scottie (lee) pippen's bankruptcy filing

29
(Official Form 1) (12/03) West Group, Rochester, NY Voluntary Petition FORM B1 United States Bankruptcy Court District of KANSAS Name of Debtor (if individual, enter Last, First, Middle): All Other Names used by the Debtor in the last 6 years (include married, maiden, and trade names): NONE Last four digits of Soc. Sec. No./Complete EIN or other Tax I.D. No. (if more than one, state all): 3524 Street Address of Debtor (No. & Street, City, State & Zip Code): 9002 W. 78th Circle Overland Park KS 66202 County of Residence or of the Principal Place of Business: Johnson Mailing Address of Debtor (if different from street address): Location of Principal Assets of Business Debtor (If different from street address above): Name of Joint Debtor (Spouse)(Last, First, Middle): All Other Names used by the Joint Debtor in the last 6 years Last four digits of Soc. Sec. No./Compete EIN or other Tax I.D. No. Street Address of Joint Debtor Mailing Address of Joint Debtor (include married, maiden, and trade names): (if more than one, state all): (No. & Street, City, State & Zip Code): County of Residence or of the Principal Place of Business: (if different from street address): SAME NOT APPLICABLE Pippen, Scottie Lee Information Regarding the Debtor (Check the Applicable Boxes) Venue (Check any applicable box) Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this District for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other District. There is a bankruptcy case concerning debtor's affiliate, general partner, or partnership pending in this District. Type of Debtor (Check all boxes that apply) Individual(s) Railroad Stockbroker Commodity Broker Other Partnership Corporation Chapter 13 Chapter 12 Sec. 304 - Case ancillary to foreign proceeding Chapter 9 Chapter 11 Chapter 7 Chapter or Section of Bankruptcy Code Under Which the Petition is Filed (Check one box) Nature of Debts Filing Fee (Check one box) (Check one box) Business Consumer/Non-Business Full Filing Fee attached Filing Fee to be paid in installments (Applicable to individuals only) Must attach signed application for the court's consideration certifying that the debtor is unable to pay fee except in installments. Rule 1006(b). See Official Form No. 3. Chapter 11 Small Business (Check all boxes that apply) Debtor is and elects to be considered a small business under Debtor is a small business as defined in 11 U.S.C. § 101 11 U.S.C. § 1121(e) (Optional) Clearing Bank THIS SPACE IS FOR COURT USE ONLY Statistical/Administrative Information (Estimates only) Debtor estimates that funds will be available for distribution to unsecured creditors. Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for distribution to unsecured creditors. Estimated Number of Creditors 1-15 1000-over 200-999 100-199 50-99 16-49 Estimated Assets Estimated Debts More than $50,000,001 to $10,000,001 to $1,000,001 to $10 million $50 million $100 million $100 million $1 million $500,001 to $500,000 $100,001 to $100,000 $50,001 to $0 to $50,000 $0 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1 million $1,000,001 to $10 million $10,000,001 to $50 million $50,000,001 to $100 million More than $100 million Case 05-24592 Doc# 1 Filed 09/21/05 Page 1 of 29

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Page 1: Scottie (Lee) Pippen's Bankruptcy Filing

(Official Form 1) (12/03) West Group, Rochester, NY

Voluntary PetitionFORM B1 United States Bankruptcy Court

District of KANSAS

Name of Debtor (if individual, enter Last, First, Middle):

All Other Names used by the Debtor in the last 6 years(include married, maiden, and trade names):

NONE

Last four digits of Soc. Sec. No./Complete EIN or other Tax I.D. No.(if more than one, state all): 3524Street Address of Debtor (No. & Street, City, State & Zip Code):

9002 W. 78th CircleOverland Park KS 66202

County of Residence or of thePrincipal Place of Business: JohnsonMailing Address of Debtor (if different from street address):

Location of Principal Assets of Business Debtor(If different from street address above):

Name of Joint Debtor (Spouse)(Last, First, Middle):

All Other Names used by the Joint Debtor in the last 6 years

Last four digits of Soc. Sec. No./Compete EIN or other Tax I.D. No.

Street Address of Joint Debtor

Mailing Address of Joint Debtor

(include married, maiden, and trade names):

(if more than one, state all):(No. & Street, City, State & Zip Code):

County of Residence or of thePrincipal Place of Business:

(if different from street address):

SAME

NOT APPLICABLE

Pippen, Scottie Lee

Information Regarding the Debtor (Check the Applicable Boxes)Venue (Check any applicable box)

Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this District for 180 days immediatelypreceding the date of this petition or for a longer part of such 180 days than in any other District.There is a bankruptcy case concerning debtor's affiliate, general partner, or partnership pending in this District.

Type of Debtor (Check all boxes that apply)

Individual(s) RailroadStockbrokerCommodity Broker

OtherPartnershipCorporation Chapter 13

Chapter 12Sec. 304 - Case ancillary to foreign proceedingChapter 9

Chapter 11Chapter 7

Chapter or Section of Bankruptcy Code Under Which the Petition is Filed (Check one box)

Nature of Debts Filing Fee (Check one box)(Check one box)

BusinessConsumer/Non-BusinessFull Filing Fee attachedFiling Fee to be paid in installments (Applicable to individuals only)Must attach signed application for the court's considerationcertifying that the debtor is unable to pay fee except in installments.Rule 1006(b). See Official Form No. 3.

Chapter 11 Small Business (Check all boxes that apply)

Debtor is and elects to be considered a small business underDebtor is a small business as defined in 11 U.S.C. § 101

11 U.S.C. § 1121(e) (Optional)

Clearing Bank

THIS SPACE IS FOR COURT USE ONLYStatistical/Administrative Information (Estimates only)

Debtor estimates that funds will be available for distribution to unsecured creditors.

Debtor estimates that, after any exempt property is excluded and administrative expensespaid, there will be no funds available for distribution to unsecured creditors.

Estimated Number of Creditors 1-15 1000-over200-999100-19950-9916-49

Estimated Assets

Estimated Debts

More than$50,000,001 to$10,000,001 to$1,000,001 to$10 million $50 million $100 million $100 million$1 million

$500,001 to$500,000

$100,001 to$100,000$50,001 to$0 to

$50,000

$0 to$50,000

$50,001 to$100,000

$100,001 to$500,000

$500,001 to$1 million

$1,000,001 to$10 million

$10,000,001 to$50 million

$50,000,001 to$100 million

More than$100 million

Case 05-24592 Doc# 1 Filed 09/21/05 Page 1 of 29

Page 2: Scottie (Lee) Pippen's Bankruptcy Filing

(Official Form 1) (12/03) West Group, Rochester, NY

Voluntary Petition FORM B1, Page 2Name of Debtor(s):

(This page must be completed and filed in every case)

Prior Bankruptcy Case Filed Within Last 6 Years

Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor

(If more than one, attach additional sheet)

(If more than one, attach additional sheet)

Location Where Filed:

District:

Name of Debtor:

Judge:

Date Filed:

Date Filed:

Relationship:

Case Number:

Case Number:

NONE

NONE

Scottie Lee Pippen

SignaturesSignature(s) of Debtor(s) (Individual/Joint)

