Fill and Sign the Fillable Online Claim of Exemption Volusia County Clerk Fax Email Form

In the District Court of _______________________ County State of Oklahoma __________________________ ) Plaintiff ) ) vs.) ) ____________________________ ) Case No. _______________ Defendant ) ) and) ) ____________________________ ) Garnishee ) Claim for Exemption and Request for Hearing 1. Funds sought in garnishment are exempt from execution because they are (check applicable box): 9 A. Social Security benefits – 42 U.S.C. § 407. 9 B. Supplemental security income – 42 U.S.C. §1383(d). 9 C. Unemployment benefits – 40 O.S. §2-303. 9 D. Workmen’s Compensation benefits – 85 O.S. §48. 9 E. Welfare benefits – 56 O.S. §173. 9 F. Veterans’ benefits – 38 U.S.C. §3101, 31 O.S. §7. 9 G. Monies in Possession of Police Pensions – 11 O.S. §50-124. 9 H. Monies in Possession of Firemen’s Relief & Pension Fund – 11 O.S. §49-126. 9 I. Monies in Possession of County Employee’s Retirement System – 19 O.S. §959. 9 J. Monies in Possession of Public Employee’s Retirement Fund – 74 O.S. §923. 9 K. Teacher’s Annuities or Retirement Allowance – 70 O.S. §17-109. 9 L. Annuities and pension payments under Railroad Retirement Act – 45 U.S.C. §231(m) 9 M. United States Civil Service Retirement and Disability Pension Fund Payments – 5 U.S.C. §8346. 9 N. United States Civil Service Survivor Annuities – 5 U.S.C. §8346. 9 O. Interest in Retirement, Pension and Profit Sharing Plans – 60 O.S. §327, 60 O.S. §328. 9 P. The Wages of Seamen – 46 U.S.C. §601. 9 Q. Funds vested in the Alien Property Custodian – 50 U.S.C. Appx. §9(f). 9 R. Prepaid Burial Benefits – 36 O.S. §6125. 9 S. Proceeds of Group-Life Insurance Policy – 36 O.S. 3632, and 36 O.S. §4026. 9 T. Alimony, support, separate maintenance, or child support necessary for support of judgment debtor or dependent – 31 O.S. §1.1. 9 U. Personal wage exemption because of undue hardship – 31 O.S. §1.1. 9 V. Other ( please state ): ________________________________________________ 2. Check one box: 9 All funds are exempt, or, 9 I believe the following amount of money is exempt: $_________________________ _ (Fill in the amount of funds to be exempt). 3. Check if applicable: 9 I have attached copies of the documents that show that my money is exempt. 4. If garnishment is for wages, this claim and request is filed for the pay period _________________ through ________________, inclusive. 5. I request that this matter be set for hearing. ________________________________________ _ Signature Address for mailing of Court Hearing Notice _________________________________________ _________________________________________ Address for mailing a copy of Claim to Judgment Creditor’s Attorney: _________________________________________ _________________________________________ You must mail the original to the Court Clerk of ____________________County at the following address: _________________________________________________________________ _________________________________________________________________________ AOC Form 22 Revised 8/05