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EXHIBIT "37"B7 (Official Form 7) (4 /10)
UNITED STATES BANKRUPTCY COURTMiddle District of Georgia
In re: James M. Donnan, III Mary W. Donnan Case No. 1131083Debtors (If known)
STATEMENT OF FINANCIAL AFFAIRS1. Income from employment or operation of business
None State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of theD debtor's business, including part-time activities either as an employee or in independent trade or business, from thebeginning of this calendar year to the date this case was commenced. State also the gross amounts received during the twoyears immediately preceding this calendar year. (A debtor that maintains, or has maintained, financial records on the basisof 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 fil ing under chapter 12 orchapter 13 must state income of both spouses whether or not a joint petition is f iled, unless the spouses are separated and ajoint petition is not filed.)AMOUNT SOURCE FISCAL YEAR PERIOD40,095.0060,462.0020,000.0040,000.00
Dickey Broadcasting 2009200920102010
Professional ServicesSpeaking EngagementsDickey Broadcasting
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, operat ion of the debtor'sD business during the two years immediately preceding the commencement of this case. Give particulars. If a joint petition isfiled, state income for each spouse separately. (Married debtors fil ing under chapter 12 or chapter 13 must state income foreach spouse whether or not a joint pet ition is f iled, unless the spouses are separated and a joint petition is not f iled.)
AMOUNT SOURCE FISCAL YEAR PERIOD1,400,621.00 Interest (See tax return) 200939,992.00 Sub S and Partnership Income 200928,712.00 Ziegler Healthcare Fund 200920,098.00 Rental Income (Dauphin Island) 2009 & 201022,876.00 Dividends (See tax return) 2009 & 2010unknown GLC Limited 2009 & 201040,000.00 Sub S and Partnership Income 201053,227.00 Contemporary Healthcare Fund 201012,249.00 Ziegler Healthcare Fund 201017,140.00 Contemporary Healthcare Fund 201118,882.00 Social Security 2011
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NoneG a
NoneD
3. Payments to creditors2
Complete a. or b., as appropriate, and c.a. Individual orjoint debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods orservices, and other debts to any creditor made within 90 days immediately preceding the commencement of this case unlessthe aggregate value of all property that constitutes or is affected by such transfer is less than $600. Indicate with an asterisk(*) any payments that were made to a creditor on account of a domestic support obligat ion or as part of an alternat iverepayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors filingunder chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.)NAME AND ADDRESS OFCREDITOR
DATES OFPAYMENTS AMOUNTPAID AMOUNTSTILL OWING
b. Debtor whose debts are not primarily consumer debts: List each payment or other transfer to any creditor made within 90days immediately preceding the commencement of the case unless the aggregate value of all property that constitutes or isaffected by such transfer is less than $5,850*. I f the debtor is an individual, indicate with an asterisk (*) any payments thatwere made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule undera plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors fil ing under chapter 12 or chapter13 must include payments and other transfers by either or both spouses whether or not a joint petition is filed, unless thespouses are separated and a joint petition is not filed.)NAME AND ADDRESS OF CREDITOR DATES OF AMOUNTPAYMENTS/ PAID ORTRANSFERS VALUE OFTRANSFERS
monthly 3,100.006/6/11 22,753.08monthly 3,000.005/4/2011 (payments on real 9,059.64estate)4/5/2011 (payments on real 8,600.00estate)4/20/11 25,000.004/25/11 9,720.004/25/11 100,000.004/2011 25,000.006/7/11 19,247.85monthly 4,000.00monthly 2,000.005/31/11 15,000.005/1/11 5,000.00
Bank of AmericaBank of OzarksBank of the OzarksBob Wimberly
Bob WimberlyCook, Noell, Tolley & BatesDavid DwyerFirst Sentry BankHarris & Liken, LLPMiller & MartinNational Bank of GeorgiaSunTrust BankTed RobertsonTed Robertson
AMOUNTSTILLOWING
528,000.00
672,000.00
0.000.00188,847.000.00
710,709.00381,778.000.00
*Amount subject to adjustment on 4101113,and every three years thereafter with respect to cases commenced on or after thedate of adjustment.