Code, specified in this petition.I request relief in accordance with the chapter of title 11, United Statesunder chapter 7.the relief available under each such chapter, and choose to proceedunder chapter 7, 11, 12, or 13 of title 11, United States Code, understandand has chosen to file under chapter 7] I am aware that I may proceed[If petitioner is an individual whose debts are primarily consumer debtspetition is true and correct.I declare under penalty of perjury that the information provided in this

X

X

Date

Signature of Debtor

Signature of Joint Debtor

Telephone Number (If not represented by attorney)

X

9/15/2005

/s/ Scottie Lee Pippen

Exhibit A(To be completed if debtor is required to file periodic reports(e.g., forms 10K and 10Q) with the Securities and ExchangeCommission pursuant to Section 13 or 15(d) of the SecuritiesExchange Act of 1934 and is requesting relief under Chapter 11)

Exhibit A is attached and made a part of this petition

Exhibit B(To be completed if debtor is an individual whose debts are primarily consumer debts)

I, the attorney for the petitioner named in the foregoing petition, declarethat I have informed the petitioner that [he or she] may proceed underchapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each such chapter.

/s/ Jason Norbury 9/15/2005Signature of Attorney for Debtor(s) Date

Exhibit CDoes the debtor own or have possession of any property that poses

Signature of Attorney

Signature of Non-Attorney Petition Preparer

Telephone Number

Firm Name

Date

Address

Signature of Attorney for Debtor(s)

Printed Name of Attorney for Debtor(s)

X

provided the debtor with a copy of this document.§ 110, that I prepared this document for compensation, and that I haveI certify that I am a bankruptcy petition preparer as defined in 11 U.S.C.

Printed Name of Bankruptcy Petition Preparer

Address

Social Security Number

sheets conforming to the appropriate official form for each person.If more than one person prepared this document, attach additional

Names and Social Security numbers of all other individuals whoprepared or assisted in preparing this document:

X

A bankruptcy petition preparer's failure to comply with the provisionsof title 11 and the Federal Rules of Bankruptcy Procedure may resultin fines or imprisonment or both 11 U.S.C. § 110; 18 U.S.C. § 156.

Signature of Bankruptcy Petition Preparer

Date

X

9/15/2005

Kansas City MO 64114

816-523-4667

8117 Wornall

Law Office of Jason Norbury, P.C.

Jason Norbury 20207

/s/ Jason Norbury

Signature of Debtor (Corporation/Partnership)

I declare under penalty of perjury that the information provided in thispetition is true and correct, and that I have been authorized to file thispetition on behalf of the debtor.

The debtor requests relief in accordance with the chapter of title 11,United States Code, specified in this petition.

Signature of Authorized Individual

Printed Name of Authorized Individual

Title of Authorized Individual

Date

or is alleged to pose a threat of imminent and identifiable harm topublic health and safety?

Yes, and exhibit C is attached and made a part of this petition.No

Case 05-24592 Doc# 1 Filed 09/21/05 Page 2 of 29

Page 3: Scottie (Lee) Pippen's Bankruptcy Filing

Form 7 (12/03) West Group, Rochester, NY

Scottie Lee Pippen Case No.Chapter

DISTRICT OF KANSASUNITED STATES BANKRUPTCY COURT

7In re

/ Debtor

STATEMENT OF FINANCIAL AFFAIRS

This statement is to be completed by every debtor. Spouses f iling a joint petition may f ile a single statement on w hich the information for bothspouses is combined. If the case is f iled under chapter 12 or chapter 13, a married debtor must furnish information for both spouses w hether or not a jointpetition is f iled, unless the spouses are separated and a joint petition is not f iled. An individual debtor engaged in business as a sole proprietor, partner,family farmer, or self-employed professional, should provide the information requested on this statement concerning all such activities as w ell as theindividual's personal affairs.

Questions 1-18 are to be completed by all debtors. Debtors that are or have been in business, as defined below , also must complete Questions19-25. If the answ er to any question is "None," or the question is not applicable, mark the box labeled "None." If additional space is needed for the answ erto any question, use and attach a separate sheet properly identif ied w ith the case name, case number (if know n), and the number of the question.

DEFINITIONS

"In business." A debtor is "in business" for the purpose of this form if the debtor is a corporation or partnership. An individual debtor is "inbusiness" for the purpose of this form if the debtor is or has been, w ithin the six years immediately preceding the f iling of this bankruptcy case, any of thefollow ing: an off icer, director, managing executive, or ow ner of 5 percent or more of the voting or equity securities of a corporation; a partner, other thana limited partner, of a partnership; a sole proprietor or self-employed.

"Insider." The term "insider" includes but is not limited to: relatives of the debtor; general partners of the debtor and their relatives; corporations ofw hich the debtor is an off icer, director, or person in control; off icers, directors, and any ow ner of 5 percent or more of the voting or equity securities of acorporation debtor and their relatives; aff iliates of the debtor and insiders of such aff iliates; any managing agent of the debtor. 11 U.S.C.  §101.

1. Income from employment or operation of business.State the gross amount of income the debtor has receiv ed f rom employ ment, trade, or prof ession, or f rom operation of the debtor's business f rom the beginningof  this calendar y ear to the date this case was commenced. State also the gross amounts receiv ed during the two y ears immediately preceding this calendar y ear. (Adebtor that maintains, or has maintained, f inancial records on the basis of a f iscal rather than a calendar y ear may report f iscal y ear income. Identif y the beginning andending dates of the debtor's f iscal y ear.) If  a joint petition is f iled, state income f or each spouse separately . (Married debtors f iling under chapter 12 or chapter 13 muststate income of both spouses whether or not a joint petition is f iled, unless the spouses are separated and a joint petition is not  f iled.)

AMOUNT SOURCE (if more than one)

Year to date: $23,868 Last Year: $26,000Year before: $24,000

2. Income other than from employment or operation of business.State the amount of income receiv ed by the debtor other than f rom employ ment, trade, prof ession, or operation of the debtor's business during the two y ears immediatelypreceding the commencement of this case. Giv e particulars. If a joint petition is f iled, state income f or each spouse separately . (Married debtors f iling under chapter 12 orchapter 13 must state income f or each spouse whether or not a joint petition is f iled, unless the spouses are separated and a joint petition is  not  f iled.)

NONE

3. Payments to creditors.a. List all pay ments on loans, installment purchases of goods or serv ices, and other debts, aggregating more than $600 to any creditor, made within 90 day s immediatelypreceding the commencement of this case. (Married debtors f iling under chapter 12 or chapter 13 must include pay ments by either or both spouses whether or not a jointpetition is f iled, unless the spouses are separated and a joint petition  is  not  f iled.)

NONE

Statement of Affairs - Page 1Case 05-24592 Doc# 1 Filed 09/21/05 Page 3 of 29

Page 4: Scottie (Lee) Pippen's Bankruptcy Filing

Form 7 (12/03) West Group, Rochester, NY

b. List all pay ments made within one y ear immediately preceding the commencement of this case to or f or the benef it of creditors who are or were insiders. (Marrieddebtors f iling under chapter 12 or chapter 13 must include pay ments by either or both spouses whether or not a joint petition is f iled, unless the spouses are separated anda joint petition  is  not  f iled.)

