81 (Offi~ial Form) shy (Rev 398)

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

All Other Names used by the Debtor in the (include married maiden and trade names)

(if more than one state all)

Street Address of Debtor (No amp Street City State amp Zip Code) 1111 Stradel Road Los Angeles California 90077

County of Residence or of the

Principal Place of Business Los

Name

Other Names used by the Joint Debtor in the last 6 years (include married maiden and trade names)

Soc SeclTax 10 No (if more than one state all)

Street Address of Joint Debtor (No amp Street City State amp Zip Code)

County of Residence or of the

Venue (Check any applicable box) I][] Debtor has been domiciled or has had a residence principal place of business or principal assets in this District for 180 days

immediately preceding the date of this petition or for a longer part of such 180 days than in any other DistriCtD There is a bankruptcy case concerning debtors affiliate general partner or partnership pending in this DistrictD This petition is being filed by a corporation or partnership under chapter 11 and the debtor acknowledges that a Venue Disclosure

Form is required to be filed by General Order 97-02

Type of Debtor (Check all boxes that apply) Chapter or Section of Bankruptcy Code Under WhichIndividual(s) E3 Railroad

the Petition is Filed (Check one box)Corporation StockbrokerI Partnersh 0 Commodity Broker Ipq Chapter 7 D Chapter 11 D Chapter 13 ~ Other tj Chapter 9 D Chapter 12 Sec304 Case Ancillary to foreign proceeding

I[][] Nature of Debts (Check one box)

ConsumerlNon-Business D Business I Filing Fee (Check one box) t------------------------l [][] Full Filing Fee attached

Chapter 11 Small Business (Check all boxes that apply) o Filing Fee to be paid in installments (Applicable to individualSD Debtor is a small bUSiness as defined in 11 USC sect 101 only) Must attach signed application for the courts

consideration certifying that the debtor is unable to pay fee D Debtor is and elects to be considered a small business except in Installments Rule 1006(b) See Official Form NO3under 11 USC sect 1121e) (Optional)

statisticalAdministrative Information (Estimates only) LA00-10718E~=

C] Debtor estimates that funds will be available for distribution to unsecured creditors

[][] Debtor estimates that after any exempt property is excluded and administrative expenses paid there will be no funds available for distribution to unsecured credito

1-15 16-49 50-99 100-199 200-999 1000-0 Estimated Number of Creditors [][] o o D o

$0shy$50000

$50001shy $100001shy$100000 $500000

Estimated Debts

$500001shy $1000001shy $10000001shy $50000001shy$1 million $10 million $50 million $100 million

o D

o Exhibit A is attached and made a

XBi__1___ 1- K_tl_Jf

Signature(s) of Debtor(s) (lndlviduaVJoint)

I deClare under penalty Of perjury that the information provided in this petition is

true and correct (If petitioner is an indiVidual whose debts are primarily

consumer debts and has chosen to tile under Chapter 1) I am aware that I may

proCeed under chapter 1 11 12 or 13 at title 11 United States code

understand the relief available under eaCh such chapter and Choose to

proceed under Chapter 7

I request relief in accordsn th the chapter of title 11 United States Code

X h~sectipoundlQature of Debtorw1thers Peter Roy Douglas

X~s~ig=n7a~w~re~0~fJ~0~in~t~D~e=b7to=r~------------------------------

8929 Wilshire Blvd Suite 100 Address

Beverly Hills CA 90211-1950

(310) 659-5444 TelePho~iarlnd(fber

155486 Date Bar Number

Exhibit A To be completed if debtor is required to file periOdic reports (eg forms 10K and 10Q) with the Securities and ExChange Commission pursuant to Section 13 or 15(d) of the Securities Exchange Act Of 1934 and is reQuesling reliel under chapter 11)

Signature of Debtor (CorporationPartnership)

declare under penalty Of perjury that the informatiOn providea in this

petition is true and correct and that I have been authoriZed to file this

petition on behalf 01 the debtor

The debtor requests relief in accordance With the Chapter of title 11

United States Code specified in this petition

XS~ig-n-a~w~r=e-o~f~Au~t=h-o=n=z-e-d~l~n-d~N~i~d~u-a=l------------------------------

Xp~nn-t~e-drN~a~m~e-o~t~A-u~th~o-r~iz~e-d~ln-d~N~i~d~u-a~I-------------------------

TItle Of Authorized IndiVidual

Signature of Non-Attorney Petition Preparer

I certify that I am a bankruptcy petilion preparer as defined In 1 t USC

sect t 10 that I prepared this document for compensation and that I have

provided the debtor with a copy of this document

Printed or tYPed Name Of Bankruptcy Petfion preparer

SOCial secur1YNWii5er

~

Names and Social Security numbers of all other Individuals whO prepared or assisted in preparing this document

If more than one person prepared this Clocument attach additional

sheets conforming to Ihe appropriate OfiCial form for each person

X___________________~___--------------------___ 1I1t)IIIiIIYfillll ltnllfuptlW lIelltirln liUII

Date

A bankruptcy petition preparers ailure to comply with the prOVisions of title 11

and the Federal Rules of Bankruptcy Procedure may result in fines or

imprisonment or both It USCsect110 18USCsect156

lccal Rule 104 (Rev 6195) 1995 USBe Central District of California

STATEMENT OF RELATED CASES INFORMATION REQUIRED BY LOCAL RULE 104

UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

1 A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previoUSly been filed by or against the debtor hiSher spouse an affiliate of the debtor any copartnerShip or joint venture of which debtor is or formerly was a general or limited partner or member or any corporation of which the debtor is a director officer or person in control as follows (Set forth the complete number and title of such prior proceeding date filed nature thereof the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate AlSO list any real property included in Schedule A that was filed with any such prior proceedlng(s)) None

2 (If petitioner is a partnership or joint venture) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by Of against the debtor or an affiliate of the debtor or a general partner in the debtor a relative of the general partner general partner of or person in control of the debtor partnership in which the debtor is a general partner general partner of the debtor or person in control of the debtor as follows (Set forth the complete number and title of such prior proceeding date filed nature of the proceeding the Bankruptcy Judge and court to whom assigned whether still pending and if not the dispositIOn thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceedlng(s))

None

3 (If Petitioner is a corporation) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Act of 1978 has previously been filed by or against the debtor or any of its affiliates or subsidiaries a director of the debtor an officer of the debtor a person in control of the debtor a partnership in which the debtor is general partner a general partner of the debtor a relative of the general partner director officer or person in control of the debtor or any persons firms or corporations owning 20 or more of its voting stock as follows (Set forth the complete number and title of such prior proceeding date filed nature of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the disposition thereof If none so indicate AlSO list any real property In9Iw Ifll~hUWI A thll WI fllll2 wltn ny Yon prior proclutng())HQne bull c

4 (If Petitioner is an individual) A petition under the Bankruptcy Reform Act including amendments thereof has been filed by or against

the debtor within the last 180 days (set forth the complete nuriibefand title of such prior proceeding date filed natura of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceeding(s))

None

I declare under penalty of perjury that the foregoing is true and correct ~~~-Beverly Hills Executed at bullCalifornia

08t1t6f

Dated 010700 Withers Peter Roy Douglas

gWIHi Ilimn

BK-101

i

Signature of Debtor

Notic~ of Available Chapters (Rev 6195)

Name Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100

Address Beverly Hills CA 90211-1950

1995 USBC Central District of California

Telephone (310) 659-5444 Fax

[XJ Attorney for Debtor

o Debtor in Pro Per

UNITED STATES BANKRUPTCY COURT

CEN1RAL DISTRICT OF CALIFORNIA

Ust all names including trade names used by Debtor(s) within CASE NUMBER last 6 years

withers Peter Roy Doglas

NOTICE OF SOCial Security No -4916 Debtor AVAILABLE CHAPTERS Social Security No Joint Debtor

Dabtor(s) EIN No

1 Section 342(b) of 11 USC ( The Bankruptcy Code ) states Priorto the commencement of a case under this title by an individual whose debts are primarily consumer debts the clerkmiddot shall give written notice to such indMdual that indicates each chapter of this title under which such individual may proceed

2 You are eligible to file under Chapter 7 whereby debts are discharged and your non-exempt assets are liquidated by the trustee for the benefit of your creditors

3 You are eligible to file under Chapter 11 for debt reorganization upon payment of the additional fee required

4 If your noncontingent liquidated debts are less than $25000000 unsecured and $75000000 secured (11 USC sect

109(e)) you are also eligible to file under Chapter 13 and to use future income to pay all or a portion of your debts

5 If you are a family farmer with a regular annual income as defined by 11 USC sect 101 (18) (19) you are eligible to file under Chapter 12

6 To determine which chapter to file under it is recommended that you consult an attorney

JON D CERETTO Court Clerk

~~ILABLE CHAPTERSH

-P6~z~ Date

Withers Peter Roy Douglas

Signature of Joint Debtor Cif applicable) Date

If the Court has previously ordered that you may not file bankruptcy for 180 days or any other period you may not file bankruptcy without prior leave of the Court BK-21

o Exhibit A is attached and made a

XBi__1___ 1- K_tl_Jf

Signature(s) of Debtor(s) (lndlviduaVJoint)

I deClare under penalty Of perjury that the information provided in this petition is

true and correct (If petitioner is an indiVidual whose debts are primarily

consumer debts and has chosen to tile under Chapter 1) I am aware that I may

proCeed under chapter 1 11 12 or 13 at title 11 United States code

understand the relief available under eaCh such chapter and Choose to

proceed under Chapter 7

I request relief in accordsn th the chapter of title 11 United States Code

X h~sectipoundlQature of Debtorw1thers Peter Roy Douglas

X~s~ig=n7a~w~re~0~fJ~0~in~t~D~e=b7to=r~------------------------------

8929 Wilshire Blvd Suite 100 Address

Beverly Hills CA 90211-1950

(310) 659-5444 TelePho~iarlnd(fber

155486 Date Bar Number

Exhibit A To be completed if debtor is required to file periOdic reports (eg forms 10K and 10Q) with the Securities and ExChange Commission pursuant to Section 13 or 15(d) of the Securities Exchange Act Of 1934 and is reQuesling reliel under chapter 11)

Signature of Debtor (CorporationPartnership)

declare under penalty Of perjury that the informatiOn providea in this

petition is true and correct and that I have been authoriZed to file this

petition on behalf 01 the debtor

The debtor requests relief in accordance With the Chapter of title 11

United States Code specified in this petition

XS~ig-n-a~w~r=e-o~f~Au~t=h-o=n=z-e-d~l~n-d~N~i~d~u-a=l------------------------------

Xp~nn-t~e-drN~a~m~e-o~t~A-u~th~o-r~iz~e-d~ln-d~N~i~d~u-a~I-------------------------

TItle Of Authorized IndiVidual

Signature of Non-Attorney Petition Preparer

I certify that I am a bankruptcy petilion preparer as defined In 1 t USC

sect t 10 that I prepared this document for compensation and that I have

provided the debtor with a copy of this document

Printed or tYPed Name Of Bankruptcy Petfion preparer

SOCial secur1YNWii5er

~

Names and Social Security numbers of all other Individuals whO prepared or assisted in preparing this document

If more than one person prepared this Clocument attach additional

sheets conforming to Ihe appropriate OfiCial form for each person

X___________________~___--------------------___ 1I1t)IIIiIIYfillll ltnllfuptlW lIelltirln liUII

Date

A bankruptcy petition preparers ailure to comply with the prOVisions of title 11

and the Federal Rules of Bankruptcy Procedure may result in fines or

imprisonment or both It USCsect110 18USCsect156

lccal Rule 104 (Rev 6195) 1995 USBe Central District of California

STATEMENT OF RELATED CASES INFORMATION REQUIRED BY LOCAL RULE 104

UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

1 A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previoUSly been filed by or against the debtor hiSher spouse an affiliate of the debtor any copartnerShip or joint venture of which debtor is or formerly was a general or limited partner or member or any corporation of which the debtor is a director officer or person in control as follows (Set forth the complete number and title of such prior proceeding date filed nature thereof the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate AlSO list any real property included in Schedule A that was filed with any such prior proceedlng(s)) None

2 (If petitioner is a partnership or joint venture) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by Of against the debtor or an affiliate of the debtor or a general partner in the debtor a relative of the general partner general partner of or person in control of the debtor partnership in which the debtor is a general partner general partner of the debtor or person in control of the debtor as follows (Set forth the complete number and title of such prior proceeding date filed nature of the proceeding the Bankruptcy Judge and court to whom assigned whether still pending and if not the dispositIOn thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceedlng(s))

None

3 (If Petitioner is a corporation) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Act of 1978 has previously been filed by or against the debtor or any of its affiliates or subsidiaries a director of the debtor an officer of the debtor a person in control of the debtor a partnership in which the debtor is general partner a general partner of the debtor a relative of the general partner director officer or person in control of the debtor or any persons firms or corporations owning 20 or more of its voting stock as follows (Set forth the complete number and title of such prior proceeding date filed nature of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the disposition thereof If none so indicate AlSO list any real property In9Iw Ifll~hUWI A thll WI fllll2 wltn ny Yon prior proclutng())HQne bull c

4 (If Petitioner is an individual) A petition under the Bankruptcy Reform Act including amendments thereof has been filed by or against

the debtor within the last 180 days (set forth the complete nuriibefand title of such prior proceeding date filed natura of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceeding(s))

None

I declare under penalty of perjury that the foregoing is true and correct ~~~-Beverly Hills Executed at bullCalifornia

08t1t6f

Dated 010700 Withers Peter Roy Douglas

gWIHi Ilimn

BK-101

i

Signature of Debtor

Notic~ of Available Chapters (Rev 6195)

Name Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100

Address Beverly Hills CA 90211-1950

1995 USBC Central District of California

Telephone (310) 659-5444 Fax

[XJ Attorney for Debtor

o Debtor in Pro Per

UNITED STATES BANKRUPTCY COURT

CEN1RAL DISTRICT OF CALIFORNIA

Ust all names including trade names used by Debtor(s) within CASE NUMBER last 6 years

withers Peter Roy Doglas

NOTICE OF SOCial Security No -4916 Debtor AVAILABLE CHAPTERS Social Security No Joint Debtor

