1.1.................... moves to amend H.F. No. 334 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 550.143, is amended to read:
1.4550.143 LEVY ON FUNDS AT A FINANCIAL INSTITUTION.
1.5    Subdivision 1. Procedure. When the sheriff is levying upon funds at a financial
1.6institution, this section must be complied with, in addition to the general provisions set
1.7forth in section 550.135.
1.8    Subd. 2. Disclosure form. Along with the writ of execution and the exemption
1.9notice described in subdivision 3, the sheriff shall serve upon the financial institution an
1.10execution disclosure form which must be substantially in the following form:

1.11	STATE OF MINNESOTA		DISTRICT COURT
1.12	COUNTY OF .....		..... JUDICIAL DISTRICT
1.13	..... (Judgment Creditor)
1.14	against		FINANCIAL INSTITUTIONS
1.15	..... (Judgment Debtor)		EXECUTION
1.16	and		DISCLOSURE
1.17	..... (Third Party)

1.18On the ..... day of ............., ......., the time of service of execution herein, there was
1.19due and owing the judgment debtor from the third party the following:
1.20(1) Money. Enter on the line below any amounts due and owing the judgment debtor,
1.21except earnings, from the third party.
..... 1.22
1.23(2) Setoff. Enter on the line below the amount of any setoff, defense, lien, or claim
1.24which the third party claims against the amount set forth on line (1). State the facts by
1.25which such setoff, defense, lien, or claim is claimed. (Any indebtedness to a third party
1.26incurred by the judgment debtor within ten days prior to the receipt of the first execution
1.27levy on a debt is void as to the judgment creditor.)
..... 2.1
2.2(3) Exemption. Enter on the line below any amounts or property claimed by the
2.3judgment debtor to be exempt from execution.
..... 2.4
2.5(4) Adverse Interest. Enter on the line below any amounts claimed by other persons
2.6by reason of ownership or interest in the judgment debtor's property.
..... 2.7
2.8(5) Enter on the line below the total of lines (2), (3), and (4).
..... 2.9
2.10(6) Enter on the line below the difference obtained (never less than zero) when line
2.11(5) is subtracted from the amount on line (1).
..... 2.12
2.13(7) Enter on the line below 110 percent of the amount of the judgment creditor's
2.14claim which remains unpaid.
..... 2.15
2.16(8) Enter on the line below the lesser of line (6) and line (7). You are hereby
2.17instructed to remit this amount only if it is $10 or more.
..... 2.18
2.20I, ....................... (person signing Affirmation), am the third party or I am authorized
2.21by the third party to complete this nonearnings disclosure, and have done so truthfully
2.22and to the best of my knowledge.

2.23	Dated: .....		.....
2.24			Signature
2.25			.....
2.26			Title
2.27			.....
2.28			Telephone Number

2.29    Subd. 3. Exemption notice. If the levy is on funds of a judgment debtor who is a
2.30natural person and if the funds to be levied are held on deposit at any financial institution,
2.31the judgment creditor or its attorney shall provide the sheriff with two copies of an
2.32exemption notice, which must be substantially in the form set forth below. The sheriff
2.33shall serve both copies of the exemption notice on the financial institution, along with the
2.34writ of execution. Failure of the sheriff to serve the exemption notices renders the levy
2.35void, and the financial institution shall take no action. However, if this subdivision is
2.36being used to execute on funds that have previously been garnished in compliance with
2.37section 571.71, the judgment creditor is not required to serve additional exemption notices.
3.1In that event, the execution levy shall only be effective as to the funds that were subject
3.2to the prior garnishment. Upon receipt of the writ of execution and exemption notices,
3.3the financial institution shall retain as much of the amount due under section 550.04 as
3.4the financial institution has on deposit owing to the judgment debtor, but not more than
3.5110 percent of the amount remaining due on the judgment.