AND RELATIONSHIP TO DEBTOR DATE OFPAYMENT AMOUNT PAID STILL OWING

AMOUNTNAME AND ADDRESS OF CREDITOR

Creditor: Ed and Danette GibbsAddress:312 S. West St.Corydon, IA 50060Relationship: Parents

over last12 months

$800 $200, oncontract tobuy car.

4. Suits and administrative proceedings, executions, garnishments and attachments.a. List all suits and administrativ e proceedings to which the debtor is or was a party within one y ear immediately preceding the f iling of this bankruptcy case. (Marrieddebtors f iling under chapter 12 or chapter 13 must include inf ormation concerning either or both spouses whether or not a joint petition is f iled, unless the spouses areseparated and a joint petition is not f iled.)

CAPTION OF SUITAND CASE NUMBER NATURE OF PROCEEDING AND LOCATION STATUS OR DISPOSITION

COURT OR AGENCY

Credit AcceptanceCorporation v.Bledsoe, PippenCL94088

Suit on contract Polk County, IowaDistrict Court

Judgment entered

b. Describe all property that has been attached, garnished or seized under any legal or equitable process within one y ear immediately preceding the commencement of thiscase.(Married debtors f iling under chapter 12 or chapter 13 must include inf ormation concerning property of either or both spouses whether or not a joint petition is f iled,unless the spouses are separated and a joint petition  is  not  f iled.)

DESCRIPTION AND VALUE OF PROPERTYSEIZUREWHOSE BENEFIT PROPERTY WAS SEIZEDNAME AND ADDRESS OF PERSON FOR DATE OF

Name: Credit AcceptanceCorporationAddress:

9/23/05 Description: Wage GarnishmentValue: unknown

5. Repossessions, foreclosures and returns.List all property that has been repossessed by a creditor, sold at a f oreclosure sale, transf erred through a deed in lieu of f oreclosure or returned to the seller, within oney ear immediately preceding the commencement of this case.(Married debtors f iling under chapter 12 or chapter 13 must include inf ormation concerning property of either orboth spouses whether or not a joint petition is f iled, unless the spouses are separated and a joint petition is  not  f iled.)

NONE

6. Assignments and receiverships.a. Describe any assignment of property f or the benef it of creditors made within 120 day s immediately preceding the commencement of this case.(Married debtors f ilingunder chapter 12 or chapter 13 must include any assignment by either or both spouses whether or not a joint petition is f iled, unless the spouses are separated and a jointpetition is not  f iled.)

NONE

b. List all property which has been in the hands of a custodian, receiv er, or court-appointed of f icial within one y ear immediately preceding the commencement of thiscase.(Married debtors f iling under chapter 12 or chapter 13 must include inf ormation concerning property of either or both spouses whether or not a joint petition is f iled,unless the spouses are separated and a joint petition is  not  f iled.)

NONE

Statement of Affairs - Page 2Case 05-24592 Doc# 1 Filed 09/21/05 Page 4 of 29

Page 5: Scottie (Lee) Pippen's Bankruptcy Filing

Form 7 (12/03) West Group, Rochester, NY

7. Gifts.List all gif ts or charitable contributions made within one y ear immediately preceding the commencement of this case except ordinary and usual gif ts to f amily membersaggregating less than $200 in v alue per indiv idual f amily member and charitable contributions aggregating less than $100 per recipient.(Married debtors f iling under chapter12 or chapter 13 must include gif ts or contributions by either or both spouses whether or not a joint petition is f iled, unless the spouses are separated and a joint petition isnot f iled.)

NONE

8. Losses.List all losses f rom f ire, thef t, other casualty or gambling within one y ear immediately preceding the commencement of this case or since the commencement of this case.(Married debtors f iling under chapter 12 or chapter 13 must include losses by either or both spouses whether or not a joint petition is f iled, unless the spouses are separatedand a joint petition is not f iled.)

NONE

9. Payments related to debt counseling or bankruptcy.List all pay ments made or property transf erred by or on behalf of the debtor to any persons, including attorney s, f or consultation concerning debt consolidation, reliefunder the bankruptcy law or preparation of a petition in bankruptcy within one y ear immediately preceding the commencement of  this  case.

NAME AND ADDRESS OF PAYEEDATE OF PAYMENT,NAME OF PAYOR IF OTHER THAN DEBTOR

AMOUNT OF MONEY OR DESCRIPTION AND VALUE OF PROPERTY

Payee: Jason NorburyAddress:8117 WornallKansas City, MO 64114

Date of Payment: 9/15/05Payor: Scottie Lee Pippen

$300.00

10. Other transfers.List all other property , other than property transf erred in the ordinary course of the business or f inancial af f airs of the debtor, transf erred either absolutely or as securitywithin one y ear immediately preceding the commencement of this case.(Married debtors f iling under chapter 12 or chapter 13 must include transf ers by either or bothspouses whether or not a joint petition is f iled, unless the spouses are separated and a joint petition  is  not  f iled.)

NONE

11. Closed financial accounts.List all f inancial accounts and instruments held in the name of the debtor or f or the benef it of the debtor which were closed, sold, or otherwise transf erred within one y earimmediately preceding the commencement of this case. Include checking, sav ings, or other f inancial accounts, certif icates of deposit, or other instruments; shares andshare accounts held in banks, credit unions, pension f unds, cooperativ es, associations, brokerage houses and other f inancial institutions. (Married debtors f iling underchapter 12 or chapter 13 must include inf ormation concerning accounts or instruments held by or f or either or both spouses whether or not a joint petition is f iled, unlessspouses are separated and a joint petition is  not  f iled.)

NONE

12. Safe deposit boxes.List each saf e deposit or other box or depository in which the debtor has or had securities, cash, or other v aluables within one y ear immediately preceding thecommencement of this case.(Married debtors f iling under chapter 12 or chapter 13 must include boxes or depositories of either or both spouses whether or not a jointpetition is f iled, unless the spouses are separated and a joint petition  is  not  f iled.)

NONE

13. Setoffs.List all setof f s made by any creditor, including a bank, against a debt or deposit of the debtor within 90 day s preceding the commencement of this case. (Married debtorsf iling under chapter 12 or chapter 13 must include inf ormation concerning either or both spouses whether or not a joint petition is f iled, unless the spouses are separated anda joint petition is not f iled.)

NONE

14. Property held for another person.List all property owned by another person that the  debtor  holds  or  controls.

NONE

Statement of Affairs - Page 3Case 05-24592 Doc# 1 Filed 09/21/05 Page 5 of 29

Page 6: Scottie (Lee) Pippen's Bankruptcy Filing

Form 7 (12/03) West Group, Rochester, NY

15. Prior address of debtor.If the debtor has mov ed within the two y ears immediately preceding the commencement of this case, list all premises which the debtor occupied during that period andv acated prior to the commencement of this case. If a joint petition is f iled, report also any separate address of either spouse.

