Fill in this information to identify your case:

United States Bankruptcy Court for the:

NORTHERN DISTRICT OF CALIFORNIA

Case number (if known) Chapter 7

Check if this an
amended filing

Official Form 201

Voluntary Petition for Non-Individuals Filing for Bankruptcy 06/22
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 the case number (if
known). For more information, a separate document, Instructions for Bankruptcy Forms for Non-Individuals, is available.

1. Debtor's name Sixteen Seventeen LLC

2. All other names debtor

used in the last 8 years
Include any assumed
names, trade names and
doing business as names

3. Debtor's federal
Employer Identification
Number (EIN)

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

2430 Sprig Court, Suite D

Concord, CA 94520
Number, Street, City, State & ZIP Code P.O. Box, Number, Street, City, State & ZIP Code

Contra Costa Location of principal assets, if different from principal

County place of business

Number, Street, City, State & ZIP Code

5. Debtor's website (URL) sixteenseventeen.com

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

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 1 of 45

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 1
Debtor Sixteen Seventeen LLC 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.
4541

8. Under which chapter of the Check one:

Bankruptcy Code is the
debtor filing? Chapter 7
A debtor who is a “small Chapter 9
business debtor” must check
Chapter 11. Check all that apply:
the first sub-box. A debtor as
defined in § 1182(1) who The debtor is a small business debtor as defined in 11 U.S.C. § 101(51D), and its aggregate
elects to proceed under noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than
subchapter V of chapter 11 $3,024,725. If this sub-box is selected, attach the most recent balance sheet, statement of
(whether or not the debtor is a operations, cash-flow statement, and federal income tax return or if any of these documents do not
“small business debtor”) must exist, follow the procedure in 11 U.S.C. § 1116(1)(B).
check the second sub-box.
The debtor is a debtor as defined in 11 U.S.C. § 1182(1), its aggregate noncontingent liquidated
debts (excluding debts owed to insiders or affiliates) are less than $7,500,000, and it chooses to
proceed under Subchapter V of Chapter 11. If this sub-box is selected, attach the most recent
balance sheet, statement of operations, cash-flow statement, and federal income tax return, or if
any of these documents do not exist, follow the procedure 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, in
accordance with 11 U.S.C. § 1126(b).
The debtor is required to file periodic reports (for example, 10K and 10Q) with the Securities and
Exchange Commission according to § 13 or 15(d) of the Securities Exchange Act of 1934. File the
Attachment 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 bankruptcy No.

cases filed by or against
the debtor within the last 8 Yes.
years?
If more than 2 cases, attach a
separate list. District When Case number
District When Case number

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Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 2
Debtor Sixteen Seventeen LLC Case number (if known)
Name

10. Are any bankruptcy cases No

pending or being filed by a
business partner or an Yes.
affiliate of the debtor?

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 in Check all that apply:

this district?
Debtor has had its domicile, principal place of business, or principal assets in this district for 180 days immediately
preceding 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 or No

have possession of any
real property or personal Answer below for each property that needs immediate attention. Attach additional sheets if needed.
Yes.
property that needs
immediate attention? 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 Code
Is the property insured?
No
Yes. Insurance agency
Contact name
Phone

Statistical and administrative information

13. Debtor's estimation of . Check one:

available funds
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 of 1-49 1,000-5,000 25,001-50,000

creditors 5001-10,000 50,001-100,000
50-99
100-199 10,001-25,000 More than100,000
200-999

15. Estimated Assets $0 - $50,000 $1,000,001 - $10 million $500,000,001 - $1 billion

$50,001 - $100,000 $10,000,001 - $50 million $1,000,000,001 - $10 billion
$100,001 - $500,000 $50,000,001 - $100 million $10,000,000,001 - $50 billion
$500,001 - $1 million $100,000,001 - $500 million More than $50 billion

16. Estimated liabilities $0 - $50,000 $1,000,001 - $10 million $500,000,001 - $1 billion

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 3 of 45
Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 3
Debtor Sixteen Seventeen LLC Case number (if known)
Name

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

$100,001 - $500,000 $50,000,001 - $100 million $10,000,000,001 - $50 billion
$500,001 - $1 million $100,000,001 - $500 million More than $50 billion

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 4 of 45

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 4
Debtor Sixteen Seventeen LLC Case number (if known)
Name

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 or
imprisonment for up to 20 years, or both. 18 U.S.C. §§ 152, 1341, 1519, and 3571.

