(Official Form 1) (12/03)
Moxon, Theodore BurnhamName of Debtor (if individual, enter Last, First, Middle): Name of Joint Debtor (Spouse)(Last, First, Middle):
United States Bankruptcy Court Voluntary PetitionEastern District of Pennsylvania
FORM B1
All Other Names used by the Joint Debtor in the last 6 yearsAll Other Names used by the Debtor in the last 6 years(include married, maiden, and trade names): (include married, maiden, and trade names):
Last four digits of Soc. Sec. No. / Complete EIN or other Tax I.D. No. (if more than one, state all):8896
Last four digits of Soc. Sec. No. / Complete EIN or other Tax I.D. No. (if more than one, state all):
Street Address of Joint Debtor (No. & Street, City, State & Zip Code):Street Address of Debtor (No. & Street, City, State & Zip Code):
7300 Johnson Farm LaneApt 302Chadds Ford, PA 19317
County of Residence or of thePrincipal Place of Business:
County of Residence or of thePrincipal Place of Business:Delaware
Mailing Address of Joint Debtor (if different from street address):Mailing Address of Debtor (if different from street address):
Location of Principal Assets of Business Debtor(if different from street address above):
Information Regarding the Debtor (Check the Applicable Boxes)
�
Venue (Check any applicable box)
�
Debtor has been domiciled or has had a residence, 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.There is a bankruptcy case concerning debtor's affiliate, general partner, or partnership pending in this District.
Type of Debtor (Check all boxes that apply)
�
�
�
� Consumer/Non-Business Business
�
�
� Individual(s)CorporationPartnershipOther
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RailroadStockbrokerCommodity Broker
Chapter or Section of Bankruptcy Code Under Whichthe Petition is Filed (Check one box)
Chapter 7 Chapter 11 Chapter 13Chapter 9 Chapter 12Sec. 304 - Case ancillary to foreign proceeding
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Nature of Debts (Check one box) Filing Fee (Check one box)Full Filing Fee AttachedFiling Fee to be paid in installments (Applicable to individuals only)Must attach signed application for the court's consideration certifyingthat the debtor is unable to pay fee except in installments.Rule 1006(b). See Official Form No. 3.
Chapter 11 Small Business (Check all boxes that apply)Debtor is a small business as defined in 11 U.S.C. § 101Debtor is and elects to be considered a small business under11 U.S.C. § 1121(e) (Optional)
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�
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� Clearing Bank
Statistical/Administrative Information (Estimates only)��
Debtor estimates that funds will be available for distribution to unsecured creditors.Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will
THIS SPACE IS FOR COURT USE ONLY
be no funds available for distribution to unsecured creditors.
Estimated Number of Creditors 1-15 16-49 50-99 100-199 200-999 1000-over
� � � � � �
Estimated Assets $0 to $50,001 to $100,001 to $500,001 to $1,000,001 to $10,000,001 to $50,000,001 to More than $50,000 $100,000 $500,000 $1 million $10 million $50 million $100 million $100 million
� � � � � � � �
Estimated Debts
� � � � � � � �
$0 to $50,001 to $100,001 to $500,001 to $1,000,001 to $10,000,001 to $50,000,001 to More than $50,000 $100,000 $500,000 $1 million $10 million $50 million $100 million $100 million
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 1 of 59
FORM B1, Page 2(Official Form 1) (12/03)
Voluntary Petition Name of Debtor(s):(This page must be completed and filed in every case)
Theodore Burnham Moxon
District: Relationship:
Date Filed:Case Number:Name of Debtor:
Where Filed:Location Date Filed:Case Number:
Judge:
Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor (If more than one, attach additional sheet)
Prior Bankruptcy Case Filed Within Last 6 Years (If more than one, attach additional sheet)
NONE
NONE
11/4/2004
Not Applicable
s/ Theodore Burnham Moxon
specified in this petition.I request relief in accordance with the chapter of title 11, United States Code,
has chosen to file under chapter 7] I am aware that I may proceed under[If petitioner is an individual whose debts are primarily consumer debts and petition is true and correct.I declare under penalty of perjury that the information provided in this
Signature(s) of Debtor(s) (Individual/Joint)
Date
Telephone Number (If not represented by attorney)
Signature of Joint DebtorX
Signature of DebtorX
available under each such chapter, and choose to proceed under chapter 7.chapter 7, 11, 12 or 13 of title 11, United States Code, understand the relief
Signatures
Exhibit A
�
Not ApplicableDateSignature of Attorney for Debtor(s)
X
I have informed the petitioner that [he or she] may proceed under chapterI, the attorney for the petitioner named in the foregoing petition, declare that
whose debts are primarily consumer debts)(To be completed if debtor is an individual
Exhibit B
Exhibit A is attached and made a part of this petition.
Exchange Act of 1934 and is requesting relief under chapter 11)Commission pursuant to Section 13 or 15(d) of the Securities(e.g., forms 10Kand 10Q) with the Securities and Exchange(To be completed if debtor is required to file periodic reports
Exhibit C
relief available under each such chapter.7, 11, 12, or 13 of title 11, United States Code, and have explained the
Does the debtor own or have possession of any property that poses
CAROLYN A. KERN, ESQUIRE, PA 90811
One S. Church Street Suite 400
West Chester, PA 19382
Swartz Campbell LLC
Address
Social Security Number (Required by 11 U.S.C. § 110(c).)
Printed Name of Bankruptcy Petition Preparer
the debtor with a copy of this document.that I prepared this document for compensation, and that I have providedI certify that I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110,
Signature of Non-Attorney Petition Preparer
11/4/2004
or assisted in preparing this document:Names and Social Security numbers of all other individuals who prepared
Telephone Number
Address
Firm Name
Printed Name of Attorney for Debtor(s) / Bar No.
Signature of Attorney for Debtor(s)X
Signature of Attorney
or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.title 11 and the Federal Rules of Bankruptcy Procedure may result in finesA bankruptcy petition preparer's failure to comply with the provisions of
Date
Not ApplicableSignature of Bankruptcy Petition Preparer
X
conforming to the appropriate official form for each person.If more than one person prepared this document, attach additional sheets
Not Applicable
Date
(610) 692-4936(610) 692-9500
Signature of Debtor (Corporation/Partnership)
Date
Title of Authorized Individual
Printed Name of Authorized Individual
Signature of Authorized IndividualX
States Code, specified in this petition.The debtor requests relief in accordance with the chapter of title 11, Unitedpetition on behalf of the debtor.petition is true and correct, and that I have been authorized to file thisI declare under penalty of perjury that the information provided in this
Not Applicable
public health or safety?or is alleged to pose a threat of imminent and identifiable harm to
�
�
Yes, and Exhibit C is attached and made a part of this petition.
No�
Carolyn A Kern
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 2 of 59
FORM B6A
(6/90)
,In re: Case No.Theodore Burnham Moxon(If known)Debtor
SCHEDULE A - REAL PROPERTY
DESCRIPTION ANDLOCATION OF
PROPERTY
NATURE OF DEBTOR'SINTEREST IN PROPERTY
AMOUNT OFSECURED
CLAIM
CURRENTMARKET VALUEOF DEBTOR'SINTEREST IN
PROPERTY WITHOUTDEDUCTING ANYSECURED CLAIM OR EXEMPTION
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Total � 0.00(Report also on Summary of Schedules.)
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FORM B6B
(10/89)
,In re Case No.Theodore Burnham Moxon(If known)Debtor
SCHEDULE B - PERSONAL PROPERTY
TYPE OF PROPERTY
CURRENTMARKET VALUE OF
DEBTOR'S INTERESTIN PROPERTY, WITH-OUT DEDUCTING ANY
SECURED CLAIMOR EXEMPTION
DESCRIPTION AND LOCATIONOF PROPERTYN
ON
E
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Cash on hand1. X
Checking, savings or other financial accounts, certificates of deposit, or shares in banks, savings and loan, thrift, building and loan, and homestead associations, or credit unions, brokerage houses, or cooperatives.
2. Commerce Bank2005 Market StreetPhiladelphia, PA 19103
700.00
Security deposits with public utilities, telephone companies, landlords, and others.
3. X
Household goods and furnishings, including audio, video, and computer equipment.
4. Area rugs 200.00
Assorted glassware 20.00
Assorted hand tools 200.00
Assorted kitcehn utensils and knives 30.00
Assorted mix/match dinnerware 10.00
Assorted pots/pans 30.00
Bed linens, comforters, blankets 25.00
Bird Bath 15.00
Bookcases 100.00
Canister Vacuum 5.00
Coffee Maker 5.00
Dining room chairs 60.00
Dining Room Table 150.00
Dressers 600.00
DVD player 25.00
Easy chairs 50.00
Electric Fans 15.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 4 of 59
FORM B6B
(10/89)
,In re Case No.Theodore Burnham Moxon(If known)Debtor
(Continuation Sheet)SCHEDULE B - PERSONAL PROPERTY
TYPE OF PROPERTY
CURRENTMARKET VALUE OF
DEBTOR'S INTERESTIN PROPERTY, WITH-OUT DEDUCTING ANY
SECURED CLAIMOR EXEMPTION
DESCRIPTION AND LOCATIONOF PROPERTYN
ON
E
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Household goods and furnishings, including audio, video, and computer equipment.
4. Floor lamps/desk lamps 100.00
Flower pots 5.00
Full size beds 300.00
Hand held vacuum 5.00
Hand Mixer 5.00
Hat rack 10.00
Iron 5.00
Ironing board 5.00
Loveseat 10.00
Microwave 15.00
Quenn size bed 50.00
Side tables/Coffee tables 100.00
Sofa 100.00
Speakers 25.00
Stereo Receiver/Tuner 25.00
Stools, rocker, desk chairs 175.00
Telephones 10.00
Televisions 125.00
Toaster 3.00
VCR 25.00
Books, pictures and other art objects, antiques, stamp, coin, record, tape, compact disc, and other collections or collectibles.
5. Assorted books 125.00
Small decorative items 200.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 5 of 59
FORM B6B
(10/89)
,In re Case No.Theodore Burnham Moxon(If known)Debtor
(Continuation Sheet)SCHEDULE B - PERSONAL PROPERTY
TYPE OF PROPERTY
CURRENTMARKET VALUE OF
DEBTOR'S INTERESTIN PROPERTY, WITH-OUT DEDUCTING ANY
SECURED CLAIMOR EXEMPTION
DESCRIPTION AND LOCATIONOF PROPERTYN
ON
E
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Books, pictures and other art objects, antiques, stamp, coin, record, tape, compact disc, and other collections or collectibles.
