Bankruptcy Filing
Bankruptcy Filing
11
Case number (If known): _________________________ Chapter ______
Check if this is an
amended filing
If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor’s name and the case
number (if known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.
4. Debtor’s address Principal place of business Mailing address, if different from principal place
of business
1801 NW 126 Way _______________________________________________
______________________________________________
Number Street Number Street
______________________________________________ _______________________________________________
P.O. Box
_______________________________________________
_______________________________________________
City State ZIP Code
6. Type of debtor
✔ Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP))
Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 2 of 69
A. Check one:
7. Describe debtor’s business
Health Care Business (as defined in 11 U.S.C. § 101(27A))
Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))
Railroad (as defined in 11 U.S.C. § 101(44))
Stockbroker (as defined in 11 U.S.C. § 101(53A))
Commodity Broker (as defined in 11 U.S.C. § 101(6))
Clearing Bank (as defined in 11 U.S.C. § 781(3))
✔ None of the above
✔ Debtor’s aggregate noncontingent liquidated debts (excluding debts owed to
insiders or affiliates) are less than $3,024,725 (amount subject to adjustment on
4/01/25 and every 3 years after that).
A debtor who is a “small business
debtor” must check the first sub- The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). If the
box. A debtor as defined in debtor is a small business debtor, attach the most recent balance sheet, statement
§ 1182(1) who elects to proceed of operations, cash-flow statement, and federal income tax return or if all of these
documents do not exist, follow the procedure in 11 U.S.C. § 1116(1)(B).
under subchapter V of chapter 11
(whether or not the debtor is a
✔
The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and it
“small business debtor”) must chooses to proceed under Subchapter V of Chapter 11.
check the second sub-box.
A plan is being filed with this petition.
Acceptances of the plan were solicited prepetition from one or more classes of
creditors, in accordance with 11 U.S.C. § 1126(b).
The debtor is required to file periodic reports (for example, 10K and 10Q) with the
Securities and Exchange Commission according to § 13 or 15(d) of the Securities
Exchange Act of 1934. File the Attachment to Voluntary Petition for Non-Individuals
Filing for Bankruptcy under Chapter 11 (Official Form 201A) with this form.
The debtor is a shell company as defined in the Securities Exchange Act of 1934
Rule 12b-2.
Chapter 12
Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 2
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 3 of 69
11. Why is the case filed in this Check all that apply:
district?
Debtor has had its domicile, 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.
A bankruptcy case concerning debtor’s affiliate, general partner, or partnership is pending in this district.
It includes perishable goods or assets that could quickly deteriorate or lose value without
attention (for example, livestock, seasonal goods, meat, dairy, produce, or securities-related
assets or other options).
Other _______________________________________________________________________________
____________________________________________________________________
Phone ________________________________
After any administrative expenses are paid, no funds will be available for distribution to unsecured creditors.
$0-$50,000
✔
$1,000,001-$10 million $500,000,001-$1 billion
15. Estimated assets $50,001-$100,000 $10,000,001-$50 million $1,000,000,001-$10 billion
$100,001-$500,000 $50,000,001-$100 million $10,000,000,001-$50 billion
$500,001-$1 million $100,000,001-$500 million More than $50 billion
Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 3
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 4 of 69
$0-$50,000
✔
$1,000,001-$10 million $500,000,001-$1 billion
16. Estimated liabilities $50,001-$100,000 $10,000,001-$50 million $1,000,000,001-$10 billion
$100,001-$500,000 $50,000,001-$100 million $10,000,000,001-$50 billion
$500,001-$1 million $100,000,001-$500 million More than $50 billion
WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to
$500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.
17. Declaration and signature of The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this
authorized representative of
petition.
debtor
I have been authorized to file this petition on behalf of the debtor.
I have examined the information in this petition and have a reasonable belief that the information is true and
correct.
I declare under penalty of perjury that the foregoing is true and correct.
10/02/2024
Executed on _________________
MM / DD / YYYY
President
Title _________________________________________
Angelo Gasparri
_________________________________________________________________________________________________
Printed name
Kelley Kronenberg
_________________________________________________________________________________________________
Firm name
10360 West State Road 84
_________________________________________________________________________________________________
Number Street
Fort Lauderdale
____________________________________________________ FL 33324
____________ ______________________________
City State ZIP Code
5615045341
____________________________________ [email protected]
__________________________________________
Contact phone Email address
32158 FL
______________________________________________________ ____________
Bar number State
Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 4
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 5 of 69
Check if this is an
amended filing
Pa rt 1 : Sum m a ry of Asse t s
2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
0.00
$ __________________
Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D ................................................
3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals page 1
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 6 of 69
A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which the debtor
disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do not include claims by
secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditor among the holders of the 20
largest unsecured claims.