17. Declaration and signature

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

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

Executed on February 5, 2024

MM / DD / YYYY

X /s/ Vanessa McGee Vanessa McGee

Signature of authorized representative of debtor Printed name

Title Owner

18. Signature of attorney X /s/ Gina R. Klump Date February 5, 2024

Signature of attorney for debtor MM / DD / YYYY

Gina R. Klump
Printed name

Law Office of Gina R. Klump

Firm name

11 5th Street, Suite 102

Petaluma, CA 94952
Number, Street, City, State & ZIP Code

Contact phone Email address

Bar number and State

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 5 of 45

Official Form 201 Voluntary Petition for Non-Individuals Filing for Bankruptcy page 5
Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 202

Declaration Under Penalty of Perjury for Non-Individual Debtors 12/15

An individual who is authorized to act on behalf of a non-individual debtor, such as a corporation or partnership, must sign and submit this
form for the schedules of assets and liabilities, any other document that requires a declaration that is not included in the document, and any
amendments of those documents. This form must state the individual’s position or relationship to the debtor, the identity of the document,
and the date. Bankruptcy Rules 1008 and 9011.

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

Declaration and signature

I am the president, another officer, or an authorized agent of the corporation; a member or an authorized agent of the partnership; or another
individual serving as a representative of the debtor in this case.

I have examined the information in the documents checked below and I have a reasonable belief that the information is true and correct:

Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)

Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G)
Schedule H: Codebtors (Official Form 206H)
Summary of Assets and Liabilities for Non-Individuals (Official Form 206Sum)
Amended Schedule
Chapter 11 or Chapter 9 Cases: List of Creditors Who Have the 20 Largest Unsecured Claims and Are Not Insiders (Official Form 204)
Other document that requires a declaration

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

Executed on February 5, 2024 X /s/ Vanessa McGee

Signature of individual signing on behalf of debtor

Vanessa McGee
Printed name

Owner
Position or relationship to debtor

Official Form 202 Declaration Under Penalty of Perjury for Non-Individual Debtors

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 6 of 45

 Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 206Sum

Summary of Assets and Liabilities for Non-Individuals 12/15

Part 1: Summary of Assets

1. Schedule A/B: Assets-Real and Personal Property (Official Form 206A/B)

1a. Real property:

Copy line 88 from Schedule A/B............................................................................................................................. $ 0.00

1b. Total personal property:

Copy line 91A from Schedule A/B......................................................................................................................... $ 152,166.00

1c. Total of all property:

Copy line 92 from Schedule A/B........................................................................................................................... $ 152,166.00

Part 2: Summary of Liabilities

2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)
Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D.................................... $ 0.00

3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)

3a. Total claim amounts of priority unsecured claims:

Copy the total claims from Part 1 from line 5a of Schedule E/F.......................................................................... $ 0.00

3b. Total amount of claims of nonpriority amount of unsecured claims:

Copy the total of the amount of claims from Part 2 from line 5b of Schedule E/F................................................ +$ 447,490.00

4. Total liabilities .......................................................................................................................................................

Lines 2 + 3a + 3b $ 447,490.00

Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals page 1
Software Copyright (c) 1996-2023 Best Case, LLC - www.bestcase.com
Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 7 of 45
Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 206A/B

Schedule A/B: Assets - Real and Personal Property 12/15
Disclose all property, real and personal, which the debtor owns or in which the debtor has any other legal, equitable, or future interest.
Include all property in which the debtor holds rights and powers exercisable for the debtor's own benefit. Also include assets and properties
which have no book value, such as fully depreciated assets or assets that were not capitalized. In Schedule A/B, list any executory contracts
or unexpired leases. Also list them on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G).

