Official Form 106D Schedule D: Creditors Who Have Claims Secured by Property (Individuals) and Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property (Nonindividual debtor)

The B6D (Official Form 6D) or Scheduled – Creditors Holding Secured Claims form can be found on pages 30-31 at the following link: http://www.cob.uscourts.gov/formsdom/ch13volpp.pdf. This is essential for stating the debtor’s necessary information. Such information includes but not limited to the name and mailing address, zip code or any last four digits of any account number of all claims related to entities holding that has been secured by Property of the Debtor. The included date has to be the same as the one used for filing the petition.

Extracted Text for Proper Search

Official Form 106DSchedule D: Creditors Who Have Claims Secured by Property
 page 1 of ___  Offi	
cial Form 106D 	
Schedule D: Creditors
 Who Have Claims Secured by Property	 	12/15	
Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying  correct 
information. If more space is needed, copy the Additional Page, f ill it out, number the entries, and attach it to this form. On the top of any 
additional pages, write your name and case number (if known).  
1. 	Do any creditors have claims secured by your property?
 No. Check this box and submit this form to the court with yo ur other schedules. You have nothing else to report on this form.	
 Yes. Fill in all of the information below.	
Part 1:  List All Secured Claims 
2. 	List all secured claims.  If a creditor has more than one secured claim, list the creditor separatelyfor each claim.  If more than one creditor has a partic ular claim, list the other creditors in Part 2.As much as possible, list the claims in alphabetical order according to the creditor’s name.	
Column A 
Amount of claim	  	
Do not deduct the value of collateral.	 	
Column B 
Value of collateral that supports this claim	 	
Column C 
Unsecured portion 
If any	 	
2.1 	______________________________________ Creditor’s Name 
______________________________________ Number Street 
______________________________________ 
______________________________________ City State  ZIP Code	 	
Describe the property that secures the claim: 	$_________________ $________________ $____________	
As of the date you file, the claim is:	 Check all that apply. 	
	Contingent	
	Unliquidated	
	Disputed	
Nature of lien	. Check all that apply.	 	
	An agreement you made (such as mortgage or secured 
car loan) 	
	Statutory lien (such as tax lien, mechanic’s lien) 	
	Judgment lien from a lawsuit 	
	Other (including a right to offset) ____________________	
Who owes the debt?	 Check one. 	
	Debtor 1 only 	
	Debtor 2 only 	
	Debtor 1 and Debtor 2 only 	
	At least one of the debtors and another	
	Check if this claim relates to a
community debt	
Date debt was incurred   ____________ 	Last 4 digits of account number ___  ___  ___  ___  	
2.2 	______________________________________ Creditor’s Name 
______________________________________ Number Street 
______________________________________ 
______________________________________ City State ZIP Code	 	
Describe the property that secures the claim: 	$_________________ $________________ $____________	
As of the date you file, the claim is:	 Check all that apply. 	
	Contingent	
	Unliquidated	
	Disputed	
Nature of lien	. Check all that apply.	 	
	An agreement you made (such as mortgage or secured 
car loan) 	
	Statutory lien (such as tax lien, mechanic’s lien) 	
	Judgment lien from a lawsuit 	
	Other (including a right to offset) ____________________	
Who owes the debt?	 Check one. 	
	Debtor 1 only 	
	Debtor 2 only 	
	Debtor 1 and Debtor 2 only 	
	At least one of the debtors and another	
	Check if this claim relates to a
community debt	
Date debt was incurred   ____________ 	Last 4 digits of account number ___  ___  ___  ___   Add 
the dollar value of your entries in Colum n A on this page. 	
 Write that number here:  $________________	
Debtor 1  __________________________________________________________________   	First Name 
Middle Name Last Name	 	
Debtor 2  ________________________________________________________________ (Spouse, if filing)	 First Name  Middle Name Last Name	 	
United States Bankruptcy Court for the:	 __________	 District of 	__________ 	
Case number  ___________________________________________  (If known	) 	
  Fill in this information to identify your case: 	
	Check if this is an
amended filing

Debtor 1	 _______________________________________________________ Case number 	(if known )	_____________________________________  	First Name  Middle Name  Last Name	  Official Form 106D	
Additional Page of 
Schedule D: Creditors Who Have Claims Secured by Property  page ___ of ___ 	
Part 1: Additional Page 
After listing any entries on this page, number them beginning with 2.3, followed 
by 2.4, and so forth.
 	