Name of creditor and complete Name, telephone number, Nature of the claim Indicate if Amount of unsecured claim
mailing address, including zip code and email address of (for example, trade claim is If the claim is fully unsecured, fill in only unsecured
creditor contact debts, bank loans, contingent, claim amount. If claim is partially secured, fill in
professional unliquidated, total claim amount and deduction for value of
services, and or disputed collateral or setoff to calculate unsecured claim.
government
contracts)
Total claim, if Deduction for Unsecured
partially value of claim
secured collateral or
setoff
Bradley / Grombacher LLP (o/b/o Charles Kiley L. Grombacher Civil Claims Disputed
1 J. Geletko) Unliquidated
31365 Oak Crest DRive Contingent 0.00
Suite 240
Westlake Village, CA, 91361
Danile J. Rodriguez Daniel J. Rodriguez Civil Claims Disputed
2 531 NE 39 St. Apt. 202 [email protected] Unliquidated
Miami, FL, 33133 Contingent
0.00
Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 1
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 7 of 69
Name of creditor and complete Name, telephone number, Nature of the claim Indicate if Amount of unsecured claim
mailing address, including zip code and email address of (for example, trade claim is If the claim is fully unsecured, fill in only unsecured
creditor contact debts, bank loans, contingent, claim amount. If claim is partially secured, fill in
professional unliquidated, total claim amount and deduction for value of
services, and or disputed collateral or setoff to calculate unsecured claim.
government
contracts)
Total claim, if Deduction for Unsecured
partially value of claim
secured collateral or
setoff
Atty Gen Massachusetts Andrea Campbell Civil Penalties Disputed
9 1 Ashburton Place Unliquidated
20th Floor Contingent 0.00
Boston, MA, 2108
Official Form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims page 2
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 8 of 69
Fill in this information to identify the case:
Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest. Include
all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties which have
no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts or unexpired
leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).
Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write
the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an
additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.
For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset
schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the
debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.
Pa rt 1 : Ca sh a nd c a sh e quiva le nt s
No. Go to Part 2.
✔
Yes. Fill in the information below.
All cash or cash equivalents owned or controlled by the debtor Current value of debtor’s
interest
Name of institution (bank or brokerage firm) Type of account Last 4 digits of account number
Flagstar, 102 Duffy Avenue, Hicksville, New York 11801______________________
3.1. _________________________________________________ Checking 2
____ 1
____ 0
____ 8
____ $______________________
33,105.00
3.2. _________________________________________________ ______________________ ____ ____ ____ ____ $______________________
Pa rt 2 : De posit s a nd pre pa ym e nt s
✔
No. Go to Part 3.
Yes. Fill in the information below.
Current value of
debtor’s interest
7. Deposits, including security deposits and utility deposits
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 1
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 9 of 69
Debtor Jerico Pictures, Inc.
_______________________________________________________ Case number (if known)_____________________________________
Name
8. Prepayments, including prepayments on executory contracts, leases, insurance, taxes, and rent
Description, including name of holder of prepayment
8.1.___________________________________________________________________________________________________________ $______________________
8.2.___________________________________________________________________________________________________________ $_______________________
9. Total of Part 2.
$______________________
Add lines 7 through 8. Copy the total to line 81.
No. Go to Part 4.
✔
Pa rt 4 : I nve st me nt s
15. Non-publicly traded stock and interests in incorporated and unincorporated businesses,
including any interest in an LLC, partnership, or joint venture
16. Government bonds, corporate bonds, and other negotiable and non-negotiable
instruments not included in Part 1
Describe:
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 2
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 10 of 69
Jerico Pictures, Inc.
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
18. Does the debtor own any inventory (excluding agriculture assets)?
No. Go to Part 6.
✔
No
Yes. Book value _______________ Valuation method____________________ Current value______________
26. Has any of the property listed in Part 5 been appraised by a professional within the last year?
No
Yes
27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?
No. Go to Part 7.
✔
30. Farm machinery and equipment (Other than titled motor vehicles)
32. Other farming and fishing-related property not already listed in Part 6
______________________________________________________________ $________________ ____________________ $______________________
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 3
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 11 of 69
Jerico Pictures, Inc.
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
No
Yes. Is any of the debtor’s property stored at the cooperative?
No
Yes
35. Has any of the property listed in Part 6 been purchased within 20 days before the bankruptcy was filed?
No
Yes. Book value $_______________ Valuation method ____________________ Current value $________________
36. Is a depreciation schedule available for any of the property listed in Part 6?
No
Yes
37. Has any of the property listed in Part 6 been appraised by a professional within the last year?
No
Yes
38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?
No. Go to Part 8.
Yes. Fill in the information below.
✔
General description Net book value of Valuation method Current value of debtor’s
debtor's interest used for current value interest
(Where available)
39. Office furniture
44. Is a depreciation schedule available for any of the property listed in Part 7?
✔ No
Yes
45. Has any of the property listed in Part 7 been appraised by a professional within the last year?
✔ No
Yes
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 4
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 12 of 69
Jerico Pictures, Inc.
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
46. Does the debtor own or lease any machinery, equipment, or vehicles?
No. Go to Part 9.
✔
General description Net book value of Valuation method used Current value of
debtor's interest for current value debtor’s interest
Include year, make, model, and identification numbers (i.e., VIN,
(Where available)
HIN, or N-number)
47. Automobiles, vans, trucks, motorcycles, trailers, and titled farm vehicles
52. Is a depreciation schedule available for any of the property listed in Part 8?
No
Yes
53. Has any of the property listed in Part 8 been appraised by a professional within the last year?
No
Yes
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 5
Case 24-20281-SMG
Jerico Pictures, Inc.
Doc 1 Filed 10/02/24 Page 13 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 9 : Re a l prope rt y
Description and ___location of property Nature and extent Net book value of Valuation method used Current value of
Include street address or other description such as of debtor’s interest debtor's interest for current value debtor’s interest
Assessor Parcel Number (APN), and type of property in property (Where available)
(for example, acreage, factory, warehouse, apartment
or office building), if available.
