Vanden Bos & Chapman, LLP
Unsecured Creditor’s Name Complete Correspondence/Inquiry Address of CreditorCity, State & ZipWho Incurred DebtBank of America123 Main StIone, CA 96671Debtor & Co-DebtorIs The ClaimSubject To OffsetAcct. No.Type of Debt(medical, credit card,student loan, etc.)Amount OwedDate Incurred (if known)No123412341234credit card$10,000.00unknownCo-Signor NameAddressCity, State & ZipRelationshipExample: Jane Doe555 SW 5thPortland, OR 97205Spouse Unsecured Creditor’s Name Complete Correspondence/Inquiry Address of CreditorCity, State & ZipWho Incurred DebtBank of America123 Main StIone, CA 96671Debtor & Co-DebtorIs The ClaimSubject To OffsetAcct. No.Type of Debt(medical, credit card,student loan, etc.)Amount OwedDate Incurred (if known)No123412341234credit card$10,000.00unknownCo-Signor NameAddressCity, State & ZipRelationshipExample: Jane Doe555 SW 5thPortland, OR 97205Spouse Unsecured Creditor’s Name Complete Correspondence/Inquiry Address of CreditorCity, State & ZipWho Incurred DebtBank of America123 Main StIone, CA 96671Debtor & Co-DebtorIs The ClaimSubject To OffsetAcct. No.Type of Debt(medical, credit card,student loan, etc.)Amount OwedDate Incurred (if known)No123412341234credit card$10,000.00unknownCo-Signor NameAddressCity, State & ZipRelationshipExample: Jane Doe555 SW 5thPortland, OR 97205Spouse Unsecured Creditor’s Name Complete Correspondence/Inquiry Address of CreditorCity, State & ZipWho Incurred DebtBank of America123 Main StIone, CA 96671Debtor & Co-DebtorIs The ClaimSubject To OffsetAcct. No.Type of Debt(medical, credit card,student loan, etc.)Amount OwedDate Incurred (if known)No123412341234credit card$10,000.00unknownCo-Signor NameAddressCity, State & ZipRelationshipExample: Jane Doe555 SW 5thPortland, OR 97205Spouse ................
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