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3None~
c. All debtors: List all payments made within one year immediately preceding the commencement of this case to or for thebenefit of creditors who are or were insiders. (Married debtors fil ing under chapter 12 or chapter 13 must include paymentsby either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint pet ition isnot filed.)NAME AND ADDRESS OF CREDITOR DATE OF AMOUNT AMOUNTAND RELATIONSHIP TO DEBTOR PAYMENT PAID STILL OWING
4. Suits and administrative proceedings, executions, garnishments and attachmentsNone 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 or chapter 13 must include information concerningeither or both spouses whether or not a joint petit ion is filed, unless the spouses are separated and a joint petition isnot filed.)
CAPTION OF SUITAND CASE NUMBER NATURE OF PROCEEDING COURT OR AGENCYAND LOCATIO STATUS ORDISPOSITION
Nonel! f
b. Describe all property that has been attached, garnished or seized under any legal or equitable process within one yearimmediately preceding the commencement of this case. (Married debtors fil ing under chapter 12 or chapter 13 must includeinformation concerning property of either or both spouses whether or not a [oint petition is filed, unless the spouses areseparated and a joint petition is not filed.)NAME AND ADDRESSOF PERSON FOR WHOSEBENEFIT PROPERTY WAS SEIZED
DATE OFSEIZURE
DESCRIPTIONAND VALUE OFPROPERTY
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
1 1 2 1 foreclosure or returned to the seller, within one year immediately preceding the commencement of this case. (Marrieddebtors fil ing under chapter 12 or chapter 13 must include information concerning property of either or both spouseswhether or not a joint petition is filed, unless the spouses are separated and a joint pet ition is not filed.)DATE OF REPOSSESSION, DESCRIPTION
NAME AND ADDRESS FORECLOSURE SALE, AND VALUE OFOF CREDITOR OR SELLER TRANSFER OR RETURN PROPERTY
6. Assignments and receivershipsNone a. Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the~ commencement of this case. (Married debtors fi ling under chapter 12 or chapter 13 must include any assignment by eitheror both spouses whether or not a joint petit ion is f iled, unless the spouses are separated and a joint petition is notfiled.)
NAME AND ADDRESSOF ASSIGNEE
DATE OFASSIGNMENT
TERMS OFASSIGNMENTOR SETTLEMENT
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4None b. List all property which has been in the hands of a custodian, receiver, or court-appointed official within one year~ immediately preceding the commencement of this case. (Married debtors f iling under chapter 12 or chapter 13 mustinclude information concerning property of either or both spouses whether or not a joint petition is filed, unless thespouses are separated and a joint petition is not filed.)
NAME AND ADDRESSOF CUSTODIAN
NAME AND ADDRESSOF COURTCASE TITLE & NUMBER
DATE OFORDER
DESCRIPTIONAND VALUE OFPROPERTY
7. GiftsNone~
List all gifts or charitable contributions made within one year immediately preceding the commencement of this case exceptordinary and usual gifts to family members aggregating less than $200 in value per individual family member and charitablecontributions aggregating less than $100 per recipient. (Married debtors fil ing under chapter 12 or chapter 13 must includegifts or contributions by either or both spouses whether or not a Joint petition is filed, unless the spouses are separated and ajoint petition is not filed.)
NAME AND ADDRESSOF PERSONOR ORGANIZATION
RELATIONSHIPTO DEBTOR,IF ANY DATEOF GIFT
DESCRIPTIONAND VALUE OFGIFT
8. LossesNone List all losses from fire, theft, other casualty or gambl ing within one year immediately preceding the commencement~ of this case or since the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 mustinclude losses by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and ajoint petition is not filed.)
