1 Any Attorney or Party

Any Street
2 Any Town, CA 55555

3 714-555-5555

4 Any Attorney or Party

8 UNITED STATES BANKRUPTCY COURT

9 ___________ DISTRICT OF ____________

10

11 IN RE: ________________, ) Case No.

)
12 Debtors, ) Chapter 7
)
13 Any Plaintiff ) Adv. Proc No.
)
14 Plaintiff, ) COMPLAINT TO DETERMINE NON-
) DISCHARGEABILITY OF DEBT UNDER
15 vs. ) SECTION 523A(a)(2) OF THE BANKRUPTCY
) CODE AND FOR DENIAL OF DISCHARGE
16 Any Defendant, ) UNDER SECTION 727(a)(4) OF THE
) BANKRUPTCY CODE
17 Defendant. )
)
18 ) (Hearing date to be set by summons)
)
19 )
)
20

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address. Be sure to remove this notice before using this document.
25

26 COMPLAINT TO DETERMINE NON-DISCHARGEABILITY OF DEBT

27
COMES NOW, _____________________Pro Se (“Plaintiff”), for his complaint
28

- 1 -
COMPLAINT TO DETERMINE NON-DISCHARGEABILITY OF DEBT
 1 against the Defendant, ______________ (“Defendant”), and alleges as follows:
2 1. This is a core proceeding over which this court has jurisdiction under Title 28
3
U.S.C. § 157(b).
4
2. Defendant is the debtor in this chapter 7 case which was filed on __________,
5

6
the Deadline to file a complaint for determination of dischargeability is _________, so this complaint

7 is timely. Plaintiff is a creditor of defendant by virtue of the following facts:

8 a. On or about ___________, Defendant published specific public solicitations

9
on the internet, requesting loans for real estate projects that promised large, prompt returns on
10
investments. Plaintiff inquired into Defendant’s solicitation, wherein Defendant formally offered
11
Plaintiff an investment opportunity in the form of a loan that guaranteed a large, prompt return on his
12

13 principal, plus interest.

14 b. On or about _____________, __________ and Plaintiff agreed to specific

15
terms of a loan. _________________represented to Plaintiff that in exchange for
16
_______________________ (__________), he would provide him with a repayment of that amount
17
on or before ____________, plus ______________ ($_____________) in interest on the principal
18

19 amount. The total amount agreed upon, which came due on _____________ was

20 ____________________________($__________________). The agreement was reduced to writing

21
and signed by Plaintiff and ________on ______________ (hereinafter referred to as "Promissory
22
Note").
23

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27 complaint-for-fraud-in-united-states-bankruptcy-court
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COMPLAINT TO DETERMINE NON-DISCHARGEABILITY OF DEBT