Official Form 201 Voluntary Petition for Non …...Voluntary Petition for Non-Individuals Filing for...

Fill in this information to identify your case:

United States Bankruptcy Court for the:

DISTRICT OF MINNESOTA

Case number (if known) Chapter 11Check if this anamended filing

Official Form 201Voluntary Petition for Non-Individuals Filing for Bankruptcy 4/16

If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor's name and case number (if known).For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

1. Debtor's name PREMIER MARINE, INC.

2. All other names debtorused in the last 8 yearsInclude any assumednames, trade names anddoing business as names

3. Debtor's federalEmployer IdentificationNumber (EIN)

41-1728418

4. Debtor's address Principal place of business Mailing address, if different from principal place ofbusiness

26612 FALLBROOK AVENUEWYOMING, MN 55092

P. O. BOX 509WYOMING, MN 55092

Number, Street, City, State & ZIP Code P.O. Box, Number, Street, City, State & ZIP Code

Chisago Location of principal assets, if different from principalplace of businessCounty

Number, Street, City, State & ZIP Code

5. Debtor's website (URL) WWW.PONTOONS.COM

6. Type of debtor Corporation (including Limited Liability Company (LLC) and Limited Liability Partnership (LLP))

Partnership (excluding LLP)

Other. Specify:

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1

Case 17-32006 Doc 1 Filed 06/19/17 Entered 06/19/17 13:20:40 Desc Main Document of 50

Debtor PREMIER MARINE, INC. Case number (if known)Name

7. Describe debtor's business A. Check one:

Health Care Business (as defined in 11 U.S.C. § 101(27A))

Single Asset Real Estate (as defined in 11 U.S.C. § 101(51B))

Railroad (as defined in 11 U.S.C. § 101(44))

Stockbroker (as defined in 11 U.S.C. § 101(53A))

Commodity Broker (as defined in 11 U.S.C. § 101(6))

Clearing Bank (as defined in 11 U.S.C. § 781(3))

None of the above

B. Check all that apply

Tax-exempt entity (as described in 26 U.S.C. §501)

Investment company, including hedge fund or pooled investment vehicle (as defined in 15 U.S.C. §80a-3)

Investment advisor (as defined in 15 U.S.C. §80b-2(a)(11))

C. NAICS (North American Industry Classification System) 4-digit code that best describes debtor. See http://www.uscourts.gov/four-digit-national-association-naics-codes.

8. Under which chapter of theBankruptcy Code is thedebtor filing?

Check one:

Chapter 7

Chapter 9

Chapter 11. Check all that apply:

Debtor's aggregate noncontingent liquidated debts (excluding debts owed to insiders or affiliates)are less than $2,566,050 (amount subject to adjustment on 4/01/19 and every 3 years after that).

The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). If the debtor is a smallbusiness debtor, attach the most recent balance sheet, statement of operations, cash-flowstatement, and federal income tax return or if all of these documents do not exist, follow theprocedure in 11 U.S.C. § 1116(1)(B).

A plan is being filed with this petition.

Acceptances of the plan were solicited prepetition from one or more classes of creditors, inaccordance with 11 U.S.C. § 1126(b).

The debtor is required to file periodic reports (for example, 10K and 10Q) with the Securities andExchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File theattachment to Voluntary Petition for Non-Individuals Filing for Bankruptcy under Chapter 11(Official Form 201A) with this form.

The debtor is a shell company as defined in the Securities Exchange Act of 1934 Rule 12b-2.

Chapter 12

9. Were prior bankruptcycases filed by or againstthe debtor within the last 8years?

No.

Yes.

If more than 2 cases, attach aseparate list. District When Case number

District When Case number

10. Are any bankruptcy casespending or being filed by abusiness partner or anaffiliate of the debtor?

No

Yes.

List all cases. If more than 1,attach a separate list Debtor Relationship

District When Case number, if known




11. Why is the case filed inthis district?

Check all that apply:

Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days immediatelypreceding the date of this petition or for a longer part of such 180 days than in any other district.

A bankruptcy case concerning debtor's affiliate, general partner, or partnership is pending in this district.

