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Caption (Full) (United States)

This is caption (full) and a supplemental form to a Bankruptcy form. The form provided here is simply a sample of what the actual Form B16A looks like.

Form B16A
11/94

Form 16A. CAPTION (FULL)

UNITED STATES BANKRUPTCY COURT

________________________ DISTRICT OF_____________________


In re __________________________________________, )

Set forth here all names including married, )

maiden, and trade names used by debtor within )

last 6 years.] )

Debtor ) Case No. ________________

)
)
Address _________________________________________ )
)
_________________________________________

) Chapter _________________
)
Social Security No(s). _____________________ and all )

Employer's Tax Identification No(s). [if any]_________ )

________________________________________________ )

[Designation of Character of Paper]

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