5. Wall prints, mirrors, frames 300.00
Wearing apparel.6. Assorted slacks/shorts 15.00
Assorted Sweaters 66.00
Coats, jackets, outdoor wear 55.00
Dress Shirts 20.00
Dress slacks 20.00
Golf Shirts 25.00
Hats 15.00
Shoes, boots, sneakers 15.00
Sport coats 30.00
Suit 25.00
Ties 25.00
Furs and jewelry.7. Wedding Band 50.00
Firearms and sports, photographic, and other hobby equipment.
8. Bike 10.00
Camping equipment/tent, camp stove, camp chairs 50.00
Golf clubs 50.00
Guitar 200.00
Rowing Machine 300.00
Rowing shell 2,500.00
Student Microscope 10.00
Student telescope 50.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 6 of 59
FORM B6B
(10/89)
,In re Case No.Theodore Burnham Moxon(If known)Debtor
(Continuation Sheet)SCHEDULE B - PERSONAL PROPERTY
TYPE OF PROPERTY
CURRENTMARKET VALUE OF
DEBTOR'S INTERESTIN PROPERTY, WITH-OUT DEDUCTING ANY
SECURED CLAIMOR EXEMPTION
DESCRIPTION AND LOCATIONOF PROPERTYN
ON
E
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Interests in insurance policies. Name insurance company of each policy and itemize surrender or refund value of each.
9. Penn Mutual (008143225) Death Benefit 1,250,000.00
0.00
Penn Mutual (008143237)Death Benefit 1,000,000.00cash value unknown
0.00
Annuities. Itemize and name each issuer.
10. X
Interests in IRA, ERISA, Keogh, or other pension or profit sharing plans. Itemize.
11. Image Tech - Profit Sharing Plan 60,788.00
Stock and interests in incorporated and unincorporated businesses. Itemize.
12. Image Tech Associates, Inc (100 shares) J 0.00
Interests in partnerships or joint ventures. Itemize.
13. X
Government and corporate bonds and other negotiable and nonnegotiable instruments.
14. X
Accounts receivable.15. X
Alimony, maintenance, support, and property settlements to which the debtor is or may be entitled. Give particulars.
16. X
Other liquidated debts owing debtor including tax refunds. Give particulars.
17. X
Equitable or future interests, life estates, and rights or powers exercisable for the benefit of the debtor other than those listed in Schedule of Real Property.
18. X
Contingent and noncontingent interests in estate of a decedent, death benefit plan, life insurance policy, or trust.
19. X
Other contingent and unliquidated claims of every nature, including tax refunds, counterclaims of the debtor, and rights to setoff claims. Give estimated value of each.
20. X
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FORM B6B
(10/89)
,In re Case No.Theodore Burnham Moxon(If known)Debtor
(Continuation Sheet)SCHEDULE B - PERSONAL PROPERTY
TYPE OF PROPERTY
CURRENTMARKET VALUE OF
DEBTOR'S INTERESTIN PROPERTY, WITH-OUT DEDUCTING ANY
SECURED CLAIMOR EXEMPTION
DESCRIPTION AND LOCATIONOF PROPERTYN
ON
E
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
Patents, copyrights, and other intellectual property. Give particulars.
21. X
Licenses, franchises, and other general intangibles. Give particulars.
22. X
Automobiles, trucks, trailers, and other vehicles and accessories.
23. 1999 Chevy Tahoe (125,000 miles) 5,715.00
2002 Landrover J 10,123.00
Boats, motors, and accessories.24. X
Aircraft and accessories.25. X
Office equipment, furnishings, and supplies.
26. X
Machinery, fixtures, equipment and supplies used in business.
27. X
Inventory.28. X
Animals.29. X
Crops - growing or harvested. Give particulars.
30. X
Farming equipment and implements.31. X
Farm supplies, chemicals, and feed.32. X
Other personal property of any kind not already listed. Itemize.
33. Escrow funds held by title company J 57,000.00
Total � $ 141,120.00
(Include amounts from any continuation sheets attached. Report total also on Summary of Schedules.)
continuation sheets attached4
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 8 of 59
,In re Case No.Theodore Burnham Moxon
FORM B6C
(6/90)
Debtor. (If known)
SCHEDULE C - PROPERTY CLAIMED AS EXEMPT
� 11 U.S.C. § 522(b)(1)
(Check one box)
Debtor elects the exemption to which debtor is entitled under:
Note: These exemptions are available only in certain states.Exemptions provided in 11 U.S.C. § 522(d).
Exemptions available under applicable nonbankruptcy federal laws, state or local law where the debtor's domicile has been located for the 180 days immediately preceding the filing of the petition, or for a longer portion of the 180-day period than in any other place, and the debtor's interest as a tenant by the entirety or joint tenant to the extent the interest is exempt from process under applicable nonbankruptcy law.
11 U.S.C. § 522(b)(2) �
DESCRIPTION OF PROPERTYSPECIFY LAW
PROVIDING EACHEXEMPTION
VALUE OFCLAIMED
EXEMPTION
CURRENT MARKETVALUE OF PROPERTY,WITHOUT DEDUCTING
EXEMPTIONS
1999 Chevy Tahoe (125,000 miles)
5,715.0011 USC § 522(d)(2) 2,775.00
Area rugs 200.0011 USC § 522(d)(3) 200.00
Assorted books 125.0011 USC § 522(d)(3) 125.00
Assorted glassware 20.0011 USC § 522(d)(3) 20.00
Assorted hand tools 200.0011 USC § 522(d)(3) 200.00
Assorted kitcehn utensils and knives
30.0011 USC § 522(d)(3) 30.00
Assorted mix/match dinnerware
10.0011 USC § 522(d)(3) 10.00
Assorted pots/pans 30.0011 USC § 522(d)(3) 30.00
Assorted slacks/shorts 15.0011 USC § 522(d)(3) 15.00
Assorted Sweaters 66.0011 USC § 522(d)(3) 66.00
Bed linens, comforters, blankets
25.0011 USC § 522(d)(3) 25.00
Bike 10.0011 USC § 522(d)(3) 10.00
Bird Bath 15.0011 USC § 522(d)(3) 15.00
Bookcases 100.0011 USC § 522(d)(3) 100.00
Camping equipment/tent, camp stove, camp chairs
50.0011 USC § 522(d)(3) 50.00
Canister Vacuum 5.0011 USC § 522(d)(3) 5.00
Coats, jackets, outdoor wear 55.0011 USC § 522(d)(3) 55.00
Coffee Maker 5.0011 USC § 522(d)(3) 5.00
Commerce Bank2005 Market StreetPhiladelphia, PA 19103
700.0011 USC § 522(d)(5) 700.00
Dining room chairs 60.0011 USC § 522(d)(3) 60.00
Dining Room Table 150.0011 USC § 522(d)(3) 150.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 9 of 59
,In re Case No.Theodore Burnham Moxon
FORM B6C
(6/90)
Debtor. (If known)
SCHEDULE C - PROPERTY CLAIMED AS EXEMPT
DESCRIPTION OF PROPERTYSPECIFY LAW
PROVIDING EACHEXEMPTION
VALUE OFCLAIMED
EXEMPTION
CURRENT MARKETVALUE OF PROPERTY,WITHOUT DEDUCTING
EXEMPTIONS
Dress Shirts 20.0011 USC § 522(d)(3) 20.00
Dress slacks 20.0011 USC § 522(d)(3) 20.00
Dressers 600.0011 USC § 522(d)(3) 600.00
DVD player 25.0011 USC § 522(d)(3) 25.00
Easy chairs 50.0011 USC § 522(d)(3) 50.00
Electric Fans 15.0011 USC § 522(d)(3) 15.00
Escrow funds held by title company
57,000.0011 USC § 522(d)(1) 17,425.00
Floor lamps/desk lamps 100.0011 USC § 522(d)(3) 100.00
Flower pots 5.0011 USC § 522(d)(3) 5.00
Full size beds 300.0011 USC § 522(d)(3) 300.00
Golf clubs 50.0011 USC § 522(d)(3) 50.00
Golf Shirts 25.0011 USC § 522(d)(3) 25.00
Guitar 200.0011 USC § 522(d)(3) 200.00
Hand held vacuum 5.0011 USC § 522(d)(3) 5.00
Hand Mixer 5.0011 USC § 522(d)(3) 5.00
Hat rack 10.0011 USC § 522(d)(3) 10.00
Hats 15.0011 USC § 522(d)(3) 15.00
Image Tech - Profit Sharing Plan
60,788.0011 USC § 522(d)(10)(E) 60,788.00
Image Tech Associates, Inc (100 shares)
0.0011 USC § 522(d)(10)(E) 0.00
Iron 5.0011 USC § 522(d)(3) 5.00
Ironing board 5.0011 USC § 522(d)(3) 5.00
Loveseat 10.0011 USC § 522(d)(3) 10.00
Microwave 15.0011 USC § 522(d)(3) 15.00
Penn Mutual (008143225) Death Benefit 1,250,000.00
0.0011 USC § 522(d)(7) 0.00
Penn Mutual (008143237)Death Benefit 1,000,000.00cash value unknown
0.0011 USC § 522(d)(7) 0.00
Quenn size bed 50.0011 USC § 522(d)(3) 50.00
Rowing Machine 300.0011 USC § 522(d)(3) 300.00
Rowing shell 2,500.0011 USC § 522(d)(3) 2,500.00
Shoes, boots, sneakers 15.0011 USC § 522(d)(3) 15.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 10 of 59
,In re Case No.Theodore Burnham Moxon
FORM B6C
(6/90)
Debtor. (If known)
SCHEDULE C - PROPERTY CLAIMED AS EXEMPT
DESCRIPTION OF PROPERTYSPECIFY LAW
PROVIDING EACHEXEMPTION
VALUE OFCLAIMED
EXEMPTION
CURRENT MARKETVALUE OF PROPERTY,WITHOUT DEDUCTING
EXEMPTIONS
Side tables/Coffee tables 100.0011 USC § 522(d)(3) 100.00
Small decorative items 200.0011 USC § 522(d)(3) 200.00
Sofa 100.0011 USC § 522(d)(3) 100.00
Speakers 25.0011 USC § 522(d)(3) 25.00
Sport coats 30.0011 USC § 522(d)(3) 30.00
Stereo Receiver/Tuner 25.0011 USC § 522(d)(3) 25.00
Stools, rocker, desk chairs 175.0011 USC § 522(d)(3) 175.00
Student Microscope 10.0011 USC § 522(d)(3) 10.00
Student telescope 50.0011 USC § 522(d)(3) 50.00
Suit 25.0011 USC § 522(d)(3) 25.00
Telephones 10.0011 USC § 522(d)(3) 10.00
Televisions 125.0011 USC § 522(d)(3) 125.00
Ties 25.0011 USC § 522(d)(3) 25.00
Toaster 3.0011 USC § 522(d)(3) 3.00
VCR 25.0011 USC § 522(d)(3) 25.00
Wall prints, mirrors, frames 300.0011 USC § 522(d)(3) 300.00
Wedding Band 50.0011 USC § 522(d)(4) 50.00
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 11 of 59
FORM B6D(12/03)
Theodore Burnham MoxonIn re: Case No.,
(If known)Debtor
SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS
� Check this box if debtor has no creditors holding secured claims to report on this Schedule D.