Be as complete and accurate as possible. If more space is needed, attach a separate sheet to this form. At the top of any pages added, write
the debtor’s name and case number (if known). Also identify the form and line number to which the additional information applies. If an
additional sheet is attached, include the amounts from the attachment in the total for the pertinent part.

For Part 1 through Part 11, list each asset under the appropriate category or attach separate supporting schedules, such as a fixed asset
schedule or depreciation schedule, that gives the details for each asset in a particular category. List each asset only once. In valuing the
debtor’s interest, do not deduct the value of secured claims. See the instructions to understand the terms used in this form.
Part 1: Cash and cash equivalents
1. Does the debtor have any cash or cash equivalents?

No. Go to Part 2.
Yes Fill in the information below.
All cash or cash equivalents owned or controlled by the debtor Current value of
debtor's interest
2. Cash on hand $187.00

3. Checking, savings, money market, or financial brokerage accounts (Identify all)

Name of institution (bank or brokerage firm) Type of account Last 4 digits of account
number

3.1. Chase Bank #0081 Business Checking $0.00

4. Other cash equivalents (Identify all)

5. Total of Part 1. $187.00

Add lines 2 through 4 (including amounts on any additional sheets). Copy the total to line 80.

Part 2: Deposits and Prepayments

6. Does the debtor have any deposits or prepayments?

No. Go to Part 3.
Yes Fill in the information below.

7. Deposits, including security deposits and utility deposits

Description, including name of holder of deposit

7.1. MKD Garaventa LLC of Delaware - Security Deposit $10,120.00

Lassen Commercial Properties LLC - Security Deposit

12885 Alcosta Blvd.
7.2. San Ramon, CA 94583 $2,250.00

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 1

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 8 of 45

Debtor Sixteen Seventeen LLC Case number (If known)
Name

8. Prepayments, including prepayments on executory contracts, leases, insurance, taxes, and rent
Description, including name of holder of prepayment

9. Total of Part 2. $12,370.00

Add lines 7 through 8. Copy the total to line 81.

Part 3: Accounts receivable

10. Does the debtor have any accounts receivable?

No. Go to Part 4.
Yes Fill in the information below.

Part 4: Investments
13. Does the debtor own any investments?

No. Go to Part 5.
Yes Fill in the information below.

Part 5: Inventory, excluding agriculture assets

18. Does the debtor own any inventory (excluding agriculture assets)?

No. Go to Part 6.
Yes Fill in the information below.

General description Date of the last Net book value of Valuation method used Current value of
physical inventory debtor's interest for current value debtor's interest
(Where available)

19. Raw materials

See attached $134,109.00 Recent cost $134,109.00

20. Work in progress

21. Finished goods, including goods held for resale

22. Other inventory or supplies

23. Total of Part 5. $134,109.00

Add lines 19 through 22. Copy the total to line 84.

24. Is any of the property listed in Part 5 perishable?

No
Yes

25. Has any of the property listed in Part 5 been purchased within 20 days before the bankruptcy was filed?
No
Yes. Book value Valuation method Current Value

26. Has any of the property listed in Part 5 been appraised by a professional within the last year?
No
Yes

Part 6: Farming and fishing-related assets (other than titled motor vehicles and land)
27. Does the debtor own or lease any farming and fishing-related assets (other than titled motor vehicles and land)?

No. Go to Part 7.

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 2

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Debtor Sixteen Seventeen LLC Case number (If known)
Name

Yes Fill in the information below.

Part 7: Office furniture, fixtures, and equipment; and collectibles

38. Does the debtor own or lease any office furniture, fixtures, equipment, or collectibles?

No. Go to Part 8.
Yes Fill in the information below.

