{"id":"court_ctb_404_5","court":"CTB","case_no":"22-50073","doc_number":404,"sub_number":5,"doc_type":"EXHIBIT","filed_date":null,"title":"EXHIBIT PAX 05 Declaration About Individual Debtor's Schedules","summary_zh":null,"summary_en":null,"body_en":"## **EXHIBIT PAX 05**\n\nDeclaration About Individual Debtor's Schedules\n\n|                                                                 | Fill in this information to identify your case: |             |           |                           |\n|-----------------------------------------------------------------|-------------------------------------------------|-------------|-----------|---------------------------|\n| Debtor 1                                                        | Ho Wan Kwok                                     |             |           |                           |\n|                                                                 | First Name                                      | Middle Name | Last Name |                           |\n| Debtor 2                                                        |                                                 |             |           |                           |\n| (Spouse if, filing)                                             | First Name                                      | Middle Name | Last Name |                           |\n| United States Bankruptcy Court for the: DISTRICT OF CONNECTICUT |                                                 |             |           |                           |\n| Case number                                                     | 22-50073                                        |             |           |                           |\n| (if known)                                                      |                                                 |             |           | Check if this is an<br>10 |\n|                                                                 |                                                 |             |           | amended filing            |\n\n## Official Form 106Dec Declaration About an Individual Debtor's Schedules\n\n12/15\n\nIf two married people are filing together, both are equally responsible for supplying correct information.\n\nYou must file this form whenever you file bankruptcy schedules. Making a false statement, concealing property, or obtaining money or property by fraud in connection with a bankruptcy case can result in fines up to \\$250,000, or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.\n\n| Sign Below                                                                                                                                        |                                                                                                 |  |  |  |  |  |\n|---------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|--|--|--|--|--|\n| Did you pay or agree to pay someone who is NOT an attorney to help you fill out bankruptcy forms?                                                 |                                                                                                 |  |  |  |  |  |\n| No                                                                                                                                                |                                                                                                 |  |  |  |  |  |\n| Yes. Name of person                                                                                                                               | Attach Bankruptcy Petition Preparer's Notice,<br>Declaration, and Signature (Official Form 119) |  |  |  |  |  |\n| Under penalty of perjury, I declare that I have read the summary and schedules filed with this declaration and<br>that they are true and correct. |                                                                                                 |  |  |  |  |  |\n| Ho Wan Kwok<br>Signature of Debtor 1                                                                                                              | ×<br>Signature of Debtor 2                                                                      |  |  |  |  |  |\n| 22<br>9<br>20<br>Date                                                                                                                             | Date                                                                                            |  |  |  |  |  |\n\nOfficial Form 106Dec\n\n## Declaration About an Individual Debtor's Schedules\n\nSoftware Copyright (c) 1996-2022 Best Case, LLC - www.bestcase.com","body_zh":"证物 PAX 05\n\n个人债务人财产明细表相关声明\n\n填写此信息以识别您的案件：\n\n债务人 1　Ho Wan Kwok（郭文贵）\n名　中间名　姓\n债务人 2\n（若配偶共同申请）　名　中间名　姓\n受理法院：United States Bankruptcy Court for the: DISTRICT OF CONNECTICUT（美国康涅狄格区联邦破产法院）\n案号　22-50073\n（如已知）　若此件为修正申报请勾选\n\n修正申报\nOfficial Form 106Dec 个人债务人财产明细表相关声明\n\n12/15\n\n如果已婚二人共同申请，双方均对提供正确信息负有同等责任。\n\n每当您提交破产财产明细表时，必须提交本表格。在破产案件中作出虚假陈述、隐匿财产，或通过欺诈手段获取金钱或财产，可导致最高 \\$250,000 的罚金，或最高 20 年监禁，或二者并处。18 U.S.C. §§ 152, 1341, 1519, and 3571.\n\n在下方签名\n\n您是否已向或同意向非律师人员支付报酬以协助您填写破产表格？\n否\n是。该人员姓名　附上破产申请书代写人通知、声明及签名（Official Form 119）\n我谨在此声明，在受伪证罪处罚的原则下，我已阅读与本声明一同提交的摘要和财产明细表，且其内容均真实、准确。\nHo Wan Kwok（郭文贵）\n债务人 1 签名　×\n债务人 2 签名\n\n日期　日期\n\nOfficial Form 106Dec\n个人债务人财产明细表相关声明\n\n软件版权所有 (c) 1996-2022 Best Case, LLC - www.bestcase.com","key_entities":["Kwok","Ho Wan Kwok"],"ecf_references":[],"word_count":343,"status":"published","published_at":null,"created_at":null,"updated_at":"2026-08-23 12:29:07"}