---
type: court_doc
id: "court_ctb_249_3"
court: "CTB"
case_no: "22-50073"
doc_number: 249
doc_type: "UNKNOWN"
filed_date: null
lang: "zh"
url: "https://mubeitech.com/court/court_ctb_249_3"
json_url: "https://mubeitech.com/api/court/court_ctb_249_3"
---
# | Fill in this information to identify your case:                 |             |             |           |



> 原始法庭文件为英文；下方为英文全文，顶部为中文摘要。

| Fill in this information to identify your case:                 |             |             |           |                          |
|-----------------------------------------------------------------|-------------|-------------|-----------|--------------------------|
| Debtor 1                                                        | Ho Wan Kwok |             |           |                          |
|                                                                 | 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 CONNECTICUT |             |             |           |                          |
| Case number                                                     | 22-50073    |             |           |                          |
| (if known)                                                      |             |             |           | D<br>Check if this is an |
|                                                                 |             |             |           | amended filing           |

## Official Form 106Dec Declaration About an Individual Debtor's Schedules

12/15

If two married people are filing together, both are equally responsible for supplying correct information.

You 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.

| Sign Below                                                                                                                                                       |                                                                                                 |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|
| Did you pay or agree to pay someone who is NOT an attorney to help you fill out bankruptcy forms?                                                                |                                                                                                 |
| No                                                                                                                                                               |                                                                                                 |
| Yes. Name of person                                                                                                                                              | Attach Bankruptcy Petition Preparer's Notice,<br>Declaration, and Signature (Official Form 119) |
| 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>Ho Wan Kwok | X<br>Signature of Debtor 2                                                                      |
| Signature of Debtor 1<br>22<br>0<br>20<br>Date                                                                                                                   | Date                                                                                            |

Official Form 106Dec

## Declaration About an Individual Debtor's Schedules

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## DEBTOR 03