CO
NT
ING
EN
T
DATE CLAIM WAS INCURRED,NATURE OF LIEN, AND
DESCRIPTION AND MARKETVALUE OF PROPERTY
SUBJECT TO LIEN
AMOUNTOF CLAIMWITHOUT
DEDUCTINGVALUE OF
COLLATERAL
UNSECUREDPORTION,
IF ANY
DIS
PU
TE
D
UN
LIQ
UID
AT
ED
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
DE
BT
ORCREDITOR'S NAME,
MAILING ADDRESSINCLUDING ZIP CODE,
AND ACCOUNT NUMBER(See instructions, above.)
ACCOUNT NO. X J 314,467.54Security AgreementEquipment of Image Tech__________________________VALUE $0.00
1st National Bank of Chester County9 North High StreetP.O. Box 523West Chester, PA 19381
0.00
ACCOUNT NO. X J 652,357.14All assets of Image Tech__________________________VALUE $150,000.00
Hudson United Bank1000 MacArthur Blvd.Mahwah, NJ 07430
0.00
ACCOUNT NO. 30530906 X J 18,007.97Security Agreement2002 Land Rover Freelander__________________________VALUE $10,123.00
Land Rover CapitalP.O. Box 55000Detroit, MI 48255
0.00
ACCOUNT NO. 60800074801 8,713.82Security Agreement1999 Chevy Tahoe__________________________VALUE $5,715.00
Wachovia Bank, N.A.P.O. Box 50010Roanoke, VA 24022
0.00
0 Continuation sheets attached
$993,546.47
$993,546.47
Subtotal �
Total �
(Report total also on Summary of Schedules)
(Total of this page)
(Use only on last page)
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 12 of 59
Form B6E
(04/04)
Theodore Burnham Moxon , Case No.In re
Debtor (If known)
SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS
� Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.
TYPES OF PRIORITY CLAIMS
� Extensions of credit in an involuntary case
Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(2).
(Check the appropriate box(es) below if claims in that category are listed on the attached sheets)
� Wages, salaries, and commissions
Wages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying independent sales representatives up to $4,925* per person earned within 90 days immediately preceding
the filing of the original petition, or the cessation of business, whichever occurred first, to the extent provided in
11 U.S.C. § 507(a)(3).
� Contributions to employee benefit plans
Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(4).
� Certain farmers and fishermen
Claims of certain farmers and fishermen, up to $4,925* per farmer or fisherman, against the debtor, as provided in 11
U.S.C. § 507(a)(5).
� Deposits by individuals
Claims of individuals up to $2,225* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that were not delivered or provided. 11 U.S.C. § 507(a)(6).
� Alimony, Maintenance, or Support
Claims of a spouse, former spouse, or child of the debtor for alimony, maintenance, or support, to the extent provided in 11 U.S.C. § 507(a)(7).
Taxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11
Taxes and Certain Other Debts Owed to Governmental Units�
U.S.C. § 507(a)(8).
an insured depository institution. 11 U.S.C. § 507(a)(9).or Board of Governors of the Federal Reserve System, or their predecessors or successors, to maintain the capital of
Claims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency,
� Commitments to Maintain the Capital of an Insured Depository Institution
* Amounts are subject to adjustment on April 1, 2007, and every three years thereafter with respect to cases commenced on or
after the date of adjustment.
Other Priority Debts�
Continuation sheets attached1
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 13 of 59
Form B6E - Cont.
(04/04)
Case No.In re ,
(If known)Debtor
Theodore Burnham Moxon
SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS
CO
DE
BT
OR
HU
SB
AN
D,
WIF
E,
JOIN
TO
R C
OM
MU
NIT
Y
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
AMOUNT OF CLAIM
AMOUNTENTITLED
TOPRIORITY
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER
(See instructions.)
DATE CLAIM WAS INCURRED AND CONSIDERATION
FOR CLAIM
ACCOUNT NO.
$0.00
$0.00
�
�Subtotal
(Total of this page)
Total(Use only on last page of the completed Schedule E.)
Sheet no. 1 of 1 sheets attached to Schedule of Creditors Holding Priority Claims
(Report total also on Summary of Schedules)
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 14 of 59
,
Form B6F (12/03)
Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS
Check this box if debtor has no creditors holding unsecured nonpriority claims to report on this Schedule F.�
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
15.00XACCOUNT NO. XXX
AAA Financial ServicesP.O. Box 15268Wilmington, DE 19886-5286
Services for Image Tech
25,612.63XACCOUNT NO. XXX
ABC Mailer Inc5301 Tacony Street Bldg 48ABox 102Philadelphia, PA
Image Tech Vendor
0.00XACCOUNT NO. XXX
ABCO Printing Company54 Marlen DriveHamilton Twp, NJ 08691
(Image Tech) Vendor
300.00XACCOUNT NO. XXX
ABIS10324 South Dolphin RoadOwings Mills, MD 21117
(Image Tech) Vendor
211.6701300 146204124 XACCOUNT NO. XXX
ADT Security ServesP.O. Box 371967Pittsburgh, PA 15250-7967
(Image Tech) Vendor
Continuation sheets attached20
Total �
� $26,139.30Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 15 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
5,834.065477539241280015 XACCOUNT NO. XXX
ADVANTA Business CardsP.O. Box 8088Philadelphia, PA 19101-8088
(Image Tech) Credit Card/Line of Credit
0.00XACCOUNT NO. XXX
Advantage, Inc.1611 Kent StreetSuite 905Arlington, VA 22209
(Image Tech) Vendor
79.50XACCOUNT NO. XXX
Allegra Print and Image501 East Gay StreetWest Chester, PA 19380
(Image Tech) Vendor
16,807.20XACCOUNT NO. XXX
Alliance Business Systems, IncKevin P. Mullarkey501 Abbott DriveBroomall, PA 19008
(Image Tech) Vendor
50.20908122425ACCOUNT NO.
Allstate Insurance500 Chesterbrook BoulevardWayne, PA 19087
Renter's Insurance
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 1 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $22,770.96Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 16 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
2,138.37098925169ACCOUNT NO.
Allstate Insurance500 Chestnut BoulevardWayne, PA 19087
Auto Insurance
131.1234 0802 8741ACCOUNT NO.
American Education Service1200 North Seventh StreetHarrisburg, PA 17102
School Loan for Son
1,200.00378265938152009ACCOUNT NO. X
American Express CorpP.O. Box 360001Fort Lauderdale, FL 33336-0001
Credit Card
0.00372261691121006 XACCOUNT NO. XXX
American Express CorpP.O. Box 360001Fort Lauderdale, FL 33336-0001
(Image Tech) Credit Card/Line of Credit
740.25XACCOUNT NO. XXX
AnycolorAttn: Kathy AtkinsOne Graphics DriveEwing, NJ 08628
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 2 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $4,209.74Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 17 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
302.00ACCOUNT NO. XXX
Armstrong Development202 W. Virginia AveWest Chester, PA 19380
Image Tech Vendor
48.84A0921025804801ACCOUNT NO.
AT&T/GC Services LPP.O. Box 1419Copperas Cove, TX 76522
Telephone Service
6,955.974246311201250187 XACCOUNT NO. XXX
Bank One - 42464246 P.O. Box 15153Wilmington, DE 19886-5153
(Image Tech) Credit Card/Line of Credit
12,793.294417128640121735 XACCOUNT NO. XXX
Bank One - 4417P.O. Box 15153Wilmington, DE 19886-5153
(Image Tech) Credit Card/Line of Credit
1,021.00XACCOUNT NO. XXX
BCC Software, Inc75 Josons DriveRochester, NY 14623-9639
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 3 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $21,121.10Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 18 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
256.83160132307585 XACCOUNT NO. XXX
BFI Waste SystemBrandywine District613 P.O. Box 830121Baltimore, MD 21283-0121
(Image Tech)
1,305.00XACCOUNT NO. XXX
Bill Trimbur16 Montrose AvenueUpper Darby, PA 19082
(Image Tech) Vendor
0.00XACCOUNT NO. XXX
Box King Products40 South Second AveP.O. Box 784Phoenixville, PA 19460
(Image Tech) Vendor
0.00XACCOUNT NO. XXX
Brandywine Electrical ContractorsP.O. Box 1643West Chester, PA 19380
(Image Tech) Vendor
912.180175327 XACCOUNT NO. XXX
Canon Financial Services158 Gaithers DriveSuite 200Mt. Laurel, NJ 08054
(Image Tech)
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 4 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $2,474.01Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 19 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
4,768.594115072108066310 XACCOUNT NO. XXX
Capital One Bank - VisaP.O. Box 85147Richmond, VA 23276
(Image Tech) Credit Card/Line of Credit
0.00XACCOUNT NO. XXX
Capital One Bank - MCP.O. Box 85147Richmonad, VA 23285-5147
(Image Tech) Credit Card/Line of Credit
5,851.284305877090074605ACCOUNT NO. X
ChaseP.O. Box 15659Wilmington, DE 19886
10,765.0010308017064109ACCOUNT NO.
Chase Auto FinanceP.O. Box 15700Wilmington, DE 19886-5700
2001 Camaro
13,910.0010225411302509ACCOUNT NO.