General description Net book value of Valuation method used Current value of
debtor's interest for current value debtor's interest
(Where available)

39. Office furniture

See Attached $0.00 $2,500.00

40. Office fixtures

Metal Storage Racks $0.00 $500.00

41. Office equipment, including all computer equipment and

communication systems equipment and software
Laptops (7); Cell Phones (3); Printers (3);
Cordless phone (4) $0.00 $2,500.00

Other Machinery - See Attached $0.00 Unknown

42. Collectibles Examples: Antiques and figurines; paintings, prints, or other artwork;
books, pictures, or other art objects; china and crystal; stamp, coin, or baseball card
collections; other collections, memorabilia, or collectibles

43. Total of Part 7. $5,500.00

Add lines 39 through 42. Copy the total to line 86.

44. Is a depreciation schedule available for any of the property listed in Part 7?
No
Yes

45. Has any of the property listed in Part 7 been appraised by a professional within the last year?
No
Yes

Part 8: Machinery, equipment, and vehicles

46. Does the debtor own or lease any machinery, equipment, or vehicles?

No. Go to Part 9.
Yes Fill in the information below.

General description Net book value of Valuation method used Current value of
Include year, make, model, and identification numbers debtor's interest for current value debtor's interest
(i.e., VIN, HIN, or N-number) (Where available)

47. Automobiles, vans, trucks, motorcycles, trailers, and titled farm vehicles

47.1. 2023 Nissan Pathfinder - Leased Vehicle $0.00 $0.00

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 3

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Debtor Sixteen Seventeen LLC Case number (If known)
Name

No. Go to Part 11.

Yes Fill in the information below.

General description Net book value of Valuation method used Current value of
debtor's interest for current value debtor's interest
(Where available)

60. Patents, copyrights, trademarks, and trade secrets

Sixteen Seventeen $0.00 $0.00

61. Internet domain names and websites

sixteenseventeen.com $0.00 $0.00

62. Licenses, franchises, and royalties

63. Customer lists, mailing lists, or other compilations

Email database in Shopify $0.00 $0.00

Customer List $0.00 Unknown

64. Other intangibles, or intellectual property

65. Goodwill

66. Total of Part 10. $0.00

Add lines 60 through 65. Copy the total to line 89.

67. Do your lists or records include personally identifiable information of customers (as defined in 11 U.S.C.§§ 101(41A) and 107?
No
Yes

68. Is there an amortization or other similar schedule available for any of the property listed in Part 10?
No
Yes

69. Has any of the property listed in Part 10 been appraised by a professional within the last year?
No
Yes

Part 11: All other assets

70. Does the debtor own any other assets that have not yet been reported on this form?
Include all interests in executory contracts and unexpired leases not previously reported on this form.

No. Go to Part 12.

Yes Fill in the information below.

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 12 of 45

Debtor Sixteen Seventeen LLC Case number (If known)
Name

Part 12: Summary

In Part 12 copy all of the totals from the earlier parts of the form
Type of property Current value of Current value of real
personal property property

80. Cash, cash equivalents, and financial assets.

Copy line 5, Part 1 $187.00

81. Deposits and prepayments. Copy line 9, Part 2. $12,370.00

82. Accounts receivable. Copy line 12, Part 3. $0.00

83. Investments. Copy line 17, Part 4. $0.00

84. Inventory. Copy line 23, Part 5. $134,109.00

85. Farming and fishing-related assets. Copy line 33, Part 6. $0.00

86. Office furniture, fixtures, and equipment; and collectibles.

Copy line 43, Part 7. $5,500.00

87. Machinery, equipment, and vehicles. Copy line 51, Part 8. $0.00

88. Real property. Copy line 56, Part 9.........................................................................................> $0.00

89. Intangibles and intellectual property. Copy line 66, Part 10. $0.00

90. All other assets. Copy line 78, Part 11. + $0.00

91. Total. Add lines 80 through 90 for each column $152,166.00 + 91b. $0.00

92. Total of all property on Schedule A/B. Add lines 91a+91b=92 $152,166.00

Official Form 206A/B Schedule A/B Assets - Real and Personal Property page 6

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Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 206D

Schedule D: Creditors Who Have Claims Secured by Property 12/15
Be as complete and accurate as possible.
1. Do any creditors have claims secured by debtor's property?