12. Does the debtor own orhave possession of anyreal property or personalproperty that needsimmediate attention?

No

Yes. Answer below for each property that needs immediate attention. Attach additional sheets if needed.

Why does the property need immediate attention? (Check all that apply.)

It poses or is alleged to pose a threat of imminent and identifiable hazard to public health or safety.

What is the hazard?

It needs to be physically secured or protected from the weather.

It includes perishable goods or assets that could quickly deteriorate or lose value without attention (for example,livestock, seasonal goods, meat, dairy, produce, or securities-related assets or other options).

Other

Where is the property?

Number, Street, City, State & ZIP CodeIs the property insured?

No

Yes. Insurance agency

Contact name

Phone

Statistical and administrative information

13. Debtor's estimation ofavailable funds

. Check one:

Funds will be available for distribution to unsecured creditors.

After any administrative expenses are paid, no funds will be available to unsecured creditors.

14. Estimated number ofcreditors

1-49 50-99 100-199 200-999

1,000-5,000 5001-10,000 10,001-25,000

25,001-50,000 50,001-100,000 More than100,000

15. Estimated Assets $0 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 - $1 million

$1,000,001 - $10 million $10,000,001 - $50 million $50,000,001 - $100 million $100,000,001 - $500 million

$500,000,001 - $1 billion $1,000,000,001 - $10 billion $10,000,000,001 - $50 billion More than $50 billion

16. Estimated liabilities $0 - $50,000$50,001 - $100,000

$100,001 - $500,000 $500,001 - $1 million

$1,000,001 - $10 million $10,000,001 - $50 million $50,000,001 - $100 million $100,000,001 - $500 million

$500,000,001 - $1 billion $1,000,000,001 - $10 billion $10,000,000,001 - $50 billion More than $50 billion




Request for Relief, Declaration, and Signatures

WARNING -- Bankruptcy fraud is a serious crime. Making a false statement in connection with a bankruptcy case can result in fines up to $500,000 orimprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

17. Declaration and signatureof authorizedrepresentative of debtor

The debtor requests relief in accordance with the chapter of title 11, United States Code, specified in this petition.

I have been authorized to file this petition on behalf of the debtor.

I have examined the information in this petition and have a reasonable belief that the information is trued and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on June 19, 2017MM / DD / YYYY

X /s/ LORI J. MELBOSTAD LORI J. MELBOSTADSignature of authorized representative of debtor Printed name

Title PRESIDENT

18. Signature of attorney X /s/ MICHAEL F McGRATH Date June 19, 2017Signature of attorney for debtor MM / DD / YYYY

MICHAEL F McGRATHPrinted name

RAVICH MEYER KIRKMAN MCGRATH NAUMAN & TANSEY, P.A.Firm name

150 S. FIFTH STREET, SUITE 3450MINNEAPOLIS, MN 55402-4201Number, Street, City, State & ZIP Code

Contact phone 612-332-8511 Email address [email protected]

168610Bar number and State



Fill in this information to identify the case:Debtor name PREMIER MARINE, INC.United States Bankruptcy Court for the: DISTRICT OF MINNESOTA Check if this is an

Case number (if known): amended filing

Official Form 204Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims andAre Not Insiders 12/15

A list of creditors holding the 20 largest unsecured claims must be filed in a Chapter 11 or Chapter 9 case. Include claims which thedebtor disputes. Do not include claims by any person or entity who is an insider, as defined in 11 U.S.C. § 101(31). Also, do notinclude claims by secured creditors, unless the unsecured claim resulting from inadequate collateral value places the creditoramong the holders of the 20 largest unsecured claims.

