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B 10 (Official Form 10) (12/11) UNITED STATES BANKRUPTCY COURT DISTRICT OF PROOF OF CLAIM Case Number: Name of Debtor: NOTE: Do not use this form to make a claim for an administrative expense that
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How to fill out proof of claim form

How to Fill Out Proof of Claim Form:
01
Obtain the form: Start by obtaining a proof of claim form from the relevant court or bankruptcy trustee. You can usually find it on their website or by contacting their office directly.
02
Read the instructions: Before filling out the form, carefully read the instructions provided. These instructions will guide you through each section and inform you about any supporting documents that may be required.
03
Provide your personal information: Begin by providing your full legal name, address, and contact information. Double-check the accuracy of this information to avoid any discrepancies.
04
Specify your claim: Indicate the type of claim you are making, such as a personal injury claim, creditor claim, or tax claim. Be precise in your description and provide as much detail as possible to support your claim.
05
Explain the basis for your claim: Clearly state the reason or justification for your claim. If you have supporting documents or evidence, attach them to the form as instructed.
06
Calculate the amount of your claim: Carefully calculate the amount of money you are claiming, specifying any interest or penalties, if applicable. Provide a clear breakdown of how you arrived at this total.
07
Describe any collateral or security: If your claim is secured by collateral or a specific asset, provide a detailed description of the property, including its value and any relevant documentation to support its existence.
08
Attach supporting documents: Review the instructions to determine what supporting documents need to be attached to the proof of claim form. Examples may include invoices, contracts, court orders, or relevant correspondence.
09
Date and sign the form: Once you have completed all the necessary sections, date and sign the form. Ensure that your signature is legible and matches the name provided at the beginning of the form.
Who Needs Proof of Claim Form?
01
Creditors: Creditors who are owed money by an individual or entity that has filed for bankruptcy may need to fill out a proof of claim form. This form allows them to assert their right to receive a portion of the debtor's assets.
02
Claimants in lawsuits: If you have filed a lawsuit and are seeking compensation, you may need to fill out a proof of claim form to assert your claim against the defendant's assets. This form ensures that you are included in the distribution of any available funds.
03
Tax authorities: Government tax agencies, such as the Internal Revenue Service (IRS), may require individuals or businesses to fill out a proof of claim form when seeking to recover unpaid taxes or penalties.
In summary, to fill out a proof of claim form, you should obtain the form, carefully read the instructions, provide your personal information, specify your claim, explain the basis for the claim, calculate the amount, describe any collateral, attach supporting documents, and sign the form. The form is typically required by creditors, claimants in lawsuits, and tax authorities.
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What is proof of claim form?
Proof of claim form is a legal document that a creditor or claimant must file in a bankruptcy case to assert their right to receive payment from the debtor's assets.
Who is required to file proof of claim form?
Any creditor or claimant who seeks to be included in the distribution of assets in a bankruptcy case is required to file a proof of claim form.
How to fill out proof of claim form?
The proof of claim form can be obtained from the bankruptcy court or the trustee. It must be filled out accurately and completely, providing all necessary information such as the creditor's name, address, and the amount of the claim.
What is the purpose of proof of claim form?
The purpose of the proof of claim form is to ensure that creditors or claimants are given an opportunity to assert their right to receive payment from the debtor's assets in a fair and orderly manner.
What information must be reported on proof of claim form?
The proof of claim form typically requires the creditor or claimant to report their name, address, the amount of the claim, the basis for the claim, any supporting documents, and any other relevant information as specified by the bankruptcy court.
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