Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 1 of 13 Fill in this information to identify your case: Debtor 4 Willard Lee Debior2 (Gpouse, fing) FistName Tai Nae Tana United States Bankruptcy Cour for the: NORTHERN DISTRICT OF TEXAS Case number 17-43815-7 (enon). HX check itis is an amended fing Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy oat Bo as complete and accurate as possible. iftwo married people ae filing together, both are equally responsible for supplying, correct information. if more space is needed, atach a separate sheet to this form. On the top of any additional pages, wi your name and case number (if known). Answer every question. Give Details About Your Marital Status and Whi ‘What is your current marital status? 1 Marea By Not marries 2 During the last 3 years, have you lived anywher TN [Bf Yes. List all ofthe places you ed inthe last 3 years. Do notinclude where you lve now, ther than where you live now? Debtor 1: Dates Debtor Debtor 2 Dates Debtor 2 lived ther lWved there 1 Same as Debtor Dy Same as Debtor + 811 Laurel Oaks Lane From_10/2015 From Noambor_ Steet amber Stet To __7i2016 To Colleyville 1x _76034 ory ate ZP Code ow Sale ZIP Cove Debtor 1: Dates Debtor! Debtor 2: Dates Debtor 2 Wed there ved there 1 Same as Debror 4 Ly Same as Debtor + From_April 2014 From To October 2015 St To yy Sas ZP Code wy cose Statement of Financial Affairs for Individuals Filing for Bankruptcy page 1Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 2 of 13 Doblor1 Willard Lee MeCusker (case number (f known) _17-43815-7 Debtor 4 Dates Debtor Debtor 2: Dates Debtor 2 Wad there lWved there: [ Same as Debtor 1 Dy Same as Debtor 2707 San Jacinto From_June 2016 From “meer See To _Apriizorz_ HF Ste To Euless 1x _76039 oy ‘Sale _ZP Cade ow Sale 2 Case 3. Within the last 8 years, did you ever live with a spouse or legal equivalent in a community property state or teritory? (Communty propery states and tomtores include Arizona, Calfomia, Idaho, Lousiana, Nevada, Now Mexico, Puerto Rico, Texas, ‘Washinglon, and Wisconsin, DN I Yes. Make sure you fil out Schedule H: Your Codebtors (Oficial Frm 1064) FEERZIBE cxxain the sources of Your Income ‘4. Did you have any income trom employment or trom operating a business during this year or the two previous calendar years? Fillin the fotal amount of income you received from all jobs and al businesses, including parttime activites. If you are fling joint case and you have income that you receive together, stk only once under Debtor TN FZ Yes. Fil inthe datas Debtor 1 Debtor 2 Sources of income Gross income Sources of income Gross income Check all tat apply. (belore deductions Check all hat apply, (before deductions and excisions and exclusions From January 1 ofthe current year unt J Wages, commissions, $12,500.00 [] Wages, comm ssions, the date you filed for bankruptcy: bonuses, tips bonuses, tps Dy Operating a business 1D Operating a business For the last calendar year: Wages, commissions, $64,243.67. [] Wages, commissions, anu Deemer 31, 2016 ) bonuses, ips bonuses, ips ” oar Dy Operating a business 1 Operating a business For the calendar year before that: IZ Wages, commissions, $40,068.41 [] Wages, commissions, bonuses, tps ee bon, ts (January 1 0 Decombor 31, 201: (anvary 018 ) Dy Operating a business 1D Operating a business Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 2Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 3 of 13 Doblor1 Willard Lee MeCusker Ccase number (f own) _17-43815-7 Did you receive any other income during this year or the two previous calendar years? Include income regardless of whether that ncome is taxable. Examples of othor income are alimony: child support Socal Securty unemployment; and other public benefit payments; pensions; rental income; intrest; dividends; money collected from lawsuls;royaes; ‘and gambling and lotery winnings. If you are in joint case and you have Income that you recelved together, Ist only once under Deotor 1 List each source andthe gross income from each source separately. Do not include income that you listed inline 4 Ne Yes. Fil inthe deta Debtor 1 Debtor 2 Sources of income Gross income Sources of income Gross income Deserbe below, from each source Descrite below. from each source (bofore deductions (before deductions and exchisions and exclusions Non-Filing Spouses incor __ $14,333.32 rvice USA draw $186.29 mecusker & compay, Inc. $69,294.43 From January 1 ofthe current year