Result boxes on page 1
Three boxes at the top: 1, there is no presumption of abuse; 2, the calculation is made under Form 122A-2; 3, the Means Test does not apply now because of qualified military service but could apply later.
B 122A-1
Chapter 7 Statement of Your Current Monthly Income
- Agency
- U.S. Courts
- Revision
- 12/19
- Fillable fields
- 58
- Pages
- 3
- Official source
- U.S. Courts form page
- Checked
- October 20, 2026
Form B 122A-1: Chapter 7 Statement of Your Current Monthly Income
Form B 122A-1, Chapter 7 Statement of Your Current Monthly Income, is an Official Bankruptcy Form that the U.S. Courts list under Means Test Forms. It reports the average monthly income a debtor received from all sources during the 6 full months before filing, then compares that income for a year with the median family income for the debtor's state and household size. The current version is dated 12/19, and the U.S. Courts page lists it as effective on December 1, 2019.
The form asks you to check one of three boxes at the top of page 1: there is no presumption of abuse, the calculation is made on Chapter 7 Means Test Calculation (Form 122A-2), or the Means Test does not apply now because of qualified military service. The form is derived from Official Form 22A-1.
This page explains the form in plain words and is not legal advice. You can fill it out free in your browser on this page and download the result without an account.
What's on Form B 122A-1
Line 1: marital and filing status
Not married, married with the spouse filing, or married with the spouse not filing, split by whether the spouses share a household or live apart. The answer sets which columns are filled out.
Lines 2 to 4: wages and support
Gross wages, salary, tips, bonuses, overtime and commissions; alimony and maintenance; and amounts regularly paid for household expenses, including child support and contributions from an unmarried partner, household members, parents or roommates.
Lines 5 to 7: business and property income
Net income from a business, profession or farm and from rental or other real property, each figured as gross receipts minus ordinary and necessary operating expenses, plus interest, dividends and royalties.
Lines 8 to 11: other income and total
Unemployment compensation, pension or retirement income, and income from all other sources, each with listed exclusions such as benefits under the Social Security Act. Line 11 adds lines 2 to 10 for each column.
Part 2: lines 12 to 14
Line 12 multiplies the monthly total by 12. Line 13 holds the median family income for your state and household size. Line 14 compares the two and says which box on page 1 to check.
How to fill out Form B 122A-1
- 1
Find the 6-month period
The form uses the 6 full months before the case is filed. Its example: filing on September 15 means March 1 through August 31.
- 2
Average each kind of income
If income varied, add all 6 months and divide by 6. Write $0 on any line with nothing to report, and count no amount more than once. For example, rent from property both spouses own goes in one column only.
- 3
Total it and multiply by 12
Line 11 adds lines 2 to 10 for each column and then both columns together. Line 12 copies that total and multiplies it by 12 for the annual income on line 12b.
- 4
Look up the median income
Line 13 asks for your state, the number of people in your household and the median family income. The form says the list is online at the link in its separate instructions and may also be at the bankruptcy clerk's office.
- 5
Compare and check a box
Line 14a, where line 12b is less than or equal to line 13, points to box 1 on page 1. Line 14b, where line 12b is more than line 13, points to box 2 and Form 122A-2.
- 6
Sign and attach
Each debtor signs Part 3 under penalty of perjury. The form says Form 122A-2 is filed with it after line 14b is checked, and extra pages carry the line number, your name and the case number.
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Filing and related forms
Where it goes
The form is filed in the case at the United States Bankruptcy Court, with the district and the case number, if known, at the top. A box marks an amended filing.
Median income figures
The form does not print median income amounts. It says to find them through the link in the separate instructions for this form, and that the list may also be available at the bankruptcy clerk's office.
Form 122A-2
Chapter 7 Means Test Calculation. The form says not to fill out or file it after checking line 14a, and to fill it out and file it with this form after checking line 14b.
Form 122A-1Supp
Statement of Exemption from Presumption of Abuse Under § 707(b)(2). The form says to file it with this form when claiming an exemption for debts that are not primarily consumer debts or for qualifying military service.
CARES Act version
The U.S. Courts page says the form was amended from April 3, 2020, to March 27, 2022, for temporary CARES Act changes. Those changes lapsed on March 27, 2022, and the form reverted to the pre-CARES Act version.
Related forms
Who fills out Form B 122A-1?
The form is the Chapter 7 statement of current monthly income. Line 1 sets which columns each filer fills out.
Official sources and the blank
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Questions about Form B 122A-1
What is current monthly income on Form B 122A-1?
The form describes it as the average monthly income received from all sources during the 6 full months before the case is filed, citing 11 U.S.C. § 101(10A). If income varied, the 6 months are added and divided by 6.
Where is the median family income for line 13?
The form does not list the amounts. It says to go online using the link in the separate instructions for this form, and that the list may also be available at the bankruptcy clerk's office.
When is Form 122A-2 filed with it?
The form ties it to line 14. With line 14a checked, it says not to fill out or file Form 122A-2. With line 14b checked, it says to fill out Form 122A-2 and file it with this form.
Does a non-filing spouse's income go on the form?
Line 1 decides it. For spouses in the same household who are not legally separated, the form says to fill out Column B for the spouse. For spouses living separately or legally separated, Column B is not filled out.
Are Social Security benefits counted?
The form says not to include benefits received under the Social Security Act on lines 9 and 10. On line 8, unemployment compensation that you contend was a Social Security Act benefit is listed separately instead of entered in the columns.
What if the debts are not mainly consumer debts?
The form says that anyone who believes they are exempt from a presumption of abuse because they do not have primarily consumer debts, or because of qualifying military service, completes and files Form 122A-1Supp with this form.
Is the CARES Act version still used?
The U.S. Courts page says the CARES Act changes lapsed on March 27, 2022, and the form reverted to the pre-CARES Act version. The form now posted is dated 12/19.