No. Check this box and submit page 1 of this form to the court with debtor's other schedules. Debtor has nothing else to report on this form.
Yes. Fill in all of the information below.

Official Form 206D Schedule D: Creditors Who Have Claims Secured by Property page 1 of 1

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 25 of 45

Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 206E/F

Schedule E/F: Creditors Who Have Unsecured Claims 12/15
Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured claims.
List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Assets - Real and
Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and
2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.

Part 1: List All Creditors with PRIORITY Unsecured Claims

1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507).

No. Go to Part 2.

Yes. Go to line 2.

2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than 3 creditors
with priority unsecured claims, fill out and attach the Additional Page of Part 1.

Total claim Priority amount

2.1 Priority creditor's name and mailing address As of the petition filing date, the claim is: $0.00 $0.00
Franchise Tax Board Check all that apply.
Bankruptcy Section MS A-340 Contingent
PO. Box 2952 Unliquidated
Sacramento, CA 95812-2952 Disputed

Date or dates debt was incurred Basis for the claim:

Notice Only
Last 4 digits of account number Is the claim subject to offset?
Specify Code subsection of PRIORITY No
unsecured claim: 11 U.S.C. § 507(a) (8)
Yes

2.2 Priority creditor's name and mailing address As of the petition filing date, the claim is: $0.00 $0.00
Internal Revenue Service Check all that apply.
Insolvency Unit Contingent
P.O. Box 7346 Unliquidated
Philadelphia, PA 19101-7346 Disputed

Date or dates debt was incurred Basis for the claim:

Notice Only
Last 4 digits of account number Is the claim subject to offset?
Specify Code subsection of PRIORITY No
unsecured claim: 11 U.S.C. § 507(a) (8)
Yes

Part 2: List All Creditors with NONPRIORITY Unsecured Claims

3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 6 creditors with nonpriority unsecured claims, fill
out and attach the Additional Page of Part 2.
Amount of claim

Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims page 1 of 5
43038
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Debtor Sixteen Seventeen LLC Case number (if known)
Name

3.1 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Accublend Corp. Contingent
364 Malbert Street Unliquidated
Perris, CA 92570 Disputed
Date(s) debt was incurred 2022 Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.2 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $6,980.00
ADT Contingent
2150 John Glenn Dr., #100 Unliquidated
Concord, CA 94520 Disputed
Date(s) debt was incurred
Basis for the claim: Utilities
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.3 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
AFI Contingent
85 Wansley Dr., SE Unliquidated
Cartersville, GA 30121 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.4 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
CalWax Contingent
3120 East Washington Unliquidated
Phoenix, AZ 85034 Disputed
Date(s) debt was incurred 2021
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.5 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $28,070.00
Chase Bank Contingent
P.O. Box 182051 Unliquidated
Columbus, OH 43218 Disputed
Date(s) debt was incurred Various Basis for the claim: Credit card purchases
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.6 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $29,176.00
Chase Bank Contingent
P.O. Box 182051 Unliquidated
Columbus, OH 43218 Disputed
Date(s) debt was incurred Various Basis for the claim: Credit card purchases
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.7 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Contra Costa Health and Hazard Contingent
4585 Pacheco Blvd., Suite 100 Unliquidated
Martinez, CA 94553 Disputed
Date(s) debt was incurred 1/1/2024
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 2 of 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 27 of 45