55.1
55.2
55.3
57. Is a depreciation schedule available for any of the property listed in Part 9?
No
Yes
58. Has any of the property listed in Part 9 been appraised by a professional within the last year?
No
Yes
59. Does the debtor have any interests in intangibles or intellectual property?
No. Go to Part 11.
Yes. Fill in the information below.
✔
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 6
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 14 of 69
Debtor Jerico Pictures, Inc.
_______________________________________________________ Case number (if known)_____________________________________
Name
67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C. §§ 101(41A) and 107)?
✔ No
Yes
68. Is there an amortization or other similar schedule available for any of the property listed in Part 10?
✔ No
Yes
69. Has any of the property listed in Part 10 been appraised by a professional within the last year?
✔ No
Yes
Pa rt 1 1 : All ot he r a sse t s
70. Does the debtor own any other assets that have not yet been reported on this form?
Include all interests in executory contracts and unexpired leases not previously reported on this form.
✔
No. Go to Part 12.
Yes. Fill in the information below.
Current value of
debtor’s interest
71. Notes receivable
Description (include name of obligor)
______________________________________________________
_______________ – __________________________ = $_____________________
Total face amount doubtful or uncollectible amount
_________________________________________________________________________________
Tax year ___________ $_____________________
_________________________________________________________________________________
Tax year ___________ $_____________________
_________________________________________________________________________________
Tax year ___________ $_____________________
______________________________________________________________ $_____________________
77. Other property of any kind not already listed Examples: Season tickets,
country club membership
____________________________________________________________ $_____________________
____________________________________________________________ $_____________________
78. Total of Part 11.
$_____________________
Add lines 71 through 77. Copy the total to line 90.
79. Has any of the property listed in Part 11 been appraised by a professional within the last year?
No
Yes
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 7
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 15 of 69
Jerico Pictures, Inc.
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 1 2 : Sum ma ry
In Part 12 copy all of the totals from the earlier parts of the form.
0.00
81. Deposits and prepayments. Copy line 9, Part 2. $_______________
0.00
82. Accounts receivable. Copy line 12, Part 3. $_______________
0.00
83. Investments. Copy line 17, Part 4. $_______________
0.00
84. Inventory. Copy line 23, Part 5. $_______________
0.00
85. Farming and fishing-related assets. Copy line 33, Part 6. $_______________
0.00
$________________
88. Real property. Copy line 56, Part 9. . ..................................................................................
675.00
89. Intangibles and intellectual property. Copy line 66, Part 10. $_______________
0.00
90. All other assets. Copy line 78, Part 11. + $_______________
39,225.00 0.00
91. Total. Add lines 80 through 90 for each column. ........................... 91a. $_______________ + 91b.
$________________
39,225.00 39,225.00
92. Total of all property on Schedule A/B. Lines 91a + 91b = 92. ........................................................................................... $__________________
Official Form 206A/B Schedule A/B: Assets Real and Personal Property page 8
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 16 of 69
Jerico Pictures, Inc.
Debtor 1 _ Case number (if known)
First Name Middle Name Last Name
41) Office equipment, including all computer equipment and communication systems equipment
and software
Database-People Unknown
Find
er/Non-regulated
Database-Bankruptcy Unknown
Information
Database-Campaign Unknown
Data
Database-Canadian Unknown
Consumer Database
Database-Demographic Unknown
s
Database-FAA Unknown
Airman/Airplanes
Database-Vital Unknown
Records (4 states
only - historical)
Database-People Unknown
Finder/Regulated
Data
Television Unknown
Show-Country Daze
(6 Episodes of 23
mins each)
Database-USA Unknown
Consumer Database
Database-FI Unknown
Concealed Weapons
Permits
Database-DEA Unknown
Licenses
Database-Medicare Unknown
Sanctions
Database-Marriage/Di Unknown
vorce Data
Database-Merchant Unknown
Vessels
Database-Geocode Unknown
Data
Database-Sex Unknown
Offender Database
Database-Social Unknown
Security Death
Index
Database-OFAC Unknown
Watchlist
Application 0.00
Database-Criminal Unknown
Information (this
item is titled in
the name of the
debtor's owner and
utilized by the
organization
through a lease
arrangement)
________________________________________________________
________________________________________________________
________________________________________________________
3. Total of the dollar amounts from Part 1, Column A, including the amounts from the Additional $________________
Page, if any.
Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property 0
page 1 of ___
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 22 of 69
Fill in this information to identify the case:
Debtor
Jerico Pictures, Inc.
__________________________________________________________________
Check if this is an
amended filing
Official Form 206E/F
Sc he dule E/F: Cre dit ors Who Ha ve U nse c ure d Cla im s 12/15
Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY
unsecured claims. List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts
on Schedule A/B: Assets - Real and Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases
(Official Form 206G). Number the entries in Parts 1 and 2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach
the Additional Page of that Part included in this form.
Pa rt 1 : List All Cre ditors w ith PRI ORI T Y U nse c ure d Cla im s
2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than
3 creditors with priority unsecured claims, fill out and attach the Additional Page of Part 1.
2.3 Priority creditor’s name and mailing address As of the petition filing date, the claim is: $______________________ $_________________
Check all that apply.
Contingent
Unliquidated
Disputed
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 14
page 1 of ___
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 23 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : List All Cre ditors w ith NONPRI ORI T Y U nse c ure d Cla ims
3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority
unsecured claims, fill out and attach the Additional Page of Part 2.