Chase Auto FinanceP.O. Box 15700Wilmington, DE 19886-5700
2002 Subaru
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 5 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $35,294.87Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 20 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
1,214.365424181019567080ACCOUNT NO. X
Citi CardsP.O. Box 6077Sioux Falls, SD 57117
credit card
4,180.315410658446418764ACCOUNT NO. X
Citi CardsP.O. Box 6077Sioux Falls, SD 57117
credit card
0.00XACCOUNT NO. XXX
Citibusiness CardP.O. Box 410437Salt Lake City, UT 84141-0437
(Image Tech) Credit Card/Line of Credit
50.4209527352123018ACCOUNT NO.
Comcast4008 N. DuPont HighwayNew Castle, DE 19720
Cable Television Service
80.88ACCOUNT NO. XX
Comcast4008 N. DuPont HighwayNew Castle, DE 19720
Cable Television Service at 1100 West Chester Pike, West Chester, PA 19380
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 6 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $5,525.97Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 21 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
0.00XACCOUNT NO. XXX
Corporate ImagingP.O. Box 7126Gaithersburg, MD 20898-7126
(Image Tech) Vendor
158.22XACCOUNT NO. XXX
Date Label, Inc.1000 Spruce StreetTerre Haute, IN 47807
(Image Tech) Vendor
578.5206496 XACCOUNT NO. XXX
Davis Business Machines, Inc.P.O. Box 20447Lehigh Valley, PA 18002-0047
(Image Tech)
1,841.95XACCOUNT NO. XXX
DSC Systems Graphics10223 Southard DrBeltsville, MD 20705
(Image Tech) Vendor
418.75XACCOUNT NO. XXX
East Coast Communications, Inc.P.O. Box 617Westtown, PA 19395-0617
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 7 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $2,997.44Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 22 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
144.00XACCOUNT NO. XXX
EC Tek, Inc.5469 White Cedar TerraceSugar Hill, GA 30518
(Image Tech) Vendor
1,430.00XACCOUNT NO. XXX
Envelope America2 Lukens DriveSuite 100New Castle, DE 19720
(Image Tech) Vendor
0.00XACCOUNT NO. XXX
ExxonMobil/GECCP.O. Box 4575Carol Stream, IL 60197-4575
(Image Tech) Vendor
749.17160928611 XACCOUNT NO. XXX
Federal Express CorpP.O. Box 360353Pittsburgh, PA 15250-6353
(Image Tech)
10,944.37XACCOUNT NO. XXX
Fernhill - Political1901 North Penn RoadHatfield, PA 19440
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 8 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $13,267.54Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 23 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
2,313.81XACCOUNT NO. XXX
FMI, Inc.2100 Kubach RoadPhiladelphia, PA 19116
(Image Tech) Vendor
20,375.224046910010671178 XACCOUNT NO. XXX
GE Corporate PlusP.O. Box 410420Salt Lake City, UT 84141-0420
(Image Tech) Credit Card/Line of Credit
0.00XACCOUNT NO. XXX
Grainger Dept592-836010892Palatine, IL 60038-0001
(Image Tech) Vendor
0.00XACCOUNT NO. XXX
Hartford Fire Insurance CoP.O. Box 2907Hartford, CT 06104-2907
(Image Tech)
1,446.64164335 X JACCOUNT NO.
Heritage PropaneP.O. Box 10687Wilmington, DE 19850-0687
Propane
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 9 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $24,135.67Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 24 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
596.656035322013000439 XACCOUNT NO. XXX
Home Depot CRCP.O. Box 105991 Dept 24Atlanta, GA 30348-5991
(Image Tech)
886.62XACCOUNT NO. XXX
HomeNetP.O. Box 8500-52163Philadelphia, PA 19178-2163
(Image Tech) Vendor
289,715.00ACCOUNT NO. XXX
Image Tech Associates, Inc.101 Willowbrook LaneWest Chester, PA 19382
Loans to Officer
12,797.40XACCOUNT NO. XXX
International Business Systems431 Yerkes RoadKing of Prussia, PA 19406
(Image Tech) Vendor
1,200.00XACCOUNT NO. XXX
J. Michael RyanExton Office Court 300-FN. Pottstown PikeExton, PA 19341-2235
(Image Tech)
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 10 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $305,195.67Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 25 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
0.00XACCOUNT NO. XXX
Joe Warner1131 Dodson RoadWest Chester, PA 19382
(Image Tech) Vendor
2,130.06XACCOUNT NO. XXX
Labels & Lists, Inc.2500 116th Avenue, N.E.Bellevue, WA 98004
(Image Tech) Vendor
2,473.0622482921 XACCOUNT NO. XXX
Labor Ready Northeast, IncP.O. Box 641034Pittsburgh, PA 15264-1034
(Image Tech) Vendor
341.25ACCOUNT NO.
Lamb McErlane P.C.24 E. Market StreetP.O. Box 565West Chester, PA 19381
Initial Divorce Interview Fee
50,925.00XACCOUNT NO.
Leslie N. Moxon1101 Lafayette RoadWayne, PA 19087
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 11 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $55,869.37Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 26 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
3,577.85XACCOUNT NO. XXX
March Imaging SystemsP.O. Box 1775West Chester, PA 19380
(Image Tech) Vendor
68.34XACCOUNT NO. XXX
MARCO, Incorporated320 Commerce DriveExton, PA 19341
(Image Tech) Vendor
24,800.00XACCOUNT NO. XXX
Mary Kay Wopatek551 Patrice LaneWest Chester, PA 19380
Image Tech
7,328.3674923015993318ACCOUNT NO. XXX
MBNA (Textron)P.O. Box 15102Wilmington, DE 19886-5102
Line of credit to Image Tech - Personal Guaranty
6,461.765490991464938394ACCOUNT NO. XX
MBNA AmericaP.O. Box 15137Wilmington, DE 19886
credit card
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 12 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $42,236.31Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 27 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
10,014.62XACCOUNT NO. XXX
McClafferty Printing Co.1600 N. Scott StreetWilmington, DE 19806
(Image Tech) Vendor
8,589.529150134288 XACCOUNT NO. XXX
MCI Long DistanceP.O. Box 96022Charlotte, NC 28296-0022
(Image Tech)
29,668.37XACCOUNT NO. XXX
MCS, Inc.8101 Cessna AveGaithersburg, MD 20879
(Image Tech) Vendor
19,467.33XACCOUNT NO. XXX
MR Direct Mailing, Inc.711 East Union StreetWest Chester, PA 19382
(Image Tech) Vendor
34,536.354264290559193818 XACCOUNT NO. XXX
N.F.I.B.P.O. Box 15019Wilmington, DE 19886-5019
(Image Tech) Credit Card/Line of Credit
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 13 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $102,276.19Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 28 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
74,790.49XACCOUNT NO. XXX
National Mail Graphics Corp300 Old Mill LaneExton, PA 19341
(Image Tech) Vendor
622.50XACCOUNT NO. XXX
New York Sound166 Fifth Ave6th FloorNew York, NY 10010
(Image Tech) Vendor
407.32630404127ACCOUNT NO.
Nextel Comm/GC Services LPP.O. Box 32500Columbus, OH 43232
Nextel Phone
26,879.23XACCOUNT NO. XXX
Nipson America, Inc.1501 Landmeir RoadElk Grove Village, IL 6001
(Image Tech) Vendor
25.00C2278774ACCOUNT NO.
Paoli Memorial Hospitalc/o Penn Credit CorpP.O. Box 988Harrisburg, PA 17108
Emergency Room Services
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 14 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $102,724.54Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 29 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
2,179.43XACCOUNT NO. XXX
Paul Revere Insurance GroupP.O. Box 17179Wilmington, DE 19886-7179
(Image Tech)
169.2936-04-41-082525ACCOUNT NO.
PECOP.O. Box 13778Philadelphia, PA 19101
Electricity
364.3750-02-080-705036ACCOUNT NO.
PECOP.O. Box 13778Philadelphia, PA 19101
Electricity
292.09350342268223 XACCOUNT NO. XXX
PECOP.O. Box 13778Philadelphia, PA 19162-3778
(Image Tech)
0.00XACCOUNT NO. XXX
Penn National Insurance CompanyP.O. Box 2257Harrisburg, PA 17105
(Image Tech)
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 15 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $3,005.18Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 30 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
1,310.0218627768866 XACCOUNT NO. XXX
Pitney BowesP.O. Box 856390Louisville, KY 40285-6390
(Image Tech) Vendor
3,714.39XACCOUNT NO. XXX
Prestige Mailing Services102 Willowbrook LaneWest Chester, PA 19382
(Image Tech) Vendor
1,201.0118627768866 XACCOUNT NO. XXX
Purchase PowerP.O. Box 856042Louisville, KY 49285-6042
(Image Tech) Vendor
33,168.85XACCOUNT NO. XXX
RedGo Properties315 Willowbrook LaneWest Chester, PA 19382
(Image Tech)
254.0000160041 XACCOUNT NO. XXX
Reliable Office SuppliesDept 8001135 S. LaSalle StreetChicago, IL 60674-8001
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 16 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $39,648.27Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 31 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
5,589.62XACCOUNT NO. XXX
Riegel PrintingP.O. Box 7430One Graphics DriveEwing, NJ 08628
(Image Tech) Vendor
652,357.14PLP5233374005 & GP35ACCOUNT NO. XXX
Small Business Administration400 North 8th StreetP.O. Box 10126Richmond, VA 23240-0126
Personal Guaranty for loan to Image Tech
34,000.005381032781ACCOUNT NO. XXX
Sovereign BankP.O. Box 12646Reading, PA 19612
Personal Guaranty for loan to Image Tech
105.386168ACCOUNT NO.
