Fill and Sign the Fillable Online Family Court Division in Re the Marriage of Form

- 1 - STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. ,Petitioner, EXECUTION EXEMPTIONNOTICE AND NOTICE OF AND INTENT TO LEVY EARNINGS WITH IN TEN DAYS ,Respondent,TH E S T A TE O F M IN NESO TA T O T H E A BO VE-N AM ED J U DGM EN T D EB TO R: PL EA SE T A KE N OTIC E t h at a l e v y m ay b e s e rv ed u pon y our e m plo yer o r o th er t h ir d partie s, w ith out a n y f u rth er c o urt p ro ceed in gs o r n otic e t o y ou, t e n d ay s o r m ore f ro m t h e d ate he re o f. Y our e arn in gs a re c o m ple te ly e x em pt f ro m e x ecu tio n l e v y i f y ou a re n ow a r e cip ie n t o f re lie f b ase d o n n eed , i f y ou h av e b een a r e cip ie n t o f s u ch r e lie f w ith in t h e l a st s ix m onth s, o r i f y ou hav e b ee n a n i n m ate o f a c o rre ctio nal i n stitu tio n i n t h e l a st s ix m onth s. R elie f b ase d o n n eed i n clu des, o nly A id t o F am ilie s w ith D ep en dan t C hild re n ( A FD C), AF D C- E m erg en cy A ssis ta n ce ( A FD C-E A ), M ed ic al A ssis ta n ce ( M A), G en era l A ssis ta n ce ( G A), Ge n era l A ssis ta n ce M ed ic al C are ( G AM C), E m erg en cy G en era l A ssis ta n ce ( E G A), W ork Read in ess, M in neso ta S upp le m en ta l A id ( M SA ), M SA E m erg en cy A ssis ta n ce ( M SA -E A ), Su pple m en ta l S ecu rity I n co m e ( S SI), a n d E nerg y A ssis ta n ce.If y ou w is h t o c la im a n e x em ptio n, y ou s h ould f ill o ut t h e a p pro pria te f o rm b elo w , s ig n i t, an d s e n d i t t o t h e c re d ito r's a tto rn ey a n d t h e g arn is h ee. - 2 - You m ay w is h t o c o nta ct t h e a tto rn ey f o r t h e j u dgm en t c re d ito r i n o rd er t o a rra n ge f o r a se ttle m en t o f t h e d eb t o r c o nta ct a n a tto rn ey t o a d vis e y ou a b out e x em ptio ns o r o th er r ig hts . P E N ALTIE S 1. B e a d vis e d t h at e v en i f y ou c la im a n e x em ptio n, a n e x ecu tio n l e v y m ay s till b e s e rv ed o n your e m plo yer. I f y our e arn in gs a re l e v ie d o n a fte r y ou c la im a n e x em ptio n, y ou m ay p etitio n t h e co urt f o r a d ete rm in atio n o f y our e x em ptio n. I f t h e c o urt f in ds t h at t h e j u dgm en t c re d ito r dis re g ard ed y ou r c la im o f e x em ptio n i n b ad f a ith , y ou w ill b e e n title d t o c o sts , r e aso nab le a tto rn ey fees, a ctu al d am ag es, a n d a n a m ount n ot t o e x ceed $ 100.2. H OW EV ER , B E W ARN ED i f y ou c la im a n e x em ptio n, t h e j u dgm en t c re d ito r c an a ls o petitio n t h e c o urt f o r a d ete rm in atio n o f y our e x em ptio n, a n d i f t h e c o urt f in ds t h at y ou c la im ed a n ex em pti o n i n b ad f a ith , y ou w ill b e a sse sse d c o sts a n d r e aso nab le a tto rn ey 's f e es p lu s a n a m ount n ot to e x cee d $ 100.3. I f a fte r r e ceip t o f t h is n otic e, y ou i n b ad f a ith t a k e a ctio n t o f ru str a te t h e g arn is h m en t, th us r e q uir in g t h e j u dgm en t c re d ito r t o p etitio n t h e c o urt t o r e so lv e t h e p ro ble m , y ou w ill b e l ia b le t o the j u d gm en t c re d ito r f o r c o sts a n d r e aso nab le a tto rn ey f e es p lu s a n a m ount n ot t o e x ceed $ 100. D ate d : _ ______ _______________________________________________________Attorney for Petitioner#1 Address#2 AddressCity, State ZipTelephone (____) __________Attorney Reg. No.: ______ - 3 - JU DG M EN T D EBTO R'S E X EM PT IO N C LA IM N O TIC E I h ere b y c la im t h at m y e arn in gs a re e x em pt f ro m e x ecu tio n b ecau se :1 . I a m p re se n tly a r e cip ie n t o f r e lie f b ase d o n n eed . ( S pecif y t h e p ro gra m , c ase n um ber, an d t h e c o unty f ro m w hic h r e lie f i s b ein g r e ceiv ed .) _ _ _____ _______ ______________ ______________P ro gra m Case N um ber ( if k now n) County 2 . I a m n ot n ow r e c eiv in g r e lie f b ase d o n n eed , b ut I h av e r e ceiv ed r e lie f b ase d o n n eed with in t h e l a st s ix m onth s. ( S pecif y t h e p ro gra m , c ase n um ber, a n d t h e c o unty f ro m w hic h r e lie f ha s b een r e ceiv ed .) _ _ _____ _______ ______________ ______________P ro gra m Case N um ber ( if k now n) County 3 . I h av e b een a n i n m ate o f a c o rre ctio nal i n stitu tio n w ith in t h e l a st s ix m onth s. ( S pecif y th e c o rre ctio nal i n stitu tio n a n d l o catio n). _ _ _____ _______ ________ ______ _______________ _____________C orre ctio nal I n stitu tio n Locatio n I h ere b y a u th oriz e a n y a g en cy t h at h as d is tr ib ute d r e lie f t o m e o r a n y c o rre ctio nal i n stitu tio n in w hic h I w as a n i n m ate t o d is c lo se t o t h e a b ove-n am ed j u dgm en t c re d ito r o r t h e j u dgm en t cr e d ito r's a tto rn ey o nly w heth er o r n ot I a m o r h av e b ee n a r e cip ie n t o f r e lie f b ase d o n n eed o r a n in m ate o f a c o rre ctio nal i n stitu tio n w ith in t h e l a st s ix m onth s. I h av e m aile d o r d eliv ere d a c o py o f th is f o rm t o t h e c re d ito r o r t h e c re d ito r's a tto rn ey . D ATED _____ _________ ___________________________ Ju dgm en t D eb to r _______________ ____________________________ ____________________________ _____________