Name of creditor andcomplete mailing address,including zip code

Name, telephone numberand email address ofcreditor contact

Nature of claim(for example, tradedebts, bank loans,professional services,and governmentcontracts)

Indicate if claimis contingent,

unliquidated, ordisputed

Amount of claimIf the claim is fully unsecured, fill in only unsecured claim amount. Ifclaim is partially secured, fill in total claim amount and deduction forvalue of collateral or setoff to calculate unsecured claim.Total claim, ifpartially secured

Deduction for valueof collateral or setoff

Unsecured claim

INFINITY WOVENPRODUCTS LLCDEPT 2408PO BOX 11407BIRMINGHAM, AL35246-2804

954-345-5797

GOODS ANDSERVICES

$590,822.99

DOWCO PLASTICSLLC1020 INDUSTRIALSTREET NEPINE CITY, MN55063

320-629-4916

GOODS ANDSERVICES

$475,191.20

LIPPERTCOMPONENTS INC3501 COUNTYROAD 6 EASTELKHART, IN46514-7663

574-295-8166

GOODS ANDSERVICES

$462,483.90

QUALITY METALSINC2575 DOSWELLAVENUESAINT PAUL, MN55108

651-65-5875

GOODS ANDSERVICES

$428,506.99

AEROTEKCOMMERCIALSTAFFINGPO BOX 198531ATLANTA, GA30384-8531

888-817-5024

GOODS ANDSERVICES

$364,270.98

THE WEITZCOMPANY LLC5901 THORNTONAVENUEDES MOINES, IA50321

515-246-4700

GOODS ANDSERVICES

$308,624.27

Official form 204 Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured claims page 1

Software Copyright (c) 1996-2017 Best Case, LLC - www.bestcase.com Best Case Bankruptcy










Unsecured claim

SAMUEL SON & COMIDWEST INC580 KIRTS BLVDSUITE 300TROY, MI 48084

BESS PLIAKOS

800-521-0870

GOODS ANDSERVICES

$200,618.02

MNSTARTECHNOLOGIES4201 HIGHWAY 169GRAND RAPIDS, MN55744

218-326-5566

GOODS ANDSERVICES

$191,680.33

CROWNEXTRUSIONS122 COLUMBIACOURT NCHASKA, MN 55318

952-448-3533

GOODS ANDSERVICES

$147,435.69

YAMAHA MOTORCORPORATIONMARINE POWERGROUP1270 CHASTAINROADKENNESAW, GA30144

770-420-5876

GOODS ANDSERVICES

$110,780.13

MYTECHPARTNERS300 2ND STREETNWSAINT PAUL, MN55112

DAY JAMES

651-488-4800

GOODS ANDSERVICES

$92,725.82

NMMA231 S LASALLESUITE 2050CHICAGO, IL 60604

312-946-6200

GOODS ANDSERVICES

$86,726.45

WINTHROP &WEINSTINE PA225 S SIXTHSTREET SUITE 3500MINNEAPOLIS, MN55402-4629

MARK PIHART

612-604-6400

LEGAL SERVICES $86,605.94

LIGHTNINGPRINTING INCDBA WALLACECARLSONPRINTINGLOCKBOX 113MINNEAPOLIS, MN55480-1575

952-545-1645

GOODS ANDSERVICES

$79,367.00

RSM US LLP801 NICOLLETMALL SUITE 1100MINNEAPOLIS, MN55402

612-573-8750

GOODS ANDSERVICES

$71,995.00












Unsecured claim

WESTFIELDINSURANCEPO BOX 9001566LOUISVILLE, KY40290-1566

GOODS ANDSERVICES

$60,594.94

MEDICANW 7105PO BOX 1450MINNEAPOLIS, MN55485-7105

800-892-8354

GOODS ANDSERVICES

$58,904.08

ECHO GLOBALLOGISTICS600 W CHICAGOAVENUE SUITE 725CHICAGO, IL 60654

952-746-6111

GOODS ANDSERVICES

$57,529.66

MARINEELECTRICALPRODUCTS1401 TOWER ROADLEBANON, MO65536-3437

417-588-3128

GOODS ANDSERVICES

$56,453.42

RAOMANUFACTURINGCOMPANY200 MISSISSIPPISTREET NEMINNEAPOLIS, MN55432-4396

GOODS ANDSERVICES

$55,313.22




\ryRITTEN ACTION BY BOARD OF DIRECTORS OFPREMIER MARINE, INC.