until the date you filed for bankruptey: For the las calendar year Non-Filing Spouse's incor __ $50,757.51 (uanuary tio December 31, 2016 ) Sorvice USA draw ___ $87,988.65. ae mecusker & company Ine $50,604.97 For the calendar year before that Non-Filing Spouse's incor __ $32,367.78 (uanuary to December31, 2015 ) sorvice USA draw ____$6,200.00. wa imecusker & company dra — $97,663.91 Statement of Financial Affairs for Individuals Filing for Bankruptcy pagesCase 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 4 of 13 Dobior1 Willard Lee MeCusker Ccase number (f known) _17-43815-7 List Certain Payments You Ma You Filed for Bankruptcy ‘Are ait arly consumer debts? Debtor 1s oF Debtor 2s debts p IZ} No. Neither Debtor 1 nor Debtor 2 has primarily consumer debts, Consumer dobis are defined in 11 U.S.C. § 101(8) 26, incurred by an individual primary fora personal, family, or householé purpose." During the 80 days befor you fled for bankruptcy, dd you pay any croltor a toll of $6,425" or more? 1 Ne. Gototine 7. 7 Yes. List below each creditor ta whom you paie a total of $6,425" or more in one er more payments and the total amount you pad that creer. Do not include payments for domostc support obligations, such as child suppor and almony. Also, do not include payments to an attomey for this bankruptey case. * Subject o adjustment on 4/01/19 ang every 3 years after that for cases files on or ater the date of adjustment Ly Yes. Debtor 1 or Debtor? or both have primarily consumer debts, During the 80 days before you fled fr bankruptcy, did you pay any crete a total of $600 or more? 1 Na. Gototine 7. 1] Yes. List below each creditor to whom you paid a total of $500 or more andthe total amount you paid that ‘editor. Do not include payments for domestic suppor obligations, such as child support and alimony. ‘Also, do netinclude payments to an attoray for his bankruptcy case Datos of Totalamount Amount you Was this payment for. payment paid stil owe Jan Debouckdaer $10,200.00 1 Mortgage ears monthly last 90 days O cer 5606 Normandy Dr. 1 crest can DD Loan repayment a Suopliers or vendors Colleyville Tx__76034 J Other residential lease oS Zs 7. Within year before you fled for bankruptcy, dd you make a payment on a dabt you owed anyone who was an insider? Insiders include your relatives; any general partners; relatives of any general pariners; parmership of which you area general partner, corporations of which you are an officer, director, person in conta, of er of 20% ar more of thee vating secures; and any managing agent, including one fora business you operate as a sole proprietor. 11 U.S.C. § 101. Inclide payments for domestic support cbigations suchas child support an alimony. No Dy Yes. List all payments to an insicer. page 4 Form 107 Statement of Financial Affairs for IndividualsCase 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 5 of 13 Dobior1 Willard Lee MeCusker case number (f own) _17-43815-7 8, Within 1 year before you filed for bankruptcy, did you make any payments or transfer any property on account ofa debt that benefited an insider? Include payments on debs guaranteed or cosigned by an insider. No Dy Yes. List all payments that benefited an insider. TERRZEEE tecontity Legat Actions, Repossessions, and Foreclosures ‘Within year betore you fled for bankruptcy, were you a party in any lawsult, court action, or administrative proceeding? Listall such mater, ineluding personal injury eases, smal claims actions, dvorees, collection suits, paternity actions, suppor or custody ‘modifications, and contract aisputes DN FZ Yes. Fil inte datas case tite Nature ofthe case Court or agency Status of the case Dallas National Insurance Dallas National Insurance 153rd Judicial District 1 Pending Company vs McCusker & Co. Company vs. McCusker & Co. Coun Name: Incet al Inc., Willard L. MeCusker, Tier One Tarrant County, Texas. 