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State of Florida Bankruptcy Proof of Claim Form

Free State of Florida Bankruptcy Proof of Claim Form - PDF Form Download

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State of Florida Bankruptcy Proof of Claim Form offers a creditor to claim the money owed by the debtor in the Florida State United States Bankruptcy Court. You should not use this form to claim administrative expense. Section 11 U.S.C. § 503 of the Bankruptcy Act has directives for filing such claims.


You undertake to provide truthful information in this B10 form as you are liable for imprisonment for up to 5 years, or fine of up to $500,000 or both under the section 18 U.S.C. §§ 152 and 3571 in case of violation.

Fill State of Florida Bankruptcy Proof of Claim Form completely and enclose copies of supporting documents to establish a proof of debt as well as secured claim if any. Read instructions carefully before proceeding. You must sign this form duly in part 8 of the form.


  1. Personal Information – Begin by entering the legal name of the debtor, followed by the case number, and then mention the name of the debtor. Please select the boxes on the right only when applicable. The next portion of State of Florida Bankruptcy Proof of Claim Form B10 requires mentioning name and address for sending notices and payment. Mention the address for sending the payment if different from the above address.
  2. Amount of Claim – Enter the amount of the claim in part 1 as of filing the claim. Then mark the box in case the claim amount comprises of interest and/or other charges in addition to the principal amount.
  3. Basis for Claim – Mention the basis for the claim in line with the instructions. You must specify the basis for the claim in detail.
  4. Identification – Mention the last 4 digits of creditor’s ID. Then provide debtor’s scheduled account in 3a and lastly insert Uniform Claim Identifier if any in 3b.
  5. Secured Claim – A lien and/or right to setoff a property back a secured claim. Specify the property type from the available options, enter the amount of arrearage, property value, the basis for perfection, amount of secured claim, annual interest rate, type of interest rate, and amount unsecured in the respective fields.
  6. Amount of Claim Entitled to Priority – Section 11 U.S.C. § 507 (a) of Bankruptcy Law has directives for amount of claim entitled to priority. Select the correct box to specify the type of claim. However, you must mention the paragraph number of the type in case you select other. Lastly, enter the amount entitled to priority in the space provided for the same.
  7. Signature – The last portion of State of Florida Bankruptcy Proof of Claim Form B10 has spaces for your printed name, title, company name, address, phone number, and email address. You must sign this legal instrument and insert date after selecting your role by marking the correct box among the four options offered.

State of Florida Bankruptcy Proof of Claim Form

State of Florida Bankruptcy Proof of Claim Form

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