TAKEN WITHOUT A MEETING

The undersigned, being three of the four members of the Board of Directors of PremierMarine, Inc., a Minnesota corporation (the "Company") do hereby take the following action:

WHEREAS, the Company's Articles of Incorporation and Bylaws provide that any actionpermitted to be taken at a meeting of the Company's Board of Directors (the "Board") may be

taken by written action signed by the number of directors that would be required to take such

action at a meeting of the Board at which all directors are present, provided such action does notrequire approval by the Company's shareholders;

WHEREAS, it is in the best interest of the Company to file a voluntary petition in the

United States Bankruptcy Court pursuant to Chapter 11 of Title 11 of the United States Code;

and

WHEREAS, the actions set forth below do not require the approval of the Company'sshareholders under the Company's Articles of Incorporation or Bylaws or applicable law.

NOW THEREFORE, the undersigned directors hereby adopt the following resolutionseffective as of the 1 8th day of June 2017:

RESOLVED, that Lori Melbostad, President of the Company, is authorized and directed

to execute and deliver all documents necessary to perfect the filing of a chapter 1l voluntarybankruptcy case in the United States Bankruptcy Court on behalf of the Company and is furtherauthorized to execute and deliver all documents necessary during the administration of thebankruptcy case;

RESOLVED, that Lori Melbostad, President of the Company, is authorized and directedto appear in all bankruptcy proceedings on behalf of the Company, and to otherwise do and

perform all acts and deeds on behalf of the Company as are necessary and appropriate inconnection with the administration of the bankruptcy case;

RESOLVED, that Lori Melbostad, President of the Company, is authorized and directedto employ Michael F. McGrath, attorney and the law firm of Ravich Meyer Kirkman McGrathNauman & Tansey, A Professional Association, to represent the Company in such bankruptcycase, and is authorized and directed to employ any other professionals needed to assist theCompany in fulfilling its duties as a chapter 1l debtor;

RESOLVED, that Lori Melbostad, President of the Company, is authorized and directedto employ Richard Gallagher, financial consultant and the firm of GuideSource, to represent the

Company in such bankruptcy case, and is authorized and directed to employ any otherprofessionals needed to assist the Company in fulfilling its duties as a chapter I I debtor; and

{00354rsr }


RESOLVED, that Lori Melbostad, President of the Company, be and is authorized anddirected to take any and all action necessary to carry out the intent ofthe foregoing resolutionsand to perform the Company's obligations that æise as a result of the foregoing resolutions.

The above action is taken without a meeting by authorization in witing signed by thenumber of members of the Board of Directors required to take the same action at imeeting ofthe Board of Directors at which all members are present.