3.6	STATE OF MINNESOTA				DISTRICT COURT
3.7	COUNTY OF .....				..... JUDICIAL DISTRICT
3.8 3.9	.....	(Judgment Creditor)
3.10	.....	(Judgment Debtor)
3.11	TO: Debtor				EXEMPTION NOTICE

3.12An order for attachment, garnishment summons, or levy of execution (strike
3.13inapplicable language) has been served on ............. (Bank or other financial institution
3.14where you have an account.)
3.15Your account balance is $........
3.16The amount being held is $........
3.17However, all or a portion of the funds in your account will normally be exempt from
3.18creditors' claims if they are in one of the following categories:
3.19(1) relief based on need. This includes the Minnesota Family Investment Program
3.20(MFIP), Emergency Assistance (EA), Work First Program, Medical Assistance (MA),
3.21General Assistance (GA), General Assistance Medical Care (GAMC), Emergency General
3.22Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA Emergency Assistance
3.23(MSA-EA), Supplemental Security Income (SSI), and Energy Assistance;
3.24(2) Social Security benefits (Old Age, Survivors, or Disability Insurance);
3.25(3) unemployment benefits, workers' compensation, or veterans' benefits;
3.26(4) an accident, disability, or retirement pension or annuity;
3.27(5) life insurance proceeds;
3.28(6) the earnings of your minor child and any child support paid to you; or
3.29(7) money from a claim for damage or destruction of exempt property (such as
3.30household goods, farm tools, business equipment, a mobile home, or a car).
3.31The following funds are also exempt:
3.32(8) all earnings of a person in category (1);
3.33(9) all earnings of a person who has received relief based on need, or who has been
3.34an inmate of a correctional institution, within the last six months;
3.35(10) 75 percent of every debtor's after tax earnings; and
3.36(11) all of a judgment debtor's after tax earnings below 40 times the federal
3.37minimum wage.
4.1TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:
4.2Categories (10) and (11): 20 days
4.3Categories (8) and (9): 60 days
4.4All others: no time limit, as long as funds are traceable to the exempt source. (In
4.5tracing funds, the first-in, first-out method is used. This means money deposited first
4.6is spent first.) The money being sought by the judgment creditor is being held in your
4.7account to give you a chance to claim an exemption.
4.8TO CLAIM AN EXEMPTION:
4.9Fill out, sign, and mail or deliver one copy of the attached exemption claim form to
4.10the institution which sent you this notice and mail or deliver one copy to the judgment
4.11creditor's attorney. In the event that there is no attorney for the judgment creditor, then
4.12the notice shall be sent directly to the judgment creditor. The address for the judgment
4.13creditor's attorney or the judgment creditor is set forth below. Both copies must be
4.14mailed or delivered on the same day.
4.15NOTE: You may help resolve your claim faster if you send to the creditor's
4.16attorney written proof or documents that show why your money is exempt. If
4.17you have questions regarding the documents to send as proof of an exemption,
4.18call the creditor's attorney. If you do not send written proof and the creditor's
4.19attorney has questions about your exemption claim, the creditor's attorney
4.20may object to your claim which may result in a further delay in releasing your
4.21exempt funds.
4.22If the financial institution does not get the exemption claim back from you within 14
4.23days of the date they mailed or gave it to you, they will be free to turn the money over to
4.24the sheriff or the judgment creditor. If you are going to claim an exemption, do so as soon
4.25as possible, because your money may be held until it is decided.
4.26IF YOU CLAIM AN EXEMPTION:
4.27(1) nonexempt money can be turned over to the judgment creditor or sheriff;
4.28(2) the financial institution will keep holding the money claimed to be exempt; and
4.29(3) seven days after receiving your exemption claim, the financial institution will
4.30release the money to you unless before then it receives an objection to your exemption
4.31claim.
4.32IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM:
4.33the institution will hold the money until a court decides if your exemption claim is
4.34valid, BUT ONLY IF the institution gets a copy of your court motion papers asserting
4.35the exemption WITHIN TEN DAYS after the objection is personally served on you, or
5.1within 13 days from the date the objection is mailed to you. You may wish to consult an
5.2attorney at once if the creditor objects to your exemption claim.
5.3MOTION TO DETERMINE EXEMPTION:
5.4At any time after your funds have been held, you may ask for a court decision on the
5.5validity of your exemption claim by filing a request for hearing which may be obtained
5.6at the office of the court administrator of the above court.
5.7PENALTIES:
5.8If you claim an exemption in bad faith, or if the judgment creditor wrongly objects
5.9to an exemption in bad faith, the court may order the person who acted in bad faith to pay
5.10costs, actual damages, attorney fees, and an additional amount of up to $100.