Debtor Sixteen Seventeen LLC Case number (if known)
Name

3.8 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,600.00
CoverWallet Inc. Contingent
P.O. Box 6718, Floor 15 Unliquidated
Somerset, NJ 08875 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.9 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $172,641.00
JP Morgan Chase Bank Contingent
P.O. Box 182051 Unliquidated
Columbus, OH 43218 Disputed
Date(s) debt was incurred 2023
Basis for the claim: Business Line of Credit
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.10 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $15,000.00
Kelly Spicers Contingent
47422 Kato Road Unliquidated
Fremont, CA 94538 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.11 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $800.00
Mercury Insurance Contingent
4484 Wilshire Blvd. Unliquidated
Los Angeles, CA 90010 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.12 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,500.00
Mt Diablo Resource Recovery Contingent
P.O. Box 5397 Unliquidated
Concord, CA 94524 Disputed
Date(s) debt was incurred 12/2023
Basis for the claim: Utilities
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.13 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $2,500.00
PG & E Contingent
Box 997300 Unliquidated
Sacramento, CA 95899-7300 Disputed
Date(s) debt was incurred 1/2024
Basis for the claim: Utilities
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.14 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $600.00
Primo Water/Alhambra Contingent
P.O. Box 660579 Unliquidated
Dallas, TX 75266 Disputed
Date(s) debt was incurred 12/2023
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 3 of 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 28 of 45

Debtor Sixteen Seventeen LLC Case number (if known)
Name

3.15 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $1,600.00
RT Specialty LLC Contingent
5660 Greenwood Plaza Suite 500 Unliquidated
Englewood, CO 80111 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.16 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Shipstation Contingent
4301 Bull Creek Rd., 3rd Floor Unliquidated
Austin, TX 78731 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.17 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $93,023.00
Shopify Capital Contingent
151 O'Connor Street Unliquidated
Ground Floor Disputed
Ottawa ON K2P 2L8, ON
Basis for the claim: Merchant Loan Agreement
Date(s) debt was incurred 2023
Last 4 digits of account number Is the claim subject to offset? No Yes

3.18 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Shopify Capital Contingent
151 O'Connor Street Unliquidated
Ground Floor Disputed
Ottawa ON K2P 2L8, ON
Basis for the claim: Trade debt - Online Store
Date(s) debt was incurred
Last 4 digits of account number Is the claim subject to offset? No Yes

3.19 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $21,000.00
Sound Communications Contingent
149 36th Street, Floor 11 Unliquidated
New York, NY 10018 Disputed
Date(s) debt was incurred 6/2023
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.20 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $50,000.00
UPS Contingent
P.O. Box 650116 Unliquidated
Dallas, TX 75265 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.21 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Van Winkle Law Firm Contingent
P.O. Box 7376 Unliquidated
Asheville, NC 28802 Disputed
Date(s) debt was incurred 5/4/2022 Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 4 of 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 29 of 45

Debtor Sixteen Seventeen LLC Case number (if known)
Name

3.22 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Wave Apps Contingent
1550 Wewatta St., #200 Unliquidated
Denver, CO 80202 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.23 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Wax and Timber/Candle Art Contingent
102 Norb Ave. Unliquidated
Dieterich, IL 62424 Disputed
Date(s) debt was incurred 1/2023
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.24 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. Unknown
Wicks Unlimiited/Stimpson Contingent
1515 SW 13th Court Unliquidated
Pompano Beach, FL 33069 Disputed
Date(s) debt was incurred 6/2020
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.25 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $20,000.00
Yotpo Contingent
233 Spring Street, 6th Floor Unliquidated
New York, NY 10013 Disputed
Date(s) debt was incurred 11/1/2023
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

3.26 Nonpriority creditor's name and mailing address As of the petition filing date, the claim is: Check all that apply. $3,000.00
You Tech & Associates Contingent
1011 Warrenville Rd., #255 Unliquidated
Lisle, IL 60532 Disputed
Date(s) debt was incurred
Basis for the claim: Trade debt
Last 4 digits of account number
Is the claim subject to offset? No Yes

Part 3: List Others to Be Notified About Unsecured Claims

4. List in alphabetical order any others who must be notified for claims listed in Parts 1 and 2. Examples of entities that may be listed are collection agencies,
assignees of claims listed above, and attorneys for unsecured creditors.

