8 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
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In re ,Debtor
Case No. 11-54098Rafael Agustin Cardona
xxxxx-x4058 Business Debt
Georgia Power1841 Cmablee Tucker RdAtlanta, GA 30341
X -
500.00
Business Debt
Halpern Business5269 Buford Hwy Ste AAtlanta, GA 30340
X -
11,480.00
Business Debt
Insight600 Beacon Pkwy West Ste 901Birmingham, AL 35209
X -
785.00
Business Debt
IPP Bill Payment330 Passiac AveFairfield, NJ 07004
X -
250.00
Business Debt
Itransfer-Tempo Financial LLC7995 E Prentice Ave Ste 103Englewood, CO 80111
X -
90,000.00
103,015.003 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 9 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com Best Case Bankruptcy
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Case No. 11-54098Rafael Agustin Cardona
Business Debt
Itransfer-Tempo Financial LLC7995 E Prentice Ave Ste 103Englewood, CO 80111
X -
34,295.00
Business Debt
Lawrence Buckles9330 Tailey CirAlpharetta, GA 30022
X -
55,000.00
Payment owed
Melaleuca, Inc.3910 S. Yellowstone HwyIdaho Falls, ID 83402
-
185.13
Business Debt
Money Gram1550 Utica Ave SouthMinneapolis, MN 55416
X -
28,651.00
Business Debt
Money Gram Money Orders1550 Utica Ave SouthMinneapolis, MN 55416
X -
309,876.00
428,007.134 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 10 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
Software Copyright (c) 1996-2011 - CCH INCORPORATED - www.bestcase.com Best Case Bankruptcy
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Case No. 11-54098Rafael Agustin Cardona
For Notice Only
New Plan Realty3440 Preston Ridge RdAlpharetta, GA 30005
-
0.00
Business Debt
Orlandi Valuta1301 International Pkwy 4th FlFort Lauderdale, FL 33323
X -
4,872.00
Business Debt
Prepaidworx - Page Plus Cellul11121 Hwy 70 Ste 202Arlington, TN 38002
X -
804.00
Personal Loan
Raymond Berrones, Jr.4553 Rivercliff Dr.Lilburn, GA 30047
-
25,000.00
Business Debt
Ria Financial13828 Cerritos Corp Dr Ste CCerritos, CA 90703
X -
100,000.00
130,676.005 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 11 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
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Case No. 11-54098Rafael Agustin Cardona
Business Debt
Ria Financial13828 Cerritos Corp Dr Ste CCerritos, CA 90703
X -
30,000.00
Business Debt
Sigue13291 Ralston AveSylmar, CA 91342
X -
2,586.00
Membership Dues
Smoke Rise County Club4900 Chedworth DriveStone Mountain, GA 30087
-
537.00
Business Debt
South Exchange80 SW 8th St Ste 120Miami, FL 33130
X -
20,000.00
xxxxx7384 Business Debt
T-MobileP.O. Box 742596Cincinnati, OH 45274-2596
X -
500.00
53,623.006 7
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 12 of 22
B6F (Official Form 6F) (12/07) - Cont.
CODEBTOR
CONTINGENT
UNLIQUIDATED
DISPUTED
Husband, Wife, Joint, or Community
HWJC
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions above.)
Account No.
Account No.
Account No.
Account No.
Account No.
Sheet no. _____ of _____ sheets attached to Schedule of SubtotalCreditors Holding Unsecured Nonpriority Claims (Total of this page)
DATE CLAIM WAS INCURRED ANDCONSIDERATION FOR CLAIM. IF CLAIM
IS SUBJECT TO SETOFF, SO STATE. AMOUNT OF CLAIM
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
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Case No. 11-54098Rafael Agustin Cardona
Business Debt
Transpayment Services3721 Kings RdChattanooga, TN 37416
X -
20,749.00
Business Debt
Unidos Money Transfers1250 Broadway AveNew York, NY 10001
X -
10,651.00
Business Debt
Vigo1301 International Pkwy 4th FlFort Lauderdale, FL 33323
X -
50,000.00
Business Debt
Vigo1301 International Pkwy 4th FlFort Lauderdale, FL 33323
X -
43,823.00
125,223.007 7
1,125,237.13Total
(Report on Summary of Schedules)
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 13 of 22
}bk1{Form6.SummaryofSchedules}bk{
United States Bankruptcy CourtNorthern District of Georgia
In re ,Debtor
Case No.