Amount of claim
As of the petition filing date, the claim is:
3.1 Nonpriority creditor’s name and mailing address Check all that apply.
Atty Gen Alabama Unknown
$________________________________
✔
Contingent
501 Washington Ave
✔
Unliquidated
P.O. Box 300152
✔
Disputed
Montgomery, AL 36130-0152 Civil Penalties
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
3.2 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Atty Gen Alaska Check all that apply. Unknown
$________________________________
1031 W. 4th Avenue
✔
Contingent
Suite 200
✔ Unliquidated
Anchorage, AK 99501-1994
✔ Disputed
Basis for the claim:
Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
✔ No
Last 4 digits of account number XXXX
__________________ Yes
As of the petition filing date, the claim is:
3.3 Nonpriority creditor’s name and mailing address Check all that apply.
Atty Gen American Samoa Unknown
$________________________________
✔
Contingent
American Samoa Gov?t, Exec. Ofc. Bldg
✔ Unliquidated
Utulei
✔ Disputed
Pago Pago, AS 96799
Basis for the claim:
Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number ___________________
XXXX
✔
No
Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 2 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 24 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
7
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Colorado
✔ Contingent
Ralph L. Carr Colorado Judicial Center, 1300
✔ Unliquidated
Broadway
✔ Disputed
10th Floor
Denver, CO 80203 Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
9
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Delaware Check all that apply.
Unknown
$________________________________
Carvel State Office Bldg.
✔
Contingent
820 N. French St.
✔
Unliquidated
Wilmington, DE 19801
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
10
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen District of Columbia Check all that apply.
400 6th St., NW
✔
Contingent
✔
Unliquidated
Washington, DC 20001
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
11
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Florida Check all that apply.
Unknown
$________________________________
The Capitol, PL 01
✔
Contingent
✔
Unliquidated
Tallahassee, FL 32399-1050
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 3 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 25 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
12
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Georgia
✔ Contingent
40 Capitol Square, SW
✔ Unliquidated
✔ Disputed
Atlanta, GA 30334-1300
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
14
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Hawaii Check all that apply.
Unknown
$________________________________
425 Queen Street
✔
Contingent
✔
Unliquidated
Honolulu, HI 96813
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
15
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Idaho Check all that apply.
700 W. Jefferson Street
✔
Contingent
Suite 210, P.O. Box 83720
✔
Unliquidated
Boise, ID 83720-1000
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
16
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Illinois Check all that apply.
Unknown
$________________________________
James R. Thompson Ctr. 100 W. Randolph St.
✔
Contingent
✔
Unliquidated
Chicago, IL 60601
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 4 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 26 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
17
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Indiana
✔ Contingent
Indiana Government Center South ? 5th Floor,
✔ Unliquidated
302 West Washington Street
✔ Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
19
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Kansas Check all that apply.
Unknown
$________________________________
120 S.W. 10th Ave
✔
Contingent
2nd Fl.
✔
Unliquidated
Topeka, KS 66612-1597
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
20
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Kentucky Check all that apply.
700 Capital Avenue
✔
Contingent
Suite 118
✔
Unliquidated
Frankfort, KY 40601-3449
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
21
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Louisiana Check all that apply.
Unknown
$________________________________
1885 North Third Street
✔
Contingent
✔
Unliquidated
Baton Rouge, LA 70802
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 5 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 27 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
22
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Maine
✔ Contingent
State House Station 6
✔ Unliquidated
✔ Disputed
Augusta, ME 4333
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
24
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Massachusetts Check all that apply.
Unknown
$________________________________
1 Ashburton Place
✔
Contingent
20th Floor
✔
Unliquidated
Boston, MA 2108
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
25
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Michigan Check all that apply.
525 W. Ottawa St.
✔
Contingent
P.O. Box 30212
✔
Unliquidated
Lansing, MI 48909-0212
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
26
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Minnesota€ Check all that apply.
Unknown
$________________________________
75 Dr. Martin Luther King, Jr. Blvd.
✔
Contingent
Suite 102, State Capital
✔
Unliquidated
Saint Paul, MN 55155
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 6 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 28 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
27
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Mississippi
✔ Contingent
Department of Justice
✔ Unliquidated
P.O. Box 220
✔ Disputed
Jackson, MS 39205
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
29
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Montana Check all that apply.
Unknown
$________________________________
Justice Bldg. 215 N. Sanders
✔
Contingent
✔
Unliquidated
Helena, MT 59620-1401
✔
Disputed
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
30
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Nebraska Check all that apply.
State Capitol
✔
Contingent
P.O.Box 98920
✔
Unliquidated
Lincoln, NE 68509-8920
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
31
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Nevada Check all that apply.
Unknown
$________________________________
Old Supreme Ct. Bldg. 100 N. Carson St.
✔
Contingent
✔
Unliquidated
Carson City, NV 89701
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 7 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 29 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
32
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen New Hampshire
✔ Contingent
33 Capitol Street
✔ Unliquidated
✔ Disputed
Concord, NH 3301
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
34
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen New Mexico Check all that apply.
Unknown
$________________________________
P.O. Drawer 1508
✔
Contingent
✔
Unliquidated
Santa Fe, NM 87504-1508
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
35
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen New York Check all that apply.
Dept. of Law ? The Capitol
✔
Contingent
2nd fl.