Dabtor(s) EIN No

1 Section 342(b) of 11 USC ( The Bankruptcy Code ) states Priorto the commencement of a case under this title by an individual whose debts are primarily consumer debts the clerkmiddot shall give written notice to such indMdual that indicates each chapter of this title under which such individual may proceed

2 You are eligible to file under Chapter 7 whereby debts are discharged and your non-exempt assets are liquidated by the trustee for the benefit of your creditors

3 You are eligible to file under Chapter 11 for debt reorganization upon payment of the additional fee required

4 If your noncontingent liquidated debts are less than $25000000 unsecured and $75000000 secured (11 USC sect

109(e)) you are also eligible to file under Chapter 13 and to use future income to pay all or a portion of your debts

5 If you are a family farmer with a regular annual income as defined by 11 USC sect 101 (18) (19) you are eligible to file under Chapter 12

6 To determine which chapter to file under it is recommended that you consult an attorney

JON D CERETTO Court Clerk

~~ILABLE CHAPTERSH

-P6~z~ Date

Withers Peter Roy Douglas

Signature of Joint Debtor Cif applicable) Date

If the Court has previously ordered that you may not file bankruptcy for 180 days or any other period you may not file bankruptcy without prior leave of the Court BK-21

lccal Rule 104 (Rev 6195) 1995 USBe Central District of California

STATEMENT OF RELATED CASES INFORMATION REQUIRED BY LOCAL RULE 104

UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

1 A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previoUSly been filed by or against the debtor hiSher spouse an affiliate of the debtor any copartnerShip or joint venture of which debtor is or formerly was a general or limited partner or member or any corporation of which the debtor is a director officer or person in control as follows (Set forth the complete number and title of such prior proceeding date filed nature thereof the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate AlSO list any real property included in Schedule A that was filed with any such prior proceedlng(s)) None

2 (If petitioner is a partnership or joint venture) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Reform Act of 1978 has previously been filed by Of against the debtor or an affiliate of the debtor or a general partner in the debtor a relative of the general partner general partner of or person in control of the debtor partnership in which the debtor is a general partner general partner of the debtor or person in control of the debtor as follows (Set forth the complete number and title of such prior proceeding date filed nature of the proceeding the Bankruptcy Judge and court to whom assigned whether still pending and if not the dispositIOn thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceedlng(s))

None

3 (If Petitioner is a corporation) A petition under the Bankruptcy Act of 1898 or the Bankruptcy Act of 1978 has previously been filed by or against the debtor or any of its affiliates or subsidiaries a director of the debtor an officer of the debtor a person in control of the debtor a partnership in which the debtor is general partner a general partner of the debtor a relative of the general partner director officer or person in control of the debtor or any persons firms or corporations owning 20 or more of its voting stock as follows (Set forth the complete number and title of such prior proceeding date filed nature of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the disposition thereof If none so indicate AlSO list any real property In9Iw Ifll~hUWI A thll WI fllll2 wltn ny Yon prior proclutng())HQne bull c

4 (If Petitioner is an individual) A petition under the Bankruptcy Reform Act including amendments thereof has been filed by or against

the debtor within the last 180 days (set forth the complete nuriibefand title of such prior proceeding date filed natura of proceeding the Bankruptcy Judge and court to whom aSSigned whether still pending and if not the diSposition thereof If none so indicate Also list any real property included in Schedule A that was filed with any such prior proceeding(s))

None

I declare under penalty of perjury that the foregoing is true and correct ~~~-Beverly Hills Executed at bullCalifornia

08t1t6f

Dated 010700 Withers Peter Roy Douglas

gWIHi Ilimn

BK-101

i

Signature of Debtor

Notic~ of Available Chapters (Rev 6195)

Name Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100

Address Beverly Hills CA 90211-1950

1995 USBC Central District of California

Telephone (310) 659-5444 Fax

[XJ Attorney for Debtor

o Debtor in Pro Per

UNITED STATES BANKRUPTCY COURT

CEN1RAL DISTRICT OF CALIFORNIA

Ust all names including trade names used by Debtor(s) within CASE NUMBER last 6 years

withers Peter Roy Doglas

NOTICE OF SOCial Security No -4916 Debtor AVAILABLE CHAPTERS Social Security No Joint Debtor

Dabtor(s) EIN No

1 Section 342(b) of 11 USC ( The Bankruptcy Code ) states Priorto the commencement of a case under this title by an individual whose debts are primarily consumer debts the clerkmiddot shall give written notice to such indMdual that indicates each chapter of this title under which such individual may proceed

2 You are eligible to file under Chapter 7 whereby debts are discharged and your non-exempt assets are liquidated by the trustee for the benefit of your creditors

3 You are eligible to file under Chapter 11 for debt reorganization upon payment of the additional fee required

4 If your noncontingent liquidated debts are less than $25000000 unsecured and $75000000 secured (11 USC sect

109(e)) you are also eligible to file under Chapter 13 and to use future income to pay all or a portion of your debts

5 If you are a family farmer with a regular annual income as defined by 11 USC sect 101 (18) (19) you are eligible to file under Chapter 12

6 To determine which chapter to file under it is recommended that you consult an attorney

JON D CERETTO Court Clerk

~~ILABLE CHAPTERSH

-P6~z~ Date

Withers Peter Roy Douglas

Signature of Joint Debtor Cif applicable) Date

If the Court has previously ordered that you may not file bankruptcy for 180 days or any other period you may not file bankruptcy without prior leave of the Court BK-21

i

Signature of Debtor

Notic~ of Available Chapters (Rev 6195)

Name Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100

Address Beverly Hills CA 90211-1950

1995 USBC Central District of California

Telephone (310) 659-5444 Fax

[XJ Attorney for Debtor

o Debtor in Pro Per

UNITED STATES BANKRUPTCY COURT

CEN1RAL DISTRICT OF CALIFORNIA

Ust all names including trade names used by Debtor(s) within CASE NUMBER last 6 years

withers Peter Roy Doglas

NOTICE OF SOCial Security No -4916 Debtor AVAILABLE CHAPTERS Social Security No Joint Debtor

Dabtor(s) EIN No

1 Section 342(b) of 11 USC ( The Bankruptcy Code ) states Priorto the commencement of a case under this title by an individual whose debts are primarily consumer debts the clerkmiddot shall give written notice to such indMdual that indicates each chapter of this title under which such individual may proceed

2 You are eligible to file under Chapter 7 whereby debts are discharged and your non-exempt assets are liquidated by the trustee for the benefit of your creditors

3 You are eligible to file under Chapter 11 for debt reorganization upon payment of the additional fee required

4 If your noncontingent liquidated debts are less than $25000000 unsecured and $75000000 secured (11 USC sect

109(e)) you are also eligible to file under Chapter 13 and to use future income to pay all or a portion of your debts

5 If you are a family farmer with a regular annual income as defined by 11 USC sect 101 (18) (19) you are eligible to file under Chapter 12

6 To determine which chapter to file under it is recommended that you consult an attorney

JON D CERETTO Court Clerk

~~ILABLE CHAPTERSH

-P6~z~ Date

Withers Peter Roy Douglas

Signature of Joint Debtor Cif applicable) Date

If the Court has previously ordered that you may not file bankruptcy for 180 days or any other period you may not file bankruptcy without prior leave of the Court BK-21

United States Bankruptcy Court Central District of California

~re Withers Peter Roy Douglas Case No Debtor (if known)

Chapter 7

SUMMARY OF SCHEDULES

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 debtors assets Add the amounts from schedules D E and F to determine the total amount of the debtors liabilities

AMOUNTS SCHEDULED

ATTACHED NOOF I NAME OF SCHEDULE (YESNO) SHEETS I ASSETS

Real Property Yes 11$

Personal Property Yes 31$

Property Claimed Yes 2As Exempt

Creditor Holding I Yes 1Secured Claims

Creditors Holding Unsecured Yes 2Priority Claims

Creditors Holding Unsecured Yes 3Nonpriority Claims

Executory Contracts and Yes 1Unexpired Leases

Codebtors Yes 1

Current Income of Individual Debtor(s) Yes 1

Current Expenditures of Individual Debtor(s) Yes 1

Total Number of sheets 16 in All Schedules

Total Assets $ - I 10 -

FORMB6

Total Liabilities $ 777 24 (12195)

19900

~re Withers Peter Roy Douglas Case No ~hlm (If known)

SCHEDULE A - REAL PROPERTY

Except as directed below list all real property in which the debtor has any legal equitable or future Interest including all property owned as a a co-tenant community property or in which the debtor has a life estate Include any property in which the debtor holds rights and powers exercisable for the debtors own benefit If the debtor is married state whether husband wife or both own the property by placing an H W J or C in the column labeled Husband Wife Joint or Community If the debtor holds no interest in real property write None under Description and Location of Property

Do not include interests in executory contracts and unexpired leases on this schedule List them in SchedUle G - Executory Contracts and Unexpired Leases

If any entity claims to have a lien or hold a secured interest in any property state the amount of the secured claim See Schedule D If no entity claims to hold a secured interest in the property write None in the column labeled Amount of Secured Claim

If the debtor is an individual or if a jOint petition is filed state the amount of any exemption claimed in the property only in Schedule C Property Claimed as Exempt

DESCRIPTION AND

LOCATION OF

PROPERTY

None

z CURRENT 0gtshy MARKET VALUE1shy

NATURE OF DEBTORS z OF DEBTORS ~gt- INTEREST ININTEREST IN PROPERTY s PROPERTY WITHOUT 00

DEDUCTING ANY zo lttr SECURED CLAIM~o OR EXEMPTION =gt J

AMOUNT OF

SECURED

CLAIM

FORM B6 (1295)

Page 1 Page Total $ 000

Schedule T olal $ 000

~reWithers Peter Roy Douglas Case No (If known)Debtor

SCHEDULE B - PERSONAL PROPERTY

Except as directed below list all personal property of the debtor of whatever kind If the debtor has no property in one or more of the categories place an X in the appropriate position in the column labeled None If additional space is needed in any category attach a separate sheet properly identified with the case name case number and the number of the category If the debtor is married state whether husband wife or both own the property by placing an H W J or c in the column labeled Husband Wife Joint or Community If the debtor is an individual or a joint petition is filed state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt

Do not list interests in executory contracts and unexpired leases on this schedule List them in Schedule G - Executory Contracts and Unexpired Leases

If the property is being held for the debtor by someone else state that persons name and address under Description and Location of Property

TYPE OF PROPERTY NONE DESCRIPTION AND LOCATION

OF PROPERTY

shyz o gtshy t-WZ ~3_ E e 0 Z 0i a III 0 gt I

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

01 Cash on hand Cash 4000

02 Checking savings or other financial X accounts certificates of deposi~ or shares in banks savings and loan thrift building and loan and homeshystead associations or credit unions brokerage houses or cooperatives

03 Security deposits with public utilities Ms Diana Gaba-Landlord 950000 telephone companies landlords and others

04 Household goods and furnishings Household furnishings 210000 including audio video and computer equipment

05 Books pictures and other art Art and Books 180000 objects antiques stamp coin record tape compact disc and other collections or collectibles

06 Wearing apparel lMens wearing apparel 50000

Womens wearing apparel 100000

07 Furs and jewelry Personal jewelry 100000

08 Firearms and sports photographic Hand tools 50000 and other hobby equipment

09 Interests in insurance policies Life insurance no surrender 000 Name insurance company of each policy and itemize surrender or value refund value of each

10 Annuities Itemize and name X each issuer

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans Itemize

FORM B6B Page Total $ 1644000 (1295)

Page 1

In re Wi thers Peter Roy Douglas Case No _____________ Debtor (If known)

SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet)

TYPE OF PROPERTY

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans ltemize(continued)

12 Stock and interests in incorporated and unincorporated businesses Itemize

13 Interests in partnerships or jOint ventures itemize

14 Government and corporate bonds and other negotiable and nonshynegotiable instruments

15 Accounts receivable

16 Alimony maintenance support and property settlements to which the debtor is or may be entitled Give particulars

17 Other liquidated debts owing debtor including tax refunds Give particulars

18 Equitable or future Interest life estates and rights or powers exermiddot cisable for the benefit of the debtor other than those listed in Schedule of Real Property

19 Contingent and nonmiddotcontingent interests in estate of a decedent death benefit plan life insurance policy or trust

20 Other contingent and unliquidated claims of every nature including tax refunds counterclaims of the debtor and rights to setoff claims Give estimated value of each

21 Patents copyrights and other intelmiddot lectual property Give partiCUlars

22 Licenses franchises and other general intangibles Give particulars

23 Automobiles trucks trailers and other vehicles and accessories

I

NONE DESCRIPTION AND LOCATION OF PROPERTY

Claremont College Retirement

Market Interface LLC

X

X

X X

Tax refund

X

X

X

X

X

1992 Ford Mustang

1972 Trimumph GT6

Ii (5 gtshy

- IshyW _ u z ~ 5 ciE z 0

m u 0

) 0 t

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

600000

10000

300000

300000

60000

I

1956 Ford F100 50000

24 Boats motors and accessories

25 Aircraft and accessories

26 Office eqUipment furnishings and supplies

X

X

FORM B6B-Cont

(12195)

Page 2

Page Total $ 1320000

In re Withers Peter Roy Douglas Case No ____------_---_____ Debtor (If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY

26 Office equipment furnishings and supplies (continued

27 Machinery fixtures equipment and supplies used in business

28 Inventory

29 Animals

30 Crop-growing or halYested Give particulars

31 Farming equipment and implements

32 Farm supplies chemicals and feed

33 Other personal property of any kind not already listed Itemize

NONE

X

X X X

X

X

X

DESCRIPTION AND LOCATION OF PROPERTY

2 (5 gtshyWbull I-_ II 23 )bull Iii

a Iii

~ 8 II) II ) 0 r

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WlTH-OUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