5.11		.....
5.12		.....
5.13		.....
5.14		.....
5.15 5.16		Name and address of (Attorney for) Judgment Creditor

5.17EXEMPTION:
5.18(a) Amount of exemption claim.
5.19/ / I claim ALL the funds being held are exempt.
5.20/ / I claim SOME of the funds being held are exempt.

5.21

The exempt amount is $ .....

5.22(b) Basis for exemption.
5.23Of the 11 categories listed above, I am in category number ............ (If more than one
5.24category applies, you may fill in as many as apply.) The source of the exempt funds is
5.25the following:

5.26	.....
5.27	.....
5.28	.....

5.29(If the source is a type of relief based on need, list the case number and county:
5.30case number: ...............;
5.31county: ....................)
5.32I hereby authorize any agency that has distributed relief to me or any correctional
5.33institution in which I was an inmate to disclose to the above named creditor or its attorney
5.34only whether or not I am or have been a recipient of relief based on need or an inmate of a
5.35correctional institute within the last six months.
5.36I have mailed or delivered a copy of the exemption notice to the judgment creditor
5.37or judgment creditor's attorney if represented at the address indicated above.

6.1			.....
6.2			DEBTOR
6.3	DATED: .....		.....
6.4			.....
6.5			.....
6.6			DEBTOR ADDRESS
6.7			.....
6.8			DEBTOR TELEPHONE NUMBER

6.9	STATE OF MINNESOTA				DISTRICT COURT
6.10	COUNTY OF .....				JUDICIAL DISTRICT
6.11	.....	(Creditor)
6.12	.....	(Debtor)
6.13 6.14	.....	(Financial institution)

6.17The Creditor has frozen money in your account at your financial institution. The
6.18account is frozen for 14 days from the date of this notice.
6.19Some of your money in your account may be protected (the legal word is
6.20exempt). You may be able to get it sooner than 14 days if you act quickly and follow
6.21the instructions on the next page.
6.22The attached form lists some different sources of money in your account that are
6.23protected. If your money is from one or more of these sources, check the box on the
6.24form next to the sources of your money. If it is from one of these sources, the Creditor
6.25cannot take it.
6.26BUT, you must follow the instructions and return the exemption form and
6.27copies of your bank statements from the last 60 days to have the bank unfreeze your
6.28money. If you do not follow the instructions or your creditor gets an order from the court
6.29or writ of execution, your financial institution will give the money to the Creditor. If that
6.30happens and it is protected, you can still get it back from the creditor later, but that is not
6.31as easy to do as filling in the form now.
6.33    Subd. 3a. Form of Instructions. The instructions must be substantially in the
6.34following form.
6.36Note: The creditor is who you owe the money to. You are the debtor.
6.371. Fill out the attached exemption form in this packet.
7.1If you check one of the boxes, you should also give proof that shows that some
7.2or all of the money in your account is from one or more of the protected sources.
7.3Creditors may ask for a hearing if they question your exemptions. To avoid a hearing:
7.4Case numbers should be added to the form. Copies of documents should be
7.5sent with the form.
7.6NOTICE: You must send copies of your bank statements for the past 60 days
7.7before the garnishment. If you do not send bank statements with your exemption
7.8claim the financial institution may release your money to the creditor.
7.92. Sign the exemption form. Make 3 copies. Keep 1 for yourself.
7.102. Mail or deliver the other copies of the form by (insert date).
7.11BOTH COPIES MUST BE MAILED OR DELIVERED THE SAME DAY.
7.121 copy of the form goes to:

7.13	.....
7.14	(Insert name of creditor or creditor's attorney)
7.15	.....
7.16	(Insert address of creditor or creditor's attorney)

7.171 copy goes to:

7.18	.....
7.19	(Insert name of bank)
7.20	.....
7.21	(Insert address of the bank)