Robert J. Jr.,

Director

2


}bk1{Creditor Address Matrix}bk{

1383113 ALBERTA LTD4012 50TH STREETCOLD LAKE, AB T9M 1P2CANADA

154 MARINE LLC40175 HIGHWAY 154PERRY MO 63462

80SEVENMARKO ZITZER FILMS LLC3509 NE STINSON BLVDMINNEAPOLIS MN 55418

A 1 TIRE SERVICE INCPO BOX 475STACY MN 55079

ABRASIVE BLAST SUPPLY INC1000 S BENTON DRIVE UNIT 422SAUK RAPIDS MN 56379

ABSOLUTE LOCATING SERVICES5230 150TH NWCLEARWATER MN 55320

ACCON MARINE LLC13665 AUTOMOBILE BLVDCLEARWATER FL 33762

ACE PATTERN & FOUNDRYOF KANSAS1901 N 10TH STREETKANSAS CITY KS 66104

ACROTECH OF MINNESOTA14311 EWING AVE S STE 100BURNSVILLE MN 55306


AD TAPE & LABEL COMPANY INCW140 N9504 FOUNTAIN BLVDPO BOX 637MENOMONEE FALLS WI 53052-0637

ADP LLCPO BOX 842875BOSTON MA 02284-2875

ADVANCEDTEK255 E ROSELAWN AVENUESAINT PAUL MN 55117

AEROFAST INC360 GUNDERSEN DRIVECAROL STREAM IL 60188

AEROTEK COMMERCIAL STAFFINGPO BOX 198531ATLANTA GA 30384-8531

AIA COUNTERTOPS501 W RAILROAD AVENUESYRACUSE IN 46567

AIR COMPRESSOR TECHNOLOGIES5143 FAWN LAKE DRIVESTACY MN 55079

AKZO NOBEL INTERPON POWDER20 CULVER STREETNASHVILLE TN 37210

ALL WELDING9155 ARCHIBALD AVE SUITE 107RANCHO CUCAMONGA CA 91730


ALLINA HEALTHNW 629601PO BOX 1450MINNEAPOLIS MN 55485-6296

ALOHA RV MARINEPO BOX 909078300 PAN AMERICAN HWY NEALBUQUERQUE NM 87199

AMBASSADOR MARINE INC1173 CALLE SUERTECAMARILLO CA 93012-8052

AMERASSISTPO BOX 26095COLUMBUS OH 43226

AMERI-KART CORP17196 STATE ROAD 120BRISTOL IN 46507

AMERICAN BANK OF THE NORTH522 E HOWARD STREET SUITE 104HIBBING MN 55746-1826

AMERICAN FLEXIBLE PRODUCTS124 PEAVEY CIRCLECHASKA MN 55318

AMERICAN FUNDSATTN FINANCE AND ACCOUNTINGPO BOX 659530SAN ANTONIO TX 78265-9530

AMERICAN SUZUKI MOTOR CORP3251 E IMPERIAL HIGHWAYPO BOX 1100BREA CA 92822-1100


AMERIGAS7411 W HIGHWAY 10 NWANOKA MN 55303-6039

APLIX12300 STEELE CREEK ROADCHARLOTTE NC 28273

ARNELL INC255 E ROSELAWN AVE SUITE 39SAINT PAUL MN 55117

ARNOLD MACHINERY COMPANY2975 W 2100 SPO BOX 30020SALT LAKE CITY UT 84130

ASA ELECTRONICS LLC2602 MARINA DRIVEELKHART IN 46514

ASSOCIATED BAG COMPANYPO BOX 3036MILWAUKEE WI 53201

ASSOCIATED SPRING RAYMOND370 WEST DUSSEL DR SUITE AMAUMEE OH 43537

ASTRO PLASTICS16350 ASHER AVENUEPO BOX 459ROSEMOUNT MN 55068

ATLAS COPCO COMPRESSORS LLC2501 LANDMEIER ROAD SUITE BELK GROVE VILLAGE IL 60007


AUBRIGHT INC6305 GLENN CARLSON DRIVESAINT CLOUD MN 56301

AVALA MARKETING GROUP1078 HEADQUARTERS PARK DRIVEFENTON MO 63026

AXALTA COATING SYSTEMSPOWDER COATINGS NA9800 GENARD ROADHOUSTON TX 77041

B & N SHEET METAL26564 FAXTON AVENUEPO BOX 187WYOMING MN 55092-0187

BARBOUR PLASTICS INCPO BOX 2158BROCKTON MA 02305-2158

BAY TO BAY BOAT CLUB4831 MANITOU ROADEXCELSIOR MN 55331

BCH IMAGE500 MAIN STREETPO BOX 500JACKMAN ME 04945-0500

BEAR COMPONENTS INC27873 ROUTE 66PO BOX 311LEBANON MO 65536