PL Computer and Printer 50000

Fax machine

I Page Total $ 52000

Schedule Total $ 3016000g

2000

~re Withers Peter Roy Douglas Case No ~hlm (If known)

SCHEDULE A - REAL PROPERTY

Except as directed below list all real property in which the debtor has any legal equitable or future Interest including all property owned as a a co-tenant community property or in which the debtor has a life estate Include any property in which the debtor holds rights and powers exercisable for the debtors own benefit If the debtor is married state whether husband wife or both own the property by placing an H W J or C in the column labeled Husband Wife Joint or Community If the debtor holds no interest in real property write None under Description and Location of Property

Do not include interests in executory contracts and unexpired leases on this schedule List them in SchedUle G - Executory Contracts and Unexpired Leases

If any entity claims to have a lien or hold a secured interest in any property state the amount of the secured claim See Schedule D If no entity claims to hold a secured interest in the property write None in the column labeled Amount of Secured Claim

If the debtor is an individual or if a jOint petition is filed state the amount of any exemption claimed in the property only in Schedule C Property Claimed as Exempt

DESCRIPTION AND

LOCATION OF

PROPERTY

None

z CURRENT 0gtshy MARKET VALUE1shy

NATURE OF DEBTORS z OF DEBTORS ~gt- INTEREST ININTEREST IN PROPERTY s PROPERTY WITHOUT 00

DEDUCTING ANY zo lttr SECURED CLAIM~o OR EXEMPTION =gt J

AMOUNT OF

SECURED

CLAIM

FORM B6 (1295)

Page 1 Page Total $ 000

Schedule T olal $ 000

~reWithers Peter Roy Douglas Case No (If known)Debtor

SCHEDULE B - PERSONAL PROPERTY

Except as directed below list all personal property of the debtor of whatever kind If the debtor has no property in one or more of the categories place an X in the appropriate position in the column labeled None If additional space is needed in any category attach a separate sheet properly identified with the case name case number and the number of the category If the debtor is married state whether husband wife or both own the property by placing an H W J or c in the column labeled Husband Wife Joint or Community If the debtor is an individual or a joint petition is filed state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt

Do not list interests in executory contracts and unexpired leases on this schedule List them in Schedule G - Executory Contracts and Unexpired Leases

If the property is being held for the debtor by someone else state that persons name and address under Description and Location of Property

TYPE OF PROPERTY NONE DESCRIPTION AND LOCATION

OF PROPERTY

shyz o gtshy t-WZ ~3_ E e 0 Z 0i a III 0 gt I

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

01 Cash on hand Cash 4000

02 Checking savings or other financial X accounts certificates of deposi~ or shares in banks savings and loan thrift building and loan and homeshystead associations or credit unions brokerage houses or cooperatives

03 Security deposits with public utilities Ms Diana Gaba-Landlord 950000 telephone companies landlords and others

04 Household goods and furnishings Household furnishings 210000 including audio video and computer equipment

05 Books pictures and other art Art and Books 180000 objects antiques stamp coin record tape compact disc and other collections or collectibles

06 Wearing apparel lMens wearing apparel 50000

Womens wearing apparel 100000

07 Furs and jewelry Personal jewelry 100000

08 Firearms and sports photographic Hand tools 50000 and other hobby equipment

09 Interests in insurance policies Life insurance no surrender 000 Name insurance company of each policy and itemize surrender or value refund value of each

10 Annuities Itemize and name X each issuer

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans Itemize

FORM B6B Page Total $ 1644000 (1295)

Page 1

In re Wi thers Peter Roy Douglas Case No _____________ Debtor (If known)

SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet)

TYPE OF PROPERTY

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans ltemize(continued)

12 Stock and interests in incorporated and unincorporated businesses Itemize

13 Interests in partnerships or jOint ventures itemize

14 Government and corporate bonds and other negotiable and nonshynegotiable instruments

15 Accounts receivable

16 Alimony maintenance support and property settlements to which the debtor is or may be entitled Give particulars

17 Other liquidated debts owing debtor including tax refunds Give particulars

18 Equitable or future Interest life estates and rights or powers exermiddot cisable for the benefit of the debtor other than those listed in Schedule of Real Property

19 Contingent and nonmiddotcontingent interests in estate of a decedent death benefit plan life insurance policy or trust

20 Other contingent and unliquidated claims of every nature including tax refunds counterclaims of the debtor and rights to setoff claims Give estimated value of each

21 Patents copyrights and other intelmiddot lectual property Give partiCUlars

22 Licenses franchises and other general intangibles Give particulars

23 Automobiles trucks trailers and other vehicles and accessories

I

NONE DESCRIPTION AND LOCATION OF PROPERTY

Claremont College Retirement

Market Interface LLC

X

X

X X

Tax refund

X

X

X

X

X

1992 Ford Mustang

1972 Trimumph GT6

Ii (5 gtshy

- IshyW _ u z ~ 5 ciE z 0

m u 0

) 0 t

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

600000

10000

300000

300000

60000

I

1956 Ford F100 50000

24 Boats motors and accessories

25 Aircraft and accessories

26 Office eqUipment furnishings and supplies

X

X

FORM B6B-Cont

(12195)

Page 2

Page Total $ 1320000

In re Withers Peter Roy Douglas Case No ____------_---_____ Debtor (If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY

26 Office equipment furnishings and supplies (continued

27 Machinery fixtures equipment and supplies used in business

28 Inventory

29 Animals

30 Crop-growing or halYested Give particulars

31 Farming equipment and implements

32 Farm supplies chemicals and feed

33 Other personal property of any kind not already listed Itemize

NONE

X

X X X

X

X

X

DESCRIPTION AND LOCATION OF PROPERTY

2 (5 gtshyWbull I-_ II 23 )bull Iii

a Iii

~ 8 II) II ) 0 r

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WlTH-OUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

PL Computer and Printer 50000

Fax machine

I Page Total $ 52000

Schedule Total $ 3016000g

2000

~reWithers Peter Roy Douglas Case No (If known)Debtor

SCHEDULE B - PERSONAL PROPERTY

Except as directed below list all personal property of the debtor of whatever kind If the debtor has no property in one or more of the categories place an X in the appropriate position in the column labeled None If additional space is needed in any category attach a separate sheet properly identified with the case name case number and the number of the category If the debtor is married state whether husband wife or both own the property by placing an H W J or c in the column labeled Husband Wife Joint or Community If the debtor is an individual or a joint petition is filed state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt

Do not list interests in executory contracts and unexpired leases on this schedule List them in Schedule G - Executory Contracts and Unexpired Leases

If the property is being held for the debtor by someone else state that persons name and address under Description and Location of Property

TYPE OF PROPERTY NONE DESCRIPTION AND LOCATION

OF PROPERTY

shyz o gtshy t-WZ ~3_ E e 0 Z 0i a III 0 gt I

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

01 Cash on hand Cash 4000

02 Checking savings or other financial X accounts certificates of deposi~ or shares in banks savings and loan thrift building and loan and homeshystead associations or credit unions brokerage houses or cooperatives

03 Security deposits with public utilities Ms Diana Gaba-Landlord 950000 telephone companies landlords and others

04 Household goods and furnishings Household furnishings 210000 including audio video and computer equipment

05 Books pictures and other art Art and Books 180000 objects antiques stamp coin record tape compact disc and other collections or collectibles

06 Wearing apparel lMens wearing apparel 50000

Womens wearing apparel 100000

07 Furs and jewelry Personal jewelry 100000

08 Firearms and sports photographic Hand tools 50000 and other hobby equipment

09 Interests in insurance policies Life insurance no surrender 000 Name insurance company of each policy and itemize surrender or value refund value of each

10 Annuities Itemize and name X each issuer

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans Itemize

FORM B6B Page Total $ 1644000 (1295)

Page 1

In re Wi thers Peter Roy Douglas Case No _____________ Debtor (If known)

SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet)

TYPE OF PROPERTY

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans ltemize(continued)

12 Stock and interests in incorporated and unincorporated businesses Itemize

13 Interests in partnerships or jOint ventures itemize

14 Government and corporate bonds and other negotiable and nonshynegotiable instruments

15 Accounts receivable

16 Alimony maintenance support and property settlements to which the debtor is or may be entitled Give particulars

17 Other liquidated debts owing debtor including tax refunds Give particulars

18 Equitable or future Interest life estates and rights or powers exermiddot cisable for the benefit of the debtor other than those listed in Schedule of Real Property

19 Contingent and nonmiddotcontingent interests in estate of a decedent death benefit plan life insurance policy or trust

20 Other contingent and unliquidated claims of every nature including tax refunds counterclaims of the debtor and rights to setoff claims Give estimated value of each

21 Patents copyrights and other intelmiddot lectual property Give partiCUlars

22 Licenses franchises and other general intangibles Give particulars

23 Automobiles trucks trailers and other vehicles and accessories

I

NONE DESCRIPTION AND LOCATION OF PROPERTY

Claremont College Retirement

Market Interface LLC

X

X

X X

Tax refund

X

X

X

X

X

1992 Ford Mustang

1972 Trimumph GT6

Ii (5 gtshy

- IshyW _ u z ~ 5 ciE z 0

m u 0

) 0 t

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

600000

10000

300000

300000

60000

I

1956 Ford F100 50000

24 Boats motors and accessories

25 Aircraft and accessories

26 Office eqUipment furnishings and supplies

X

X

FORM B6B-Cont

(12195)

Page 2

Page Total $ 1320000

In re Withers Peter Roy Douglas Case No ____------_---_____ Debtor (If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY

26 Office equipment furnishings and supplies (continued

27 Machinery fixtures equipment and supplies used in business

28 Inventory

29 Animals

30 Crop-growing or halYested Give particulars

31 Farming equipment and implements

32 Farm supplies chemicals and feed

33 Other personal property of any kind not already listed Itemize

NONE

X

X X X

X

X

X

DESCRIPTION AND LOCATION OF PROPERTY

2 (5 gtshyWbull I-_ II 23 )bull Iii

a Iii

~ 8 II) II ) 0 r

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WlTH-OUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

PL Computer and Printer 50000

Fax machine

I Page Total $ 52000

Schedule Total $ 3016000g

2000

In re Wi thers Peter Roy Douglas Case No _____________ Debtor (If known)

SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet)

TYPE OF PROPERTY

11 Interests in IRA ERISA Keogh or other pension or profit sharing plans ltemize(continued)

12 Stock and interests in incorporated and unincorporated businesses Itemize

13 Interests in partnerships or jOint ventures itemize

14 Government and corporate bonds and other negotiable and nonshynegotiable instruments

15 Accounts receivable

16 Alimony maintenance support and property settlements to which the debtor is or may be entitled Give particulars

17 Other liquidated debts owing debtor including tax refunds Give particulars

18 Equitable or future Interest life estates and rights or powers exermiddot cisable for the benefit of the debtor other than those listed in Schedule of Real Property

19 Contingent and nonmiddotcontingent interests in estate of a decedent death benefit plan life insurance policy or trust

20 Other contingent and unliquidated claims of every nature including tax refunds counterclaims of the debtor and rights to setoff claims Give estimated value of each

21 Patents copyrights and other intelmiddot lectual property Give partiCUlars

22 Licenses franchises and other general intangibles Give particulars

23 Automobiles trucks trailers and other vehicles and accessories

I

NONE DESCRIPTION AND LOCATION OF PROPERTY

Claremont College Retirement

Market Interface LLC

X

X

X X

Tax refund

X

X

X

X

X

1992 Ford Mustang

1972 Trimumph GT6

Ii (5 gtshy

- IshyW _ u z ~ 5 ciE z 0

m u 0

) 0 t

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WITHshyOUT DEDUCTING ANY

SECURED CLAIM OR EXEMPTION

600000

10000

300000

300000

60000

I

1956 Ford F100 50000

24 Boats motors and accessories

25 Aircraft and accessories

26 Office eqUipment furnishings and supplies

X

X

FORM B6B-Cont

(12195)

Page 2

Page Total $ 1320000

In re Withers Peter Roy Douglas Case No ____------_---_____ Debtor (If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY

26 Office equipment furnishings and supplies (continued

27 Machinery fixtures equipment and supplies used in business

28 Inventory

29 Animals

30 Crop-growing or halYested Give particulars

31 Farming equipment and implements

32 Farm supplies chemicals and feed

33 Other personal property of any kind not already listed Itemize

NONE

X

X X X

X

X

X

DESCRIPTION AND LOCATION OF PROPERTY

2 (5 gtshyWbull I-_ II 23 )bull Iii

a Iii

~ 8 II) II ) 0 r

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WlTH-OUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

PL Computer and Printer 50000

Fax machine

I Page Total $ 52000

Schedule Total $ 3016000g

2000

In re Withers Peter Roy Douglas Case No ____------_---_____ Debtor (If known)

SCHEDULE B - PERSONAL PROPERTY

(Continuation Sheet)

TYPE OF PROPERTY

26 Office equipment furnishings and supplies (continued

27 Machinery fixtures equipment and supplies used in business

28 Inventory

29 Animals

30 Crop-growing or halYested Give particulars

31 Farming equipment and implements

32 Farm supplies chemicals and feed

33 Other personal property of any kind not already listed Itemize

NONE

X

X X X

X

X

X

DESCRIPTION AND LOCATION OF PROPERTY

2 (5 gtshyWbull I-_ II 23 )bull Iii

a Iii

~ 8 II) II ) 0 r

CURRENT MARKET VALUE OF

DEBTORS INTEREST IN PROPERTY WlTH-OUT DEDUCTING ANY

SECURED CLAIM

OR EXEMPTION

PL Computer and Printer 50000

Fax machine

I Page Total $ 52000

Schedule Total $ 3016000g

2000

~~ Withers Peter Roy Douglas Case no (If known)Debtor

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT

Debtor elects the exemptions to which debtor is entitled under

(Check one box)

IX] 11 USC sect 522 (b)(1) Exemptions provided in 11 USC sect 522 Cd) Note These exemptions are available only in certain states

