B2020 Statement of Military Service

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This statement is for information use only.  Filing this statement with the Bankruptcy Court does not constitute an application for 
or invoke the benefits and relief available under the Servicemembers’ Civil Relief Act of 2003.	
 	
B202 0 (Form 2020 ) (12/15)	 	
 
  United States Bankruptcy Court   
  ____________________ District of ____________________ 
 
In re _________________________     Case Number   _______________________ 
        Chapter _______________________ 
 
 	
STATEMENT OF MILITARY SERVICE	 	
 
  The Servicemembers’ Civil Relief Act of 2003, Pub. L. No. 108- 189, provides for the temporary 
suspension of certain judicial proceedings or transactions that may adversely affect military servicemembers, their 
dependents, an d others.  Each party to a bankruptcy case who might be eligible for relief under the act should 
complete this form and file it with the Bankruptcy Court. 	
 
 
IDENTIFICATION OF SERVICEMEMBER  
   Self (Debtor, Codebtor, Creditor, Other)  
   Non-Filing Spouse of Debtor (name)________________________________________  
   Other   (Name of servicemember)__________________________________________  
   (Relationship of filer to servicemember)_______________________________  
  (Type of liability) ________________________________________________  
 
TYPE OF MILITARY SERVICE  
U.S. Armed Forces (Army, Navy, Air Force, Marine Corps, or Coast Guard) or commissioned officer  
of the Public Health Service or the National Oceanic and Atmospheric Administration (specify type  
of service)  __________ ___________________________________________________  
   Active Service since    ____________________________________________(date)  
   Inductee -  ordered to report on  ____________________________________________(date)  
   Retired / Discharged    ____________________________________________(date)  
 
U.S. Military Reserves and National Guard  
   Active Service since     ____________________________________________(date)  
   Impending Active Service - orders postmarked _______________________________(date)  
   Ordered to report on   ____________________________________________(date)  
   Retired /Discharged    ____________________________________________(date)  
 
U.S. Citizen Serving with U.S. ally in war or military action (specify ally and war or action)  
  _______________ _______________________________________________________  
   Active Service since    ____________________________________________(date)  
   Retired/Discharged    ____________________________________________(date)  
 
DEPLOYMENT  
   Servicemember deployed overseas on ______ _________________________________(date)  
  Anticipated completion of overseas tour -of -duty  ______________________________(date)  
 
SIGNATURE   
 
____________________________________    ___________________________  
Date	
 	
____________________________________  
(print  name)