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Items to be completed in Proof of Claim form. A proof of claim is a written statement setting out a creditor's claim and asserting its right to receive a distribution from the bankruptcy estate.Read the instructions before filling out this form. This form is for making a claim for payment in a bankruptcy case. Everything you need to know about filing an accurate Bankruptcy Proof of Claim. We also included a nine-point checklist to guide you through the process. A Proof of Claim is a document that a creditor files with the bankruptcy court to assert their legal right to repayment from the Debtor. Attach a complete copy of any power of attorney. Criminal penalties apply for making a false statement on a proof of claim. __________DEFINITIONS__________. The Bar Date is the last date creditors may file Proofs of Claim against the customer.