D 11 USC sect 522 (b)2) Exemptions available under applicable nonbankruptcy federal laws state or local law where the debtors domicile has been located for the 180 days immediately preceding the filing of the petition or for a longer portion of the 18O-day period than in any other place and the debtors interest as a tenant by the entirety or joint tenant to the extent the interest is exempt from process under applicable nonbankruptcy law

rash

DESCRIPTION OF PROPERTY SPECIFY LAW

PROVIDING EACH EXEMPTION

~CP sect 703140(b) (5

VALUE OF CLAIMED

EXEMPTION

4000

CURRENT MARKET VALUE OF THE PROPERTY WITHOUT DEDUCTING

EXEMPTIONS

4000

~s Diana Gaba-Landlord KCP sect 703140 (b) (5)1 950000 950000

~ousehold shings ~CP sect 703140(b) (3 210000 210000

~rt and Books ~CP sect 703140(b) (3 180000 180000

Mens wearing apparel sect 703140 (b) (3 50000 50000

Womens wearing apparel sect 703140 (b) (3 100000 100000

~ersonal jewelry rCP sect 703140 (b) (4 100000 100000

fiand tools rCP sect 703140(b) (6)1 50000 50000

~laremont College Retirement ~CPsect703140(b) (lO)E 600000 600000

FORM86C (12195)

~re Withers Peter Roy Douglas Case no (If known)Debtor

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT (Continuation Sheet)

CURRENT MARKET VALUE OF THE PROPERTY

SPECIFY LAW VALUE OF DESCRIPTION OF PROPERTY PROVIDING EACH CLAIMED WITHOUT DEDUCTING

EXEMPTION EXEMPTION EXEMPTIONS

10000~arket Interface LLC ~CP sect 703 140 (b) (5) 10000

rrax refund ~CP sect 703140(b) (5) 300000 300000

1992 Ford Mustang CCP sect 703140(b) (2) 400000 3 00000

1972 Trimumph GT6 ~CP sect 703140(b) (5) 200000 60000

1956 Ford FIOO ~CP sect 703140 (b) (5) 100000 50000

PL Computer and Printer ~CP sect 703140 (b) (6) 50000 50000

Fax machine ~CP sect 703140 (b) (6) 2000 2000

I

FORMBBC (12195)

~re Withers Peter Roy Douglas Case no (If known)Debtor

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT (Continuation Sheet)

CURRENT MARKET VALUE OF THE PROPERTY

SPECIFY LAW VALUE OF DESCRIPTION OF PROPERTY PROVIDING EACH CLAIMED WITHOUT DEDUCTING

EXEMPTION EXEMPTION EXEMPTIONS

10000~arket Interface LLC ~CP sect 703 140 (b) (5) 10000

rrax refund ~CP sect 703140(b) (5) 300000 300000

1992 Ford Mustang CCP sect 703140(b) (2) 400000 3 00000

1972 Trimumph GT6 ~CP sect 703140(b) (5) 200000 60000

1956 Ford FIOO ~CP sect 703140 (b) (5) 100000 50000

PL Computer and Printer ~CP sect 703140 (b) (6) 50000 50000

Fax machine ~CP sect 703140 (b) (6) 2000 2000

I

FORMBBC (12195)

In re Withers I Peter Roy Douglas Case No Debtor (If known)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS

State the name mailing address including zip code and account number if any of all entities holding claims secured by property of the debtor as of the date of filing petition List creditors holding all types of secured interest such as judgment liens garnishments statutory liens mortgages deeds of trust and other security interests List creditors in alphabetical order to the extent practicable If all secured 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 u includeu u

the entity on the appropriate schedule of creditors and complete schedule H - Codebtors If a joint petition is filed state whether husband wife both of them or the marital community may be liable on each claim by placing an H W U J or C in the column labeled u Husbandu U

Wife Joint or Community u

If the claim is contingent place an X in the column labeled u Contingent If the claim is unliquidated place an X in the columnU U

labeled Unliquidated If the claim is disputed place an X in the column labeled Disputed (You may need to place an X U in more than oneu u U

of these three columns)

Report the total of all claims listed in this schedule in the box labeled Total on the last sheet of the completed schedule Report this total also on the Summary of Schedules

DO Check this box if debtor has no creditors holding secured claims to report on this Schedule D

DATE CLAIM WAS INCURRED AMOUNT

Q OF CREDITORS NAME AND It ~ NATURE OF LIEN AND I CLAIM UNSECUREDz

MAILING ADDRESS ~ ui~ DESCRIPTION AND MARKET w jsect

~ WITHOUT

PORTION~~ ()

~ DEDUCTINGVALUE OF PROPERTY zINCLUDING ZIP CODE w ~ VALUE OF IF ANYQ ~8 SUBJECT TO LIEN i COLLATERAL8 ~f5 0 z is() l

ACCOUNT NO

VALUE $

ACCOUNT NO

VALUE $

ACCOUNT NO

VALUE $

ACCOUNT NO

VALUE $

Continuation sheets attached Subtotal S 000 FORM B6D

OOO (1295)

Schedule Total $

In Re Debtor Case No (If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

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 entitled to priority should be listed in this schedule In the boxes provided on the attached sheets state the name and mailing address including zip code and account 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

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 appropriate schedule of creditors and complete Schedule H-Codebtors If a joint petition is filed state whether husband wife both of them or the marital community may be liable on each claim by placing an H WJ 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 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 coiumns)

Report the total of claims listed on each sheet in the box labeled Subtotal on each sheet Report the total of all claims listed on this Schedule E in the box labeled Totar on the last sheet of the completed schedule Repeat this total also on the Summary of Schedules

D 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)

Extensions of credit in an involuntary case

Claims arising in the ordinary course of the debtors 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 USC sect 507(a)(2)

Wages salaries and commissions

Wages salaries and commissions including vacation severance and sick leave pay owing to employees and commissions owing to qualifying independent sales representatives up to $4300 per person earned within 90 days immediately preceding the filing of the original petition or the cessation of business whichever occurred first to the extent provided in 11 USC sect 507(a)(3)

D Contributions to employee benefit plans

Money 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 USC sect 507(a)(4)

Certain farmers and fishermen

Claims of certain farmers and fishermen up to $4300 per farmer or fisherman against the debtor as provided in 11 USC sect 507(a)(5)

D Deposits by individuals

Claims of individuals up to a maximum of $1950 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 USC sect 507(a)(6)

D Alimony Maintenance or Support

Claims of a spouse former spouse or child of the debtor for alimony maintenance or support to the extent provided in 11 USC sect 507(a)(7)

Taxes and Certain Other Debts Owed to Governmental Units

Taxes customs duties and penalties owing to federal state and local governmental units as set forth in 11 USC sect 507(a)(8)

D Commitments to Maintain the Capital of an Insured Depository Institution

Claims 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 USC sect 507(a)(9)

bull Amounts are subject to adjustment on April 1 1998 and every three years thereafter with respect to cases commenced on or after the date of adjustment

1 86E continuation sheets attached (4198)

In re Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet) Taxes and Certain Other Debts Owed to Government Units

TYPE OF PRIORITY

CREDITORS NAME AND DATE CLAIM WAS MAILING ADDRESS I~ amp INCURRED AND CONSIDERATION

INCLUDING ZIP CODE ~ l

FOR CLAIM fB ~i0lt

815

ACCOUNT NO Income taxes6-4916

IInternal Revenue Servic ~4062FedBldgStop5022 300 NLos Angeles st ~os Angeles CA 90012

T NO I I INotice only-4916

Iu S Dept of Justice PO Box 683 ~en Franklin Station

ashington DC 20044

T NO I I INotice only-4916L

bs Attorneys Of ce FedBldgRm2315 300 N Los Angeles st ~os Angeles CA 90012

T NO IllNotice only-4916L

Franchise Tax Board lBankruptcy Unit PO Box 2052 Sacramento CA 95872

T NO I 1 IIncome Taxes -4916L

Franchise Tax Board PO Box 942867 Sacramento CA 94267

0

wZW

~ICI 0 zshy-) 0z- ~oJOZ

)

I I

I I I I

I I I I

III

I I I

TOTAL AMOUNT

OF CLAIM

9000001

0001

0001

O 00 i

600 001

AMOUNT ENTITLED TO

PRIORITY

900000

000

000

000

60000

Subtotal FORM BeE bull Cont Sheet nolof l sheets attached to Schedule of Creditors 60000 (TDtal of thIS page) (12195)Holding Priority Claims

Schedule Tota I 60000

In Re Debtor Case No (If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

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 entitled to priority should be listed in this schedule In the boxes provided on the attached sheets state the name and mailing address including zip code and account 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

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 appropriate schedule of creditors and complete Schedule H-Codebtors If a joint petition is filed state whether husband wife both of them or the marital community may be liable on each claim by placing an H WJ 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 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 coiumns)

Report the total of claims listed on each sheet in the box labeled Subtotal on each sheet Report the total of all claims listed on this Schedule E in the box labeled Totar on the last sheet of the completed schedule Repeat this total also on the Summary of Schedules

D 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)

Extensions of credit in an involuntary case

Claims arising in the ordinary course of the debtors 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 USC sect 507(a)(2)

Wages salaries and commissions

Wages salaries and commissions including vacation severance and sick leave pay owing to employees and commissions owing to qualifying independent sales representatives up to $4300 per person earned within 90 days immediately preceding the filing of the original petition or the cessation of business whichever occurred first to the extent provided in 11 USC sect 507(a)(3)

D Contributions to employee benefit plans

Money 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 USC sect 507(a)(4)

Certain farmers and fishermen

Claims of certain farmers and fishermen up to $4300 per farmer or fisherman against the debtor as provided in 11 USC sect 507(a)(5)

D Deposits by individuals

Claims of individuals up to a maximum of $1950 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 USC sect 507(a)(6)

D Alimony Maintenance or Support

Claims of a spouse former spouse or child of the debtor for alimony maintenance or support to the extent provided in 11 USC sect 507(a)(7)

Taxes and Certain Other Debts Owed to Governmental Units

Taxes customs duties and penalties owing to federal state and local governmental units as set forth in 11 USC sect 507(a)(8)

D Commitments to Maintain the Capital of an Insured Depository Institution

Claims 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 USC sect 507(a)(9)

bull Amounts are subject to adjustment on April 1 1998 and every three years thereafter with respect to cases commenced on or after the date of adjustment

1 86E continuation sheets attached (4198)

In re Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet) Taxes and Certain Other Debts Owed to Government Units

TYPE OF PRIORITY

CREDITORS NAME AND DATE CLAIM WAS MAILING ADDRESS I~ amp INCURRED AND CONSIDERATION

INCLUDING ZIP CODE ~ l

FOR CLAIM fB ~i0lt

815

ACCOUNT NO Income taxes6-4916

IInternal Revenue Servic ~4062FedBldgStop5022 300 NLos Angeles st ~os Angeles CA 90012

T NO I I INotice only-4916

Iu S Dept of Justice PO Box 683 ~en Franklin Station

ashington DC 20044

T NO I I INotice only-4916L

bs Attorneys Of ce FedBldgRm2315 300 N Los Angeles st ~os Angeles CA 90012

T NO IllNotice only-4916L

Franchise Tax Board lBankruptcy Unit PO Box 2052 Sacramento CA 95872

T NO I 1 IIncome Taxes -4916L

Franchise Tax Board PO Box 942867 Sacramento CA 94267

0

wZW

~ICI 0 zshy-) 0z- ~oJOZ

)

I I

I I I I

I I I I

III

I I I

TOTAL AMOUNT

OF CLAIM

9000001

0001

0001

O 00 i

600 001

AMOUNT ENTITLED TO

PRIORITY

900000

000

000

000

60000

Subtotal FORM BeE bull Cont Sheet nolof l sheets attached to Schedule of Creditors 60000 (TDtal of thIS page) (12195)Holding Priority Claims

Schedule Tota I 60000

In re Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

(Continuation Sheet) Taxes and Certain Other Debts Owed to Government Units

TYPE OF PRIORITY

CREDITORS NAME AND DATE CLAIM WAS MAILING ADDRESS I~ amp INCURRED AND CONSIDERATION

INCLUDING ZIP CODE ~ l

FOR CLAIM fB ~i0lt

815

ACCOUNT NO Income taxes6-4916

IInternal Revenue Servic ~4062FedBldgStop5022 300 NLos Angeles st ~os Angeles CA 90012

T NO I I INotice only-4916

Iu S Dept of Justice PO Box 683 ~en Franklin Station

ashington DC 20044

T NO I I INotice only-4916L

bs Attorneys Of ce FedBldgRm2315 300 N Los Angeles st ~os Angeles CA 90012

T NO IllNotice only-4916L

Franchise Tax Board lBankruptcy Unit PO Box 2052 Sacramento CA 95872

T NO I 1 IIncome Taxes -4916L

Franchise Tax Board PO Box 942867 Sacramento CA 94267

0

wZW

~ICI 0 zshy-) 0z- ~oJOZ

)

I I

I I I I

I I I I

III

I I I

TOTAL AMOUNT

OF CLAIM

9000001

0001

0001

O 00 i

600 001

AMOUNT ENTITLED TO

PRIORITY

900000

000

000

000

60000

Subtotal FORM BeE bull Cont Sheet nolof l sheets attached to Schedule of Creditors 60000 (TDtal of thIS page) (12195)Holding Priority Claims

Schedule Tota I 60000

~re Withers Peter Roy Douglas Case No (If known)

Debtor

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

State the name mailing address including zip code and account number if any of all entities holding unsecured claims without priority against the debtor or the property of the debtor as of the date of filing of the petition Do not include claims listed in Schedules 0 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 XU in the column labeled Codebtor include the entity on the appropriate schedule of creditors and complete Schedule H - Codebtors If a joint petition is filed state whether husband wife both of them or the marital community may be liable 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 and X in the column labeled Contingent If the claim is unliquidated place an X in the column labeled Unliquidated If the claim is disputed place an XU in the column labeled Disputed (You may need to place an X in more than one of these three columns)

Report total of all claims listed on this schedule in the box labeled Total on the last sheet of the completed schedule Report this total total on the Summary of Schedules

D Check this box if debtor has no creditors holding unsecured nonpriority claims to report on this Schedule F