DESCRIPTION OF CIRCUMSTANCES AND, IFLOSS WAS COVERED IN WHOLE OR IN PARTBY INSURANCE, GIVE PARTICULARS
DATE OFLOSS
DESCRIPTIONAND VALUE OFPROPERTY
None9. Payments related to debt counseling or bankruptcyList all payments made or property transferred by or on behalf of the debtor to any persons, including attorneys, forconsultation concerning debt consolidation, relief under the bankruptcy law or preparation of a petition in bankruptcy withinone year immediately preceding the commencement of this case.
NAME AND ADDRESSOF PAYEE
DATE OF PAYMENT,NAME OF PAYOR IFOTHER THAN DEBTOR6f29f2011
AMOUNT OF MONEY ORDESCRIPTION AND VALUEOF PROPERTY$200,000.00Placed in trust account
Cook Noell Tolley & Bates, LLP
Harris & Liken, L.L.P.P.O. Box 1586Athens, GA 306034f2011 25,000.00
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6Todd Donnan 06/02/2011 25,231.00 (school tuition)SonTodd Donnan 02/01/2010 $655,000.00 LoanSonTom Luginbill
12/02/2010 $30,000.00Trey Byus 06/28 /2010 $1,663.55Trey Byus 01/06/2011 $10,000.00Trey Byus 03/10/2011 $10,000.00Trey Byus 12/03/2010 $10,000.00Trey Byus 02/08 /2011 $10,000.00William Gilmore 09/13/2010 $8,000.00 (loan repayment)Woody Chastain 06/23/2010 $10,000.00Zach Stribling 11/22/2010 $5,000.00Zach Stribling 10/01/2010 $4,000.00
None b. List al l property transferred by the debtor within ten years immediately preceding the commencement of this case to a~ self-settled trust or similar device of which the debtor is a beneficiary.
NAME OF TRUST OR OTHERDEVICE DATE(S) OFTRANSFER(S) AMOUNT OF MONEY OR DESCRIPTIONAND VALUE OF PROPERTY OR DEBTORINTEREST IN PROPERTY
11. Closed financial accountsNoneD
List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed,sold, or otherwise transferred within one year immediately preceding the commencement of this case. Include checking,savings, or other financial accounts, certif icates of deposit, or other instruments; shares and share accounts held in banks,credit unions, pension funds, cooperatives, associations, brokerage houses and other financial institutions. (Married debtorsfiling under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either orboth spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.)
NAME AND ADDRESSOF INSTITUTIONSunTrust Bank
TYPE OF ACCOUNT, LAST FOURDIGITS OF ACCOUNT NUMBER,AND AMOUNT OF FINAL BALANCECD
AMOUNT ANDDATE OF SALEOR CLOSING$260,000.006/30/2011
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12. Safe deposit boxesNone List each safe deposit or other box or depository in which the debtor has or had securit ies, cash, or other valuables within
J : a one year immediately preceding the commencement of this case. (Married debtors fil ing under chapter 12 or chapter 13must include boxes or depositories of 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 ADDRESSOF BANK OROTHER DEPOSITORY
NAMES AND ADDRESSESOF THOSE WITH ACCESSTO BOX OR DEPOSITOR
DESCRIPTIONOFCONTENTS
DATE OF TRANSFEROR SURRENDER,IF ANY
13. SetoffsNone List all setoffs made by any creditor, including a bank, against a debt or deposit of the debtor within 90 days precedingI i Z I the commencement of this case. (Married debtors fil ing under chapter 12 or chapter 13 must include informationconcerning either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a jointpetition is not filed.)
NAME AND ADDRESS OF CREDITORDATE OFSETOFF AMOUNT OFSETOFF
14. Property held for another personNone List all property owned by another person that the debtor holds or controls.D NAME AND ADDRESS
OF OWNERDESCRIPTION AND VALUEOF PROPERTY LOCATION OF PROPERTY
Toyota of ClevelandCleveland, TN
2005 Toyota Camry$10,000.00
Debtor's residence
15. Prior address of debtorNone If debtor has moved within three years immediately preceding the commencement of this case, l ist all premises which theI i Z I debtor occupied during that period and vacated prior to the commencement of this case. If a joint petition is filed, report alsoany separate address of either spouse.