✔
Unliquidated
Albany, NY 12224
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
36
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Nominee U.S. Virgin Islands Check all that apply.
Unknown
$________________________________
3438 Kronprindsens Gade, GERS Building
✔
Contingent
2nd Floor
✔
Unliquidated
Saint Thomas, VI 802
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 8 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 30 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
37
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen North Carolina
✔ Contingent
Dept. of Justice
✔ Unliquidated
P.O.Box 629
✔ Disputed
Raleigh, NC 27602-0629
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
39
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Northern Mariana Islands Check all that apply.
Unknown
$________________________________
Administration Building
✔
Contingent
P.O. Box 10007
✔
Unliquidated
Saipan, MP 96950-8907
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
40
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Ohio Check all that apply.
State Office Tower, 30 E. Broad St.
✔
Contingent
✔
Unliquidated
Columbus, OH 43266-0410
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
41
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Oklahoma Check all that apply.
Unknown
$________________________________
313 NE 21st Street
✔
Contingent
✔
Unliquidated
Oklahoma City, OK 73105
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 9 of ___
page __ 14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 31 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
42
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Oregon
✔ Contingent
Justice Bldg. 1162 Court St., NE
✔ Unliquidated
✔ Disputed
Salem, OR 97301
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
44
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Puerto Rico Check all that apply.
Unknown
$________________________________
PO Box 9020192
✔
Contingent
✔
Unliquidated
San Juan, PR 00902-0192
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
45
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Rhode Island Check all that apply.
150 S. Main St.
✔
Contingent
✔
Unliquidated
Providence, RI 2903
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
46
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen South Carolina Check all that apply.
Unknown
$________________________________
Rembert C. Dennis Office Bldg.
✔
Contingent
P.O.Box 11549
✔
Unliquidated
Columbia, SC 29211-1549
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __
10 of ___
14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 32 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
47
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen South Carolina
✔ Contingent
293 Greystone Boulevard
✔ Unliquidated
Suite 400
✔ Disputed
Columbia, SC 29250
Basis for the claim: Civil Penalties
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
49
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Tennessee Check all that apply.
Unknown
$________________________________
425 5th Avenue North
✔
Contingent
✔
Unliquidated
Nashville, TN 37243
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
50
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Texas Check all that apply.
Capitol Station
✔
Contingent
P.O.Box 12548
✔
Unliquidated
Austin, TX 78711-2548
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
51
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Utah Check all that apply.
Unknown
$________________________________
State Capitol
✔
Contingent
Rm. 236
✔
Unliquidated
Salt Lake City, UT 84114-0810
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __
11 of ___
14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 33 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
52
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Vermont
✔ Contingent
109 State St.
✔ Unliquidated
✔ Disputed
Montpelier, VT 05609-1001
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
54
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen Washington Check all that apply.
Unknown
$________________________________
1125 Washington St. SE
✔
Contingent
P.O. Box 40100
✔
Unliquidated
Olympia, WA 98504-0100
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
55
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Atty Gen Washington Check all that apply.
800 Fifth Avenue
✔
Contingent
Suite 2000
✔
Unliquidated
Seattle, WA 98104
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
674968
✔
No
Last 4 digits of account number ___________________ Yes
56
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Atty Gen West Virginia Check all that apply.
Unknown
$________________________________
State Capitol, 1900 Kanawha Blvd., E.
✔
Contingent
✔
Unliquidated
Charleston, WV 25305
✔
Disputed
Basis for the claim:
Date or dates debt was incurred ____________________ Is the claim subject to offset?
✔
No
Last 4 digits of account number ___________________
XXXX Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __
12 of ___
14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 34 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Pa rt 2 : Addit iona l Pa ge
Copy this page only if more space is needed. Continue numbering the lines sequentially from the
Amount of claim
previous page. If no additional NONPRIORITY creditors exist, do not fill out or submit this page.
57
3.___ Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. Unknown
$________________________________
Atty Gen Wisconsin
✔ Contingent
Wisconsin Department of Justice State Capitol
✔ Unliquidated
Room 114 East
✔ Disputed
P. O. Box 7857
P. O. Box 7857, WI 53707-7857 Basis for the claim:
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number XXXX
___________________
✔
No
Yes
59
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Bradley / Grombacher LLP (o/b/o Charles J. Check all that apply.
Unknown
$________________________________
Geletko)
✔
Contingent
31365 Oak Crest DRive
✔
Unliquidated
Suite 240
✔
Disputed
Westlake Village, CA 91361
Basis for the claim: Civil Claims
Date or dates debt was incurred ___________________ Is the claim subject to offset?
Last 4 digits of account number __________________
XXXX
✔
No
Yes
60
3.___ Nonpriority creditor’s name and mailing address
As of the petition filing date, the claim is:
Unknown
$________________________________
Danile J. Rodriguez Check all that apply.
531 NE 39 St. Apt. 202
✔
Contingent
Miami, FL 33133
✔
Unliquidated
✔
Disputed
Date or dates debt was incurred ___________________ Is the claim subject to offset?
XXXX
✔
No
Last 4 digits of account number ___________________ Yes
Date or dates debt was incurred ____________________ Is the claim subject to offset?