ADDRESS NAME USED OCCUPANCYDATES OF

Debtor:Address: 7097 Hickory Lane,Urbandale IA 50322

Name(s): 8/2004 -2/2005

Debtor:Address: Norwalk, IA

Name(s): 8/2003-8/2004

16. Spouses and Former SpousesIf the debtor resides or resided in a community property state, commonwealth or territory (including Alaska, Arizona, Calif ornia, Idaho, Louisiana, Nev ada, New Mexico,Puerto Rico, Texas, Washington, or Wisconsin) within the six-y ear period immediately preceding the commencement of the case, identif y the name of the debtor's spouseand of any f ormer spouse who resides or resided with the debtor in the community property state.

NONE

17. Environmental InformationFor the purpose of this question, the f ollowing def initions apply :

"Env ironmental Law" means any f ederal, state, or local statute or regulation regulating pollution, contamination, release of hazardous or toxic substances, wastes or materialinto the air, land, soil, surf ace water, groundwater, or other medium, including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes,or material.

"Site" means any location, f acility , or property as def ined under any Env ironmental Law, whether or not presently or f ormerly owned or operated by the debtor, including, but not limited to disposal sites.

"Hazardous Material" means any thing def ined as hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, or contaminant or similar term under and Env ironmental Law:

a. List the name and address of ev ery site f or which the debtor has receiv ed notice in writing by a gov ernmental unit that it may be liable or potentially liable under or inv iolation of an Env ironmental Law. Indicate the gov ernmental unit, the date of the notice, and, if known, the Env ironmental Law:

NONE

b. List the name and address of ev ery site f or which the debtor prov ided notice to a gov ernmental unit of a release of Hazardous Material. Indicate the gov ernmental unitto which the notice was sent and the date of the notice.

NONE

c. List all judicial or administrativ e proceedings, including settlements or orders, under any Env ironmental Law, with respect to which the debtor is or was a party . Indicatethe name and address of the gov ernmental unit that is or was a party to the proceeding, and the docket number.

NONE

Statement of Affairs - Page 4Case 05-24592 Doc# 1 Filed 09/21/05 Page 6 of 29

Page 7: Scottie (Lee) Pippen's Bankruptcy Filing

Form 7 (12/03) West Group, Rochester, NY

18. Nature, location and name of businessa. If the debtor is an indiv idual, list the names, addresses, taxpay er identif ication numbers, nature of the businesses and beginning and ending dates of all businesses inwhich the debtor was an of f icer, director, partner, or managing executiv e of a corporation, partnership, sole proprietorship, or was a self -employ ed prof essional within thesix y ears immediately preceding the commencement of this case, or in which the debtor owned 5 percent or more of the v oting or equity securities within the six y earsimmediately preceding the commencement of this case

If the debtor is a partnership, list the names, addresses, taxpay er identif ication numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the v oting or equity securities within the six y ears immediately preceding the commencment of thiscase.

If the debtor is a corporation, list the names, addresses, taxpay er identif ication numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the v oting or equity securities, within the six y ears immediately preceding the commencment of thiscase.

NONE

b. Identif y any business listed in response to subdiv ision a., abov e, that is "single asset real estate" as def ined in 11 U.S.C. § 101.

NONE

DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR

Date

Date

Signature

Signature

Penalty for making a false statement: Fine of up to $500,000 or imprisonment for up to 5 years or both, 18 U.S.C. § 152 and § 3571.

9/15/2005Scottie Lee Pippen

I declare under penalty of Perjury that I have read the answers contained in the foregoing statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge, information, and belief.

/s/ Scottie Lee Pippen

Statement of Affairs - Page 5Case 05-24592 Doc# 1 Filed 09/21/05 Page 7 of 29

Page 8: Scottie (Lee) Pippen's Bankruptcy Filing

Scottie Lee Pippen

FORM B6A (6/90) West Group, Rochester, NY

In re / Debtor Case No.(if known)

SCHEDULE A-REAL PROPERTY

Except as directed below , list all real property in w hich the debtor has any legal, equitable, or future interest, including all property ow ned as a cotenant,community property, or in w hich the debtor has a life estate. Include any property in w hich the debtor holds rights and pow ers exercisable for the debtor'sow n benefit. If the debtor is married, state w hether the husband, w ife, or both ow n the property by placing an "H," "W," "J," or "C" in the column labeled"Husband, Wife, Joint, or Community." If the debtor holds no interest in real property, w rite "None" under "Description and Location of Property."

Do not include interests in executory contracts and unexpired leases on this schedule. List them in Schedule G-Executory Contracts and UnexpiredLeases.If an entity claims to have a lien or hold a secured interest in any property, state the amount of the secured claim. See Schedule D. If no entity claims tohold a secured interest in the property, w rite "None" in the column labeled "Amount of Secured Claim."

If the debtor is an individual or if a joint petition is f iled, state the amount of any exemption claimed in the property only in Schedule C-Property Claimed asExempt.

Description and Location of Property Nature of Debtor'sInterest in Property

Husband--HWife--WJoint--J

Community--C

Current MarketValue

of Debtor's Interest,in Property Without

Deducting anySecured Claim or

Exemption

Amount ofSecured Claim

None None

No continuation sheets attached TOTAL $(Report also on Summary of Schedules.)

0.00

Case 05-24592 Doc# 1 Filed 09/21/05 Page 8 of 29

Page 9: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6B (10/89) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor

SCHEDULE B-PERSONAL PROPERTY

Case No.(if known)

Except as directed below , list all personal property of the debtor of w hatever kind. If the debtor has no property in one or more of the categories, place an"X" in the appropriate position in the column labeled "None." If additional space is needed in any category, attach a separate sheet properly identif ied w iththe case name, case number, and the number of the category. If the debtor is married, state w hether husband, w ife, or both ow n property by placing an"H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the debtor is an individual or a joint petition is f iled, state the amount ofany exemptions claimed only in Schedule C-Property Claimed as Exempt.Do not list interests in executory contracts and unexpired leases on this schedule. List them in Schedule G-Executory Contracts and Unexpired Leases.If the property is being held for the debtor by someone else, state that person's name and address under "Description and Location of Property."

Description and Location of Property

Husband--HWife--WJoint--J

Community--C

Type of Property

Current MarketValue

of Debtor's Interest,in Property Without

Deducting any

ExemptionSecured Claim or

N

o

n

e

1. Cash on hand. X

2. Checking, savings or other financialaccounts, certificates of deposit, orsharesin banks, savings and loan, thrift,buildingand loan, and homestead associations, orcredit unions, brokerage houses, orcooperatives.

Checking Account - Bank of AmericaLocation: In debtor's possession

00.001 $

Savings Account - Bank of AmericaLocation: In debtor's possession

00.2 $

3. Security deposits with public utilities,telephone companies, landlords, andothers.

X

4. Household goods and furnishings,including audio, video, and computerequipment.

Household Goods and Furnishings - includingfurniture, TV, paintings, kitchen itemsLocation: In debtor's possession

00.005,2 $

5. Books, pictures and other art objects,antiques, stamp, coin, record, tape,compact disc, and other collections orcollectibles.