II DATE CLAIM WAS INCURRED CREDITORS NAME AND

I~ ~ AND CONSIDERATION FOR CLAIM MAILING ADDRESS

i IF CLAIM IS SUBJECT TO INCLUDING ZIP CODE II SETOFF SO STATE

ACCOUNT NO

-4916-1 [~99 s through September

Sallie Mae Servicing POBox 11449 Killeen TX 76547-1449

ACCOUNT NO

5468470390027802 II es through September

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

ACCOUNT NO

0661036028776 II turchases through September Sears 999

Payment Center PO Box 182149 Columbus OH 43218-2149

ACCOUNT NO

4128003634514379 I turchases September

Citibank 999

PO Box 6415 The Lakes NV 88901-6415

~lil~1 z 0 u

I I I I

I I I I

I I I I

II I I

AMOUNT OF CLAIM

3174734

919648

294737

1319881

I I I 5709000Ij I Icontinuation sheets attached

FORM 86F (1295)

In re Withers Peter Roy Douglas Case No

Debtor (If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

DATE CLAIM WAS INCURRED c ~ w AMOUNTCREDITORS NAME AND 0 AND CONSIDERATION FOR CLAIM iii ~ 0 ~ c OF CLAIM MAILING ADDRESS i IF CLAIM IS SUBJECT TO CI c w~ 3m z ~

INCLUDING ZIP CODE w SETOFF SO STATE j a c u z J D

I)0 0 8 z0 is

ACCOUNT NO 5445-1669-62910-1147 Purchases through September 439873

Household Bank 1999 PO Box 7036 Anaheim CA 92850-7036

ACCOUNT NO

575746T Services through September 9500

UCLA Dental Clinic 1999 PO Box 961668 Los Angeles CA 90095

ACCOUNT NO

7001-1650-0244-7220 Purchases through September 30440

HRS USA 1999 PO Box 7010 Anaheim CA 92850-7010

ACCOUNT NO

4428-0007-7491-2873 Purchases through September 527011

Providian 1999 PO Box 4017 Woburn MA 01888-4017

ACCOUNT NO

0970 Services through September 100400

Gumbiner Savett Finke 1999 1723 Cloverfield Blvd Santa MonicaCA 90404

Sheet no ~_ of 2 sheets attached to Schedule of Page Total $ 1107224 Creditors Holding Unsecured Nonpriority Claims

Inre Wi thers Peter Roy Douglas Case No

Debtor (If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

CREDITORS NAME AND MAILING ADDRESS

INCLUDING ZIP CODE

0 g ID w c 0 0

i

~ 0 u 3

DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM

IF CLAIM IS SUBJECT TO SETOFF SO STATE

~

ffi C) z i= Z

8

c w ~ c

~ J z gt

c w 5 0 I)

0

AMOUNT OF CLAIM

ACCOUNT NO EC025846 Notice only 000

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

ACCOUNT NO 1314121 Notice only 000

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

ACCOUNT NO

ACCOUNT NO

ACCOUNT NO

Sheet no L of L sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims

Page Total

Schedule Total

$

$

000 6816224

Inre Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

Describe all executory contracts of any nature and all unexpired leases of real or personal property Include any timeshare interests

State nature of debtors interest in contract ie Purchaser Agent etc State whether debtor is the lessor or lessee of a lease

Provide the names and complete mailing addresses of all other parties to each lease or contract described

NOTE A party listed on this schedule will not receive notice of the filing of this case unless the party is also scheduled in the appropriate schedule of creditors

o Check this box if debtor has no executory contracts or unexpired leases

NAME AND MAILING ADDRESS INCLUDING ZIP CODE OF OTHER PARTIES TO LEASE OR CONTRACT

Ms Diana Gaba Landlord

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTORS INTEREST STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY STATE CONTRACT

NUMBER OF ANY GOVERNMENT CONTRACT

Residential Lease September 2000

Form 86G

(12195)

lore Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE H - CODEBTORS

Provide the information requested concerning any person or entity other than a spouse in a joint case that is also liable on any debts listed by debtor in the schedules of creditors Include all guarantors and co-signers In community property states a married debtor not filling a joint case should report the name and address of the nondebtor spouse on this schedule Include all names used by the nondebtorspouse during the six years immediately preceding the commencement of this case

00 Check this box if debtor has no codebtors

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

Form fl6H (12195)

In re withers Peter Roy Douglas Case No ________________________

Debtor (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled Spouse must be completed in all cases filed by joint debtors and by married debtor in a chapter 12 or 13 case whether or not a jOint petition Is filed unless the spouses are separated and a joint patition is not filed

DEBTORS MARITAL STATUS

arried

DEPENDENTS OF DEBTOR AND SPOUSE NAMES

AGE

RELATIONSHIP

EMPLOYMENT DEBTOR SPOUSE

INCOME (Estimate of average monthly income)

Current monthly gross wages salary and commissions

(pro rate if not paid monthly)

Estimated monthly overtime

$ $

DEBTOR

583334 000

SPOUSE

$ $ Q 00

SUBTOTAL $ 583334 $

LESS PAYROLL DEDUCTIONS a Payroll taxes and social security

b Insurance

c Union dues

d Other (Specify Sl1pervjSQr Fees

$

$

$

$

22]6 192

0 0

00 z 9 00 00

$ $ 000 $ 000 $ 00

SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$ ~~ Q~ I

Regular income from operation of business or profession or farm

(attach detailed statement)

$ 000 $ 000

Income from real property $ 000 $ 000

Interest and dividends $ 000 $ o 00

Alimony maintenance or support payments payable to the debtor for the

debtors use or that of dependents listed above $ Q QQ $ QQO

Social security or other government assistance

(Specify $ 0 00 $ 0 00

Pension or retirement income $ $ o 00

Other monthly income $ 0 00 $ 000

(Specify $ 0 00 $ 000

$ 0 DO $ 0 00

TOTAL MONTHLY INCOME $ 3424 55 $ 00

TOTAL COMBINED MONTHLY INCOME $5J 9955 (Report also on Summary of Schedules)

Describe any increase or decrease of more than 10 in any of the above categories anticipated to occur within the year

following the filing of this document

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

Inre Wi thers Peter Roy Douglas Case No

Debtor (If known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

(Continuation Sheet)

CREDITORS NAME AND MAILING ADDRESS

INCLUDING ZIP CODE

0 g ID w c 0 0

i

~ 0 u 3

DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM

IF CLAIM IS SUBJECT TO SETOFF SO STATE

~

ffi C) z i= Z

8

c w ~ c

~ J z gt

c w 5 0 I)

0

AMOUNT OF CLAIM

ACCOUNT NO EC025846 Notice only 000

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

ACCOUNT NO 1314121 Notice only 000

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

ACCOUNT NO

ACCOUNT NO

ACCOUNT NO

Sheet no L of L sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims

Page Total

Schedule Total

$

$

000 6816224

Inre Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

Describe all executory contracts of any nature and all unexpired leases of real or personal property Include any timeshare interests

State nature of debtors interest in contract ie Purchaser Agent etc State whether debtor is the lessor or lessee of a lease

Provide the names and complete mailing addresses of all other parties to each lease or contract described

NOTE A party listed on this schedule will not receive notice of the filing of this case unless the party is also scheduled in the appropriate schedule of creditors

o Check this box if debtor has no executory contracts or unexpired leases

NAME AND MAILING ADDRESS INCLUDING ZIP CODE OF OTHER PARTIES TO LEASE OR CONTRACT

Ms Diana Gaba Landlord

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTORS INTEREST STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY STATE CONTRACT

NUMBER OF ANY GOVERNMENT CONTRACT

Residential Lease September 2000

Form 86G

(12195)

lore Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE H - CODEBTORS

Provide the information requested concerning any person or entity other than a spouse in a joint case that is also liable on any debts listed by debtor in the schedules of creditors Include all guarantors and co-signers In community property states a married debtor not filling a joint case should report the name and address of the nondebtor spouse on this schedule Include all names used by the nondebtorspouse during the six years immediately preceding the commencement of this case

00 Check this box if debtor has no codebtors

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

Form fl6H (12195)

In re withers Peter Roy Douglas Case No ________________________

Debtor (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled Spouse must be completed in all cases filed by joint debtors and by married debtor in a chapter 12 or 13 case whether or not a jOint petition Is filed unless the spouses are separated and a joint patition is not filed

DEBTORS MARITAL STATUS

arried

DEPENDENTS OF DEBTOR AND SPOUSE NAMES

AGE

RELATIONSHIP

EMPLOYMENT DEBTOR SPOUSE

INCOME (Estimate of average monthly income)

Current monthly gross wages salary and commissions

(pro rate if not paid monthly)

Estimated monthly overtime

$ $

DEBTOR

583334 000

SPOUSE

$ $ Q 00

SUBTOTAL $ 583334 $

LESS PAYROLL DEDUCTIONS a Payroll taxes and social security

b Insurance

c Union dues

d Other (Specify Sl1pervjSQr Fees

$

$

$

$

22]6 192

0 0

00 z 9 00 00

$ $ 000 $ 000 $ 00

SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$ ~~ Q~ I

Regular income from operation of business or profession or farm

(attach detailed statement)

$ 000 $ 000

Income from real property $ 000 $ 000

Interest and dividends $ 000 $ o 00

Alimony maintenance or support payments payable to the debtor for the

debtors use or that of dependents listed above $ Q QQ $ QQO

Social security or other government assistance

(Specify $ 0 00 $ 0 00

Pension or retirement income $ $ o 00

Other monthly income $ 0 00 $ 000

(Specify $ 0 00 $ 000

$ 0 DO $ 0 00

TOTAL MONTHLY INCOME $ 3424 55 $ 00

TOTAL COMBINED MONTHLY INCOME $5J 9955 (Report also on Summary of Schedules)

Describe any increase or decrease of more than 10 in any of the above categories anticipated to occur within the year

following the filing of this document

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

Inre Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES

Describe all executory contracts of any nature and all unexpired leases of real or personal property Include any timeshare interests

State nature of debtors interest in contract ie Purchaser Agent etc State whether debtor is the lessor or lessee of a lease

Provide the names and complete mailing addresses of all other parties to each lease or contract described

NOTE A party listed on this schedule will not receive notice of the filing of this case unless the party is also scheduled in the appropriate schedule of creditors

o Check this box if debtor has no executory contracts or unexpired leases

NAME AND MAILING ADDRESS INCLUDING ZIP CODE OF OTHER PARTIES TO LEASE OR CONTRACT

Ms Diana Gaba Landlord

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTORS INTEREST STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY STATE CONTRACT

NUMBER OF ANY GOVERNMENT CONTRACT

Residential Lease September 2000

Form 86G

(12195)

lore Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE H - CODEBTORS

Provide the information requested concerning any person or entity other than a spouse in a joint case that is also liable on any debts listed by debtor in the schedules of creditors Include all guarantors and co-signers In community property states a married debtor not filling a joint case should report the name and address of the nondebtor spouse on this schedule Include all names used by the nondebtorspouse during the six years immediately preceding the commencement of this case

00 Check this box if debtor has no codebtors

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

Form fl6H (12195)

In re withers Peter Roy Douglas Case No ________________________

Debtor (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled Spouse must be completed in all cases filed by joint debtors and by married debtor in a chapter 12 or 13 case whether or not a jOint petition Is filed unless the spouses are separated and a joint patition is not filed

DEBTORS MARITAL STATUS

arried

DEPENDENTS OF DEBTOR AND SPOUSE NAMES

AGE

RELATIONSHIP

EMPLOYMENT DEBTOR SPOUSE

INCOME (Estimate of average monthly income)

Current monthly gross wages salary and commissions

(pro rate if not paid monthly)

Estimated monthly overtime

$ $

DEBTOR

583334 000

SPOUSE

$ $ Q 00

SUBTOTAL $ 583334 $

LESS PAYROLL DEDUCTIONS a Payroll taxes and social security

b Insurance

c Union dues

d Other (Specify Sl1pervjSQr Fees

$

$

$

$

22]6 192

0 0

00 z 9 00 00

$ $ 000 $ 000 $ 00

SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$ ~~ Q~ I

Regular income from operation of business or profession or farm

(attach detailed statement)

$ 000 $ 000

Income from real property $ 000 $ 000

Interest and dividends $ 000 $ o 00

Alimony maintenance or support payments payable to the debtor for the

debtors use or that of dependents listed above $ Q QQ $ QQO

Social security or other government assistance

(Specify $ 0 00 $ 0 00

Pension or retirement income $ $ o 00

Other monthly income $ 0 00 $ 000

(Specify $ 0 00 $ 000

$ 0 DO $ 0 00

TOTAL MONTHLY INCOME $ 3424 55 $ 00

TOTAL COMBINED MONTHLY INCOME $5J 9955 (Report also on Summary of Schedules)

Describe any increase or decrease of more than 10 in any of the above categories anticipated to occur within the year

following the filing of this document

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

lore Withers Peter Roy Douglas Case No Debtor (If known)

SCHEDULE H - CODEBTORS

Provide the information requested concerning any person or entity other than a spouse in a joint case that is also liable on any debts listed by debtor in the schedules of creditors Include all guarantors and co-signers In community property states a married debtor not filling a joint case should report the name and address of the nondebtor spouse on this schedule Include all names used by the nondebtorspouse during the six years immediately preceding the commencement of this case

00 Check this box if debtor has no codebtors

NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

Form fl6H (12195)

In re withers Peter Roy Douglas Case No ________________________

Debtor (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled Spouse must be completed in all cases filed by joint debtors and by married debtor in a chapter 12 or 13 case whether or not a jOint petition Is filed unless the spouses are separated and a joint patition is not filed

DEBTORS MARITAL STATUS

arried

DEPENDENTS OF DEBTOR AND SPOUSE NAMES

AGE

RELATIONSHIP

EMPLOYMENT DEBTOR SPOUSE

INCOME (Estimate of average monthly income)

Current monthly gross wages salary and commissions

(pro rate if not paid monthly)