ADDRESS NAME USED DATES OF OCCUPANCY16. Spouses and Former Spouses
None If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona,I i Z I California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight yearsimmediately preceding the commencement of the case, identify the name of the debtor's spouse and of any former spousewho resides or resided with the debtor in the community property state.
NAME
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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 ofhazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, or other medium,including, but not l imited to, statutes or regulations regulating the cleanup of these substances, wastes, or material."Site" means any location, facili ty, or property as defined under any Environmental Law, whether or not presently orformerly owned or operated by the debtor, including, but not l imited 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.
NoneIZ I a. List the name and address of every site for which the debtor has received notice in writing by a governmental unitthat it may be liable or potentially l iable under or in violation of an Environmental Law. Indicate the governmental unit, thedate of the notice, and, if known, the Environmental Law.
SITE NAME ANDADDRESS NAME AND ADDRESSOF GOVERNMENTAL UNIT DATE OFNOTICE ENVIRONMENTALLAW
None b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release ofI i a Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice.
SITE NAME ANDADDRESS
NAME AND ADDRESSOF GOVERNMENTAL UNIT
DATE OFNOTICE
ENVIRONMENTALLAW
None 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 partyto the proceeding, and the docket number.
NAME AND ADDRESSOF GOVERNMENTAL UNIT
DOCKET NUMBER STATUS ORDISPOSITION
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18. Nature, location and name of businessNoneo
a. If t he d eb to r i s a n in div id ua l, 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 managingexecutive of a corporation, partner in a partnership, sole proprietor, or was self-employed in a trade, profession, orother activity either full- or part-time 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 securi ties within the six years immediatelypreceding the commencement of this case.If th e d eb to r is a partnership, list the names, addresses, taxpayer identification numbers, nature of the businesses,and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more ofthe voting or equity securities, within the six years immediately preceding the commencement of this case.
NAME
If th e d eb to r is a corporation, l ist the names, addresses, taxpayer identification numbers, nature of the business, andbeginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting orequity securities within the six years immediately preceding the commencement of this case.LAST FOUR DIGITSOF SOCIAL SECURITYOR OTHER INDIVIDUALADDRESSTAXPAYER-I.D. NO.(ITIN)! COMPLETE EIN20-5157985
NATURE OFBUSINESS BEGINNING AND ENDINGDATESContemporaryHealthcare Fund, LP
New Jersey Investments2008 - presentJ&M Brands, Inc. 20-3875350 Jacksonville, FL Investments2005 - presentLismore Park, LLC Gastonia, NC Real Estate Dev.