Sports Card Collection - no unique orindvidually value cardsLocation: In debtor's possession

00.002 $

6. W earing apparel. ClothingLocation: In debtor's possession

00.002,1 $

7. Furs and jewelry. Watch, RingLocation: In debtor's possession

00.007 $

8. Firearms and sports, photographic, andother hobby equipment.

X

9. Interests in insurance policies. Nameinsurance company of each policy anditemize surrender or refund value ofeach.

X

Page 1 of 3

Case 05-24592 Doc# 1 Filed 09/21/05 Page 9 of 29

Page 10: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6B (10/89) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor

SCHEDULE B-PERSONAL PROPERTY

Case No.(if known)

(Continuation Sheet)

Description and Location of Property

Husband--HWife--WJoint--J

Community--C

Type of Property

Current MarketValue

of Debtor's Interest,in Property Without

Deducting any

ExemptionSecured Claim or

N

o

n

e

10. Annuities. Itemize and name each issuer. X

11. Interests in IRA, ERISA, Keogh, or otherpension or profit sharing plans. Itemize.

401k AccountLocation: In debtor's possession

00.05 $

12. Stock and interests in incorporated andunincorporated businesses. Itemize.

X

13. Interests in partnerships or jointventures.Itemize.

X

14. Government and corporate bonds andother negotiable and non-negotiableinstruments.

X

15. Accounts Receivable. X

16. Alimony, maintenance, support, andproperty settlements to which the debtoris or may be entitled. Give particulars.

X

17. Other liquidated debts owing debtorincluding tax refunds. Give particulars.

X

18. Equitable or future interests, life estates,and rights or powers exercisable for thebenefit of the debtor other than thoselisted in Schedule of Real Property.

X

19. Contingent and non-contingentinterestsin estate of a decedent, death benefitplan, life insurance policy, or trust.

X

20. Other contingent and unliquidatedclaimsof every nature, including tax refunds,counterclaims of the debtor, and rightstosetoff claims. Give estimated value ofeach.

X

21. Patents, copyrights, and other intellectualproperty. Give particulars.

X

22. Licenses, franchises, and other generalintangibles. Give particulars.

X

23. Automobiles, trucks, trailers and othervehicles.

X

24. Boats, motors, and accessories. X

25. Aircraft and accessories. X

26. Office equipment, furnishings, andsupplies.

X

27. Machinery, fixtures, equipment andsupplies used in business.

X

Page 2 of 3

Case 05-24592 Doc# 1 Filed 09/21/05 Page 10 of 29

Page 11: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6B (10/89) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor

SCHEDULE B-PERSONAL PROPERTY

Case No.(if known)

(Continuation Sheet)

Description and Location of Property

Husband--HWife--WJoint--J

Community--C

Type of Property

Current MarketValue

of Debtor's Interest,in Property Without

Deducting any

ExemptionSecured Claim or

N

o

n

e

28. Inventory. X

29. Animals. X

30. Crops - growing or harvested.Give particulars.

X

31. Farming equipment and implements. X

32. Farm supplies, chemicals, and feed. X

33. Other personal property of any kind notalready listed. Itemize.

X

Page 3 of 3(Report total also on Summary of Schedules.)

Total $ 4,752.00

Include amounts from any continuation sheets attached.Case 05-24592 Doc# 1 Filed 09/21/05 Page 11 of 29

Page 12: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6C (6/90) West Group, Rochester, NY

In reScottie Lee Pippen / Debtor

SCHEDULE C-PROPERTY CLAIMED AS EXEMPT

Case No.(if known)

Exemptions available under applicable nonbankruptcy federal law s, state or local law w here the debtor's domicile has beenlocated for the 180 days immediately preceding the f iling of the petition, or for a longer portion of the 180-day period than in anyother place, and the debtor's interest as a tenant by the entirety or joint tenant to the extent the interest is exempt from processunder applicable nonbankruptcy law .

Debtor elects the exemptions to which debtor is entitled under:

(Check one box)

11 U.S.C. § 522(b) (1):11 U.S.C. § 522(b) (2):

Exemptions provided in 11 U.S.C. § 522(d). Note: These exemptions are available only in certain states.

Providing eachDescription of PropertyCurrent Market

Value of PropertyExemption

Specify Law

Without DeductingExemptions

Value ofClaimed

Exemption

Household Goods and Furnishings Ks. Stat. Ann. §60-2304(a) 00.005,2 $00.005,2 $

Clothing Ks. Stat. Ann. §60-2304(a) 00.002,1 $00.002,1 $

Watch, Ring Ks. Stat. Ann. §60-2304(b) 00.007 $00.007 $

401k Account Ks. Stat. Ann. §60-2308 00.05 $00.05 $

Page No. 1 of 1Case 05-24592 Doc# 1 Filed 09/21/05 Page 12 of 29

Page 13: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6D (12/03) West Group, Rochester, NY

Case No.(if known)

SCHEDULE D-CREDITORS HOLDING SECURED CLAIMS

In re Scottie Lee Pippen / Debtor

State the name, mailing address, including zip code, and last four digits of any account number of all entities holding claims secured by property of thedebtor as of the date of f iling of the petition. List creditors holding all types of secured interests such as judgment liens, garnishments, statutory liens,mortgages, deeds of trust, and other security interests. List creditors in alphabetical order to the extent practicable. If all secured creditors w ill not f it onthis page, use the continuation sheet provided.

If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column marked "Codebtor," include the entity on theappropriate schedule of creditors and complete Schedule H - Codebtors. If a joint petition is f iled, state w hether husband, w ife, both of them, or the maritalcommunity 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 theclaim 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 all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedules. Report this total also on theSummary of Schedules.

Check this box if debtor has no creditors holding secured claims to report on this Schedule D.

Creditor's Name and Mailing Address

Including Zip Code

H--HusbandW--WifeJ--JointC--Community

Date Claim was Incurred,

Nature of Lien, and Description andMarket Value of Property Subject to Lien

Amount of ClaimWithout

Deducting Valueof Collateral

Unsecured

Portion, if any

Codebtor

Contingent

nU

liquidated

D

sp

tu

i

ed

Account No:

Value:

Account No:

Value:

Account No:

Value:

Account No:

Value:

No continuation sheets attached

(Use only on last page. Report total also on Summary of Schedules)Total $

(Total of this page)Subtotal $ 0.00

0.00

Case 05-24592 Doc# 1 Filed 09/21/05 Page 13 of 29

Page 14: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6E (4/04) West Group, Rochester, NY

Case No.(if known)

SCHEDULE E-CREDITORS HOLDING UNSECURED PRIORITY CLAIMS

In re Scottie Lee Pippen / Debtor

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 ofunsecured 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 last four digits of the account number, if any, of all entities holding priority claims against the debtor or the property of the debtor, asof the date of the f iling 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 onthe appropriate schedule of creditors and complete Schedule H - Codebtors. If a joint petition is f iled, state w hether husband, w ife, both of them or themarital 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 threecolumns.)

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 inthe 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 f inancial affairs after the commencement of the case but before the earlier of theappointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(2).

Wages, salaries, and commissions, including vacation, severance, and sick leave pay ow ing to employees and commissions ow ing to qualifyingindependent sales representatives up to $4,925* per person earned w ithin 90 days immediately preceding the f iling of the original petition, or thecessation of business, w hichever occurred f irst, to the extent provided in 11 U.S.C. § 507(a)(3).