Chapter
11-54098
7
Rafael Agustin Cardona
B6 Summary (Official Form 6 - Summary) (12/07)
Indicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from Schedules A,B, D, E, F, I, and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor’s assets.Add the amounts of all claims from Schedules D, E, and F to determine the total amount of the debtor’s liabilities. Individual debtors mustalso complete the "Statistical Summary of Certain Liabilities and Related Data" if they file a case under chapter 7, 11, or 13.
SUMMARY OF SCHEDULES
ATTACHED NO. OFNAME OF SCHEDULE ASSETS LIABILITIES OTHER(YES/NO) SHEETS
A - Real Property
B - Personal Property
C - Property Claimed as Exempt
D - Creditors Holding Secured Claims
E - Creditors Holding UnsecuredPriority Claims
F - Creditors Holding UnsecuredNonpriority Claims
G - Executory Contracts andUnexpired Leases
H - Codebtors
I - Current Income of IndividualDebtor(s)
J - Current Expenditures of IndividualDebtor(s)
Total Number of Sheets of ALL Schedules
Total Assets
Total Liabilities
(Total of Claims on Schedule E)
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Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
1 340,000.00
3 21,023.50
1
440,464.001
9,955.002
1,125,237.138
1
3
1 1,068.17
1 9,489.00
22
361,023.50
1,575,656.13
Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 14 of 22
}bk1{Form6.StatisticalSummaryofCertainLiabilitiesandRelatedData}bk{
United States Bankruptcy CourtNorthern District of Georgia
In re ,Debtor
Case No.
Chapter
11-54098
7
Rafael Agustin Cardona
Form 6 - Statistical Summary (12/07)
STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C.§ 101(8)), filinga case under chapter 7, 11 or 13, you must report all information requested below.
Check this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to report any information here.
This information is for statistical purposes only under 28 U.S.C. § 159.Summarize the following types of liabilities, as reported in the Schedules, and total them.
Type of Liability Amount
Domestic Support Obligations (from Schedule E)
Taxes and Certain Other Debts Owed to Governmental Units (from Schedule E)
Claims for Death or Personal Injury While Debtor Was Intoxicated(from Schedule E) (whether disputed or undisputed)
Student Loan Obligations (from Schedule F)
Domestic Support, Separation Agreement, and Divorce DecreeObligations Not Reported on Schedule E
Obligations to Pension or Profit-Sharing, and Other Similar Obligations(from Schedule F)
TOTAL
State the following:
Average Income (from Schedule I, Line 16)
Average Expenses (from Schedule J, Line 18)
Current Monthly Income (from Form 22A Line 12; OR,Form 22B Line 11; OR, Form 22C Line 20 )
State the following:
1. Total from Schedule D, "UNSECURED PORTION, IF ANY"column
2. Total from Schedule E, "AMOUNT ENTITLED TO PRIORITY"column
3. Total from Schedule E, "AMOUNT NOT ENTITLED TOPRIORITY, IF ANY" column
4. Total from Schedule F
5. Total of non-priority unsecured debt (sum of 1, 3, and 4)
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Case 11-54098-jrs Doc 20 Filed 03/15/11 Entered 03/15/11 13:24:19 Desc Main Document Page 15 of 22
}bk1{CreditorAddressMatrix}bk{
Aeromexico Visa800 Nicollet MallMinneapolis, MN 55402
Amazon Chase VisaP.O. Box 15299Wilmington, DE 19850
Assoc Credit Union Visa6251 Crooked Creed RdNorcross, GA 30092
Associated Credit Union6251 Crooked Creek Rd
AT&T Business Phone ServiceP.O. Box 105262Atlanta, GA 30348
Centro NP Northeast Plaza, LLC800 Kennesaw Ave Ste 400Marietta, GA 30060
Chamblee Retail Holdings LLC9925 Haynes Bridge Rd Ste 200Alpharetta, GA 30022
