Fill and Sign the Rules 459 1g and 67 1b Form

APPENDIX VI. NOTICE TO DEBTOR(Rules 4:59-1(g) and 6:7-1(b)) SUPERIOR COURT OF NEW JERSEY LAW DIVISION, SPECIAL CIVIL PART COUNTY Re: v. _____________________________________ Docket No. ________________________ To: , designated defendant: Your asset, automobile (plate number ), or account no. in an amount not to exceed $ at the ______________________________ has been levied upon at the instruction of to satisfy in whole or in part the judgment against you in the above matter. Some property may be exe mpt from execution by Federal and State law, including but not limited to clothi ng and a total of $1,000.00 of cash and personal property, except for goods purchased as part of the transaction which led to the judgment in this case. In addition, welfare benefits, social security benefits, S.S.I. benefits, V.A. benefits, unemployment benefits, workers' compensation bene fits and child support you receive are exempt, even if the funds have been deposited in a bank account. If the levy is against a bank account, the bank has already been notified to place a hold on your account. However, the funds will not be taken from your account until the court so order s. You may claim your exemption by notifying the clerk of the court and the person who ordered this levy of your reasons why your property is exempt. This claim must be in writ ing and if it is not mailed within 10 days of service of this notice, your property is subject to furt her proceedings for execution. The address of the court is: _____________________________. The address of the person who ordered this levy is: . CERTIFICATION OF SERVICE I mailed a copy of this notice to the defendant(s), the clerk of the above named court, and the person who requested the levy on , 20 , the same day this Levy was made. I certify that the foregoing statements made by me are true. I am aware t hat if the foregoing statements made by me are willfully false, I am subject to the punishment. Date: , 20 _________________________________________ (Signature) _________________________________________ (Court Officer) Effective: 09/01/2006, CN: 10812-English