7.23If You Do Not Send in the Exemption Form and Bank Statements:
7.2414 days after the date of this letter some or all of your money may be turned over to
7.25the creditor or to the sheriff pursuant to Minnesota Statute.
7.26If You Send in the Exemption Form and Bank Statements:
7.27Any money that is NOT protected can be turned over to the creditor or the sheriff.
7.28If the Creditor Does Not Object:
7.29The financial institution will unfreeze your money 6 business days after they get
7.30your completed form.
7.31If the Creditor Objects:
7.32The money you have said is protected on the form will be held by the bank. The
7.33creditor has 6 business days to object (disagree) and ask the court to hold a hearing. You
7.34will receive a Notice of Objection and a Notice of Hearing.
7.35The financial institution will hold the money until a court decides whether your
7.36money is protected or not.
8.1You may want to talk to a lawyer for advice about this process. If you are low
8.2income you can call Legal Aid.
8.3PENALTIES:
8.4If you claim that your money is protected and a court decides you made that claim
8.5in bad faith, the court can order you to pay costs, actual damages, attorney fees, and an
8.6additional amount of up to $100. For example: it may be bad faith if you claim you
8.7receive government benefits that you do not receive.
8.8If the creditor made a bad faith objection to your claim that your money is protected,
8.9the court can order them to pay costs, actual damages, attorney fees, and an additional
8.10amount of up to $100.
8.11    Subd. 3b. Form of exemption form. The exemption form must be substantially in
8.12the following form:

8.14	A.	HOW MUCH MONEY IS PROTECTED
8.15	.....	I claim ALL or SOME of the money being frozen by the bank is protected.
8.16	.....	The amount I claim is protected is $.......
8.17	B.	WHY THE MONEY IS PROTECTED
8.18 8.19		My money is protected because I get it from 1 or more of the following places (Check all that apply)
8.20	.....	Government benefits
8.21 8.22 8.23 8.24 8.25 8.26		Government benefits include: MFIP - Minnesota Family Investment Program, GA - General Assistance, EA - Emergency Assistance, MA - Medical Assistance, GAMC - General Assistance Medical Care, EGA - Emergency General Assistance, MSA - Minnesota Supplemental Aid, MSA-EA - MSA Emergency Assistance, SSI - Supplemental Security Income, MinnesotaCare, Medicare Part B Premium payments, Medicare Part D Extra Help, Energy Assistance.
8.27	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
8.28	.....
8.29	LIST THE CASE NUMBER AND COUNTY
8.30		Case Number: .....
8.31		County: .....
8.32	.....	Social Security benefits
8.33	.....	Unemployment benefits
8.34	.....	Workers' Compensation
8.35	.....	Veterans' benefits
8.36 8.37 8.38		If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, Unemployment, Workers Compensation or Veteran's benefits.
8.39	.....	Other Assistance based on need
8.40 8.41	You may have assistance based on need from another source that is not on the list. If you do, check this box, and fill in the source of your money in the line below:
8.42	Source:	.....
8.43	Include copies of any documents you have that show the source of this money.
9.1	.....	All of your earnings (Wages) because:
9.2		You get government benefits (see list of government benefits)
9.3		You currently receive other assistance based on need
9.4		You have received government benefits in the last 6 months
9.5		You were in jail or prison in the last 6 months
9.6 9.7 9.8 9.9		If you check this box, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK STATEMENTS that show what was in your account for the 60 days right before the bank froze your money.
9.10	.....	Some of your earnings (Wages)
9.11 9.12 9.13		If you did not check the box for all earnings, some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of the two below:
9.14		75% of your wages (after taxes are taken out); or
9.15		(insert the sum of the current federal minimum wage) multiplied by 40.
9.16 9.17		The money from the following may also be exempt for 20 days after they are deposited in your account.
9.18	.....	An accident, disability, or retirement pension or annuity
9.19	.....	Payments to you from a life insurance policy
9.20	.....	Earnings of your child who is under 18 years of age
9.21	.....	Child support
9.22 9.23 9.24 9.25	.....	Money paid to you from a claim for damage or destruction of property. Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture or appliances.
9.26	.....	Death benefits paid to you.

9.27I give permission to any agency that has given me cash benefits to give information
9.28about my benefits to the above named creditor, or its attorney. The information will ONLY
9.29concern whether I get benefits or not, or whether I have gotten them in the past 6 months.
9.30If I was an inmate in the last 6 months, I give my permission to the correctional
9.31institution to tell the above named creditor that I was an inmate there.
9.32YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S
9.33ATTORNEY AND THE BANK. FILL IN THE BLANKS BELOW AND GO BACK
9.34TO THE INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
9.35I have mailed or delivered a copy of this form to:

9.36	.....
9.37	(Insert name of creditor or creditor's attorney)
9.38	.....
9.39	(Insert address of creditor or creditor's attorney)

9.40I have also mailed or delivered a copy of this exemption form to my bank at the
9.41address listed in the instructions.