Spellman Dental Associates227 West Miner StreetWest Chester, PA 19382
Dental work
2,181.467972850000178878 XACCOUNT NO. XXX
Staples Credit PlanP.O. Box 9020DesMoines, IA 50368-9020
(Image Tech) Credit Card/Line of Credit
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 17 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $694,233.60Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 32 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
0.00XACCOUNT NO. XXX
Stategic Planning Systems, Inc.150 Knickerbocker AvenueBohemia, NY 11716
(Image Tech) Vendor
250.00XACCOUNT NO. XXX
Telematch6883 Commercial DriveSpringfield, VA 22159-0310
(Image Tech) Vendor
215.601209460326 XACCOUNT NO. XXX
TexacoP.O. Box 790055Houston, TX 77279-0055
(Image Tech) Credit Card/Line of Creditcredit card/line of credit
4,370.00XACCOUNT NO. XXX
The Print Shop319-R Westtown RoadWest Chester, PA 19382
(Image Tech) Vendor
525.00ACCOUNT NO. X
The Varrenti Company9 N. Five Points RoadWest Chester, PA 19380
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 18 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $5,360.60Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 33 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
1,333.56ACCOUNT NO. XXX
Think Ink, Inc.8101 Cessna AveueGaithersburg, MD 20879
1,298.5657287273ACCOUNT NO. XX
Tires Plus/Crdit First N.A.P.O. Box 81344Cleveland, OH
Tire/Service
159.95XACCOUNT NO. XXX
True Net201 Willowbrook LaneWest Chester, PA 19382
(Image Tech)
54.93E-19053 XACCOUNT NO. XXX
United Parcel ServiceP.O. Box 4980Hagerstown, MD 21747-4980
(Image Tech)
1,577.2520520627 XACCOUNT NO. XXX
US BancorpP.O. Box 5179Sioux Falls, SD 57117-5179
(Image Tech)
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 19 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
�
� $4,424.25Subtotal
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 34 of 59
Form B6F - Cont.(12/03)
,Theodore Burnham MoxonIn re Case No.
(If known)Debtor
SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS(Continuation Sheet)
DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM.
IF CLAIM IS SUBJECT TOSETOFF, SO STATE
CREDITOR'S NAME,MAILING ADDRESS
INCLUDING ZIP CODE,AND ACCOUNT NUMBER(See instructions, above.)
AMOUNT OF CLAIM
CO
DE
BT
OR
HU
SB
AN
D, W
IFE
, JO
INT
OR
CO
MM
UN
ITY
CO
NT
ING
EN
T
UN
LIQ
UID
AT
ED
DIS
PU
TE
D
964.87610-692-8940 XACCOUNT NO. XXX
Verizon - PAP.O. Box 28000Lehigh Valley, PA 18002-8000
(Image Tech)
33,787.843757618213 X JACCOUNT NO. XXX
Wells Fargo Business DirectDivision Mac U1852-024Boise, ID 83707
(Image Tech) Credit Card/Line of Creditcredit card/line of credit - Personal Guaranty
5,800.00XACCOUNT NO. XXX
William McClintock Associates 269 Sheffield Street #5DMountainside, NJ 07092
(Image Tech) Vendor
(Use only on last page of the completed Schedule F.)
(Total of this page)
Total
Sheet no. 20 of 20 continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims
$1,553,463.29�
� $40,552.71Subtotal
(Report also on Summary of Schedules)
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 35 of 59
, Case No.In re: Theodore Burnham Moxon
Form B6G
(10/89)
(If known)Debtor
SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES
Check this box if debtor has no executory contracts or unexpired leases.�
NAME AND MAILING ADDRESS, INCLUDING ZIP CODE,OF OTHER PARTIES TO LEASE OR CONTRACT.
DESCRIPTION OF CONTRACT OR LEASE AND NATURE OFDEBTOR'S INTEREST, STATE WHETHER LEASE IS FOR
NONRESIDENTIAL REAL PROPERTY. STATE CONTRACTNUMBER OF ANY GOVERNMENT CONTRACT.
Apartment Lease expires 3/2005 (Current on all payments)Summit Valley Brook Apts700 Johnson Farm LaneChadds Ford, PA 19137
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 36 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
Mary Kay Wopatek551 Patrice LaneWest Chester, PA 19380
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
Heritage PropaneP.O. Box 10687Wilmington, DE 19850-0687
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
1st National Bank of Chester County9 North High StreetP.O. Box 523West Chester, PA 19381
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
Hudson United Bank1000 MacArthur Blvd.Mahwah, NJ 07430
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
Land Rover CapitalP.O. Box 55000Detroit, MI 48255
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
Wells Fargo Business DirectDivision Mac U1852-024Boise, ID 83707
Anita Moxon1001 Wharton CourtNewtown Square, PA 19073
FMI, Inc.2100 Kubach RoadPhiladelphia, PA 19116
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Citibusiness CardP.O. Box 410437Salt Lake City, UT 84141-0437
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Corporate ImagingP.O. Box 7126Gaithersburg, MD 20898-7126
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Date Label, Inc.1000 Spruce StreetTerre Haute, IN 47807
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Davis Business Machines, Inc.P.O. Box 20447Lehigh Valley, PA 18002-0047
Image Tech Associates122 Turner LaneWest Chester, PA 19380
DSC Systems Graphics10223 Southard DrBeltsville, MD 20705
Image Tech Associates122 Turner LaneWest Chester, PA 19380
East Coast Communications, Inc.P.O. Box 617Westtown, PA 19395-0617
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 37 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
EC Tek, Inc.5469 White Cedar TerraceSugar Hill, GA 30518
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Envelope America2 Lukens DriveSuite 100New Castle, DE 19720
Image Tech Associates122 Turner LaneWest Chester, PA 19380
ExxonMobil/GECCP.O. Box 4575Carol Stream, IL 60197-4575
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Capital One Bank - MCP.O. Box 85147Richmonad, VA 23285-5147
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Fernhill - Political1901 North Penn RoadHatfield, PA 19440
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Box King Products40 South Second AveP.O. Box 784Phoenixville, PA 19460
Image Tech Associates122 Turner LaneWest Chester, PA 19380
GE Corporate PlusP.O. Box 410420Salt Lake City, UT 84141-0420
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Grainger Dept592-836010892Palatine, IL 60038-0001
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Hartford Fire Insurance CoP.O. Box 2907Hartford, CT 06104-2907
Image Tech Associates122 Turner LaneWest Chester, PA 19380
HomeNetP.O. Box 8500-52163Philadelphia, PA 19178-2163
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Federal Express CorpP.O. Box 360353Pittsburgh, PA 15250-6353
Image Tech Associates122 Turner LaneWest Chester, PA 19380
AnycolorAttn: Kathy AtkinsOne Graphics DriveEwing, NJ 08628
Image Tech Associates122 Turner LaneWest Chester, PA 19380
American Express CorpP.O. Box 360001Fort Lauderdale, FL 33336-0001
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 38 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
ABC Mailer Inc5301 Tacony Street Bldg 48ABox 102Philadelphia, PA
Image Tech Associates122 Turner LaneWest Chester, PA 19380
ABCO Printing Company54 Marlen DriveHamilton Twp, NJ 08691
Image Tech Associates122 Turner LaneWest Chester, PA 19380
ABIS10324 South Dolphin RoadOwings Mills, MD 21117
Image Tech Associates122 Turner LaneWest Chester, PA 19380
ADT Security ServesP.O. Box 371967Pittsburgh, PA 15250-7967
Image Tech Associates122 Turner LaneWest Chester, PA 19380
ADVANTA Business CardsP.O. Box 8088Philadelphia, PA 19101-8088
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Advantage, Inc.1611 Kent StreetSuite 905Arlington, VA 22209
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Canon Financial Services158 Gaithers DriveSuite 200Mt. Laurel, NJ 08054
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Alliance Business Systems, IncKevin P. Mullarkey501 Abbott DriveBroomall, PA 19008
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Capital One Bank - VisaP.O. Box 85147Richmond, VA 23276
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Bank One - 42464246 P.O. Box 15153Wilmington, DE 19886-5153
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Bank One - 4417P.O. Box 15153Wilmington, DE 19886-5153
Image Tech Associates122 Turner LaneWest Chester, PA 19380
BCC Software, Inc75 Josons DriveRochester, NY 14623-9639
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 39 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
BFI Waste SystemBrandywine District613 P.O. Box 830121Baltimore, MD 21283-0121
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Bill Trimbur16 Montrose AvenueUpper Darby, PA 19082
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Labor Ready Northeast, IncP.O. Box 641034Pittsburgh, PA 15264-1034
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Brandywine Electrical ContractorsP.O. Box 1643West Chester, PA 19380
Image Tech Associates122 Turner LaneWest Chester, PA 19380
International Business Systems431 Yerkes RoadKing of Prussia, PA 19406
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Allegra Print and Image501 East Gay StreetWest Chester, PA 19380
Image Tech Associates122 Turner LaneWest Chester, PA 19380
United Parcel ServiceP.O. Box 4980Hagerstown, MD 21747-4980
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Joe Warner1131 Dodson RoadWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Riegel PrintingP.O. Box 7430One Graphics DriveEwing, NJ 08628
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Staples Credit PlanP.O. Box 9020DesMoines, IA 50368-9020
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Stategic Planning Systems, Inc.150 Knickerbocker AvenueBohemia, NY 11716
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Telematch6883 Commercial DriveSpringfield, VA 22159-0310
Image Tech Associates122 Turner LaneWest Chester, PA 19380
TexacoP.O. Box 790055Houston, TX 77279-0055
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 40 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
Home Depot CRCP.O. Box 105991 Dept 24Atlanta, GA 30348-5991
Image Tech Associates122 Turner LaneWest Chester, PA 19380
RedGo Properties315 Willowbrook LaneWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
True Net201 Willowbrook LaneWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Purchase PowerP.O. Box 856042Louisville, KY 49285-6042
Image Tech Associates122 Turner LaneWest Chester, PA 19380
US BancorpP.O. Box 5179Sioux Falls, SD 57117-5179
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Verizon - PAP.O. Box 28000Lehigh Valley, PA 18002-8000
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Wells Fargo Business DirectDivision Mac U1852-024Boise, ID 83707
Image Tech Associates122 Turner LaneWest Chester, PA 19380
AAA Financial ServicesP.O. Box 15268Wilmington, DE 19886-5286
Image Tech Associates122 Turner LaneWest Chester, PA 19380
William McClintock Associates 269 Sheffield Street #5DMountainside, NJ 07092
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Hudson United Bank1000 MacArthur Blvd.Mahwah, NJ 07430
Image Tech Associates122 Turner LaneWest Chester, PA 19380
1st National Bank of Chester County9 North High StreetP.O. Box 523West Chester, PA 19381
Image Tech Associates122 Turner LaneWest Chester, PA 19380
The Print Shop319-R Westtown RoadWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
National Mail Graphics Corp300 Old Mill LaneExton, PA 19341
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 41 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
Labels & Lists, Inc.2500 116th Avenue, N.E.Bellevue, WA 98004
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Leslie N. Moxon1101 Lafayette RoadWayne, PA 19087
Image Tech Associates122 Turner LaneWest Chester, PA 19380
March Imaging SystemsP.O. Box 1775West Chester, PA 19380
Image Tech Associates122 Turner LaneWest Chester, PA 19380
MARCO, Incorporated320 Commerce DriveExton, PA 19341
Image Tech Associates122 Turner LaneWest Chester, PA 19380
McClafferty Printing Co.1600 N. Scott StreetWilmington, DE 19806
Image Tech Associates122 Turner LaneWest Chester, PA 19380
MCI Long DistanceP.O. Box 96022Charlotte, NC 28296-0022
Image Tech Associates122 Turner LaneWest Chester, PA 19380
MCS, Inc.8101 Cessna AveGaithersburg, MD 20879
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Reliable Office SuppliesDept 8001135 S. LaSalle StreetChicago, IL 60674-8001
Image Tech Associates122 Turner LaneWest Chester, PA 19380
N.F.I.B.P.O. Box 15019Wilmington, DE 19886-5019
Image Tech Associates122 Turner LaneWest Chester, PA 19380
J. Michael RyanExton Office Court 300-FN. Pottstown PikeExton, PA 19341-2235
Image Tech Associates122 Turner LaneWest Chester, PA 19380
New York Sound166 Fifth Ave6th FloorNew York, NY 10010
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Nipson America, Inc.1501 Landmeir RoadElk Grove Village, IL 6001
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Paul Revere Insurance GroupP.O. Box 17179Wilmington, DE 19886-7179
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 42 of 59
B6H
(6/90)
Case No.In re: Theodore Burnham Moxon ,
(If known)Debtor
SCHEDULE H - CODEBTORS� Check this box if debtor has no codebtors.
NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR
PECOP.O. Box 13778Philadelphia, PA 19162-3778
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Penn National Insurance CompanyP.O. Box 2257Harrisburg, PA 17105
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Pitney BowesP.O. Box 856390Louisville, KY 40285-6390
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Prestige Mailing Services102 Willowbrook LaneWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
MR Direct Mailing, Inc.711 East Union StreetWest Chester, PA 19382
Image Tech Associates122 Turner LaneWest Chester, PA 19380
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 43 of 59
Form B6I (12/03)
Case No.In re ,Theodore Burnham Moxon
(If known)Debtor
SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)Debtor’s MaritalStatus:
DEPENDENTS OF DEBTOR AND SPOUSEDivorce Pending
RELATIONSHIP AGE
Daughter 13Daughter 18Son 22
DEBTOR SPOUSE
Occupation
How long employed
Address of Employer
Business Owner
12 years
122 Turner LaneWest Chester, PA 19380
Name of Employer Image Tech Associates, Inc.
Employment:
541.56 b. Insurance0.00$ c. Union dues $
$$2,217.89 a. Payroll taxes and social security $ $
Estimated monthly overtime 0.00 $
9,166.66 $$(pro rate if not paid monthly.)
LESS PAYROLL DEDUCTIONS
9,166.66 $$SUBTOTAL
Current monthly gross wages, salary, and commissions
SPOUSEDEBTORIncome: (Estimate of average monthly income)
$
d. Other (Specify) $ $0.00
Social security or other government assistancedebtor’s use or that of dependents listed above. $ $Alimony, maintenance or support payments payable to the debtor for the
$ $
Income from real property $ $
$(attach detailed statement) $
Regular income from operation of business or profession or farm
TOTAL NET MONTHLY TAKE HOME PAY $ $
SUBTOTAL OF PAYROLL DEDUCTIONS $ $
(Specify) $ $
Interest and dividends
2,759.45
6,407.21
0.00
0.000.00
0.00
0.00
$ $0.00Pension or retirement income
Other monthly income
(Specify) $ $0.00
6,407.21 $TOTAL MONTHLY INCOME
(Report also on Summary of Schedules)TOTAL COMBINED MONTHLY INCOME
$
$ 6,407.21
the filing of this document:Describe any increase or decrease of more than 10% in any of the above categories anticipated to occur within the year following
NONE
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 44 of 59
,In re Case No.
(6/90)Form B6J
Theodore Burnham Moxon
Debtor (If known)
SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)
�
schedule of expenditures labeled "Spouse".
Check this box if a joint petition is filed and debtor's spouse maintains a separate household. Complete a separate
Are real estate taxes included?
Is property insurance included?Utilities
175.0045.00
120.00
1,295.00No
Yes �No
Rent or home mortgage payment (include lot rented for mobile home) $
�Yes
$Electricity and heating fuel
$Water and sewer
$Telephone
50.00$cableOther
343.000.000.00
25.00
0.0030.00
270.000.00
35.0025.00
375.0050.00
Life
Recreation, clubs and entertainment, newspapers, magazines, etc. $
$Charitable contributions
Auto
Health
$
Homeowner’s or renter’s $
Insurance (not deducted from wages or included in home mortgage payments)
Transportation (not including car payments) $
$Medical and dental expenses
$
$
Laundry and dry cleaning $
$Food
Home maintenance (repairs and upkeep) $
Clothing $
Other $ 0.00
0.00
598.00
Taxes (not deducted from wages or included in home mortgage payments)
AutoInstallment payments: (In chapter 12 and 13 cases, do not list payments to be included in the plan)
(Specify) $
$
Other $ 0.00
0.000.00
3,500.00$Payments for support of additional dependents not living at your home
$Regular expenses from operation of business, profession, or farm (attach detailed statement)
$Alimony, maintenance or support paid to others
Other $ 225.00
TOTAL MONTHLY EXPENSES (Report also on Summary of Schedules)
[FOR CHAPTER 12 AND 13 DEBTORS ONLY]
A. Total projected monthly income
D. Total amount to be paid into plan each
(interval)
$
$
$
some other regular interval.
B. Total projected monthly expenses
C. Excess income (A minus B)
$
$
Provide the information requested below, including whether plan payments are to be made bi-weekly, monthly, annually, or at
7,161.00
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Form B6
(6/90)
United States Bankruptcy CourtEastern District of Pennsylvania
Case No. In re Theodore Burnham Moxon
Chapter 7
SUMMARY OF SCHEDULESAMOUNTS SCHEDULED
NAME OF SCHEDULEATTACHED(YES/NO) NO. OF SHEETS ASSETS LIABILITIES OTHER
Real Property
Personal Property
Property Claimed
Creditors Holding
Creditors Holding Unsecured
Creditors Holding Unsecured
Executory Contracts and
Codebtors
Current Expenditures of
Total Number of sheets
Total Assets
Total Liabilities
$
$
$
$
$
$
$
$
$
�
�
�
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
as Exempt
Secured Claims
Priority Claims
Nonpriority Claims
Unexpired Leases
Individual Debtor(s)
Individual Debtor(s)
A -
B -
C -
D -
E -
F -
G -
H -
I -
J -
in ALL Schedules
Current Income of
1
5
3
1
2
21
1
7
1
1
141,120.00
2,547,009.76
0.00
141,120.00
993,546.47
0.00
1,553,463.29
6,407.21
7,161.00
43
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Official Form 6 - Cont .(12/03)
,Theodore Burnham MoxonIn re: Case No.Debtor (If known)
DECLARATION CONCERNING DEBTOR'S SCHEDULES
DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR
I declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of 44(Total shown on summary page plus 1.)
sheets plus the summary page, and that they are true and correct to the best of my knowledge, information, and belief.
Date: Signature:Theodore Burnham Moxons/ Theodore Burnham Moxon11/4/2004
[If joint case, both spouses must sign]
DECLARATION UNDER PENALTY OF PERJURY ON BEHALF OF CORPORATION OR PARTNERSHIP
(NOT APPLICABLE)
Penalty for making a false statement or concealing property. Fine of up to $500,000 or imprisonment for up to 5 years or both. 18 U.S.C §§ 152 and 3571.
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Form 7(12/03)
UNITED STATES BANKRUPTCY COURTEastern District of Pennsylvania
Case No.Theodore Burnham MoxonIn re:
8896 7Chapter
STATEMENT OF FINANCIAL AFFAIRS
1. Income from employment or operation of business
None�
State the gross amount of income the debtor has received from employment, trade, or profession, or fromoperation of the debtor's business from the beginning of this calendar year to the date this case wascommenced. State also the gross amounts received during the two years immediately preceding thiscalendar year. (A debtor that maintains, or has maintained, financial records on the basis of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning and ending dates of the debtor'sfiscal year.) If a joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed, unless thespouses are separated and a joint petition is not filed.)
AMOUNT SOURCE FISCAL YEAR PERIOD
Image Tech Associates, Inc.122 Turner LaneWest Chester, PA 19380
2003122,913.00
Image Tech Associates, Inc. 122 Turner LaneWest Chester, PA 19380
200443,205.00
2. Income other than from employment or operation of businessNone�
State the amount of income received by the debtor other than from employment, trade, profession, or operation of the debtor's business during the two years immediately preceding thecommencement of this case. Give particulars. If a joint petition is filed, state income for eachspouse separately. (Married debtors filing under chapter 12 or chapter 13 must state income foreach spouse whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)
AMOUNT SOURCE FISCAL YEAR PERIOD
3. Payments to creditorsNone�
a. List all payments on loans, installment purchases of goods or services, and other debts,aggregating more than $600 to any creditor, made within 90 days immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must includepayments by either or both spouses whether or not a joint petition is filed, unless the spouses areseparated and a joint petition is not filed.)
NAME AND ADDRESS OF CREDITOR PAYMENTSDATES OF
PAIDAMOUNT
STILL OWINGAMOUNT
Allstate Insurance Company500 Chesterbrook BlvdWayne, PA 19087
10/11/04 915.00
Allstate Insurance Company500 Chesterbrook BlvdWayne, PA 19087
09/14/04, 07/19/04 686.12
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NAME AND ADDRESS OF CREDITOR PAYMENTSDATES OF
PAIDAMOUNT
STILL OWINGAMOUNT
Arizona State UniversityTempe, AZ
10/23/04 1,967.00
Arizona State UniversityTempe, AZ
08/23/04 600.00
Arizona State UniversityTempe, AZ
07/26/04 2,068.00
Summit Valleybrook Apartments7000 Johnson Farm LaneChadds Ford, PA 19317
08/05/04, 09/04/04, 10/5/04, 11/3/04
1,345.00
b. List all payments made within one year immediately preceding the commencement of this caseto or for the benefit of creditors who are or were insiders. (Married debtors filing under chapter 12or chapter 13 must include payments by either or both spouses whether or not a joint petition isfiled, unless the spouses are separated and a joint petition is not filed.)
