{"id":"court_ctb_440_5","court":"CTB","case_no":"22-50073","doc_number":440,"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|                       |  | 22-50073                   |  |  |  |  |\n|-----------------------|--|----------------------------|--|--|--|--|\n| Ho Wan Kwok<br>IN RE: |  |                            |  |  |  |  |\n|                       |  |                            |  |  |  |  |\n| PAX                   |  | 5                          |  |  |  |  |\n|                       |  |                            |  |  |  |  |\n|                       |  | 5/25/2022 Admitted in Full |  |  |  |  |\n|                       |  | P.E.                       |  |  |  |  |\n|                       |  |                            |  |  |  |  |\n|                       |  |                            |  |  |  |  |\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<br>(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)                                                      |                                                 |             |           |  |\n|                                                                 |                                                 |             |           |  |\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.<br>× |                                                                                                 |  |  |  |  |  |  |  |\n| Ho Wan Kwok<br>Signature of Debtor 1                                                                                                                   | 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\n\nBest Case Bankruptcy","body_zh":"证物 PAX 05\n\n关于个人债务人附表的声明\n\n22-50073\n\nHo Wan Kwok（郭文贵）\n案由：\n\nPAX 5\n\n5/25/2022 全部采纳\nP.E.\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（配偶，如共同申请） 名 中间名 姓\n法院：DISTRICT OF CONNECTICUT（康涅狄格区）美国破产法院\n案号 22-50073\n（如已知）\n\n官方表格 106Dec 关于个人债务人附表的声明\n\n12/15\n\n如果两名已婚人士共同申请，双方均对提供正确信息承担同等责任。\n\n每当您提交破产附表时，都必须提交此表格。在破产案件中作出虚假陈述、隐匿财产，或通过欺诈获取金钱或财产，可导致高达 $250,000 的罚款，或长达 20 年的监禁，或两者并罚。18 U.S.C. §§ 152、1341、1519 及 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 附上破产申请填报人通知、声明及签名（官方表格 119）\n我谨在接受伪证罪处罚的前提下声明，我已阅读随本声明一并提交的摘要及附表，且其内容真实、正确。\n×\nHo Wan Kwok（郭文贵）\n债务人 1 签名 债务人 2 签名\n\n日期 日期\n\n官方表格 106Dec\n关于个人债务人附表的声明\n\n软件版权所有 (c) 1996-2022 Best Case, LLC - www.bestcase.com\n\nBest Case 破产","key_entities":["Kwok","Ho Wan Kwok"],"ecf_references":[],"word_count":431,"status":"published","published_at":null,"created_at":null,"updated_at":"2026-08-23 12:31:54"}