10.1	DATED: .....	.....
10.2		DEBTOR
10.3		.....
10.4		DEBTOR ADDRESS
10.5		.....
10.6		DEBTOR TELEPHONE NUMBER

10.7    Subd. 4. Effect of exemption notice. Within two business days after receipt of
10.8the writ of execution and exemption notices, the financial institution shall serve upon
10.9the judgment debtor two copies of the exemption notice. The financial institution shall
10.10serve the notice by first class mail to the last known address of the judgment debtor. If
10.11no claim of exemption is received by the financial institution within 14 days after the
10.12exemption notices are mailed to the judgment debtor, the funds remain subject to the
10.13execution levy and shall be remitted to the sheriff within seven six business days. If the
10.14judgment debtor elects to claim an exemption, the judgment debtor shall complete the
10.15exemption notice, sign it under penalty of perjury, and deliver one copy to the financial
10.16institution and one copy to the attorney for the judgment creditor within 14 days of the
10.17date postmarked on the correspondence mailed to the debtor containing the exemption
10.18notices. The judgment debtor is also required to include copies of bank statements for
10.19the prior 60 days with the exemption notice. In the event that there is no attorney for the
10.20judgment creditor, then the notice must be sent directly to the judgment creditor. Failure
10.21of the judgment debtor to deliver the executed exemption notice or copies of the required
10.22bank statements for the prior 60 days does not constitute a waiver of any claimed right
10.23to an exemption. Upon timely receipt of a claim of exemption, funds not claimed to be
10.24exempt by the debtor remain subject to the execution levy. All money claimed to be
10.25exempt shall be released to the judgment debtor upon the expiration of seven six business
10.26days after the date postmarked on the envelope containing the executed exemption
10.27notice mailed to the financial institution, or the date of personal delivery of the executed
10.28exemption notice to the financial institution, unless within that time the judgment creditor
10.29interposes an objection to the exemption.
10.30    Subd. 5. Objection to exemption claim and request for hearing. An objection
10.31shall be interposed, within six business days of receipt by the creditor of an exemption
10.32claim from the debtor, by mailing or delivering one copy of the written objection Notice of
10.33Objection and Notice of Hearing to the financial institution and one copy of the written
10.34objection Notice of Objection and Notice of Hearing to the judgment debtor along with a
10.35copy of the judgment debtor's claimed exemption form. Both copies of an objection to an
10.36exemption claim shall be mailed or delivered on the same date. The financial institution
11.1may rely on the date of mailing or delivery of a notice to it in computing any time periods
11.2in this section. The written objection Notice of Objection and Notice of Hearing must be
11.3substantially in the form specified in subdivision 7.
11.4The court administrator may charge a fee of $1 for the filing of a Notice of Objection
11.5and Notice of Hearing. Upon the filing of a Notice of Objection and Notice of Hearing,
11.6the court administrator shall schedule the matter for hearing no sooner than five business
11.7days but no later than seven business days from the date of filing. A debtor may request
11.8continuance of the hearing by notifying the creditor and the court. The court shall schedule
11.9the continued hearing within seven days of the original hearing date.
11.10An order stating whether the debtor's funds are exempt shall be issued by the court
11.11within three days of the date of the hearing.
11.12    Subd. 6. Duties of financial institution if objection is made to exemption claim.
11.13Upon receipt of a written objection Notice of Objection and Notice of Hearing from
11.14the judgment creditor or its attorney within the specified seven-day six-day period, the
11.15financial institution shall retain the funds claimed to be exempt. Unless the financial
11.16institution receives a request for hearing and notice of hearing from the judgment debtor
11.17asserting exemption rights within ten days after receipt of a written objection to the
11.18exemption, the funds remain subject to the execution levy as if no claim of exemption had
11.19been made and shall be remitted to the sheriff within seven days. If a request for hearing
11.20and notice of hearing to determine the validity of a claim of exemption is received by the
11.21financial institution within the period provided, it The financial institution shall retain the
11.22funds claimed to be exempt until otherwise ordered by the court, upon mutual agreement
11.23of the parties, or until the garnishment lapses pursuant to section 571.79.
11.24    Subd. 7. Form of Notice of Objection and Notice of Hearing. (a) The written
11.25objectionWritten Objection and Notice of Hearing to the judgment debtor's claim of
11.26exemption must be in substantially the following form:

