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State of Connecticut Bankruptcy Proof of Claim Form

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State of Connecticut Bankruptcy Proof of Claim Form B10 is a legal tool necessary during filing bankruptcy in the United States Bankruptcy Court, District of Connecticut. You must know related sections of Bankruptcy Law and please seek advice from a lawyer otherwise.


This form B10 has eight major parts requiring inputs from you. However, be sure to provide accurate and truthful information as you undertake and sign this form under the penalties of perjury attracting imprisonment for up to 5 years or fine of up to $500,000 or both under section 18 U.S.C. §§ 152 and 3571.


Do not submit originals of supporting documents related to identity and secured claim. Enclose copies along with State of Connecticut Bankruptcy Proof of Claim Form B10. You may choose to enclose a stamped and self-addressed envelope for receiving an acknowledgment of the claim. Read instructions regarding Secured Claim and Amount of Claim Entitled to Priority in case you are entitled for filing such claim/s.

Start filling State of Connecticut Bankruptcy Proof of Claim Form B10 by entering the name of the debtor and then the case number. Mark the box on the right and enter the claim number and date of filing claim in case this one amends a previously filed claim. You may select the next box in case you are aware of similar claim filed by someone. Proceed by entering creditor’s name followed by name and address for sending notices. Type name and address on the next lines in case the address for sending payment is different from address for sending notices.

State of Connecticut Bankruptcy Proof of Claim Form

State of Connecticut Bankruptcy Proof of Claim Form

Part 1: Enter the amount of the claim as of the date of filing the claim in the US dollar.

Part 2: Enter the basis for claim descriptively.

Part 3: Mention only last 4 numbers of any ID of creditor including SSN. Then enter information about debtor’s Scheduled Account in 3a and Uniform Claim Identifier if any in 3b.

Part 4: Various inputs like selection of property type, property value, annual rate of interest, amount of arrearage, basis for perfection, amount of the secured claim, and unsecured amount are required in part 4 of State of Connecticut Bankruptcy Proof of Claim Form B10.

Part 5: Mention Amount entitled to priority after selecting the correct type of claim among the five choices. However, you must specify the applicable paragraph number of the section 11 U.S.C. § 507 (a) in case you select the option other.

Part 6: Mention the amount of all credits you acknowledge receiving in part 6.

Part 7: Enclose redacted copies of supporting documents. Read instruction number 7 for details of how to prepare redacted copies by masking/deleting information.

Part 8: Part 8 of State of Connecticut Bankruptcy Proof of Claim Form B10 requires your printed name, title, and company name if applicable. Then please enter your address, phone number, and email address on the succeeding lines. You must sign and date this document after selecting your role among the four choices offered.

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