1 onappeal Consumer Products Services, Nunber Siest Case number 183-268814-13 __LL¢ aka Cornerstone Consumer Concise Products Services, LLC Lance Davis, Tim Maynard Schuur, HVAC Gj————saa ap Gas Warranty LLC & Mack Heaton case tle Nature ofthe case Court or agency status of the case Regina Serglyenko and Russell FLSA United States District Court ond Joly vs. McCusker Holding ‘Coun Name ning Corp. and Willard L. McCusker District of Kansas at Kansas City 7 onappoal nber Sree Case number 47-CV-2324 1 conctudes w TFC case te Nature ofthe case Court or agency status of the case Solomon Dausglas vs. ustice ofthe Peace MeCusker mee 1 Pending Precinct 3 LO Onappeat Cose number JP03-17-$¢0002267 Concha a ae Case tle Nature ofthe case Court or agency Status of the case Starr Surplus etal vs. Mack Starr Surplus Lines Insurance Supreme Court ofthe State of New endin Camera et al Company and Starr Indemnity & York © Peeing Liability Company vs. Mack Gourane Ly Onenpeat Camera and Video Services, Inc, County of New York ose number 65149772013 Mack Worldwide Warranty end” Surber Stee [1 Conctiies McCusker & Company; Case No. 65149772013, Form 107 Statement of Financial Affairs for Individuals ing for Bankruptcy pagesCase 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 6 of 13 Doblor1 Willard Lee MeCusker case number (f own) _17-43815-7 Case tite Nature ofthe case CCourt or agency Status of the case Starr Surplus Lines et al vs. case currently in active: ‘Supreme Court of the State of New endin Mack Camera et al Starr Surplus Lines Insurance York C1 Peneing Company and Starr Indemnity & —Cournane 1 onappeat Liability Company v. Mack Camera County of New York. Case number 653181/2013, ind Video Services, Inc, Mack Miner —Sros 1 Conctude Worldwide Warranty and McCusker & Company, Inc., Index Number 653181/2013 we ee 10, Within 1 year betore you filed for bankruptcy, was any of your property repossessed, foreclosed, gamished, attached, seized, o levied?” Check al that apply ane fin the deals below. J Ne. Goto tine 14 [J Yes. Fil in the information below, Describe the property Date Value ofthe property Wolls Fargo Dealer Services 2005 Bentley Continontal GT 512017 $60,000.00 PO Box 25341 Ronbar—Srast Explain what happened [Z| Property was repossessed. 1 Property was foreclosed, Santa Ana CA__ 92799-5341 L] Property was gamished, By Sas 2 Coss Property was atacned, seized, or levied, Describe the property Date Value of the property Cort Business Service Gor Debtor returned leased furniture, anan7 Seats tors "> —— fixtures, cubicles, lights ote. arr PO Box 17401, Rona Steet Explain what happened Ly Property was repossessed. Ey Property was foreclosed, Baltimore. MD__ 1297 Fy Property was gamished oF ‘Sal —ZP-Com— [] Propery was attacned, seized, or levied. ‘1, Within 90 days before you fled for bankruptcy, dd any creditor, Including a bank or financial Institution, set of any mounts from your accounts of refuse to make a payment because you owed a debt? No Dy Yes. Filin ne deta 12, Within 4 year before you fled for bankruptcy, was any of your property in the possession of an assign creditors, a courtappointed racelver, a custodian, or another official? No Dre. forthe benefit of Form 107 Statement of Financial Affairs for Individuals page 6Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 7 of 13 Dobior1 Willard Lee MeCusker (case number (f own) _17-43815-7 [EERE ist cortain Gifts and contributions 18, Within 2 years before you filed for bankruptcy, did you give any gifts with a total value of more than $600 per person? No By Yes. Fil inthe details or each ai. 414. within 2 years before you filed for bankruptey, did you give any gifts or contributions with a total value of more than $600 to-any charity? No Uy Yes. Fil in te details for each git or contribution, FERRE ist contain Losses 15. Within 1 year before you fled for bankruptcy or since you filed for bankruptcy, did you lose anything because of theft, ire, other disaster, or gambling? ae List Certain Payments of Transfers 16, Within 1 year before you fled for bankruptcy, did you or anyone else acting on your behalf pay or transfer any property to anyone you consulted about seeking bankruptcy or preparing a bankruptey petition? Include any atlomays, bankruptcy peiton preparers, or credit counseling agencies for services required for your bankrupey. DN FZ Yes. Fil inte deta Description and val cof any property transferred Date payment Amount of ‘The Vida Law Firm, PLLC. crtraeter was payment 3000 Central Drive 09132017 _ $2,500.00 Sump Seek petition date ___ $3,500.00 Bedford 1x_76024 oy 8s ZF Cad 417, Within 1 year before you fled for bankruptcy, dd you or anyone else acting on your behalf pay or transfer any property to anyone who promised to help you deal with your ereditors orto make payments to your creditors? Donat include any payment or transfer that you listed online 16 No 1 Yes. Fil inte datas Form 107 Statement of Financial Affairs for Individuals ing for Bankruptcy page 7Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 8 of 13 