8/2010 presentMountaineer Wings of 263875350 Huntington, WV RestaurantChar., LLC 2010 presentMountaineer Wings of 161615765 Huntington, WV RestaurantHunt.,LLC 2006 presentThree Putt Huntington, WV Investments 09/24/2002Investments, LLCThree Putt Mgt. LLC 161615758 Huntington, .WV Management2007 presentThundering Herd Inv., 161615773 Huntington, WV InvestmentsLLC 2007 PresentW. Va. Media Plans, 550784075 Charleston, WV ManagementLP 2002 presentZiegler Healthcare 223769247 New Jersey InvestmentsFundi, LP 2001 present
None b. Identify any business listed in response to subdivision a., above, that is "single asset real estate" as defined in 11IZ I U.S.C.101.NAME ADDRESS
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1019. Books, records and financial statements
None a. List all bookkeepers and accountants who within two years immediately preceding the filing of this bankruptcy case kepto or supervised the keeping of books of account and records of the debtor.NAME AND ADDRESS DATES SERVICES RENDEREDDavid J. Peetoom, CPANorman, OK 73072 through 2011
None b. List all fi rms or individuals who within two years immediately preceding the f iling of this bankruptcy case have auditedQ Q the books of account and records, or prepared a financial statement of the debtor.NAME ADDRESS DATES SERVICES RENDERED
None c. List all firms or individuals who at the time of the commencement of this case were in possession of the books of accounto and records of the debtor. I f any of the books of account and records are not available, explain.NAME ADDRESSTed Robertson Lilburn, GA
None d. List all financial institut ions, creditors and other part ies, including mercantile and trade agencies, to whom aG a f inancial statement was issued by the debtor within two years immediately preceding the commencement of this case.NAME AND ADDRESS DATE ISSUED20. Inventories
None a. List the dates of the last two inventories taken of your property, the name of the person who supervised theo taking of each inventory, and the dollar amount and basis of each inventory.DATE OF INVENTORY INVENTORY SUPERVISOR
DOLLAR AMOUNT OF INVENTORY(Specify cost, market or otherbasis)
None b. List the name and address of the person having possession of the records of each of the inventories reportedQ Q in a., above.
DATE OF INVENTORYNAME AND ADDRESSES OF CUSTODIANOF INVENTORY RECORDS
21. Current Partners, Officers, Directors and ShareholdersNone a. If the debtor is a partnership, list the nature and percentage of partnership interest of each member of theo partnership.
NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTERESTNone b. If the debtor is a corporation, l ist all off icers and directors of the corporation, and each stockholder who directly orQ Q indirectly owns, controls, or holds 5 percent or more of the voting or equity securities of the corporation.
NAME AND ADDRESS TITLENATURE AND PERCENTAGEOF STOCK OWNERSHIP
22. Former partners, officers, directors and shareholdersNone a. If the debtor is a partnership, list each member who withdrew from the partnership within one year immediately
Q !j preceding the commencement of this case.NAME ADDRESS DATE OF WITHDRAWAL
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11None b. If the debtor is a corporation, list all officers or directors whose relationship with the corporat ion terminatedI i ! : I within one year immediately preceding the commencement of this case.
NAME AND ADDRESS TITLE DATE OF TERMINATION
None~
23. Withdrawals from a partnership or distributions by a corporationIf the debtor is a partnership or corporation, l ist all withdrawals or distributions credited or given to an insider, includingcompensation in any form, bonuses, loans, stock redemptions, options exercised and any other perquisite during one yearimmediately preceding the commencement of this case.
NAME & ADDRESSOF RECIPIENT,RELATIONSHIP TO DEBTOR
DATE AND PURPOSEOF WITHDRAWAL
AMOUNT OF MONEYOR DESCRIPTIONAND VALUE OF PROPERTY
24. Tax Consolidation Group.None If the debtor is a corporation, list the name and federal taxpayer identification number of the parent corporation of anyI i ! : I consolidated group for tax purposes of which the debtor has been a member at any time within six years immediatelypreceding the commencement of the case.
NAME OF PARENT CORPORATION TAXPAYER IDENTIFICATION NUMBER (EIN)25. Pension Funds.
None If the debtor is not an individual, list the name and federal taxpayer identif ication number of any pension fund to which thel I Z ! debtor, as an employer, has been responsible for contributing at any time within six years immediately preceding the" commencement of the case.NAME OF PENSION FUND TAXPAYER IDENTIFICATION NUMBER (EIN)
* * * * * *[ if comp le ted by an individua l or in div id ua l a nd s po us e]I declare under penalty of perjury that I have read the answers contained in the foregoing statementof financial affairs and any attachments thereto and that they are true and correct.Date 7 / 14 / 2011 Signature 1 5 1 James M. Donnan, IIIof Debtor James M. Donnan, III
Date 7/14/2011 Signature 1 5 1 Mary W. Donnanof Joint Debtor Mary W. Donnan(if any)
Recommended