BLAINE BROTHERS INC10011 XYLITE STREET NEMINNEAPOLIS MN 55449


BLUE ROCK MANUFACTURING INC1336 AUTUMN ROADLONG PRAIRIE MN 56347

BLUE SEA SYSTEMS425 SEQUOIA DRIVEBELLINGHAM WA 98226

BLUESKIES INTERNATIONAL LLC3491 SWENSON AVENUESAINT CHARLES IL 60174

BOATER'S CHOICE12011 BROOKLYN ROAD (M-50)BROOKLYN MI 49230

BOATING WORLD17782 COWAN SUITE CIRVINE CA 92614

BOB'S MARINE INCPO BOX 229088 HWY 52BELLEVUE IA 52031

BOMBARDIER RECREATIONALPRODUCTS10101 SCIENCE DRIVESTURTEVANT WI 53177

BRUCE'S FOODS5358 WYOMING TRAILWYOMING MN 55092

BURLINGTON GRAPHIC SYSTEMS INC2600 CHICORY ROADRACINE WI 53403


CAL STATE MOTOR SPORTS INCDBA REDDING YAMAHA SEA DOOPO BOX 796SHASTA LAKE CA 96019

CAMCO MANUFACTURING INC121 LANDMARK DRIVEGREENSBORO NC 27409

CAPITAL ONE BANKPO BOX 6492CAROL STREAM IL 60197-6492

CARDINAL PAINT & POWDER INC21326 HEYWOOD AVENUELAKEVILLE MN 55044

CARQUEST AUTO PARTS26664 FALLBROOK AVENUEWYOMING MN 55092

CASSIDY TRICKER INDUSTRIALSALES1608 HIGHWAY 13 WBURNSVILLE MN 55337

CAST PRODUCTS INC18676 N JEFFERSON STREETATHENS AL 35612

CEDAR BOX COMPANY2012 CEDAR AVENUEMINNEAPOLIS MN 55404

CH ROBINSON WORLDWIDE INCPO BOX 9121MINNEAPOLIS MN 55480-9121


CHAMPAGNE METALS429 W 158TH STREET SGLENPOOL OK 74033

CHARLES A RICHARDSON INCPO BOX 29MANSFIELD MA 02048

CHET'S SAFETY SALES8870 RENDOVA STREET NECIRCLE PINES MN 55014-4104

CINTAS CORPORATION 47011500 95TH AVENUE NMAPLE GROVE MN 55369

CITY OF WYOMINGPO BOX 251250SAINT PAUL MN 55125-6250

CLANCY'S FIRE EXTINGUISHERSSALES & SERVICEPO BOX 312NEW ULM MN 56073

CLASS C COMPONENTS INC6825 SUNWOOD DR NWRAMSEY MN 55303

CLOCKWORK ACTIVE MEDIA SYSTEMS1501 E HENNEPIN AVENUEMINNEAPOLIS MN 55414

COLUMBUS AUTO TRUCK & TRAILER15131 FELLER STREETFOREST LAKE MN 55025


COMMERCIAL SEWING65 GRANT STREETTORRINGTON CT 06790

COMPONENT SUPPLY INC2019 W COUNTY ROAD C2ROSEVILLE MN 55113

COMPOSITES ONE LLC85 W ALGONQUIN ROAD SUITE 600ARLINGTON HEIGHTS IL 60005-4421

CONTROLLED AUTOMATION INCPO BOX 888BRYANT AR 72089

COTTAGE MARKETER98 BRANDT STREET UNIT ESTEINBACH, MB R5G 0V6CANADA

COYOTEPO BOX 742636ATLANTA GA 30374-2636

CROWN EXTRUSIONS122 COLUMBIA COURT NCHASKA MN 55318

CTC SUPPLIES INC3845 N BREMEN STREETMILWAUKEE WI 53212

D H SMITH1464 EAST COMMERCIALSPRINGFIELD MO 65803


DEC O ART INC3914 LEXINGTON PARK DRIVEELKHART IN 46514

DECKRITE LLC3912 EAST PROGRESSNORTH LITTLE ROCK AR 72114

DEURR, JOHNC/O PREMIER MARINE INC26612 FALLBROOK AVENUEWYOMING MN 55092

DOMETIC CORP-SANITATION SYS13128 STATE RT 226PO BOX 38BIG PRAIRIE OH 44611

DOWCO INC4230 CLIPPER DRIVEMANITOWOC WI 54220

DOWCO PLASTICS LLC1020 INDUSTRIAL STREET NEPINE CITY MN 55063

DOWCO PLASTICS LLC5520 COLBY LAKE ROADHOYT LAKES MN 55750

DR VINYL OF EAST CENTRALMN INC35436 DUXBURY RDSANDSTONE MN 55072