Wages, salaries, and commissions

Contributions to employee benefit plans

Money ow ed to employee benefit plans for services rendered w ithin 180 days immediately preceding the f iling of the original petition, or the cessationof business, w hichever occurred f irst, to the extent provided in 11 U.S.C. § 507(a)(4).

Certain farmers and fishermen

Claims of certain farmers and f ishermen, up to $4,925* per farmer or f isherman, against the debtor, as provided in 11 U.S.C. § 507(a)(5).

Deposits by individuals

Claims of individuals up to $2,225* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, thatw ere not delivered or provided. 11 U.S.C. § 507(a)(6).

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, custom duties, and penalties ow ing 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 FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors of theFederal 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, 2007, and every three years thereafter with respect to cases commenced on or after the date of adjustment.

No continuation sheets attached

Case 05-24592 Doc# 1 Filed 09/21/05 Page 14 of 29

Page 15: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6F (12/03) West Group, Rochester, NY

Case No.(if known)

SCHEDULE F-CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

In re Scottie Lee Pippen / Debtor

State the name, mailing address, including zip code, and last four digits of any account number, if any, of all entities holding unsecured claims w ithoutpriority against the debtor or the property of the debtor, as of the date of f iling of the petition. Do not include claims listed in Schedules D and E. If allcreditors w ill not f it on this page, use the continuation sheet provided.

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 theappropriate schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is f iled, state w hether husband, w ife, both of them, or the maritalcommunity 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 theclaim 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 total of all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedules. Report this total also on theSummary of Schedules.

Check this box if debtor has no creditors holding unsecured nonpriority claims to report on this Schedule F.

Creditor's Name and Mailing Address

including Zip Code

H--HusbandW--WifeJ--JointC--Community

Date Claim was Incurred,

and Consideration for Claim.If Claim is Subject to Setoff, so State.

Amount of ClaimCodebtor

Contingent

U

qil

uidated

nDisput

de

Account No:

Creditor # : 1Berg Rouse Spaulding Schmidt2423 Ingersoll AveDes Moines IA 50312

Attorney's Fees $ 2,000.00

Account No:

Creditor # : 2Broadlawns Medical Center1801 Hickman RoadDes Moines IA 50314

Medical Bills Unknown

Account No:

Creditor # : 3Capital OnePO Box 85015Richmond VA 23285-5015

Credit Card Purchases $ 792.000137

NCO Financial Systems2223071081480137Horsham PA 19044

Account No:

Representing:Capital One

0137

3 continuation sheets attached

(Report total also on Summary of Schedules)Total $

(Total of this page)Subtotal $ 2,792.00

Case 05-24592 Doc# 1 Filed 09/21/05 Page 15 of 29

Page 16: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6F (12/03) West Group, Rochester, NY

Case No.(if known)

SCHEDULE F-CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

In re Scottie Lee Pippen / Debtor

(Continuation Sheet)

Creditor's Name and Mailing Address

including Zip Code

H--HusbandW--WifeJ--JointC--Community

Date Claim was Incurred,

and Consideration for Claim.If Claim is Subject to Setoff, so State.

Amount of ClaimCodebtor

Contingent

U

qil

uidated

nDisput

de

Account No:

Creditor # : 4Capital OnePO Box 85522Richmond VA 23285-5522

Collection Account $ 792.00

Account No:

Creditor # : 5Credit Acceptance Corporationc/o Charles Litow EsqPO Box 2165Cedar Rapids IA 52406

2005Deficiency of Auto Lease

$ 15,515.74

Account No:

Creditor # : 6Credit Management17070 Dallas PkwyDallas TX 75248-1950

Collection Account $ 193.00

Account No:

Creditor # : 7Ford Motor CreditNational Bankruptcy ServicePO Box 537901Livonia MI 48153-7901

2001Deficiency on Auto Loan

$ 11,621.00

Account No:

Creditor # : 8Heartland Health5325 FaraonSt Joseph MO 64506

2002Medical Bills

$ 673.00

Account No:

Creditor # : 9Mercy Medical Center2894 106th St, Suite 100Des Moines IA 50322

Medical Bills $ 1,000.00

1Creditors Holding Unsecured Nonpriority Claims

3Sheet No. of continuation sheets attached to Schedule of

(Report total also on Summary of Schedules)Total $

(Total of this page)Subtotal $ 29,794.74

Case 05-24592 Doc# 1 Filed 09/21/05 Page 16 of 29

Page 17: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6F (12/03) West Group, Rochester, NY

Case No.(if known)

SCHEDULE F-CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

In re Scottie Lee Pippen / Debtor

(Continuation Sheet)

Creditor's Name and Mailing Address

including Zip Code

H--HusbandW--WifeJ--JointC--Community

Date Claim was Incurred,

and Consideration for Claim.If Claim is Subject to Setoff, so State.

Amount of ClaimCodebtor

Contingent

U

qil

uidated

nDisput

de

Account No:

Creditor # : 10Midamerica EnergyPO Box 8020Davenport IA 52808

Utility Bills $ 622.004065

Account No:

Creditor # : 11NCO Financial Systems, Inc909 E Republic RdBldg D, Suite 200Springfield MO 65807

Collection Account $ 88.00

Account No:

Creditor # : 12Northwest Financial Services720 Jules St.St. Joseph MO 64501-1918

2003Medical Bills

$ 121.00

Account No:

Creditor # : 13Northwest Financial Services720 Jules St.St. Joseph MO 64501-1918

Medical Bills $ 105.00

Account No:

Creditor # : 14Northwest Financial Services720 Jules St.St. Joseph MO 64501-1918

2002Medical Bills

$ 214.00

Account No:

Creditor # : 15Northwest Financial Services720 Jules St.St. Joseph MO 64501-1918

2002Medical Bills

$ 386.00

2Creditors Holding Unsecured Nonpriority Claims

3Sheet No. of continuation sheets attached to Schedule of

(Report total also on Summary of Schedules)Total $

(Total of this page)Subtotal $ 1,536.00

Case 05-24592 Doc# 1 Filed 09/21/05 Page 17 of 29

Page 18: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6F (12/03) West Group, Rochester, NY

Case No.(if known)

SCHEDULE F-CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS

In re Scottie Lee Pippen / Debtor

(Continuation Sheet)

Creditor's Name and Mailing Address

including Zip Code

H--HusbandW--WifeJ--JointC--Community

Date Claim was Incurred,

and Consideration for Claim.If Claim is Subject to Setoff, so State.