If no others need to be notified for the debts listed in Parts 1 and 2, do not fill out or submit this page. If additional pages are needed, copy the next page.

Name and mailing address On which line in Part1 or Part 2 is the Last 4 digits of
related creditor (if any) listed? account number, if
any

Part 4: Total Amounts of the Priority and Nonpriority Unsecured Claims

5. Add the amounts of priority and nonpriority unsecured claims.

Total of claim amounts
5a. Total claims from Part 1 5a. $ 0.00
5b. Total claims from Part 2 5b. + $ 447,490.00

5c. Total of Parts 1 and 2

Lines 5a + 5b = 5c. 5c. $ 447,490.00

Official Form 206 E/F Schedule E/F: Creditors Who Have Unsecured Claims Page 5 of 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 30 of 45

Debtor 1 Sixteen Seventeen LLC Case number (if known)
First Name Middle Name Last Name

Additional Page if You Have More Contracts or Leases

2. List all contracts and unexpired leases State the name and mailing address for all other parties with
whom the debtor has an executory contract or unexpired
lease

Official Form 206G Schedule G: Executory Contracts and Unexpired Leases Page 2 of 2

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 32 of 45

Fill in this information to identify the case:

Debtor name Sixteen Seventeen LLC

United States Bankruptcy Court for the: NORTHERN DISTRICT OF CALIFORNIA

Case number (if known)

Check if this is an
amended filing

Official Form 207

Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy 04/22
The debtor must answer every question. 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).

Part 1: Income

1. Gross revenue from business

None.

Identify the beginning and ending dates of the debtor’s fiscal year, Sources of revenue Gross revenue
which may be a calendar year Check all that apply (before deductions and
exclusions)

From the beginning of the fiscal year to filing date: Operating a business $74,406.92
From 1/01/2024 to Filing Date
Other

For prior year: Operating a business $1,634,899.17

From 1/01/2023 to 12/31/2023
Other

For year before that: Operating a business $2,291,000.00

From 1/01/2022 to 12/31/2022
Other

2. Non-business revenue
Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits,
and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1.

None.

Description of sources of revenue Gross revenue from

each source
(before deductions and
exclusions)

Part 2: List Certain Transfers Made Before Filing for Bankruptcy

3. Certain payments or transfers to creditors within 90 days before filing this case
List payments or transfers--including expense reimbursements--to any creditor, other than regular employee compensation, within 90 days before
filing this case unless the aggregate value of all property transferred to that creditor is less than $7,575. (This amount may be adjusted on 4/01/25
and every 3 years after that with respect to cases filed on or after the date of adjustment.)

None.

Creditor's Name and Address Dates Total amount of value Reasons for payment or transfer
Check all that apply

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 1

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 34 of 45

Debtor Sixteen Seventeen LLC Case number (if known)

9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of
the gifts to that recipient is less than $1,000

None

Recipient's name and address Description of the gifts or contributions Dates given Value

Part 5: Certain Losses

10. All losses from fire, theft, or other casualty within 1 year before filing this case.

None

Description of the property lost and Amount of payments received for the loss Dates of loss Value of property
how the loss occurred lost
If you have received payments to cover the loss, for
example, from insurance, government compensation, or
tort liability, list the total received.

List unpaid claims on Official Form 106A/B (Schedule

A/B: Assets – Real and Personal Property).

Part 6: Certain Payments or Transfers

11. Payments related to bankruptcy

List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing
of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy
relief, or filing a bankruptcy case.

None.

Who was paid or who received If not money, describe any property transferred Dates Total amount or
the transfer? value
Address
11.1. Law Office of Gina R. Klump
11 5th Street, Suite 102
Petaluma, CA 94952 Attorney Fees 1/18/2024 $4,338.00

Email or website address

Who made the payment, if not debtor?

12. Self-settled trusts of which the debtor is a beneficiary

List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case
to a self-settled trust or similar device.
Do not include transfers already listed on this statement.

None.