DRIFTWOOD COVE MARINA67 LACAWAC ROADLAKE ARIEL PA 18436


DUFRESNE, KENNETHC/O PREMIER MARINE INC26612 FALLBROOK AVENUEWYOMING MN 55092

DURAMARK TECHNOLOGIES LLC209 E 175TH STREETWESTFIELD IN 46074

EAGLE BAY MARINA INCDBA CLARK'S MARINAROUTE 28 FOURTH LAKEINLET NY 13360

EAGLE MOULDINGS10550 COUNTY HWY 81 STE 113MAPLE GROVE MN 55369

EC HALLBERG LEASINGC/O HALLBERG MARINE INC26470 FALLBROOK AVENUEWYOMING MN 55092

ECHO GLOBAL LOGISTICS600 W CHICAGO AVENUE SUITE 725CHICAGO IL 60654

EIDE SAW AND KNIFE SERVICE1329 TYLER ST NEMINNEAPOLIS MN 55413

EKVALL ENGINEERING4720 VIKING BLVD NEWYOMING MN 55092

ELANPO BOX 790408SAINT LOUIS MO 63179-0408


ELEVEN800 WASHINGTON AVE N SUITE 205MINNEAPOLIS MN 55401

ELIAS, TJ2716 E 31ST STMINNEAPOLIS MN 55406

ELLINGSON & ELLINGSON LTD5101 VERNON AVENUE S SUITE 501EDINA MN 55436

ENCHEM10424 TIMBERLINE ROADKINGSTON OK 73439

EPCO PRODUCTS INC3736 VANGARD DRIVEPO BOX 9250FORT WAYNE IN 46899-9250

EZ LOADER CUSTOM BOAT TRAILERSMOUNTAIN HOME INDUSTRIAL PKPO BOX 270MIDWAY AR 72651-0270

FAIRVIEW HEALTH SERVICESPO BOX 199MINNEAPOLIS MN 55440-0199

FALLS INDUSTRIAL FOAM16731 HAVEN ROADLITTLE FALLS MN 56345

FARIA BEEDE INSTRUMENTS385 NORWICH NEW LONDON TRNPKPO BOX 0983UNCASVILLE CT 06382


FARNUM STREET FINANCIAL INC240 PONDVIEW PLAZA5850 OPUS PKWYMINNETONKA MN 55343

FASTENAL COMPANY1467 LAKE STREET S STE 100FOREST LAKE MN 55025

FIAMM TECHNOLOGIES INC23880 INDUSTRIAL PARK DRIVEFARMINGTON HILLS MI 48335

FLEET ONE LLC613 BAKERTOWN ROADANTIOCH TN 37013

FLEXSTEEL INDUSTRIES INC3400 JACKSON STREETDUBUQUE IA 52001

FORD CREDITP O BOX 552679DETROIT MI 48255-2679

FOREST LAKE FLORAL508 S LAKE STREETFOREST LAKE MN 55025

FOREST LAKE MARINA10 S 5TH STREET SUITE 110MINNEAPOLIS MN 55402

FOREST LAKE SECURITY INC564 S LAKE STREETFOREST LAKE MN 55025


FREIGHTQUOTE.COM1495 PAYSPHERE CIRCLECHICAGO IL 60674

FRIEND MECHANICAL21490 FOREST BLVDFOREST LAKE MN 55025

FRONTIERPO BOX 20567 SUITE CROCHESTER NY 14602-0567

FRONTIER COMMUNICATIONSPO BOX 20550 SUITE BROCHESTER NY 14602-0550

GARLOUGH, RHIANNAC/O PREMIER MARINE INC26612 FALLBROOK AVENUEWYOMING MN 55092

GARMIN INTERNATIONAL1200 E 151ST STREETOLATHE KS 66062

GEM PRODUCTS140 INDUSTRIAL LOOPORANGE PARK FL 32073

GEMECO MARINE ACCESSORIES LLC1141 S RON MCNAIR BLVDLAKE CITY SC 29560

GLOBAL INTERIOR SOLUTIONS55375 LYON INDUSTRIAL DRIVENEW HUDSON MI 48165


GOPHER STATE ONE CALL18946 LAKE DRIVE ECHANHASSEN MN 55317

GW INDUSTRIES8900 SW CITIZENS DRIVEWILSONVILLE OR 97070

HALLBERG INCPO BOX 277WYOMING MN 55092

HANKS SPECIALTIES INCPO BOX 120150NEW BRIGHTON MN 55112

HANNAY'S INC630 ARTHUR STREET NEMINNEAPOLIS MN 55413

HANSON, RONPO BOX 509WYOMING MN 55092

NATHAN HARPER8055 291ST AVE NWPRINCETON MN 55371

HARRIS PUBLISHING INC520 PARK AVENUEIDAHO FALLS ID 83402

HELLA INCDEPT 771011201 KELLY DRIVEDETROIT MI 48277