Amount of ClaimCodebtor

Contingent

U

qil

uidated

nDisput

de

Account No:

Creditor # : 16Northwest Financial Services720 Jules St.St. Joseph MO 64501-1918

2002Medical Bills

$ 344.00

Account No:

Creditor # : 17Qwest CommunicationPO Box 9156Alexandria VA 22304

Phone Bill $ 136.009894

Account No:

Creditor # : 18Southwestern Bell TelephoneCollection DivisionPO Box 90246Arlington TX 76004

Phone Bill $ 800.00

Account No:

Creditor # : 19Sprint PCS6391 Sprint ParkwayOverland Park KS 66251-6100

Cellular Phone Bill $ 1,000.00

Account No:

Creditor # : 20T MobilePO Box 37380Albuquerque NM 87176-7380

2003Cellular Phone Bill

$ 355.00

Superior Asset Management IncPO Box 596Fort Walton Beac FL 32549-0596

Account No:

Representing:T Mobile

36,757.74

3Creditors Holding Unsecured Nonpriority Claims

3Sheet No. of continuation sheets attached to Schedule of

(Report total also on Summary of Schedules)Total $

(Total of this page)Subtotal $ 2,635.00

Case 05-24592 Doc# 1 Filed 09/21/05 Page 18 of 29

Page 19: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6G (10/89) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor

SCHEDULE G-EXECUTORY CONTRACTS AND UNEXPIRED LEASES

Case No.(if known)

Describe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests.

NOTE: A party listed on this schedule will not receive notice of the filing of this case unless the party is also scheduled in the appropriate schedule of

Check this box if the debtor has no executory contracts or unexpired leases.

State nature of debtor's interests in contract, i.e., "Purchaser," "Agent," etc. State whether debtor is the lessor or lessee of a lease.Provide the names and complete mailing addresses of all other parties to each lease or contract described.

creditors.

including Zip Code, ofDescription of Contract or Lease and

Nature of Debtor's Interest.other Parties to Lease

Name and Mailing Address,

State whether Lease is for Nonresidential Real Property.State Contract Number of any Government Contract.or Contract

Ed and Danette Gibbs312 S. West St.Corydon IA 50060

Contract Type:Terms:Beginning date:Debtor's Interest:Description:

Purchase Contract$1,000, paid over time

Purchaser1995 Ford Taurus

Buyout Option:

Victor Matos7006 W 83rd StOverland Park KS 66204

Contract Type:Terms:Beginning date:Debtor's Interest:Description:

Residential lease$750 per month, 1 year lease

3/1/2005Lessee

9002 W. 79th Circle

Buyout Option:

Page 1 of 1Case 05-24592 Doc# 1 Filed 09/21/05 Page 19 of 29

Page 20: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6H (6/90) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor

SCHEDULE H-CODEBTORS

Case No.(if known)

Check this box if the debtor has no codebtors.

Provide the information requested concerning any person or entity, other than a spouse in a joint case, that is also liable on any debts listed by debtor inthe schedules of creditors. Include all guarantors and co-signers. In community property states, a married debtor not f iling a joint case should report thename and address of the nondebtor spouse on this schedule. Include all names used by the nondebtor spouse during the six years immediately precedingthe commencement of this case.

Name and Address of CreditorName and Address of Codebtor

Page 1 of 1Case 05-24592 Doc# 1 Filed 09/21/05 Page 20 of 29

Page 21: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6I (12/03) West Group, Rochester, NY

In re Scottie Lee Pippen / Debtor Case No.(if known)

SCHEDULE I-CURRENT INCOME OF INDIVIDUAL DEBTOR(S)

The column labeled "Spouse" must be completed in all cases f iled by joint debtors and by a married debtor in a chapter 12 or 13 case w hether or not a jointpetition is f iled, unless the spouses are separated and a joint petition is not f iled.

Debtor's Marital

Status:

DEPENDENTS OF DEBTOR AND SPOUSE

AGERELATIONSHIPSingle

EMPLOYMENT: DEBTOR SPOUSE

Occupation

Name of Employer

How Long Employed

Address of Employer

2 years

Brown Group Retail IncDistrict Manager

8300 Maryland AvenuePO Box 29St. Louis MO 63166-0029

Income: (Estimate of average monthly income) DEBTOR SPOUSE

2,750.00

Current Monthly gross wages, salary, and commissions (pro rate if not paid monthly) $Estimated Monthly OvertimeSUBTOTAL

$$ $

$$

LESS PAYROLL DEDUCTIONSa. Payroll Taxes and Social Securityb. Insurancec. Union Dues

$$$

$$$

2,750.000.00

0.000.000.00

603.26110.500.00

0.000.000.00

d. Other (Specify): 401(k) $ 00.011 $ 00.0SUBTOTAL OF PAYROLL DEDUCTIONS

TOTAL NET MONTHLY TAKE HOME PAY

$

$

$

$

823.77 0.00

1,926.23 0.00

Regular income from operation of business or profession or farm (attach detailed statement) Income from Real PropertyInterest and dividendsAlimony, maintenance or support payments payable to the debtor for the debtor's use or thatof dependents listed above.Social Security or other government assistance

$$$

$$$$$

$$Specify:Pension or retirement income

0.00 0.000.00 0.000.00 0.000.00 0.00

0.00 0.00$ 0.00 $ 0.00

Specify: $ $00.0 00.0Other monthly income

TOTAL COMBINED MONTHLY INCOME (Report also on Summary of Schedules)

TOTAL MONTHLY INCOME

$ 1,926.230.00$1,926.23$

Describe any increase or decrease of more than 10% in any of the above categories anticipated to occur within the year following the filing of thisdocument:

Page No. 1 of 1Case 05-24592 Doc# 1 Filed 09/21/05 Page 21 of 29

Page 22: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6J (6/90) West Group, Rochester, NY

Case No.(if known)

SCHEDULE J-CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR

In re / DebtorScottie Lee Pippen

Complete this schedule by estimating the average expenses of the debtor and the debtor's family. Pro rate any payments made bi-w eekly, quarterly,semi-annually, or annually to show monthly rate.

Check this box if a joint petition is filed and debtor's spouse maintains a separate household. Complete a separate schedule of expenditures labeled"Spouse."

Rent or home mortgage payment (include lot rented for mobile home)

Are real estate taxes included?

Is property insurance included?

$

$

Utilities: Electricity and heating fuel

Water and sewer

Telephone

Other

$$$

750.00

125.0030.00100.000.000.00$

$ 0.00

Yes

Yes

No

No

Other

Other

Home maintenance (Repairs and upkeep)

Food

Clothing

Medical and dental expenses

Laundry and dry cleaning

Recreation, clubs and entertainment, newspapers, magazines, etc.

Transportation (not including car payments)

Charitable contributions

Homeowner's or renter's

Insurance (not deducted from wages or included in home mortgage payments)

Li fe

Health

Auto

Other

Other

Other

$ 0.00200.00$

$$ 10.00

25.00

$ 50.00$$ 100.00

250.00

$ 10.00

$ 20.000.00$

75.000.00$

$$ 0.00

0.00$$

0.00

Taxes (not deducted from wages or included in home mortgage)

Specify: $Installment payments: (in chapter 12 and 13 cases, do not list payments to be included in the plan)

Auto $$$

0.00

0.000.000.00

Other:

Other:

Other: $ 0.000.00$

$ 0.00$ 0.00

Alimony, maintenance, and support paid to others

Payments for support of additional dependents not living at your home

Regular expenses from operation of business, profession, or farm (attach detailed statement)

Other: Haircuts/CosmeticsTobaccoOther:

Other:

$$$

50.0075.000.00

TOTAL MONTHLY EXPENSES 1,870.00$(Report also on Summary of Schedules)

Case 05-24592 Doc# 1 Filed 09/21/05 Page 22 of 29

Page 23: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6 (6/90) West Group, Rochester, NY

Case No.