Column A 
Amount of claim	  	
Do not deduct the value of collateral.	 	
Column B 
Value of collateral that supports this claim	 	
Column C 
Unsecured portion 
If any	
______________________________________ Creditor’s Name 
______________________________________ Number Street 
______________________________________ 
______________________________________ 
City State  ZIP Code	 	
Describe the property that secures the claim: 	$_________________ $________________ $____________	
As of the date you file, the claim is:	 Check all that apply. 	
	Contingent	
	Unliquidated	
	Dispute	d	
Nature of	

 lien
. Check all that apply.	 	
	An agreement you made (such as mortgage or secured 
car  loan) 
	Statutory lien (such as tax lien, mechanic’s lien) 	
	Judgment lien from a lawsuit 	
	Other (including a right to offset) ____________________	
Who owes the debt?	 Check one. 	
	Debtor 1 only 	
	Debtor 2 only 	
	Debtor 1 and Debtor 2 only 	
	At least one of the debtors and anothe	r	
	Check if this claim relates to a
community debt	
Date debt was incurred   ____________ 	Last 4 digits of account number ___  ___  ___  ___  	
______________________________________ Creditor’s Name 
______________________________________ Number Street 
______________________________________ 
______________________________________ 
City State ZIP Code	
Describe the property that secures the claim: 	$_________________ $________________ $____________	
As of the date you file, the claim is:	 Check all that apply. 	
	Contingent	
	Unliquidated	
	Dispute	d	
Nature of	

 lien
. Check all that apply.	 	
	An agreement you made (such as mortgage or secured 
car  loan) 
	Statutory lien (such as tax lien, mechanic’s lien) 	
	Judgment lien from a lawsuit 	
	Other (including a right to offset) ____________________	
Who owes the debt?	 Check one. 	
	Debtor 1 only 	
	Debtor 2 only 	
	Debtor 1 and Debtor 2 only 	
	At least one of the debtors and anothe	r	
	Check if this claim relates to a
community debt	
Date debt was incurred   ____________ 	Last 4 digits of account number ___  ___  ___  ___  	
______________________________________ Creditor’s Name 
______________________________________ Number Street 
______________________________________ 
______________________________________ 
City State ZIP Code	 	
Describe the property that secures the claim: 	$_________________ $________________ $____________	
As of the date you file, the claim is:	 Check all that apply. 	
	Contingent	
	Unliquidated	
	Dispute	d	
Nature of	

 lien
. Check all that apply.	 	
	An agreement you made (such as mortgage or secured 
car  loan) 
	Statutory lien (such as tax lien, mechanic’s lien) 	
	Judgment lien from a lawsuit 	
	Other (including a right to offset) ____________________	
Who owes the debt?	 Check one. 	
	Debtor 1 only 	
	Debtor 2 only 	
	Debtor 1 and Debtor 2 only 	
	At least one of the debtors and anothe	r	
	Check if this claim relates to a
community debt	
Date debt was incurred   ____________ 	Last 4 digits of account number ___  ___  ___  ___  	
Add the dollar value of your entries in Column A on this page. Write that number here:  	$_________________  	
If this is the last page of your form, add the dollar value totals  from all pages.  
Write that number here: 	$_________________

Debtor 1	 _______________________________________________________ Case number 	(if known )	_____________________________________  	First Name  Middle Name  Last Name	     Official Form 106D	
Part 2 of 
Schedule D: Creditors Who Have Claims Secured by Property  page ___ of ___ 	
Part 2:  List Others to Be Notified for a Debt That You Already Listed 
Use this page only if you have others to be notified about your bankruptcy for a debt that you already listed in Part 1.	 For example, if a collection 	agency is trying to collect from you for a debt you owe to someone else, list the creditor in Part 1, and then list the collect ion agency here. Similarly, if you have more than one creditor for any of the debts that you listed in Part 1, list the additional creditors here. If you do not have additional persons to be notified for any debts in Part 1, do not fill out or submit this page.  	
_____________________________________________________________________ Name 
_____________________________________________________________________ Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ City State 	ZIP	Code	
On which line in Part 1 did you enter the creditor?  _____ 
Last 4 digits of account number ___  ___  ___  ___ 	
_____________________________________________________________________ Name 
_____________________________________________________________________ Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ City State 	ZIP	Code	
On which line in Part 1 did you enter the creditor?  _____	 	
Last 4 digits of account number ___  ___  ___  ___ 	
_____________________________________________________________________ Name 
_____________________________________________________________________ Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ City State 	ZIP	Code	
On which line in Part 1 did you enter the creditor?  _____ 
Last 4 digits of account number  ___  ___  ___  ___ 	
_____________________________________________________________________ Name 
_____________________________________________________________________ Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ City State 	ZIP	Code	
On which line in Part 1 did you enter the creditor?  _____ 
Last 4 digits of account number  ___  ___  ___  ___ 	
____________	

_________________________________________________________ 
Name 
_____________________________________________________________________ 
Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ 
City State 	
ZIP	

Code	On which line in Part 1 did you enter the creditor? _____ 
Last 4 digits of account number  ___  ___  ___  ___ 	
____________	

_________________________________________________________ 
Name 
_____________________________________________________________________ 
Number Street 
_____________________________________________________________________ 
_____________________________________________________________________ 
City State 	
ZIP	

Code	On which line in Part 1 did you enter the creditor? _____ 
Last 4 digits of account number ___  ___  ___  ___