Free State of Alaska Proof of Claim Form - PDF Form Download

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State of Alaska Proof of Claim Form, B10 is a document intended to provide the financial status of the debtor. Fraudulent claims made using this form attract fine and or imprisonment under 18 U.S.C. §§ 152 and 3571. You may enclose a self-addressed and stamped envelope along with Form B10 for receiving an acknowledgement. This form has 8 parts. You must date and sign this form in part 8.

You may select the cause of priority claim in part 5 of form B10 and mention amount if applicable. You must enclose copies of supporting documents as these are destroyed after scanning. Certain entities offer to purchase the bankruptcy claim; however, these are not concerned with the State of Alaska Bankruptcy Court and/or the debtor.

Filing Bankruptcy in Alaska. (Using the Proof of Claim Form in Alaska)

Read provisions and requirements of form B10 State of Alaska Proof of Claim Form carefully before proceeding to avoid falsification of information even unintentionally. Enter the name of the federal judicial district, debtor, and the case number, name of creditor along with name and address to send notices. Complete this portion by entering a phone number and email address. You may want to provide an alternate address if any.

State of Alaska Proof of Claim Form

Amount of Claim/Basis For Claim/Identification

Enter the amount of the claim in part 1 of the form. Mark the box if claim amount has a principal amount and other charges and interest. Proceed to part 2 and mention the basis for claim or reason for the claim. Enter last four numbers of the SSN, Driver’s license, or similar ID issued to a creditor. Mention debtor’s scheduled account in 3a and optionally enter Uniform Claim Identifier in 3b.

Secured Claim/Priority Claim Amount

Refer instruction # 4 to enter details in part 4. Inputs required in this part of form B10 State of Alaska Proof of Claim Form are the amount of average, basis for perfection, select Nature of property or right of setoff from available choices, mention the value of property, amount of the secured claim, amount unsecured, and annual interest rate. Mark your response to indicate if it is fixed or variable to complete filling part 4. Select appropriate option among five listed in part 5 to provide details of the priority claim amount in part 5. You may select Other and specify the details on the line provided for the same.


Mention the amounts paid to creditor in part 6 of the B10 State of Alaska Proof of Claim Form. Then mention the documents enclosed with the claim in part 7. You must specify each document separately and do not enclose originals. Proceed to part 8 and mark the appropriate box to declare your identity. Then enter printed name, title if any, name of the company, and address along with phone number and email address. Enter date, as required and sign in conformity to the details mentioned in the B10 State of Alaska Proof of Claim Form.

Preview Alaska Proof of Claim Form

State of Alaska Proof of Claim Form
State of Alaska Proof of Claim Form