No
Last 4 digits of account number ___________________ Yes
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __
13 of ___
14
Case 24-20281-SMG
Jerico Pictures, Inc. Doc 1 Filed 10/02/24 Page 35 of 69
Debtor _______________________________________________________ Case number (if known)_____________________________________
Name
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page __
14 of ___
14
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 36 of 69
Check if this is an
amended filing
Be as complete and accurate as possible. If more space is needed, copy and attach the additional page, numbering the entries consecutively.
Check if this is an
amended filing
Official Form 206H
Sc he dule H : Code bt ors 12/15
Be as complete and accurate as possible. If more space is needed, copy the Additional Page, numbering the entries consecutively. Attach
the Additional Page to this page.
2.2
D
E/F
G
2.3
D
E/F
G
2.4
D
E/F
G
2.5
D
E/F
G
2.6
D
E/F
G
______________________
United States Bankruptcy Court for the: Southern District of Florida District of _________
(State)
Case number (If known): _________________________ ___________________________________________
Check if this is an
amended filing
The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages,
write the debtor’s name and case number (if known).
Part 1: Income
None
Identify the beginning and ending dates of the debtor’s fiscal year, which Sources of revenue Gross revenue
may be a calendar year Check all that apply (before deductions and
exclusions)
2. Non-business revenue
Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected
from lawsuits, and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.
✔ None
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 1
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 39 of 69
3. Certain payments or transfers to creditors within 90 days before filing this case
List payments or transfersincluding expense reimbursementsto any creditor, other than regular employee compensation, within 90
days before filing this case unless the aggregate value of all property transferred to that creditor is less than $7,575. (This amount may be
adjusted on 4/01/23 and every 3 years after that with respect to cases filed on or after the date of adjustment.)
None
✔
Creditor’s name and address Dates Total amount or value Reasons for payment or transfer
Check all that apply
3.1.
Suppliers or vendors
Services
Other _______________________________
3.2.
Suppliers or vendors
Services
Other _______________________________
4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider
List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or
guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than
$7,575. (This amount may be adjusted on 4/01/25 and every 3 years after that with respect to cases filed on or after the date of adjustment.)
Do not include any payments listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their
relatives; general partners of a partnership debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and any managing
agent of the debtor. 11 U.S.C. § 101(31).
None
Insider’s name and address Dates Total amount or value Reasons for payment or transfer
4.1.
Salvatore Verini, Jr.
__________________________________________ _________ Unknown
$__________________
Insider’s name
Various payments made in the
1801 NW 126th Way ordinary course of business.
_________
Pompano Beach, FL 33071
_________
Relationship to debtor
Owner
__________________________________________
4.2. __________________________________________
Insider’s name
_________ $__________________
_________
_________
Relationship to debtor
__________________________________________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 2
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 40 of 69
5.2.
__________________________________________
Creditor’s name _______________ $___________
6. Setoffs
List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account of
the debtor without permission or refused to make a payment at the debtor’s direction from an account of the debtor because the debtor owed a debt.
None
✔
Creditor’s name and address Description of the action creditor took Date action was Amount
taken
7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits
List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor
was involved in any capacity—within 1 year before filing this case.
None
Case title Nature of case Court or agency’s name and address Status of case
YVETTE BURGEN, on behalf of US Southern District of Florida
7.1. herself and all others similarly situated Class Action / Impact of a data
✔ Pending
v. Jerico Pictures, LLC breach
On appeal
Case number
Concluded
299lawsuit
Class Action regarding breach of data East Broward Boulevard #108
Fort Lauderdale, FL 33301
0:24-cv-61396-DSL
_________________________________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 3
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 41 of 69
______________________________________ __________________________________________
Name
Case number
______________________________________
Date of order or assignment
______________________________________
9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value
of the gifts to that recipient is less than $1,000
None
✔
Recipient’s name and address Description of the gifts or contributions Dates given Value
9.1.
__________________________________________ _________________ $__________
Recipient’s name
_________________ $__________
_________________ $__________
10. All losses from fire, theft, or other casualty within 1 year before filing this case.
None
Description of the property lost and how the loss Amount of payments received for the loss Date of loss Value of property
occurred If you have received payments to cover the loss, for lost
example, from insurance, government compensation, or
tort liability, list the total received.
List unpaid claims on Official Form 106A/B (Schedule A/B:
Assets – Real and Personal Property).
Enterprise Wide Data Breach against Social
Security Database 1,000,000.00
___________________________________________ _________________ $__________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 4
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 42 of 69
None
Who was paid or who received the transfer? If not money, describe any property transferred Dates Total amount or
value
Kelley Kronenberg
__________________________________________ Debtor made cash retainer payment to Kelley
11.1. 8/20/2024
Kronenberg. ______________ $_________
25,000.00
Address
__________________________________________
Who was paid or who received the transfer? If not money, describe any property transferred Dates Total amount or
value
Kelley Kronenberg
__________________________________________ The Debtor prepaid filing fee for a Chapter 11
11.2. 8/20/2024
Bankruptcy to the firm for us in filing the case. ______________ $_________
1,738.00
Address
10360 West State Road 84
Fort Lauderdale, FL 33324
__________________________________________
__________________________________________
✔ None
Name of trust or device Describe any property transferred Dates transfers Total amount or
were made value
Trustee
__________________________________________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 5
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 43 of 69
List any transfers of money or other propertyby sale, trade, or any other meansmade by the debtor or a person acting on behalf of the debtor
within 2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs.
Include both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.