UNITED STATES BANKRUPTCY COURT

In re

/ Debtor

Scottie Lee Pippen

DISTRICT OF KANSAS

Chapter 7

Indicate as to each schedule w hether that schedule is attached and state the number of pages on each. Report the totals from Schedules A, B, D, E, F, I,and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor's assets. Add the amounts fromSchedules D, E and F to determine the total amount of the debtor's liabilities.

SUMMARY OF SCHEDULES

AMOUNTS SCHEDULED

NAME OF SCHEDULEAttached(Yes/No)

No. ofSheets ASSETS LIABILITIES OTHER

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

1

3

1

1

1

4

1

1

1

1

A-Real Property

B-Personal Property

C-Property Claimed asExempt

D-Creditors Holding SecuredClaims

E-Creditors HoldingUnsecured Priority Claims

F-Creditors HoldingUnsecured Nonpriority Claims

G-Executory Contracts andUnexpired Leases

H-Codebtors

I-Current Income of IndividualDebtor(s)

J-Current Expenditures ofIndividual Debtor(s)

$ 0.00

4,752.00$

0.00$

0.00$

36,757.74$

1,926.23$

1,870.00$

15

36,757.74$

4,752.00$

Total Number of Sheets in All Schedules

Total Assets

Total Liabilities

Case 05-24592 Doc# 1 Filed 09/21/05 Page 23 of 29

Page 24: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B6 (6/90) West Group, Rochester, NY

In re

DECLARATION CONCERNING DEBTOR'S SCHEDULES

/ Debtor Case No.(if known)

DECLARATION UNDER PENALTY OF PERJURY BY AN INDIVIDUAL DEBTOR

Scottie Lee Pippen

I declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of 16 sheets, and that they are true and

correct to the best of my knowledge, information and belief.

Date: 9/15/2005 SignatureScottie Lee Pippen/s/ Scottie Lee Pippen

Case 05-24592 Doc# 1 Filed 09/21/05 Page 24 of 29

Page 25: Scottie (Lee) Pippen's Bankruptcy Filing

FORM B8 (12/03) West Group, Rochester, NY

In re Scottie Lee Pippen

/ Debtor

Case No.Chapter 7

DISTRICT OF KANSASUNITED STATES BANKRUPTCY COURT

CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION

2. I intend to do the following with respect to the property of the estate which secures those consumer debts:

1. I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate.

a. Property to Be Surrendered.

Description of Property Creditor's Name

None

b. Property to Be Retained.

Description of Property Creditor's NameProperty will be

reaffirmedpursuant to

Property isredeemedpursuant toexempt

claimed asDebt will be

[Check any applicable statement.]

11 U.S.C. § 722 11 U.S.C. § 524(c)

None

Date: Debtor:

Signature of Debtor(s)

/s/ Scottie Lee Pippen9/15/2005

Date: Joint Debtor:9/15/2005

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Rule 2016(b) (8/91) West Group, Rochester, NY

UNITED STATES BANKRUPTCY COURT DISTRICT OF KANSAS

In reCase No.Chapter

Scottie Lee Pippen7

Jason NorburyAttorney for Debtor:/ Debtor

STATEMENT PURSUANT TO RULE 2016(B)

The undersigned, pursuant to Rule 2016(b), Bankruptcy Rules, states that:

1. The undersigned is the attorney for the debtor(s) in this case.

2.a)

connection with this case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $Prior to the filing of this statement, debtor(s) have paid . . . . . . . . . . . . . . . $The unpaid balance due and payable is . . . . . . . . . . . . . . . . . . . . . . . . . . . $

b)c)

The compensation paid or agreed to be paid by the debtor(s), to the undersigned is:For legal services rendered or to be rendered in contemplation of and in

900.00300.00600.00

3. $ 209.00 of the filing fee in this case has been paid.

4.a)

file a petition under title 11 of the United States Code.b)

c)

Analysis of the financial situation, and rendering advice and assistance to the debtor(s) in determining whether toThe Services rendered or to be rendered include the following:

Preparation and filing of the petition, schedules, statement of financial affairs and other documents required by the

Representation of the debtor(s) at the meeting of creditors.court.

5.services performed, andThe source of payments made by the debtor(s) to the undersigned was from earnings, wages and compensation for

None other

6.be from earnings, wages and compensation for services performed, andThe source of payments to be made by the debtor(s) to the undersigned for the unpaid balance remaining, if any, will

None other

7.the value stated:The undersigned has received no transfer, assignment or pledge of property from debtor(s) except the following for

None

8.law firm, any compensation paid or to be paid except as follows:The undersigned has not shared or agreed to share with any other entity, other than with members of undersigned's

None

Dated:

Attorney for Petitioner:

9/15/2005 Respectfully submitted,

Jason NorburyLaw Office of Jason Norbury, P.C.8117 WornallKansas City MO 64114

X/s/ Jason Norbury

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UNITED STATES BANKRUPTCY COURT DISTRICT OF KANSAS

In re Scottie Lee PippenChapter 7Case No.

Attorney for Debtor: Jason Norbury/ Debtor

COVER SHEET FOR LIST OF CREDITORS

I hereby certify under penalty of perjury that the attached list of creditors, which consists of __________ pages,

is true, correct and complete to the best of my knowledge.

2

Date:Debtor

9/15/2005 /s/ Scottie Lee Pippen

Jason NorburyAttorney for the debtor(s)8117 WornallKansas City, MO 64114

/s/ Jason Norbury

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Berg Rouse Spaulding Schmidt2423 Ingersoll AveDes Moines IA 50312

Broadlawns Medical Center1801 Hickman RoadDes Moines IA 50314

Capital OnePO Box 85522Richmond VA 23285-5522

Capital OnePO Box 85015Richmond VA 23285-5015

Credit Acceptance Corporationc/o Charles Litow EsqPO Box 2165Cedar Rapids IA 52406

Credit Management17070 Dallas PkwyDallas TX 75248-1950

Ford Motor CreditNational Bankruptcy ServicePO Box 537901Livonia MI 48153-7901

Heartland Health5325 FaraonSt Joseph MO 64506

Mercy Medical Center2894 106th St Suite 100Des Moines IA 50322

Midamerica EnergyPO Box 8020Davenport IA 52808

NCO Financial Systems2223071081480137Horsham PA 19044

NCO Financial Systems Inc 909 E Republic Rd Bldg D Suite 200Springfield MO 65807

Northwest Financial Services720 Jules St St Joseph MO 64501-1918

Qwest CommunicationPO Box 9156Alexandria VA 22304

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Southwestern Bell TelephoneCollection DivisionPO Box 90246Arlington TX 76004

Sprint PCS6391 Sprint ParkwayOverland Park KS 66251-6100

Superior Asset Management Inc PO Box 596Fort Walton Beac FL 32549-0596

T MobilePO Box 37380Albuquerque NM 87176-7380

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