Estimated monthly overtime

$ $

DEBTOR

583334 000

SPOUSE

$ $ Q 00

SUBTOTAL $ 583334 $

LESS PAYROLL DEDUCTIONS a Payroll taxes and social security

b Insurance

c Union dues

d Other (Specify Sl1pervjSQr Fees

$

$

$

$

22]6 192

0 0

00 z 9 00 00

$ $ 000 $ 000 $ 00

SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$ ~~ Q~ I

Regular income from operation of business or profession or farm

(attach detailed statement)

$ 000 $ 000

Income from real property $ 000 $ 000

Interest and dividends $ 000 $ o 00

Alimony maintenance or support payments payable to the debtor for the

debtors use or that of dependents listed above $ Q QQ $ QQO

Social security or other government assistance

(Specify $ 0 00 $ 0 00

Pension or retirement income $ $ o 00

Other monthly income $ 0 00 $ 000

(Specify $ 0 00 $ 000

$ 0 DO $ 0 00

TOTAL MONTHLY INCOME $ 3424 55 $ 00

TOTAL COMBINED MONTHLY INCOME $5J 9955 (Report also on Summary of Schedules)

Describe any increase or decrease of more than 10 in any of the above categories anticipated to occur within the year

following the filing of this document

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

In re withers Peter Roy Douglas Case No ________________________

Debtor (If known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled Spouse must be completed in all cases filed by joint debtors and by married debtor in a chapter 12 or 13 case whether or not a jOint petition Is filed unless the spouses are separated and a joint patition is not filed

DEBTORS MARITAL STATUS

arried

DEPENDENTS OF DEBTOR AND SPOUSE NAMES

AGE

RELATIONSHIP

EMPLOYMENT DEBTOR SPOUSE

INCOME (Estimate of average monthly income)

Current monthly gross wages salary and commissions

(pro rate if not paid monthly)

Estimated monthly overtime

$ $

DEBTOR

583334 000

SPOUSE

$ $ Q 00

SUBTOTAL $ 583334 $

LESS PAYROLL DEDUCTIONS a Payroll taxes and social security

b Insurance

c Union dues

d Other (Specify Sl1pervjSQr Fees

$

$

$

$

22]6 192

0 0

00 z 9 00 00

$ $ 000 $ 000 $ 00

SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$ ~~ Q~ I

Regular income from operation of business or profession or farm

(attach detailed statement)

$ 000 $ 000

Income from real property $ 000 $ 000

Interest and dividends $ 000 $ o 00

Alimony maintenance or support payments payable to the debtor for the

debtors use or that of dependents listed above $ Q QQ $ QQO

Social security or other government assistance

(Specify $ 0 00 $ 0 00

Pension or retirement income $ $ o 00

Other monthly income $ 0 00 $ 000

(Specify $ 0 00 $ 000

$ 0 DO $ 0 00

TOTAL MONTHLY INCOME $ 3424 55 $ 00

TOTAL COMBINED MONTHLY INCOME $5J 9955 (Report also on Summary of Schedules)

Describe any increase or decrease of more than 10 in any of the above categories anticipated to occur within the year

following the filing of this document

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

~reWithers Peter Roy Douglas Case No _______________________________

Debtor (If known)

SCHEDULE J ~ CURRENT EXPENDITURES OF INDIVIDUAL DEBTORS

Complete this schedule by estimating the average monthly expenses of the debtor and the debtors family Pro rate any payments made bi-weekly quarterly semi-annually or annually to show monthly rate

D Check this box if a joint petition is filed and debtors spouse maintains a separate household Complete a separate schedule of expenditures

labeled Spouse

Rent or home mortgage payment (include lot rented for mobile home) $ 330000 Are real estate taxes included Yes X No ____

Is property insurance included Yes X No ____

Utilities Electricity and heating fuel $ ] 00 00 Water and sewer $ JBOOO Telephone $ 40000 Other $ 5QQQ

Home Maintenance (Repairs and upkeep) $ JOOOO Food $ 5]5 00 Clothing $ IOOOO Laundry and dry cleaning $ 3000 Medical and dental expenses $ 2500 Transportation (not including car payments) $ 48QQQ Recreation clubs and entertainment newspapers magazines etc $ 5000 Charitable contributions $ 30 00 Insurance (not deducted from wages or included in home mortgage payments)

Homeowners or renters $ Ufe $ Health $ Auto $ Other $

Taxes (not deducted from wages or included in home mortgage payments)

(Specify)

Installment payments (In chapter 12 and 13 cases do not list payments to be included in the plan)

Auto $ 000 Other Sa]] ie Mae non-dischargeable debt $ 28814 Other IRS Tusta 11 ement payment $ J 65 00

Alimony maintenance and support paid to others $ QQO Payments for support of additional dependents not living at your home $ 200 00 Regular expenses from operation of business profession or farm (attach detailed statement) $ 000 Other $ DOQ

TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)

(FOR CHAPTER 12 AND 13 DEBTORS ONLy) Provide the information requested below including whether plan payments are to be made bi-weekly monthly annually or at some other regUlar interval

A Total projected monthly income $ QDO B Total prOjected monthly expenses $ 000 C Excess income (A minus B) $ DOO D Total amount to be paid into plan each $ OOQ

(interval) FORM B6J (12195)

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

-----------------------------------------------------------------------

FORM Ba ConI (12194)

In re withers I Peter Roy Douglas Case No Debtor (If known)

DECLARATION CONCERNING DEBTORS SCHEDULES

DECLARATION UNDER PENALlY OF PERJURY BY INDIVIDUAL DEBTOR

I declare under penalty of perjury that I have read the foregoing summary and schedules consisting of 1~6L-=====--==--===---______ (Total ShOwn on SUllllllafY page pIUs IJ

sheets and that they are true and correct to the best of my knowledge information and belief

Qate -26~2~ ~~

Debtor

Withers Peter Roy Douglas

Date Signature (Joint Debtor if

(If joint case both spouses must sign)

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certity that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document lor compensation and that I have provided the debtor with a copy Of this document

Printed or 1)Iped Name of Bankruptcy Petition Preparer Social Security No

Address

Names and SOCial Security numbers of all other individuals WhO prepared or assisted in preparing this document

If more than one person prepared this document attach additional signed Sheets conforming to the appropriate Official Form for eaCh person

x______________~__---------shySignature of Bankruptcy Petition Preparer Date

A bankruptcypetition pieparers ailUre 0 cOmpyWith the pioVisions Of title f 1 and the Federal RUles Of Bankruptcy Procedure may result in fines or imPfisonment or bOth

11 USC sect 110 18 USC sect f56

DECLARATION UNDER PENALlY OF PERJURY ON BEHALF OF A CORPORATION OR PARTNERSHIP

I the [the president or other officer or an authorized agent of the corporation or a member or an authorized agent

of the partnership) of the __ (corporation or partnership) named as debtor in this case declare under penalty or perjury

deciars that I have read the foregoing summary and schedules consisting or --------c-c----------------- Sheets and that they are true and

correct 10 the best of my knowledge information and betisf (Total shOwn on summary page Plus fJ

Oale______________________________ Signature

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor)

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

FORM 1 (Rev 12194)

FORM 7 STATEMENT OF FINANCIAL AFFAIRS

UNITED STATES BANKRUPTCY COURT ___Ce=nt=r~a=-l DISTRICTOF California

In Re witherslaquo Peter Roy Douglas Case No (If knOWn)(Name)

Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor Spouses filing a jOint petition may file a single statement on whiCh the information for both spouses is combined If the case is filed under chapter 12 or chapter 13 a married debtor must furnish information for both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed An individual debtor engaged in business as a sole proprietor partner family farmer or self-employed professional should provide the information requested on this statement concerning all such activities as well as the individualS personal affairs

Questions 1 15 are to be completed by all debtors Debtors that are or have been in business as defined below also must complete Questions 16 21 If the answer to any question is None or the question is not applicable mark the box labeled None If additional space is needed for the answer to any question use and attach a separate sheet properly identified with the case name case number (if known) and the number of the Question

DEFINITIONS

In business A debtor is in business for the purpose of this form if the debtor is a corporation or partnerShip An individual debtor is in business for the purpose of this form if the debtor is or has been within the two years immediately preceding the filing of thiS bankruptcy case any of the following an officer director managing executive or person in control of a corporation a partner other than a limited partner of a partnership a sole proprietor or self-employed

HlnsiderH The term insider includes but is not limited to relatives of the debtor general partners of the debtor and their relatives corporations of which the debtor is an officer director or a person in control officers directors and any person in control of a corporate debtor and their relatives affiliates of the debtor and insiders of such affiliates any managing agent of the debtor 11 USC sect 101(30)

1 Income from employment or operation of business

None State the gross amount of income the debtor has received from employment trade or profession or from operation of the debtors business from the beginning of this calendar year to the date this case was commenced State also the gross amounts received during the two years immediately preceding this calendar year (A debtor that maintains or has maintained financial records on the basis of a fiscal rather than a calendar year may report fiscal year income Identify the beginning and ending dates of the debtors fiscal year) If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed u unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE (if more than one)

$6879600 Estimated income 1999-to date $2427900 Estimated income 1998 $3100000 Spouses estimated income 1999-to date $2000000 Spouses estimated income 1998 $2400000 Spouses estimated income 1997

None

None

None [XI

None

2 Income other than from employment or operation of business

State the amount of income received by the debtor other than from employment trade profession or operation of the debtors business during the two years immediately preceding the commencement of this case Give particulars If a joint petition is filed state income for each spouse separately (Married debtors filing under chapter 12 or chapter 13 must state income for each spouse whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

AMOUNT SOURCE $1100000 Part time Teaching

3 Payment to creditors

a List all payments on loans installment purchases of goods or services and other debts aggregating more than $600 to any creditor made within 90 days immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

DATES OF AMOUNT AMOUNT NAME AND ADDRESS OF CREDITOR PAYMENTS PAID STILL OWING GTE 092599 $65000 $40000 Consumer Credit 092799 $821 00 Counseling Service

b List all payments made Within one year immediately preceding the commencement of this case to or for the benefit of creditors who are or were insiders (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESSOF CREDITOR DATE OF AMOUNT AMOUNT AND RELATIONSHIP TO DEBTOR PAYMENT PAID STILL OWING

4 Suits and administrative proceedings executions garnishments and attachments

a List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding the filing of this bankruptcy case (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed unless the spouses are separated and a jOint petition is not filed)

CAPTION OF SUIT COURT OR AGENCY STATUS OR AND CASE NUMBER NATURE OF PROCEEDING AND LOCATION DISPOSITION Naturally New Zeeland Products Inc v The Kinesis syndicat Ets et al Case No EC025846 Pending Breach of Contract Action

None IX]

b Describe all property that has been attached garnished or seized under any legal or equitable process within one year immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF PERSON FOR WHOSE

BENEFIT PROPERTY WAS SEIZED DATE OF

SEIZURE

DESCRIPTION AND VALUE OF

PROPERTY

5 Repossessions foreclosures and returns

None List all property that has been repossessed by a creditor sold at a foreclosure sale transferred IX] through a deed in lieu of foreclosure or returned to the seller within one year immediately preceding the

commencement of thiS case (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

DATE OF REPOSSESSION DESCRIPTION NAME AND ADDRESS FORECLOSURE SALE AND VALUE OF

OF CREDITOR OR SELLER TRANSFER OR RETURN PROPERTY

6 Assignments and receiverships

None IX]

a Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include any assignment by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF ASSIGNEE

DATE OF ASSIGNMENT

TERMS OF ASSIGNMENT

OR SETTLEMENT

None 00

b List all property which has been In the hands of a custodian receiver or a court-appointed official within one year immedIately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF CUSTODIAN

NAME AND LOCATION OF COURT

CASE TITLE amp NUMBER DATE OF ORDER

DESCRIPTION AND VALUE OF

PROPERTY

7 Gifts

None 00

List all gifts or commencement of this in value per individual recipient (Married debeither or both spouses joint petition is not filed)

chcase

ftors

wh

aritable contributions made except ordinary and usual gifts

amily member and charitable filing under chapter 12 or chaether or not a joint petition is

within one year immediately preceding the to family members aggregating less than $200

contributions aggregating less than $100 per pter 13 must include gifts or contributions by filed unless the spouses are separated and a

NAME AND ADDREOF PERSON

OR ORGANIZATIO

SS

N

RELATIONSHIP TO DEBTOR

IF ANY D

OF GIFT ATE

DESCRIPTION AND VALUE OF GIFT

8 Losses

None 00

List all losses from commencement of this chapter 12 or chapter filed unless the spouses

fire case

13 must are s

theft other casualty or gambor since the commencement

include losses by either or eparated and a joint petition is not

ling within one year immediately preceding the of this case (Married debtors filing under

both spouses whether or not a joint petition is filed)

DESCRIPTION AND VALUE OF

PROPERTY L

DESCRIPTION OF CIRCUMSTAOSS WAS COVERED IN WHOLE

BY INSURANCE GIVE PAR

NCES AND IF OR IN PART TICULARS

DATE OF LOSS

9 Payments related to debt counseling or bankruptcy

None List all payments made or property transferred by or on behalf of the debtor to any persons including attorneys for consultation concerning debt consolidation relief under the bankruptcy law or preparation of a petition in bankruptcy within one year immediately preceding the commencement of this case

DATE OF PAYMENT AMOUNT OF MONEY OR NAME AND ADDRESS NAME OF PAYER IF DESCRIPTION AND VALUE

OF PAYEE OTHER THAN DEBTOR OF PROPERTY

Jeffrey S Shin8929 Wilshire Blvd100 Beverly Hills

bro

CA

tAPLC

90211

0100 $97500 for attorney fees

10 other transfers

None 00

a List all other property other than property transferred in the ordinary course of business or financial affairs of the debtor transferred either absolutely or as security within one year immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF TRANSFEREE RELATIONSHIP TO DEBTOR DATE