Doblor1 Willard Lee MeCusker Ccase number (f known) _17-43815-7 418, within 2 years before you fied for bankruptey, did you sell trade, or otherwise transfer any property to anyone, ther than Property transferred in the ordinary course of your business or financial atfairs? Include both ought transfers and transfers made as secur (such as granting of a secury interest or mortgage on your property). Do nat include gifts and transfers that you have already Iisted on this statement o™ Descrionand vie oy esrb any propery or payments Dat ranafer Oceanic Research & Recovery ine, _ Preveryteetred cee ee oe eas REST ne err soldand wansferred Oeeanle Rasaareh& Recovery, BO17. 01 ownershpot wee business Incrpaldof laites ef the entities: (1) McCusker & McCusker & Company, Inc. and Company erie Caribbean Inc, Service USA, ne aves totale @ MeCusker Service Group,” erates fora otal amount pal then and(@) McCusker Holding $882/45087 (ala ct eredtore Qympin_wa_susot_ 5 pald canbe furnished upon feavest Person's relationship to you 419. Within 10 years before you filed for bankruptcy, did you transfer any property to a self settled trust or similar device of which yyouare abeneficiary? (These aro often called asset protection devices.) No Dy Yes. Filia te dota, 7 En Deposit Boxes, and Storage Units 20. Within 1 year before you filed for bankruptcy, were any financial accounts or instruments held in your name, or for your benefit, closed, sold, moved, or transferred? Include checking, savings, money market o other fnanclal accounts; catiicates of deposit; shares in banks, credit unions, brokerage houses, pension funds, cooperatives, associations, and other financial institutions. Ne Yes. Fil in te deta Last digits of account Type of accountor Date account Last balance number instrument was closed, before closing sold, moved, or transfer or transferred First Internet Bank of Indiana 40 5 gy Checking ars0ni7 $0.00 1 Savings Hy Money market i Brokerage [Z| Other Corp account: McCusker & Company, Inc. yor Form 107 Statement of Financial Affairs for Individuals ing for Bankruptcy pagesCase 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 9 of 13 Doblor1 Willard Lee MeCusker Ccase number (f known) _17-43815-7 21, Do you now have, or did you have within 1 year before you fled for bankruptcy, any safe deposit box or other depository for securities, cash, or other valuables? No Ey Yes. Fi inte dota 22, Have you stored property in a storage unit or place other than your home within 1 year before you filed fr bankruptey? No By Yes. Fil inte deta FEEREII ecentity Property You Hold or Control for Someone Else 23, Do you hold or contro! any property that someone else owns? Include any property You borrowed from, are storing fr, oF holdin trust for someone. Ne 1 Yes. Filin ne deta Where is the property? Describe the property Value McCusker & Company, Inc money market checking $397.71 Owners Nene account ending 421 Where isthe property? Describe the property Value McCusker & Company, Inc savings account ending 413, $53.00 Owners Nene Where isthe property? Describe the property Value checking account ending 233 $36.00 Were isthe property? Describe the property Value ‘savings account ending 995 $25.00 First internet Bank of indiana Statement of Financial Affairs for Individuals Filing for Bankruptcy page9Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 10 of 13 Doblor1 Willard Lee MeCusker case number (f own) _17-43815-7 Where isthe property? Describe the property Value MeCusker & Company, In ‘checking account ending 405, $0.00 First Internet Bank of Indiana oF IPCs — ty sae Were isthe property? Describe the property Value ‘Time Payment Systems point of sale system: ‘wera Ne 2 point of sale (all one) units 41600 District Ave., Ste 200 1741 Fountain Pa 2 printers receipts Romar Sra Winbe-Sier 2 cash drawers, Burlington, MA 1803 Burlington, MA_ 1803, Colleyville, 1% oy IP Cais Gy SZC For the purpose of Part 10, the following definitions apply '= Environmental aw means any federal, state, or local statute or regulation concerning pollation, contamination, releases of hazardous or toxic substance, wastes, or material into the air, land, soll, surface water, groundwater, or other medium, including statutes or regulations controlling the cleanup of these substances, wastes, or material, 1 Site means any location, facilly, oF property as defined under any environmental law, whether you now own, operate, oF tlize it oF used to own, operate, or utlze it, ncluding disposal sites, '= Hazardous material means anything an environmental aw defines a8 a hazardous waste, hazardous substance, toxic ‘substance, hazardous material, pollutant, contaminant, or similar item. Report all notices, releases, and proceedings that you know about, regardless of when they occurred. 