Chamblee Retail Holdings, LLC2498 Chamblee Tucker RdAtlanta, GA 30341
Crime Free Alarm Service5825 Live Oak Pkwy Ste ANorcross, GA 30093
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Dekalb County Water1300 Commerce DrDecatur, GA
Dennis Matthews2934 Mabry LaneDacula, GA 30019
Dinex188 Bering Dr Ste 420Houston, TX 77057
GA Dept of Banking & Finance2990 Brandywine RoadSuite 200Atlanta, GA 30341
Gano Excel USA, Inc.4828 Fourth St.Baldwin Park, CA 91706
Georgia Power1841 Cmablee Tucker RdAtlanta, GA 30341
Halpern Business5269 Buford Hwy Ste AAtlanta, GA 30340
Insight600 Beacon Pkwy West Ste 901Birmingham, AL 35209
IPP Bill Payment330 Passiac AveFairfield, NJ 07004
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Itransfer-Tempo Financial LLC7995 E Prentice Ave Ste 103Englewood, CO 80111
Ladden Group, LLC2498 Chamblee Dunwody Rd.Atlanta, GA 30341
Lawrence Buckles9330 Tailey CirAlpharetta, GA 30022
Melaleuca, Inc.3910 S. Yellowstone HwyIdaho Falls, ID 83402
Money Gram1550 Utica Ave SouthMinneapolis, MN 55416
Money Gram Money Orders1550 Utica Ave SouthMinneapolis, MN 55416
Nationstar Mortgage350 Highland DrLewisville, TX 75067
New Plan Realty3440 Preston Ridge RdAlpharetta, GA 30005
Orlandi Valuta1301 International Pkwy 4th FlFort Lauderdale, FL 33323
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Prepaidworx - Page Plus Cellul11121 Hwy 70 Ste 202Arlington, TN 38002
Raymond Berrones, Jr.4553 Rivercliff Dr.Lilburn, GA 30047
Ria Financial13828 Cerritos Corp Dr Ste CCerritos, CA 90703
Sigue13291 Ralston AveSylmar, CA 91342
Smoke Rise County Club4900 Chedworth DriveStone Mountain, GA 30087
South Exchange80 SW 8th St Ste 120Miami, FL 33130
T-MobileP.O. Box 742596Cincinnati, OH 45274-2596
Transpayment Services3721 Kings RdChattanooga, TN 37416
Unidos Money Transfers1250 Broadway AveNew York, NY 10001
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United Americas Bank/StateBank3789 Roswell RdAtlanta, GA 30342
Vigo1301 International Pkwy 4th FlFort Lauderdale, FL 33323
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Creditors Added to Mailing Matrix:
Georgia Department of Banking and Finance 2990 Brandywine Rd. Suite 200 Atlanta, GA 30341
Smoke Rise Country Club 4900 Chedworth Dr. Stone Mountain, Ga 30087
Melaleuca, Inc. 3910 S. Yellowstone Hwy. Idaho Falls, ID. 83402
Gano Excel USA, Inc. 4828 Fourth St. Irwindale, CA 91706
Raymond Berrones Jr. 4553 Rivercliff Dr. Lilburn, GA 30047
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IN THE UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION
IN RE: ) ) CHAPTER 7 RAFAEL CARDONA ) ) CASE NO. 11-54098-JRS Debtor. )
CERTIFICATE OF SERVICE
I hereby certify that I have served a copy of the “AMENDMENT TO SCHEDULES AND
CREDITOR MATRIX” on all parties referenced below by depositing a copy of same in the
United States Mail, postage prepaid, to the following:
Georgia Department of Banking and Finance 2990 Brandywine Rd. Suite 200 Atlanta, GA 30341
Gano Excel USA, Inc. 4828 Fourth St. Irwindale, CA 91706
Smoke Rise Country Club 4900 Chedworth Dr. Stone Mountain, GA 30087
Raymond Berrones Jr. 4553 Rivercliff Dr. Lilburn, GA 30047
Melaleuca, Inc. 3910 S. Yellowstone Hwy. Idaho Falls, ID. 83402
Rafael Cardona 2869 Briarlake Road NE Atlanta, GA 30345
Tamara Miles Ogier Ellenberg, Ogier, Rothschild & Rosenfeld 170 Mitchell St. S.W. Atlanta, GA 30303
This 15th day of March, 2011.
JONES & WALDEN, LLC
/s/ Noel J. BartelsNoel J. Bartles Georgia Bar No. 823714 Attorney for Debtor 21 Eighth Street Atlanta, Georgia 30309 (404) 564-9300 [email protected]
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