Name of trust or device Describe any property transferred Dates transfers Total amount or
were made value

13. Transfers not already listed on this statement

List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within
2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include
both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement.

None.

Who received transfer? Description of property transferred or Date transfer Total amount or
Address payments received or debts paid in exchange was made value

Part 7: Previous Locations

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 3

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 36 of 45

Debtor Sixteen Seventeen LLC Case number (if known)

20. Off-premises storage

List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in
which the debtor does business.

None

Facility name and address Names of anyone with Description of the contents Does debtor
access to it still have it?

Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own

21. Property held for another

List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do
not list leased or rented property.

None

Part 12: Details About Environment Information

For the purpose of Part 12, the following definitions apply:

Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the
medium affected (air, land, water, or any other medium).

Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly
owned, operated, or utilized.

Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a
similarly harmful substance.

Report all notices, releases, and proceedings known, regardless of when they occurred.

22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders.

No.
Yes. Provide details below.

Case title Court or agency name and Nature of the case Status of case
Case number address

23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an
environmental law?

No.
Yes. Provide details below.

Site name and address Governmental unit name and Environmental law, if known Date of notice
address

24. Has the debtor notified any governmental unit of any release of hazardous material?

No.
Yes. Provide details below.

Site name and address Governmental unit name and Environmental law, if known Date of notice
address

Part 13: Details About the Debtor's Business or Connections to Any Business

25. Other businesses in which the debtor has or has had an interest
List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case.
Include this information even if already listed in the Schedules.

None

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 5

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 38 of 45

Debtor Sixteen Seventeen LLC Case number (if known)

Part 14: Signature and Declaration

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

I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the information is true
and correct.

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

Executed on February 5, 2024

/s/ Vanessa McGee Vanessa McGee

Signature of individual signing on behalf of the debtor Printed name

Position or relationship to debtor Owner

Are additional pages to Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?
No
Yes

Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy page 8

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 41 of 45

Vendor Payments over $6245 in last 90 days

12/15/2023 $12,735.64
01/01/2024 $94.00
01/12/2024 $8,776.70
$55,406.91
Yotpo
10/29/2023 $100.00
11/01/2023 $24.98
11/01/2023 $100.00
11/03/2023 $22.07
11/04/2023 $100.00
11/05/2023 $100.00
11/07/2023 $100.00
11/07/2023 $12.57
11/08/2023 $100.00
11/08/2023 $1.00
11/10/2023 $14.46
11/10/2023 $35.53
11/10/2023 $100.00
11/11/2023 $100.00
11/13/2023 $100.00
11/14/2023 $4,192.00
11/15/2023 $100.00
11/17/2023 $100.00
11/17/2023 $14.06
11/19/2023 $100.00
11/20/2023 $100.00
11/21/2023 $100.00
11/21/2023 $12.29
11/21/2023 $99.71
11/22/2023 $100.00
11/24/2023 $46.68
11/24/2023 $100.00
11/25/2023 $125.75
11/26/2023 $100.00
11/27/2023 $149.03
11/28/2023 $100.00
11/29/2023 $100.00
11/30/2023 $100.00
11/30/2023 $11.18
12/01/2023 $10.75
12/01/2023 100
12/03/2023 $100.00
12/03/2023 $29.37
12/04/2023 $7.82
12/04/2023 $100.00
12/05/2023 $100.00
12/06/2023 $100.00
12/06/2023 $100.00
12/08/2023 $46.11
12/08/2023 $60.64
12/08/2023 $100.00

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 43 of 45

Vendor Payments over $6245 in last 90 days

12/09/2023 $100.00
12/11/2023 $48.32
12/11/2023 $100.00
12/12/2023 $100.00
12/12/2023 $49.40
12/13/2023 $100.00
12/13/2023 $100.00
12/13/2023 $65.18
01/10/2024 $100.00
01/13/2024 $100.00
$8,478.90

Case: 24-40157 Doc# 1 Filed: 02/05/24 Entered: 02/05/24 08:28:43 Page 44 of 45