None�
AND RELATIONSHIP TO DEBTOR
NAME AND ADDRESS OF CREDITOR
PAYMENTS
DATES OF
AMOUNT PAID STILL OWING
AMOUNT
4. Suits and administrative proceedings, executions, garnishments and attachments
None�
a. List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding the filing of this bankruptcy case. (Married debtors filing under chapter 12 orchapter 13 must include information concerning either or both spouses whether or not a joint petition isfiled, unless the spouses are separated and a joint petition is not filed.)
AND CASE NUMBER
CAPTION OF SUIT
NATURE OF PROCEEDING AND LOCATION
COURT OR AGENCY
DISPOSITION
STATUS OR
b. Describe all property that has been attached, garnished or seized under any legal or equitableprocess within one year immediately preceding the commencement of this case. (Married debtorsfiling under chapter 12 or chapter 13 must include information concerning property of either or bothspouses whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)
None�
BENEFIT PROPERTY WAS SEIZEDOF PERSON FOR WHOSE
SEIZUREDATE OF
PROPERTYAND VALUE OF
NAME AND ADDRESS DESCRIPTION
5. Repossessions, foreclosures and returnsNone�
List all property that has been repossessed by a creditor, sold at a foreclosure sale,transferred through a deed in lieu of foreclosure or returned to the seller, within one yearimmediately preceding the commencement of this case. (Married debtors filing under chapter 12or chapter 13 must include information concerning property of either or both spouses whether ornot a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)
OF CREDITOR OR SELLER TRANSFER OR RETURNFORECLOSURE SALENAME AND ADDRESSDATE OF REPOSSESSION,
PROPERTYAND VALUE OFDESCRIPTION
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OF CREDITOR OR SELLER TRANSFER OR RETURNFORECLOSURE SALENAME AND ADDRESSDATE OF REPOSSESSION,
PROPERTYAND VALUE OFDESCRIPTION
Chase Auto FinanceP.O. Box 15700Wilmington, DE 19886-5700
11/03/2004 2001 Camaro ($8,365.00) and 2002 Subaru ($12,170.00)
6. Assignments and receiverships
None�
a. Describe any assignment of property for the benefit of creditors made within 120 daysimmediately preceding the commencement of this case. (Married debtors filing under chapter 12or chapter 13 must include any assignment by either or both spouses whether or not a joint petitionis filed, unless the spouses are separated and a joint petition is not filed.)
OR SETTLEMENTASSIGNMENTOF ASSIGNEE
ASSIGNMENTDATE OFNAME AND ADDRESS
TERMS OF
b. List all property which has been in the hands of a custodian, receiver, or court-appointed officialwithin one year immediately preceding the commencement of this case. (Married debtors filingunder chapter 12 or chapter 13 must include information concerning property of either or bothspouses whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)
None�
PROPERTYORDERCASE TITLE & NUMBEROF CUSTODIANAND VALUE OFDATE OFOF COURTNAME AND ADDRESSDESCRIPTIONNAME AND ADDRESS
7. Gifts
None�
List all gifts or charitable contributions made within one year immediately preceding thecommencement of this case except ordinary and usual gifts to family members aggregating less than $200 in value per individual family member and charitable contributions aggregating lessthan $100 per recipient. (Married debtors filing under chapter 12 or chapter 13 must include giftsor contributions by either or both spouses whether or not a joint petition is filed, unless the spousesare separated and a joint petition is not filed.)
OR ORGANIZATION IF ANY OF GIFTOF PERSON TO DEBTOR, DATENAME AND ADDRESS RELATIONSHIP DESCRIPTION
AND VALUE OFGIFT
8. Losses
None�
List all losses from fire, theft, other casualty or gambling within one year immediately precedingthe commencement of this case or since the commencement of this case. (Married debtors filingunder chapter 12 or chapter 13 must include losses by either or both spouses whether or not ajoint petition is filed, unless the spouses are separated and a joint petition is not filed.)
PROPERTYAND VALUE OFDESCRIPTION
BY INSURANCE, GIVE PARTICULARSLOSS WAS COVERED IN WHOLE OR IN PARTDESCRIPTION OF CIRCUMSTANCES AND, IF
LOSSDATE OF
9. Payments related to debt counseling or bankruptcy
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None�
List all payments made or property transferred by or on behalf of the debtor to any persons,including attorneys, for consultation concerning debt consolidation, relief under the bankruptcy lawor preparation of a petition in bankruptcy within one year immediately preceding the commencementof this case.
OF PAYEENAME AND ADDRESS
OTHER THAN DEBTORNAME OF PAYOR IFDATE OF PAYMENT,
OF PROPERTYDESCRIPTION AND VALUEAMOUNT OF MONEY OR
Andrew GuilfoilFront StreetMedia, PA
$1700.00
10. Other transfers
None�
a. List all other property, other than property transferred in the ordinary course of the business orfinancial affairs of the debtor, transferred either absolutely or as security within one yearimmediately preceding the commencement of this case. (Married debtors filing under chapter 12or chapter 13 must include transfers by either or both spouses whether or not a joint petition isfiled, unless the spouses are separated and a joint petition is not filed.)
AND VALUE RECEIVEDDATERELATIONSHIP TO DEBTORTRANSFERREDNAME AND ADDRESS OF TRANSFEREE,DESCRIBE PROPERTY
11. Closed financial accounts
None�
List all financial accounts and instruments held in the name of the debtor or for the benefit ofthe debtor which were closed, sold, or otherwise transferred within one year immediately precedingthe commencement of this case. Include checking, savings, or other financial accounts,certificates of deposit, or other instruments; shares and share accounts held in banks, creditunions, pension funds, cooperatives, associations, brokerage houses and other financialinstitutions. (Married debtors filing under chapter 12 or chapter 13 must include informationconcerning accounts or instruments held by or for either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)
OR CLOSINGAND AMOUNT OF FINAL BALANCEOF INSTITUTIONDATE OF SALEDIGITS OF ACCOUNT NUMBER,NAME AND ADDRESSAMOUNT ANDTYPE OF ACCOUNT, LAST FOUR
12. Safe deposit boxes
None�
List each safe deposit or other box or depository in which the debtor has or had securities,cash, or other valuables within one year immediately preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include boxes or depositories of eitheror both spouses whether or not a joint petition is filed, unless the spouses are separated and ajoint petition is not filed.)
IF ANYCONTENTSTO BOX OR DEPOSITORYOTHER DEPOSITORY
OR SURRENDER,OFOF THOSE WITH ACCESSOF BANK OR
DESCRIPTIONNAMES AND ADDRESSESNAME AND ADDRESS DATE OF TRANSFER
13. SetoffsNone�
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List all setoffs made by any creditor, including a bank, against a debt or deposit of the debtorwithin 90 days preceding the commencement of this case. (Married debtors filing under chapter 12or chapter 13 must include information concerning either or both spouses whether or not a jointpetition is filed, unless the spouses are separated and a joint petition is not filed.)
SETOFFSETOFFNAME AND ADDRESS OF CREDITORAMOUNT OFDATE OF
14. Property held for another personNone�
List all property owned by another person that the debtor holds or controls.
LOCATION OF PROPERTYOF PROPERTYOF OWNERDESCRIPTION AND VALUENAME AND ADDRESS
15. Prior address of debtorNone�
If the debtor has moved within the two years immediately preceding the commencement of thiscase, list all premises which the debtor occupied during that period and vacated prior to thecommencement of this case. If a joint petition is filed, report also any separate address of eitherspouse.
DATES OF OCCUPANCYNAME USEDADDRESS
1100 West Chester PikeA-7 Golf Club ApartmentsWest Chester, PA 19380
Theodore B. Moxon 1/03 - 2/04
1051 S. Media Line RoadNewtown Square, PA 19073
Theodore B. Moxon 12/96 - 1/03
16. Spouses and Former SpousesNone�
If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within the six-year period immediately preceding the commencement of the case, identify the name of the debtor 's spouse and of any former spouse who resides or resided with the debtor in the community property state.
NAME
17. Environmental Information.
For the purpose of this question, the following definitions apply:
"Environmental Law" means any federal, state or local statute or regulation regulating pollution, contamination, releases of hazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, or other medium, including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes, or material.
"Site" means any location, facility, or property as defined under any Environmental Law, whether or not presently or formerly owned or operated by the debtor, including, but not limited to, disposal sites.
"Hazardous Material" means anything defined as a hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, or contaminant or similar term under an Environmental Law.
a. List the name and address of every site for which the debtor has received notice in writing by a governmental unit that it may be liable or potentially liable under or in violation of an Environmental Law. Indicate the governmental unit, the date of the notice, and, if known, the Environmental Law.
None�
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ADDRESS
SITE NAME AND
OF GOVERNMENTAL UNIT
NAME AND ADDRESS
NOTICE
DATE OF ENVIRONMENTAL
LAW
b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release of Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice.
None�
SITE NAME AND
ADDRESS
NAME AND ADDRESS
OF GOVERNMENTAL UNIT
DATE OF
NOTICE
ENVIRONMENTAL
LAW
c. List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law with respect to which the debtor is or was a party. Indicate the name and address of the governmental unit that is or was a party to the proceeding, and the docket number.
None�
NAME AND ADDRESS
OF GOVERNMENTAL UNIT
DOCKET NUMBER STATUS OR
DISPOSITION
18. Nature, location and name of business
None�
a. If the debtor is an individual, list the names, addresses, taxpayer identification numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was an officer, director, partner, or managing executive of a corporation, partnership, sole proprietorship, or was a self-employed professional within the six years immediately preceding the commencement of this case, or in which the debtor owned 5 percent or more of the voting or equity securities within the six years immediately preceding the commencement of this case.
If the debtor is a partnership, list the names, addresses, taxpayer identification numbers, nature of the business, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities within the six years immediately preceding the commencement of this case.
If the debtor is a corporation, list the names, addresses, taxpayer identification numbers, nature of the business, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities within the six years immediately preceding the commencement of this case.
