Schedule E, Creditors Holding Unsecured Priority Claims (United States)
This is Schedule E, Creditors Holding Unsecured Priority Claims. The form provided here is simply a sample of what the actual Form B6E looks like.
FORM B6E
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,""W,""J," or "C" in the column labeled "Husband, Wife, Joint, or Community."
If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.)
Report the total of claims listed on each sheet in the box labeled "Subtotal" on each sheet. Report the total of all claims listed on this Schedule E in the box labeled "Total" on the last sheet of the completed schedule. Repeat this total also on the Summary of Schedules.
____ 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 debtor's business or financial affairs after the commencement of the case but before the earlier of the appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(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 $4,300* 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 U.S.C. § 507(a)(3).
____ 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 U.S.C. § 507(a)(4).
____ Certain farmers and fishermen
Claims of certain farmers and fishermen, up to $4,300* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(5).
____ Deposits by individuals
Claims of individuals up to $1,950* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that were not delivered or provided. 11 U.S.C. § 507(a)(6).
In re _________________________ Debtor
Case No. __________________________ (if known)
____ 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 U.S.C. § 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 U.S.C. § 507(a)(8).
____ 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 U.S.C. § 507 (a)(9).
* Amounts are subject to adjustment on April 1, 2001, and every three years thereafter with respect to cases commenced on or after the date of adjustment.
____________________________________
TYPE OF PRIORITY
CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE
ACCOUNT NO. __________________________
ADDRESS __________________________
CITY __________________________
STATE __________________________
ZIP CODE __________________________
CODEBTOR __________________________
HUSBAND, WIFE, JOINT, OR COMMUNITY __________________________
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM
__________________________
CONTINGENT __________________________
UNLIQUIDATED __________________________
DISPUTED __________________________
TOTAL AMOUNT OF CLAIM __________________________
AMOUNT ENTITLED TO PRIORITY __________________________
CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE
ACCOUNT NO. __________________________
ADDRESS __________________________
CITY __________________________
STATE __________________________
ZIP CODE __________________________
CODEBTOR __________________________
HUSBAND, WIFE, JOINT, OR COMMUNITY __________________________
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM
__________________________
CONTINGENT __________________________
UNLIQUIDATED __________________________
DISPUTED __________________________
TOTAL AMOUNT OF CLAIM __________________________
AMOUNT ENTITLED TO PRIORITY __________________________
CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE
ACCOUNT NO. __________________________
ADDRESS __________________________
CITY __________________________
STATE __________________________
ZIP CODE __________________________
CODEBTOR __________________________
HUSBAND, WIFE, JOINT, OR COMMUNITY __________________________
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM
__________________________
CONTINGENT __________________________
UNLIQUIDATED __________________________
DISPUTED __________________________
TOTAL AMOUNT OF CLAIM __________________________
AMOUNT ENTITLED TO PRIORITY __________________________
Subtotal (total of this page) $__________________________
Total (Use only on last page of the completed Schedule E)
$__________________________
(Report total also on Summary of Schedules)