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IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT ___________________ ) ) ) Plaintiff(s), ) vs. ) ) ) ) CASE NO. Defendant(s). ) ) CLAIM OF EXEMPTIONS FOR PROPERTY SUBJECT TO VALUE LIMITS UNDER AS 09.38.020 1. I do not wish to claim exemptions in the property described below. (You must fill out item 2 below.) I do wish to claim exemptions in the property described below. (You must fill out items 2 and 3 below.) 2. The following is a complete description of the property and how much it is worth. Description Value 3. I believe this property is exempt for the following reasons: Date Signature of Debtor Debtor: Keep one copy of this Debtor’s Name (please print) form. Give original and one copy to the Mailing Address City State ZIP court. Daytime Phone NOTICE OF HEARING A hearing on the above claim is set for: Date and Time: Courtroom: Court Address: , Alaska I certify that on , a copy of this claim and notice of hearing was sent to Debtor Clerk and Creditor/Atty: Clerk: CIV-537 (3/00)(st.3) AS 09.38.020, .060, .075 CLAIM OF EXEMPTIONS FOR PROPERTY SUBJECT TO VALUE LIMITS UNDER AS 09.38.020

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