Fill and Sign the Levying Officer File Number Form

[NOT FOR WAGE GARNISHMENT] RETURN TO LEVYING OFFICER. DO NOT FILE WITH COURT Copy all the information required above (except the top left space) from the Notice of Levy . The top left space is for your name or your attorney's name and address. The original and one copy of this form must be filed with the levying officer. DO NOT FILE WITH THE COURT. 1. My name is: 2. Papers should be sent to: my attorney (I have filed with the c ourt and served on the judgment creditor a request that papers be sent to my attorney and my attorney has consented in writing on the request to receive these papers.) shown above following (specify): at the address I am not the judgment debtor named in the notice of levy. The name and last known address of the judgment debtor is (specify): 3. 4. The property I claim to be exempt is (describe): 5. The property is claimed to be ex empt under the following code and section (specify): 6. The facts which support this claim are (describe): The claim is made pursuant to a provision exempting property to the extent necessary for the support of the judgment debtor and the spouse and dependents of the judgment debtor. A Financial Statement form is attached to this claim. 7. The property claimed to be exempt is 8. a motor vehicle, the proceeds of an ex ecution sale of a motor vehicle, or the proceeds of insurance or other indemnification for the loss, damage, or destruction of a motor vehicle. a. tools, implements, materials, unifor ms, furnishings, books, equipment, a commercial motor vehicle, a vessel, or other personal property used in the trade, busine ss or profession of the ju dgment debtor or spouse. b. c. all other property of the same type owned by the judgment debt or, either alone or in co mbination with others, is (describe): The property claimed to be exempt consists of the loan val ue of unmatured life insurance pol icies (including endowment and annuity policies) or benefits from ma tured life insurance policies (including endowment and annuity policies). All other property of the same type owned by the judgment debtor or the spouse of the judgment debtor, eit her alone or in combination with others, is (describe): 9. I declare under penalty of perjury under the laws of the St ate of California that the foregoing is true and correct. Date: CLAIM OF EXEMPTION Form Approved by the Code of Civil Procedure, § 703.520 Judicial Council of California EJ-160 [Rev. January 1, 2009] (Enforcement of Judgment) me. EJ-160 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: CLAIM OF EXEMPTION CASE NUMBER: STREET ADDRESS: MAILING ADDRESS: (Enforcement of Judgment) LEVYING OFFICER FILE NUMBER: FOR COURT USE ONLY FOR LEVYING OFFICER USE ONLY (Levying Officer Name and Address) (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) Page 1 of 1