DESCRIBE PROPERlY TRANSFERRED

AND VALUE RECEIVED

11 Closed financial accounts

None 00

List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed sold or otherwise transferred within one year immediately preceding the commencement of this case Include checking savings or other financia accounts certificates of deposit or other instruments shares and share accounts hed in banks credit unions pension funds cooperatives associations brokerage houses and other financial institutions (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or both spouses whether or not a joint petition IS filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF INSTITUTION

lYPE AND NUMBER OF ACCOUNT AND

AMOUNT OF FINAL BALANCE

AMOUNT AND DATE OF SALE OR CLOSING

12 Safe deposit boxes

None 00

List each safe deposit or other valuables within one debtors filing under chapter spouses whether or not a petition is not filed)

other box or depository in which the debtor has or had securities cash or year immediately preceding the commencement of this case (Married

12 or chapter 13 must include boxes or depositories of either or both joint petition is filed unless the spouses are separated and a joint

NAME AND ADDRESS OF BANK OR

OTHER DEPOSITORY

NAMES AND ADDRESSES OF THOSE WITH ACCESS

TO THE BOX OR DEPOSITORY

DESCRIPTION OF

CONTENTS

DATE OR TRANSFER OR SURRENDER

IF ANY

13 Setoffs

None [Xl

List all setoffs made by any creditor including a bank against a debt or deposit of the debtor within 90 days preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF CREDITOR DATE OF SETOFF

AMOUNT OF SETOFF

14 Property held for another person

None lXJ

List all property by another person that the debtor holds or controls

NAME AND ADDRESS OF OWNER

DESCRIPTION AND VALUE OF PROPERTY LOCATION OF PROPERTY

15 Prior address of debtor

None If the debtor has moved within the two years immediately preceding the commencement of this case list all premises which the debtor occupied during that period and vacated prior to the commencement of this case If a joint petition is filed report also any separate adress of either spouse

ADDRESS NAME USED DATES OF OCCUPANCY

2100 Stradella Road

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been within the two years immediately preceding the commencement of this case any of the following an Officer director managing executive or owner of more than 5 percent of the voting securities of a corporation a partner other than a limited partner of a partnership a Sole proprietor or otherwise self-employed

(An individual or a joint debtor should complete this portion of the statement only if the debtor is or has been in business as defined above within the two years immediately preceding the commencement of this case)

16 Nature location and name of business

None o a If the debtor is an individual list the names and addresses of all businesses in which the debtor was

an Officer director partner or managing executive of a corporation partnerShip sole proprietorship or was a self-employed profeSSional within two years immediately preceding the commencement of this case or in which the debtor owned 5 percent or more of the voting or equity securities within the two years immediately preceding the commencement of this case

b If the debtor is a partnership list the names and addresses of al businesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

c If the debtor is a corporation list the names and addresses of all bUSinesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

BEGINNING AND ENDING NAME ADDRESS NATURE OF BUSINESS DATES OF OPERATION

Market Interface LLC 111 Stradella RoadLos Angeles CA 90077 Marketing April 1997-0ct 1999 Self-owned

17 Books records and financial statements

None a List all bookkeepers and accountants who Within the six years immediately preceding the filing of o this bankruptcy case kept or supervised the keeping of the books of account and records of the debtor

NAME AND ADDRESS DATES SERVICES RENDERED Gumbiner SavettFinkell 1998 Taxes 1723 Cloverfield Blvd Santa Monica CA 90404 Curtis DaltonCPA 1999 Taxes

None 00

b List all firms or individuals who within the two years Immediately preceding the filing of this bankruptcy case have audited the books of account and records or prepared a financial statement of the debtor

NAME ADDRESS DATES SERVICES RENDERED

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

7 Gifts

None 00

List all gifts or commencement of this in value per individual recipient (Married debeither or both spouses joint petition is not filed)

chcase

ftors

wh

aritable contributions made except ordinary and usual gifts

amily member and charitable filing under chapter 12 or chaether or not a joint petition is

within one year immediately preceding the to family members aggregating less than $200

contributions aggregating less than $100 per pter 13 must include gifts or contributions by filed unless the spouses are separated and a

NAME AND ADDREOF PERSON

OR ORGANIZATIO

SS

N

RELATIONSHIP TO DEBTOR

IF ANY D

OF GIFT ATE

DESCRIPTION AND VALUE OF GIFT

8 Losses

None 00

List all losses from commencement of this chapter 12 or chapter filed unless the spouses

fire case

13 must are s

theft other casualty or gambor since the commencement

include losses by either or eparated and a joint petition is not

ling within one year immediately preceding the of this case (Married debtors filing under

both spouses whether or not a joint petition is filed)

DESCRIPTION AND VALUE OF

PROPERTY L

DESCRIPTION OF CIRCUMSTAOSS WAS COVERED IN WHOLE

BY INSURANCE GIVE PAR

NCES AND IF OR IN PART TICULARS

DATE OF LOSS

9 Payments related to debt counseling or bankruptcy

None List all payments made or property transferred by or on behalf of the debtor to any persons including attorneys for consultation concerning debt consolidation relief under the bankruptcy law or preparation of a petition in bankruptcy within one year immediately preceding the commencement of this case

DATE OF PAYMENT AMOUNT OF MONEY OR NAME AND ADDRESS NAME OF PAYER IF DESCRIPTION AND VALUE

OF PAYEE OTHER THAN DEBTOR OF PROPERTY

Jeffrey S Shin8929 Wilshire Blvd100 Beverly Hills

bro

CA

tAPLC

90211

0100 $97500 for attorney fees

10 other transfers

None 00

a List all other property other than property transferred in the ordinary course of business or financial affairs of the debtor transferred either absolutely or as security within one year immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF TRANSFEREE RELATIONSHIP TO DEBTOR DATE

DESCRIBE PROPERlY TRANSFERRED

AND VALUE RECEIVED

11 Closed financial accounts

None 00

List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed sold or otherwise transferred within one year immediately preceding the commencement of this case Include checking savings or other financia accounts certificates of deposit or other instruments shares and share accounts hed in banks credit unions pension funds cooperatives associations brokerage houses and other financial institutions (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or both spouses whether or not a joint petition IS filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF INSTITUTION

lYPE AND NUMBER OF ACCOUNT AND

AMOUNT OF FINAL BALANCE

AMOUNT AND DATE OF SALE OR CLOSING

12 Safe deposit boxes

None 00

List each safe deposit or other valuables within one debtors filing under chapter spouses whether or not a petition is not filed)

other box or depository in which the debtor has or had securities cash or year immediately preceding the commencement of this case (Married

12 or chapter 13 must include boxes or depositories of either or both joint petition is filed unless the spouses are separated and a joint

NAME AND ADDRESS OF BANK OR

OTHER DEPOSITORY

NAMES AND ADDRESSES OF THOSE WITH ACCESS

TO THE BOX OR DEPOSITORY

DESCRIPTION OF

CONTENTS

DATE OR TRANSFER OR SURRENDER

IF ANY

13 Setoffs

None [Xl

List all setoffs made by any creditor including a bank against a debt or deposit of the debtor within 90 days preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF CREDITOR DATE OF SETOFF

AMOUNT OF SETOFF

14 Property held for another person

None lXJ

List all property by another person that the debtor holds or controls

NAME AND ADDRESS OF OWNER

DESCRIPTION AND VALUE OF PROPERTY LOCATION OF PROPERTY

15 Prior address of debtor

None If the debtor has moved within the two years immediately preceding the commencement of this case list all premises which the debtor occupied during that period and vacated prior to the commencement of this case If a joint petition is filed report also any separate adress of either spouse

ADDRESS NAME USED DATES OF OCCUPANCY

2100 Stradella Road

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been within the two years immediately preceding the commencement of this case any of the following an Officer director managing executive or owner of more than 5 percent of the voting securities of a corporation a partner other than a limited partner of a partnership a Sole proprietor or otherwise self-employed

(An individual or a joint debtor should complete this portion of the statement only if the debtor is or has been in business as defined above within the two years immediately preceding the commencement of this case)

16 Nature location and name of business

None o a If the debtor is an individual list the names and addresses of all businesses in which the debtor was

an Officer director partner or managing executive of a corporation partnerShip sole proprietorship or was a self-employed profeSSional within two years immediately preceding the commencement of this case or in which the debtor owned 5 percent or more of the voting or equity securities within the two years immediately preceding the commencement of this case

b If the debtor is a partnership list the names and addresses of al businesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

c If the debtor is a corporation list the names and addresses of all bUSinesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

BEGINNING AND ENDING NAME ADDRESS NATURE OF BUSINESS DATES OF OPERATION

Market Interface LLC 111 Stradella RoadLos Angeles CA 90077 Marketing April 1997-0ct 1999 Self-owned

17 Books records and financial statements

None a List all bookkeepers and accountants who Within the six years immediately preceding the filing of o this bankruptcy case kept or supervised the keeping of the books of account and records of the debtor

NAME AND ADDRESS DATES SERVICES RENDERED Gumbiner SavettFinkell 1998 Taxes 1723 Cloverfield Blvd Santa Monica CA 90404 Curtis DaltonCPA 1999 Taxes

None 00

b List all firms or individuals who within the two years Immediately preceding the filing of this bankruptcy case have audited the books of account and records or prepared a financial statement of the debtor

NAME ADDRESS DATES SERVICES RENDERED

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

10 other transfers

None 00

a List all other property other than property transferred in the ordinary course of business or financial affairs of the debtor transferred either absolutely or as security within one year immediately preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF TRANSFEREE RELATIONSHIP TO DEBTOR DATE

DESCRIBE PROPERlY TRANSFERRED

AND VALUE RECEIVED

11 Closed financial accounts

None 00

List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed sold or otherwise transferred within one year immediately preceding the commencement of this case Include checking savings or other financia accounts certificates of deposit or other instruments shares and share accounts hed in banks credit unions pension funds cooperatives associations brokerage houses and other financial institutions (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or both spouses whether or not a joint petition IS filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF INSTITUTION

lYPE AND NUMBER OF ACCOUNT AND

AMOUNT OF FINAL BALANCE

AMOUNT AND DATE OF SALE OR CLOSING

12 Safe deposit boxes

None 00

List each safe deposit or other valuables within one debtors filing under chapter spouses whether or not a petition is not filed)

other box or depository in which the debtor has or had securities cash or year immediately preceding the commencement of this case (Married

12 or chapter 13 must include boxes or depositories of either or both joint petition is filed unless the spouses are separated and a joint

NAME AND ADDRESS OF BANK OR

OTHER DEPOSITORY

NAMES AND ADDRESSES OF THOSE WITH ACCESS

TO THE BOX OR DEPOSITORY

DESCRIPTION OF

CONTENTS

DATE OR TRANSFER OR SURRENDER

IF ANY

13 Setoffs

None [Xl

List all setoffs made by any creditor including a bank against a debt or deposit of the debtor within 90 days preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF CREDITOR DATE OF SETOFF

AMOUNT OF SETOFF

14 Property held for another person

None lXJ

List all property by another person that the debtor holds or controls

NAME AND ADDRESS OF OWNER

DESCRIPTION AND VALUE OF PROPERTY LOCATION OF PROPERTY

15 Prior address of debtor

None If the debtor has moved within the two years immediately preceding the commencement of this case list all premises which the debtor occupied during that period and vacated prior to the commencement of this case If a joint petition is filed report also any separate adress of either spouse

ADDRESS NAME USED DATES OF OCCUPANCY

2100 Stradella Road

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been within the two years immediately preceding the commencement of this case any of the following an Officer director managing executive or owner of more than 5 percent of the voting securities of a corporation a partner other than a limited partner of a partnership a Sole proprietor or otherwise self-employed

(An individual or a joint debtor should complete this portion of the statement only if the debtor is or has been in business as defined above within the two years immediately preceding the commencement of this case)

16 Nature location and name of business

None o a If the debtor is an individual list the names and addresses of all businesses in which the debtor was

an Officer director partner or managing executive of a corporation partnerShip sole proprietorship or was a self-employed profeSSional within two years immediately preceding the commencement of this case or in which the debtor owned 5 percent or more of the voting or equity securities within the two years immediately preceding the commencement of this case

b If the debtor is a partnership list the names and addresses of al businesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

c If the debtor is a corporation list the names and addresses of all bUSinesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

BEGINNING AND ENDING NAME ADDRESS NATURE OF BUSINESS DATES OF OPERATION

Market Interface LLC 111 Stradella RoadLos Angeles CA 90077 Marketing April 1997-0ct 1999 Self-owned

17 Books records and financial statements

None a List all bookkeepers and accountants who Within the six years immediately preceding the filing of o this bankruptcy case kept or supervised the keeping of the books of account and records of the debtor

NAME AND ADDRESS DATES SERVICES RENDERED Gumbiner SavettFinkell 1998 Taxes 1723 Cloverfield Blvd Santa Monica CA 90404 Curtis DaltonCPA 1999 Taxes

None 00

b List all firms or individuals who within the two years Immediately preceding the filing of this bankruptcy case have audited the books of account and records or prepared a financial statement of the debtor

NAME ADDRESS DATES SERVICES RENDERED

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

13 Setoffs

None [Xl

List all setoffs made by any creditor including a bank against a debt or deposit of the debtor within 90 days preceding the commencement of this case (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed unless the spouses are separated and a joint petition is not filed)

NAME AND ADDRESS OF CREDITOR DATE OF SETOFF

AMOUNT OF SETOFF

14 Property held for another person

None lXJ

List all property by another person that the debtor holds or controls

NAME AND ADDRESS OF OWNER

DESCRIPTION AND VALUE OF PROPERTY LOCATION OF PROPERTY

15 Prior address of debtor

None If the debtor has moved within the two years immediately preceding the commencement of this case list all premises which the debtor occupied during that period and vacated prior to the commencement of this case If a joint petition is filed report also any separate adress of either spouse

ADDRESS NAME USED DATES OF OCCUPANCY

2100 Stradella Road

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been within the two years immediately preceding the commencement of this case any of the following an Officer director managing executive or owner of more than 5 percent of the voting securities of a corporation a partner other than a limited partner of a partnership a Sole proprietor or otherwise self-employed

(An individual or a joint debtor should complete this portion of the statement only if the debtor is or has been in business as defined above within the two years immediately preceding the commencement of this case)