✔ None
Who received transfer? Description of property transferred or payments received Date transfer Total amount or
or debts paid in exchange was made value
Address
Relationship to debtor
__________________________________________
13.2. __________________________________________
Address
Relationship to debtor
__________________________________________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 6
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 44 of 69
✔ No. Go to Part 9.
Yes. Fill in the information below.
Facility name and address Nature of the business operation, including type of services the If debtor provides meals
debtor provides and housing, number of
patients in debtor’s care
Location where patient records are maintained (if different from facility
address). If electronic, identify any service provider. How are records kept?
Electronically
Paper
Nature of the business operation, including type of services the If debtor provides meals
Facility name and address debtor provides and housing, number of
patients in debtor’s care
15.2. ____________________
________________________________________
Facility name
Location where patient records are maintained (if different from facility How are records kept?
address). If electronic, identify any service provider.
16. Does the debtor collect and retain personally identifiable information of customers?
No.
✔ SSN
Yes. State the nature of the information collected and retained. ___________________________________________________________________
Does the debtor have a privacy policy about that information?
No
✔ Yes
17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other
pension or profit-sharing plan made available by the debtor as an employee benefit?
✔ No. Go to Part 10.
Yes. Does the debtor serve as plan administrator?
No. Go to Part 10.
Yes. Fill in below:
Name of plan Employer identification number of the plan
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 7
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 45 of 69
Part 10: Certain Financial Accounts, Safe Deposit Boxes, and Storage Units
✔ None
Financial institution name and address Last 4 digits of account Type of account Date account was Last balance
number closed, sold, moved, before closing or
or transferred transfer
✔ None
Depository institution name and address Names of anyone with access to it Description of the contents Does debtor
still have it?
______________________________________ No
Name Yes
Address
✔ None
Facility name and address Names of anyone with access to it Description of the contents Does debtor
still have it?
No
______________________________________
Name
Yes
Address
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 8
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 46 of 69
Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own
✔ None
Owner’s name and address Location of the property Description of the property Value
$_________
______________________________________
Name
Report all notices, releases, and proceedings known, regardless of when they occurred.
22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.
✔ No
Yes. Provide details below.
Case title Court or agency name and address Nature of the case Status of case
_________________________________ Pending
_____________________________________
Case number Name On appeal
_________________________________ Concluded
23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an
environmental law?
✔ No
Yes. Provide details below.
Site name and address Governmental unit name and address Environmental law, if known Date of notice
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 9
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 47 of 69
24. Has the debtor notified any governmental unit of any release of hazardous material?
✔ No
Yes. Provide details below.
Site name and address Governmental unit name and address Environmental law, if known Date of notice
Part 13: Details About the Debtor’s Business or Connections to Any Business
25. Other businesses in which the debtor has or has had an interest
List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.
Include this information even if already listed in the Schedules.
✔ None
Business name and address Describe the nature of the business Employer Identification number
Do not include Social Security number or ITIN.
EIN: ________________________
25.1. __________________________________
Name Dates business existed
Business name and address Describe the nature of the business Employer Identification number
25.2. Do not include Social Security number or ITIN.
EIN: ________________________
__________________________________
Name Dates business existed
Business name and address Describe the nature of the business Employer Identification number
Do not include Social Security number or ITIN.
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 10
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 48 of 69
None
Name and address Dates of service
26b. List all firms or individuals who have audited, compiled, or reviewed debtor’s books of account and records or prepared a financial
statement within 2 years before filing this case.
None
Dates of service
Name and address
From _______
26b.2.
______________________________________________________________________________
Name To _______
26c. List all firms or individuals who were in possession of the debtor’s books of account and records when this case is filed.
✔ None
Name and address If any books of account and records are
unavailable, explain why
26c.1. ______________________________________________________________________________
Name
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 11
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 49 of 69
26c.2. ______________________________________________________________________________
Name
26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial statement
within 2 years before filing this case.
✔ None
26d.1. ______________________________________________________________________________
Name
26d.2. ______________________________________________________________________________
Name
27. Inventories
Have any inventories of the debtor’s property been taken within 2 years before filing this case?
✔ No
Yes. Give the details about the two most recent inventories.
Name of the person who supervised the taking of the inventory Date of The dollar amount and basis (cost, market, or
inventory other basis) of each inventory
Name and address of the person who has possession of inventory records
27.1. ______________________________________________________________________
Name
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 12
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 50 of 69
Name of the person who supervised the taking of the inventory Date of The dollar amount and basis (cost, market, or
inventory other basis) of each inventory
Name and address of the person who has possession of inventory records
27.2. ______________________________________________________________________
Name
28. List the debtor’s officers, directors, managing members, general partners, members in control, controlling shareholders, or other
people in control of the debtor at the time of the filing of this case.
Name Address Position and nature of any interest % of interest, if any
Salvatore Verini, Jr. 1801 NW 126th Way, Pompano Beach, FL 33071
29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in
control of the debtor, or shareholders in control of the debtor who no longer hold these positions?
✔ No
_________ To _________
_________ To _________
_________ To _________
_________ To _________
_____________
_____________
______________________________________________________________ _____________
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 13
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 51 of 69
30.2 ______________________________________________________________
Name _____________
_____________
_____________
______________________________________________________________
31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?
✔ No
Yes. Identify below.
Name of the parent corporation Employer Identification number of the parent
corporation
32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?
✔ No
Yes. Identify below.
Name of the pension fund Employer Identification number of the pension fund
WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both.