HENNEPIN COUNTY MEDICAL CTRPO BOX 860047MINNEAPOLIS MN 55486

HENNESSEY, JAMES A8228 TYLER STSPRING LAKE PARK MN 55432

HIAWATHA METALCRAFT INC2631 31ST AVENUE SMINNEAPOLIS MN 55406

HIGHPOINT EH & S23524 ULYSSES STREET EEAST BETHEL MN 55005

HONDA MARINEPOWER EQUIPMENT DIV4900 MARCONI DRIVEALPHARETTA GA 30005

HORN MACHINE TOOLS INC40455 BRICKYARD DRIVE STE 101MADERA CA 93636

HYDRAULIC PLUS26511 FALLBROOK AVENUEWYOMING MN 55092

IMPACT NORTH INCPO BOX 274GORDON WI 54838-0274

INFINITY WOVEN PRODUCTS LLCDEPT 2408PO BOX 11407BIRMINGHAM AL 35246-2804


INFOR (US) INCNW 7418PO BOX 1450MINNEAPOLIS MN 55485-7418

INNER WORKINGS INC600 W CHICAGO AVENUE SUITE 850CHICAGO IL 60654

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SCHWINTEK INC301 RANGER DRIVECASSOPOLIS MI 49031

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ZITO, MICHAEL ASHOOK HARDY & BACON1155 F STREET NW STE 200WASHINGTON DC 20004-1305


REVISED f 2/15

UNITED STATES BANKRUPTCY COURTDISTRICT OF MINNESOTA

ln rePREMIER MARINE, INC

Debtor(s),

SIGNATURE DECLARATION

M PETITIoN, SCHEDULES & STATEMENTSE CHAPTER 13 PLANE VOLUNTARY CONVERS]O N, SCH EDU L ES AN D STATEM ENTSn AMENDMENTTO pETtTtON, SCHEDULES & STATEMENTSfl IvIODIFIED CHAPTER 13 PIANE OTHER (PLEASE DESCRIBE; )

Date: 6 e /17

x

Signalure of Debtor 2

LoriJ. Melbostad

Case No.

I [We], the undersigned debto(s) or authorized representative of the debtor, make the following declarations underpenalty of perjury;

1. The information I have given my altorney for the electronically filed petition, statements, schedules,amendmonts, and/or chapter 13 plan, as indicated above, is true and correct;

2. The So_cial Security Number or Tax ldentification Number I have given to my attorney for entry into thecoud's Case ManagemenlElectronic Case Fillng (CM/ECF) system as a part of the ãbctronic'commencement of the above-referenced case is true and correct;

3, [lndlvldual debtorc onlyl lf no Social Security Number was provided as described in paragraph 2 above,it is because I do not have a SocialSecurity Number;

4. I consent to my attorney electronically filing wíth the United States Bankruptcy Court my petition,statements and schedules, amendments, and/or chapter 13 plan, as indicated above, together with ascanned image of this Signature Declaration;

5, My eleclronic signatur€ contained on the documents filed with the Bankruptcy Court has the same effectas if it were my original signature on those documents; and

6, I have been authorized to file this petition on behalf of the debtor.

Prinled Name of Debtor 1 orAuthorized Representative

Printed Name of Debtor 2

Sofr,vare Copyrlght (c, 1 908-20 1 7 Bolt Cåso, LLC - wwwbo8tcaso,çom Bect C¡9e Bankfuplcy


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