16 Nature location and name of business

None o a If the debtor is an individual list the names and addresses of all businesses in which the debtor was

an Officer director partner or managing executive of a corporation partnerShip sole proprietorship or was a self-employed profeSSional within two years immediately preceding the commencement of this case or in which the debtor owned 5 percent or more of the voting or equity securities within the two years immediately preceding the commencement of this case

b If the debtor is a partnership list the names and addresses of al businesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

c If the debtor is a corporation list the names and addresses of all bUSinesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

BEGINNING AND ENDING NAME ADDRESS NATURE OF BUSINESS DATES OF OPERATION

Market Interface LLC 111 Stradella RoadLos Angeles CA 90077 Marketing April 1997-0ct 1999 Self-owned

17 Books records and financial statements

None a List all bookkeepers and accountants who Within the six years immediately preceding the filing of o this bankruptcy case kept or supervised the keeping of the books of account and records of the debtor

NAME AND ADDRESS DATES SERVICES RENDERED Gumbiner SavettFinkell 1998 Taxes 1723 Cloverfield Blvd Santa Monica CA 90404 Curtis DaltonCPA 1999 Taxes

None 00

b List all firms or individuals who within the two years Immediately preceding the filing of this bankruptcy case have audited the books of account and records or prepared a financial statement of the debtor

NAME ADDRESS DATES SERVICES RENDERED

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been within the two years immediately preceding the commencement of this case any of the following an Officer director managing executive or owner of more than 5 percent of the voting securities of a corporation a partner other than a limited partner of a partnership a Sole proprietor or otherwise self-employed

(An individual or a joint debtor should complete this portion of the statement only if the debtor is or has been in business as defined above within the two years immediately preceding the commencement of this case)

16 Nature location and name of business

None o a If the debtor is an individual list the names and addresses of all businesses in which the debtor was

an Officer director partner or managing executive of a corporation partnerShip sole proprietorship or was a self-employed profeSSional within two years immediately preceding the commencement of this case or in which the debtor owned 5 percent or more of the voting or equity securities within the two years immediately preceding the commencement of this case

b If the debtor is a partnership list the names and addresses of al businesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

c If the debtor is a corporation list the names and addresses of all bUSinesses in which the debtor was a partner or owned 5 percent or more of the voting securities within the two years immediately preceding the commencement of this case

BEGINNING AND ENDING NAME ADDRESS NATURE OF BUSINESS DATES OF OPERATION

Market Interface LLC 111 Stradella RoadLos Angeles CA 90077 Marketing April 1997-0ct 1999 Self-owned

17 Books records and financial statements

None a List all bookkeepers and accountants who Within the six years immediately preceding the filing of o this bankruptcy case kept or supervised the keeping of the books of account and records of the debtor

NAME AND ADDRESS DATES SERVICES RENDERED Gumbiner SavettFinkell 1998 Taxes 1723 Cloverfield Blvd Santa Monica CA 90404 Curtis DaltonCPA 1999 Taxes

None 00

b List all firms or individuals who within the two years Immediately preceding the filing of this bankruptcy case have audited the books of account and records or prepared a financial statement of the debtor

NAME ADDRESS DATES SERVICES RENDERED

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

None [XJ

c Ust all firms or individuals who the books of account and records available explain

at of

the the

time of the commencement of this case were debtor If any of the books of account and

in possession of records are not

NAME ADDRESS

None [X]

d Ust all financial institutions creditors and other parties whom a financial statement was issued within the two years this case by the debtor

including mercantile and trade agencies immediately preceding the commencement

to of

NAME AND ADDRESS DATE ISSUED

18 Inventories

None IXI

a Ust the dates of the last two inventories taken of your property the the taking of each inventory and the dollar amount and basis of each inventory

name of the person who supervised

DATE OF INVENTORY INVENTORY SUPERVISOR DOLLAR AMOUNT OF INVENTORY (Specify cost market or other basis)

None IXI

b List the name and address inventories reported in a above

of the person having possession of the records of each of the two

NAME AND ADDRESS OF CUSTODIAN DATE OF INVENTORY OF INVENTORY RECORDS

19 Current Partners Officers Directors and Shareholders

None IXI

a If the debtor is a partnership list the nature and percentage of partnership interest of each member of the partnership

NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

None [X]

b If the debtor is a corporation list all officers who directly or indirectly owns controls or holds corporation

and directors 5 percent or

of the corporation and each stockholder more of the voting securities of the

NAME AND ADDRESS TITLE NATURE AND PERCENTAGE

OF STOCK OWNERSHIP

20 Former partners officers directors and shareholders

None [X]

a If the debtor is a partnership list each member year immediately preceding the commencement of this case

who withdrew from the partnership within one

NAME ADDRESS DATE OF WITHDRAWAL

None b If the debtor is a corporation list all officers or directors whose relationship with the corporation [Xl terminated within one year immediately preceding this case

NAME AND ADDRESS TITLE DATE OF TERMINATION

21 Withdrawals from a partnership or distributions by a corporation

None If the debtor is a partnership or corporation list all withdrawals or distributions credited or given [X] to an insider including compensation in any form bonuses loans stock redemptions options exercised an

any other perquisite during one year immediately preceding the commencement of thiS case

NAME amp ADDRESS AMOUNT OF MONEY OF RECIPIENT DATE AND PURPOSE OR DESCRIPTION

RELATIONSHIP TO DEBTOR OF WITHDRAWAL AND VALUE OF PROPERTY

I I( I

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

(If completed byan indMdUai or indMdual and spouse]

I declare under penalty of perjury that I have read the answers the for g statement affairscontain~ein of financial and any attachments thereto and that they are true and correct ~

~C~~~4 ~ ~ Date Signature

of Debtor withers Peter Roy Douglas

Date _____________ Signature of Joint Debtor (if any)

CERTIFICATION AND SIGNATURE OF NONmiddotATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify that I am a bankruptcy petition preparer as defined in 11 USC sect 110 that I prepared this document for compensation and that I have provided the debtor with a copy of this document

PrInted or Typed Name of Bankruptcy Petition Preparer Social security No

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If morethan one person prepared this document attach additional signed sheets conforming to the appropriate Official Form for each person

x __________________________ Signature Of Bankruptcy Petition preparer Dale

A bankruptcy petition pteparefs failUre to comply With tne ptoVlsions 01 Iille I 41111 toe FeOSlal RUles 01 Bankruptcy Procedure may resull in Imes or mptisonment Of corn 11 USC sect 110 18 USC sect 156

(11 cOmpleted on behalf 01 a partnership Of corporaliofll

I declare under penalty of perjury that I have read the answers contained in the forego 109 statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge Information and belief

Date Signature

Prlflt Name and Title

(An indMdual signing on behalf of a partnership or corporation must indicate pOSition or relationship to debtor)

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

Form B8 (OffiCial Fam 81 - (Rev 3198) 1998 US8C Central District of California

UNITED STATES BANKRUPTCY COURT ____~C~e~n_1tr_a_=l DISTRICT OF California

In re Withers I Peter Roy Douglas

Debtor

Case No ____________

I Chapter 7

CHAPTER 7 INDIVIDUAL DEBTORS STATEMENT OF INTENTION

1 I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate

2 I intend to do the following with respect to the property of the estate which secures those consumer debts

a Property to Be Surrendered

Creditors NameDescription of Property

b Property to Be Retained (Check any applicable statement]

Property will be Debt Will be reaffirmed Property is claimed redeemed pursuant pursuant to

DesCflption 01 Property Creditors Name as exempt to 11 USC sect 722 11 usc sect S24(c)

-lt~~z~fDate Signature of Debtor Withers Peter Roy Douglas

CERTIFICATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 USC sect 110)

I certify t~at I am a bankruptcy petition preparer as defined in 11 USC sect 110 that t prepared this document for ~ ~~ ~~~-~ V

compensatkln and that I have provided the debtor with a copy Of~UllleM

Printed or Typed Name of Bankruptcy Petition Preparer Social Security Number

Address

Names and Social Security numbers of all other individuals who prepared or aSSisted in preparing this document

If more than one person prepared this document attach additional signed sheets conforming to the appropriate OffiCial Form for each person

x~____________________________________________ Signature of Bankruptcy Petition Preparer Date

bull M~myen~~~~M ~_MlIIMt__ IUltl b ~1ttIM5 of Bankruptcy Procedure may result in fines or imprisonment or both 11 USC sect 110 18 USC sect 156

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT Central DISTRICT OF California

Bankruptcy Case No

DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR

In re Withers Peter Roy Douglas

Debtor(s)

Social Security No -4916 Social Security No _______ Employers Tax Identification No

1 Pursuant to 11 USCbull sect 329(A) and Bankruptcy Rule 2016(b) I certify that I am the attorney for the above-named debtor and that compensation paid to me within one year before the filing of the petition in bankruptcy or agreed to be paid to me for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows

For legal services $ 97500

Prior to the filing of this statement I have received $ 97500

Balance Due $_---shy

2 The source of the compensation paid to me was [X) Debtor

o Other (specify)

3 The source of compensation to be paid to me is o Debtor

Other (specify)

4 0 I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm

o I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm A copy of the agreement together with a list of the names of the people sharing in the compensation is attached

BK-203

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

5 In return for the above-disclosed fee I have agreed to render legal service for all aspects of the bankruptcy case including

a Analysis of the debtors financial situation and rendering advice to the debtor in determining whether to file a petition in bankruptcy

b Preparation and filing of any petition schedules statement of affairs and plan which may be required

c Representation of the debtor at the meeting of creditors and confirmation hearing and any adjourned hearing thereof

d [Other provisions as needed]

6 By agreement with the debtor(s) the above-disclosed fee does not include the following service

CERTIFICATION

I certify that the foregoing is a complete statement of any agreement or arra~~t me for representation of the debtor(s) in this bankruptcy proceeding

010700Date

JEFFREY S SHINBROT APLC

Name of Law Firm

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

Attorney or Party Name Address and Telephone Number

Jeffrey S Shinbrot Jeffrey S Shinbrot APLC 8929 Wilshire Blvd suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

Bar No 15548

AttomeyforDebtors UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA

In ra withers I Peter Roy Douglas

Debtor

FOR COURT USE ONLY

CHAPTER 7 CASE NUMBER

(No Hearing Required)

DECLARATION RE LIMITED SCOPE OF APPEARANCE PURSUANT TO LOCAL BANKRUPTCY RULE 102

TO THE COURT THE DEBTOR THE TRUSTEE Of any) AND THE UNITED STATES TRUSTEE

1 I am the attorney for the Debtor in the above-captioned bankruptcy case

2 On (specify date) 010700 I agreed with the Debtor that for a fee of $ 1000 bull 00 I would provide

only the following services

a IXJ Prepare and file the Petition and Schedules

b IXJ Represent the Debtor at the 341(a) Hearing

c 0 Represent the Debtor in any relief from stay actions

d 0 Represent the Debtor in any proceeding involving an objection to DebtorS discharge pursuant to 11 USC sect 727

bull D ReprtlUtnt the Oal)tor In any prOe8fHIlng ttl attftrmlnft whltMr ~ flPltClfle dHt nondlJlenlllfgeabll uflder l USC l13

f 0 Other (specify)

3 I declare under penalty of perjury under the laws of the United States of America that the foregOing is true and correct and that this declaration was executed on the fOllowing date at the city set forth in the upper left-hand corner of this page

Dated ~~ ~L99 Jeffrev S Law Firm Name

I HEREBY APPROVE THE ABOVE

By A gt~ bull ~ ~~~ Name UCucLJCj oJ oJuJUJJLf __~~___

Signature of Debtor Attorney for Debtor

Withers Peter Roy Douglas

Rev 695 This lorm is optional II has been approved lor use by the United Stales Bankruptcy Court for the Central District of California 210

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

(310) 659-5444

UNITED STATES BANKRUPTCY COURT

Central DISTRICT OF CALIFORNIA

INREWithers Peter Roy Douglas

CASENO~_____________

Debtor(s)

VERIFICATION OF CREDITOR MATRIX

The above named debtor(s) or debtors attorney if applicable do hereby

certify under penalty of perjury that the attached Master Mailing List of creditors

consisting of 4 sheet(s) is complete correct and consistent with the

debtors schedules pursuant to Local Bankruptcy Rule 105(6) and Iwe assume all

responsibility for errors and omissions

7Z~Date 010700

Debtor Withers Peter Roy Douglas

Attorney (if applicable) Joint Debtor Jeffrey S Shinbrot

BKmiddot105

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

Withers Peter Roy Douglas 1111 Stradel Road Los Angeles California 90077

Jeffrey S Shinbrot APLC 8929 Wilshire Blvd Suite 100 Beverly Hills CA 90211-1950

United States Trustee 221 N Figueroa Street 800 Los AngelesCA 90211

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

AAA Financial Srvices PO Box 98730 Louisville KY 40298-8730

Citibank PO Box 6415 The Lakes NV 88901-6415

Consumer Credit Counse 500 Citadel DrSte300 Los Angeles CA 90040

Franchise Tax Board Bankruptcy Unit PO Box 2052 Sacramento CA 95872

Franchise Tax Board PO Box 942867 Sacramento CA 94267

Gumbiner Savett Finke 1723 Cloverfield Blvd Santa MonicaCA 90404

Household Bank PO Box 7036 Anaheim CA 92850-7036

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

HRS USA PO Box 7010 Anaheim CA 92850-7010

Internal Revenue Servic Rm4062FedBldgStop5022 300 NLos Angeles st Los Angeles CA 90012

Naturally New Zealand coDonald E Boss Esq 908SVillageOaksDr100 Covina CA 91724-3676

Providian PO Box 4017 Woburn MA 01888-4017

Sallie Mae Servicing PO Box 11449 Killeen TX 76547-1449

Sears Payment Center PO Box 182149 Columbus OH 43218-2149

US Attorneys Office FedBldgRm2315 300 N Los Angeles st Los Angeles CA 90012

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095

US Dept of Justice PO Box 683 Ben Franklin Station Washington DC 20044

UCLA Dental Clinic PO Box 961668 Los Angeles CA 90095