BEGINNING AND ENDING
NATURE OF BUSINESSNAME DATES
TAXPAYER
I.D. NUMBER ADDRESS
Direct Mail 07/01/1992Image Tech Associates, Inc.
P.O. Box 2567West Chester, PA 19380(formerly) 122 Turner LaneWest Chester, PA 19380
54-1644753
b. Identify any business listed in response to subdivision a., above, that is "single asset real estate" as defined in 11 U.S.C. § 101.
None�
NAME ADDRESS
19. Books, records and financial statementsNone�
a. List all bookkeepers and accountants who within two years immediately preceding the filing ofthis bankruptcy case kept or supervised the keeping of books of account and records of the debtor.
DATES SERVICES RENDEREDNAME AND ADDRESS
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DATES SERVICES RENDEREDNAME AND ADDRESS
Adam Varrenti9 N. Five Points RoadWest Chester, PA 19380
1994 - present
b. List all firms or individuals who within the two years immediately preceding the filing of thisbankruptcy case have audited the books of account and records, or prepared a financial statementof the debtor.
None�
DATES SERVICES RENDEREDNAME AND ADDRESS
Adam Varrenti9 N. Five Points RoadWest Chester, PA 19380
Annually1994- present
c. List all firms or individuals who at the time of the commencement of this case were inpossession of the books of account and records of the debtor. If any of the books of account andrecords are not available, explain.
None�
ADDRESSNAME
9 N. Five Points RoadWest Chester, PA 19380
Adam Varrenti
Debtor
d. List all financial institutions, creditors and other parties, including mercantile and tradeagencies, to whom a financial statement was issued within the two years immediately preceding thecommencement of this case by the debtor.
None�
DATE ISSUED NAME AND ADDRESS
1st National Bank of Chester County
Hudson United Bank
20. InventoriesNone�
a. List the dates of the last two inventories taken of your property, the name of the person whosupervised the taking of each inventory, and the dollar amount and basis of each inventory.
(Specify cost, market or other basis)INVENTORY SUPERVISORDATE OF INVENTORYDOLLAR AMOUNT OF INVENTORY
09/26/2004 Debtor 2,000.00
b. List the name and address of the person having possession of the records of each of the twoinventories reported in a., above.
None�
OF INVENTORY RECORDSDATE OF INVENTORYNAME AND ADDRESSES OF CUSTODIAN
21. Current Partners, Officers, Directors and ShareholdersNone�
a. If the debtor is a partnership, list the nature and percentage of partnership interest of eachmember of the partnership.
PERCENTAGE OF INTERESTNATURE OF INTERESTNAME AND ADDRESS
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b. If the debtor is a corporation, list all officers and directors of the corporation, and eachstockholder who directly or indirectly owns, controls, or holds 5 percent or more of the votingsecurities of the corporation.
None�
OF STOCK OWNERSHIPTITLENAME AND ADDRESSNATURE AND PERCENTAGE
22. Former partners, officers, directors and shareholdersNone�
a. If the debtor is a partnership, list each member who withdrew from the partnership within oneyear immediately preceding the commencement of this case.
DATE OF WITHDRAWALADDRESSNAME
b. If the debtor is a corporation, list all officers, or directors whose relationship with the corporationterminated within one year immediately preceding the commencement of this case.
None�
DATE OF TERMINATIONTITLE NAME AND ADDRESS
23. Withdrawals from a partnership or distributions by a corporationNone�
If the debtor is a partnership or corporation, list all withdrawals or distributions credited or givento an insider, including compensation in any form, bonuses, loans, stock redemptions, optionsexercised and any other perquisite during one year immediately preceding the commencementof this case.
AND VALUE OF PROPERTYOF WITHDRAWALRELATIONSHIP TO DEBTOR
OR DESCRIPTIONDATE AND PURPOSEOF RECIPIENT,
AMOUNT OF MONEYNAME & ADDRESS
24. Tax Consolidation Group.None�
If the debtor is a corporation, list the name and federal taxpayer identification number of the parent corporation of any consolidated group for tax purposes of which the debtor has been a member at any time within the six -year period immediately preceding the commencement of the case.
NAME OF PARENT CORPORATION TAXPAYER IDENTIFICATION NUMBER
25. Pension Funds.None�
If the debtor is not an individual, list the name and federal taxpayer identification number of any pension fund to which the debtor, as an employer, has been responsible for contributing at any time within the six-year period immediately preceding the commencement of the case.
NAME OF PENSION FUND TAXPAYER IDENTIFICATION NUMBER
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* * * * * *
I declare under penalty of perjury that I have read the answers contained in the foregoing statement
11/4/2004 s/ Theodore Burnham Moxon
of financial affairs and any attachments thereto and that they are true and correct.
Date Signatureof Debtor Theodore Burnham Moxon
[if completed by an individual or individual and spouse]
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Official Form 8( 12/03)
UNITED STATES BANKRUPTCY COURTEastern District of Pennsylvania
In re: Case No.
Chapter 7
Theodore Burnham Moxon
8896
CHAPTER 7 INDIVIDUAL DEBTOR'S STATEMENT OF INTENTION
2. I intend to do the following with respect to the property of the estate which secures those consumer debts:
I have filed a schedule of assets and liabilities which includes consumer debts secured by property of the estate.1.
Property To Be Surrendered.
Description of Property Creditor's Name
a.
1. 1st National Bank of Chester CountyEquipment of Image Tech 2. Hudson United BankAll assets of Image Tech
Property To Be Retained.
Propertyis claimedas exempt
Creditor'sName
DescriptionofProperty
Property willbe redeemedpursuant to11 U.S.C. § 722
Debt will bereaffirmedpursuant to11 U.S.C. § 524(c)
[Check any applicable statement.]b.
Other
Land Rover Capital2002 Land Rover Freelander
1.
Wachovia Bank, N.A.1999 Chevy Tahoe2.
Date:Signature of Debtor
11/4/2004 s/ Theodore Burnham Moxon
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UNITED STATES BANKRUPTCY COURTEastern District of Pennsylvania
ChapterCase No.
7In re: Theodore Burnham Moxon
Debtor
DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR
1. Pursuant to 11 U.S.C. § 329(a) and Bankruptcy Rule 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:
Other (specify)�Debtor�
$ Balance Due
$ Prior to the filing of this statement I have received
$ For legal services, I have agreed to accept
0.00
2. The source of compensation paid to me was:
1,200.00
1,200.00
3. The source of compensation to be paid to me is:
� �Debtor Other (specify)
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 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 in the compensation, is
�
�
attached.
5. In return for the above-disclosed fee, I have agreed to render legal service for all aspects of the bankruptcy case, including:
Analysis of the debtor's financial situation, and rendering advice to the debtor in determining whether to file
a petition in bankruptcy;a)
Preparation and filing of any petition, schedules, statement of affairs, and plan which may be required;b)
Representation of the debtor at the meeting of creditors and confirmation hearing, and any adjourned hearings thereof;c)
Representation of the debtor in adversary proceedings and other contested bankruptcy matters;d)
[Other provisions as needed]e)
None
6. By agreement with the debtor(s) the above disclosed fee does not include the following services:
None
CAROLYN A. KERN, ESQUIRE, Bar No. PA 90811
Dated:
representation of the debtor(s) in this bankruptcy proceeding.
I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for
CERTIFICATION
Attorney for Debtor(s)Swartz Campbell LLC
Carolyn A Kern
11/4/2004
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B 201 (11/03)
UNITED STATES BANKRUPTCY COURT NOTICE TO INDIVIDUAL CONSUMER DEBTOR
decide to file a petition with the court. Court employees are prohibited from giving
The purpose of this notice is to acquaint you with the four chapters of the federal
law is complicated and not easily described. Therefore, you should seek the adviceBankruptcy Code under which you may file a bankruptcy petition. The bankruptcy
of an attorney to learn of your rights and responsibilities under the law should you
you legal advice.
Chapter 7: Liquidation ($155 filing fee plus $39 administrative fee plus $15 trustee surcharge)
Bankruptcy Code.
governing law. The trustee then liquidates the property and uses the proceeds to pay your creditors according to priorities of the2. Under chapter 7 a trustee takes possession of all your property. You may claim certain of your property as exempt under
Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts.1.
The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If, however, you are found to havecommitted certain kinds of improper conduct described in the Bankruptcy Code, your discharge may be denied by the court, and the
3.
purpose for which you filed the bankruptcy petition will be defeated.
can explain the options that are available to you.
personal injury caused by driving while intoxicated from alcohol or drugs.responsible for such debts as certain taxes and student loans, alimony and support payments, criminal restitution, and debts for death or
5. Under certain circumstances you may keep property that you have purchased subject to valid security interest. Your attorney
4. Even if you receive a discharge, there are some debts that are not discharged under the law. Therefore, you may still be
Chapter 13: Repayment of All or Part of the Debts of an Individual with Regular Income ($155 filing feeplus $39 administrative fee)
2. Under chapter 13 you must file a plan with the court to repay your creditors all or part of the money that you owe them,using your future earnings. Usually, the period allowed by the court to repay your debts is three years, but no more than five years.Your plan must be approved by the court before it can take effect.
1. Chapter 13 is designed for individuals with regular income who are temporarily unable to pay their debts but would like topay them in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar amountsset forth in the Bankruptcy Code.
3. Under chapter 13, unlike chapter 7, you may keep all your property, both exempt and non-exempt, as long as you continueto make payments under the plan.
4. After completion of payments under your plan, your debts are discharged except alimony and support payments, studentloans, certain debts including criminal fines and restitution and debts for death or personal injury caused by driving while intoxicatedfrom alcohol or drugs, and long term secured obligations.
Chapter 11: Reorganization ($830 filing fee plus $39 administrative fee)
complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney.Chapter 11 is designed for the reorganization of a business but is also available to consumer debtors. Its provisions are quite
Chapter 12: Family Farmer ($200 filing fee plus $39 administrative fee)
Chapter 12 designed to permit family farmers to repay their debts over a period of time from future earnings and is in many wayssimilar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose income arises primarily from a family- owned farm.
I, the debtor, affirm that I have read this notice.
Signature of Debtor Case NumberDate11/4/2004 s/ Theodore Burnham Moxon
Case 04-34820-dws Doc 1 Filed 11/05/04 Entered 11/05/04 13:15:34 Desc Main Document Page 59 of 59
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