18 U.S.C. §§ 152, 1341, 1519, and 3571.
I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information
is true and correct.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on 10/02/2024
_________________
MM / DD / YYYY
President
Position or relationship to debtor ____________________________________
Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?
No
✔ Yes
Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 14
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 52 of 69
Jerico Pictures, Inc.
Debtor Name Case number (if known)
7) Legal Actions
0:24-cv-61383-DSL
Pending
-------
0:24-cv-61412-DSL
Pending
-------
0:24-cv-61418-DSL
Pending
-------
0:24-cv-61492-DSL
Class Action
Pending
-------
0:24-cv-61499-DSL
Pending
-------
0:24-cv-61502-DSL
Pending
-------
0:24-cv-61517-DSL
Pending
-------
0:24-cv-61525-DSL
Pending
-------
0:24-cv-61534-DSL
Pending
-------
0:24-cv-61609-RS
Pending
-------
0:24-cv-61622-DSL
Pending
-------
0:24-cv-61638-DSL
Pending
-------
0:24-cv-61717-DSL
Pending
-------
2:24-cv-08003-JLS-JC
Pending
-------
1:24-cv-00905-RJJ-PJG
Pending
-------
3:24-cv-00388-MCR-HTC
Pending
-------
CACE24012149
Pending
-------
An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit
this form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document,
and any amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the
document, and the date. Bankruptcy Rules 1008 and 9011.
WARNING -- Bankruptcy fraud is a serious crime. 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 $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341,
1519, and 3571.
I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or
another individual serving as a representative of the debtor in this case.
I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:
✔ Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)
✔ Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
✔ Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
✔ Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)
✔ Schedule H: Codebtors (Official Form 206H)
✔ Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)
✔ Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)
I declare under penalty of perjury that the foregoing is true and correct.
10/02/2024
Executed on ______________ /s/ Salvatore Verini, Jr.
_________________________________________________________________________
MM / DD / YYYY Signature of individual signing on behalf of debtor
President
______________________________________
Position or relationship to debtor
Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 58 of 69
Chapter 11
Debtor(s)
The above-named Debtor(s) hereby verify that the attached list of creditors is
true and correct to the best of their knowledge.
President
Position or relationship to debtor
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 59 of 69
Clayeo C. Arnold, PC
865 Howe Avenue
Sacramento, CA 95825
Danile J. Rodriguez
531 NE 39 St. Apt. 202
Miami, FL 33133
Manuel S Hiraldo
401 E Las Olas Blvd
Suite 1400
Fort Lauderdale, FL 33301
Debtor 11
Chapter________________
1. Pursuant to 11 U .S.C. § 329(a) and Fed. Bankr. P. 2016(b), I certify that I am the attorney for the
above named debtor(s) and that compensation paid to me within one year before the filing of the
petition in bankruptcy, or agreed to be paid to me, for services rendered or to be rendered on behalf of
the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows:
FLAT FEE
For legal services, I have agreed to accept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________
Prior to the filing of this statement I have received. . . . . . . . . . . . . . . . . . . . . . . . $______________
Balance Due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $______________
✔ RETAINER
25,000.00
For legal services, I have agreed to accept a retainer of . . . . . . . . . . . . . . . . . . . . $______________
0.00
The undersigned shall bill against the retainer at an hourly rate of . . . . . . . . . . . $______________
[Or attach firm hourly rate schedule.] Debtor(s) have agreed to pay all Court
approved fees and expenses exceeding the amount of the retainer.
4. I have not agreed to share the above-disclosed compensation with any other person unless they
are members and associates of my law firm.
I have agreed to share the above-disclosed compensation with a other person or persons who
are not members or associates of my law firm. A copy of the Agreement, together with a list of the names
of the people sharing the compensation is attached.
5. In return of the above-disclosed fee, I have agreed to render legal service for all aspects of the
bankruptcy case, including:
a. Analysis of the debtor’s financial situation, and rendering advice to the debtor in determining
whether to file a petition in bankruptcy;
b. Preparation and filing of any petition, schedules, statements of affairs and plan which may be
required;
c. Representation of the debtor at the meeting of creditors and confirmation hearing, and any
adjourned hearings thereof;
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 67 of 69
B2030 (Form 2030) (12/15)
d. [Other provisions as needed]
a. Analysis of the debtor's financial situation, and rendering advice to the debtor in determining whether to file a petition in bankruptcy;
b. Preparation and filing of any petition, schedules, statement of affairs and plan which may be required;
c. Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;
d. Negotiations with contingent creditors to reduce to market value; exemption planning; preparation and filing of reaffirmation agreements and
applications as needed; preparation and filing of motions pursuant to 11 USC 522(f)(2)(A) for avoidance of liens on household goods.
e. Response within the Bankruptcy Case to the efforts of Creditors.
f. Coordination with the Chapter V Trustee.
6. By agreement with the debtor(s), the above-disclosed fee does not include the following services:
Representation of the debtors in any dischargeability actions, judicial lien avoidances, relief from stay actions or any other adversary proceedings or
response from class action plaintiffs.
Case 24-20281-SMG Doc 1 Filed 10/02/24 Page 68 of 69
CERTIFICATION
I certify that the foregoing is a complete statement of any agreement or arrangement for
payment to me for representation of the debtor(s) in this bankruptcy proceeding.
Registered name and last known address of security holder Shares Security Class
(Or Percentage) (or kind of interest)