24, Has any governmental unit notifed you that you may be lable or potentially lable under or in violation ofan env law? mental No Ey Yes. Filin the deta 25, Have you notified any governmental unit of any release of hazardous material? No Ey Yes. Fil in te deta Form 107 Statement of Financial Affairs for Individuals ing for Bankruptey page 10Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 11 of 13 Doblor1 Willard Lee MeCusker Ccase number (f known) _17-43815-7 26, Have you been a party in any judicial oF administrative proceeding under any environmental law? Include setioments and orders No 1 Yos. Fi inte dota EE «: ls About Your Business or Connections to Any Business 27. Within 4 years before you filed for bankruptcy, did you own a business or have any ofthe following connections to any business? Dy A sole proprietor or selt-employed in a rade, profession, or other actly, either fulltime or par-ime Ey A member of atiited iabitty company (LLC) o limited tabity partnership (LLP) By Aparinerin a partnership [Z| An officer, irector, or managing executive ofa corporation Dy An ouner of at east 5% of the voting or equity secures ofa corporation [1 No. None of he above applies. Go to Part 12. [ Yos. Crock all hat apply above and filin the details below for each business. Describe the nature ofthe business Employer Identification number McCusker & Company, Inc. warranty consulting Do net include Social Security number or TN 195 §. Sen ENA 5-26 73779 £295 S. Sandhill Road, Sto F Name of accountant or bookkeoper STS Ray Milbern Dates business existed From 12/1/2008 _ To _ present Las Vegas, Nv_99120 Describe the nature ofthe business Employer Identification number ice USA, Inc. call center, consulting service Do not Include Social Security number oF ITIN. anes Name m2 7 ‘4745 West 136th Street, Ste 77 Name of accountant or bookkeeper — ‘reer See Ray Milbern Dates business existed From 2/24/2010 To_ Present Leawood, ks _ 66224 on Sits Code Describe the nature ofthe business Employer Identification number Do not include Social Security number or ITN. MeCusker Service Group, Inc. EWN: - 4508 Colleyville Blvd. ‘Name of accountant or bookkeeper ce oO Dates business existed Ste 100 From 2/3/2012 To_Prosent Colle TX_76034 Describe the nature ofthe business Employer Identification number MeCusker West, inc. California corporation Do not include Social Security number or ITIN. ‘GusressNane No in operation — ‘Name of accountant or bookkeeper Dates business existed From 10/6/2016 _To_ Present Form 107 Statement of Financial Affairs for Individuals ing for Bankruptcy page 11Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 12 of 13 Dobior1 Willard Lee MeCusker (case number (f own) _17-43815-7 28, Within 2 years before you filed for bankruptey, did you give a financial statement to anyone about your business? Include. all financial institutions, ereditors, or other parties, No 1 Yes. Fi inte dota below. Official Form 107 Statement of Financial Affairs for Individuals Filing for Bankruptcy page 12Case 17-43815-mxm7 Doc 30 Filed 11/20/17 Entered 11/20/17 11:27:21 Page 13 of 13 Doblor1 Willard Lee MeCusker Ccase number (f known) _17-43815-7 FERRER sin Be10w | have read the answers on this Statement of Financial fairs and any attachments, and | declare under penalty of perjury ‘that answers are true and correct. I understand that making a false statement, concealing property, or obtalning money or property by fraud in connection with a bankruptcy case can result in fines up to $250,000, or imprisonment for upto 20 years, orboth, 18 U.S.C. §§ 152, 1341, 1519, and 3571 X Js! Willard Lee McCusker x Wilard Lee MeCusker, Debtor? ‘Signature of Dabior2 Date 1142012017 Date Did you attach addtional pages to Your Statement of Financial Affairs for individuals Filing for Bankruptcy (Official Form 107)? No D ves Did you pay or agree to pay someone who is not an attorney to help you fill out bankruptey forms? No Yes. Name of person ‘Atach the Bankruptey Petition Preparers Notice, Declaration, and Signature (Offcial Form 119 Form 107 Statement of Financial Affairs for Individuals ing for Bankruptcy page 13