11.27	STATE OF MINNESOTA				DISTRICT COURT
11.28	COUNTY OF .....				..... JUDICIAL DISTRICT
11.29 11.30	.....	(Judgment Creditor)				OBJECTION TO
11.31	.....	(Judgment Debtor)			EXEMPTION CLAIM
11.32 11.33	.....	(Garnishee) (Third Party)

11.34The judgment creditor objects to your claim for exemption from garnishment,
11.35levy of execution, order for attachment (strike inapplicable language) for the following
11.36reason(s):
..... ..... 11.37
..... 12.1
12.2Because of this objection, your financial institution will retain the funds you claimed
12.3to be exempt for an additional ten days. If you wish to request a hearing on your exemption
12.4claim, you need to do so within ten days from the date the objection was personally served
12.5on you, or within 13 days of the date the objection was mailed to you. You may request a
12.6hearing by completing the attached form and filing it with the court administrator.
12.71. The court administrator's office shall provide clerical assistance to help with the
12.8writing and filing of a Request for Hearing by any person not represented by counsel. The
12.9court administrator may charge a fee of $1 for the filing of a Request for Hearing.
12.102. Upon the filing of a Request for Hearing, the court administrator shall schedule
12.11the matter for a hearing no later than five business days from the date of filing. The court
12.12administrator shall forthwith send a completed copy of the request, including the hearing
12.13date, time, and place to the adverse party and to the financial institution by first class mail.
12.143. If it is possible that the financial institution might not receive the request mailed
12.15from the court administrator within ten days, then you may want to personally deliver a
12.16copy of the request to the financial institution after you have filed your request with the
12.17court.
12.184. An order stating whether your funds are exempt shall be issued by the court
12.19within three days of the date of the hearing.
12.20If you do not file a Request for Hearing within ten days of the date the objection was
12.21personally served on you, or within 13 days from the date the objection was mailed to you,
12.22your financial institution may turn your funds over to your creditor.
12.23If you file a Request for Hearing and your financial institution receives it within ten
12.24days of the date it received this objection, your financial institution will retain your funds
12.25claimed to be exempt until otherwise ordered by the court.

12.26		.....
12.27		Judgment Creditor or Attorney

12.28	STATE OF MINNESOTA	DISTRICT COURT
12.29	COUNTY OF	.....
12.30	.....	JUDICIAL DISTRICT
12.31	.....
12.32	(Creditor)
12.33 12.34	.....	CREDITOR'S NOTICE OF OBJECTION AND NOTICE OF HEARING
12.35	(Debtor)
12.36	.....	ON EXEMPTION CLAIM
12.37	(Financial Institution)
12.38		(DEBTOR)
13.1		.....
13.2		ADDRESS
13.3		.....
13.4	.....	.....
13.5	.....
13.6	.....
13.7 13.8	(CREDITOR OR CREDITOR'S ATTORNEY)
13.9		.....
13.10 13.11 13.12 13.13		This Notice of Objection and Notice of Hearing is made by the creditor objecting to your exemption claim. This hearing is to resolve your exemption claim.
13.14	Hearing Date:	.....
13.15	Time:
13.16	Hearing Place:	.....

13.17The creditor objects to your claim of exemption from garnishment, levy of execution,
13.18order for attachment (strike inapplicable language) for the following reason(s):

13.19	.....
13.20	.....
13.21	.....

13.22(Note to both parties: Bring with you to the hearing all documents and materials
13.23relevant to the exemption claim. Failure to do so could delay the court's decision.)
13.24If the creditor receives all documents and materials relevant to the exemption claim
13.25before the hearing date they may agree with your exemption claim and you can avoid
13.26a hearing.
13.27Because a court hearing will be held on your claim that your funds are protected,
13.28your financial institution will retain the funds until it receives an Order from the court.
13.29    Subd. 8. Request for hearing and notice for hearing. The request for hearing
13.30accompanying the objection notice must be in substantially the following form:

13.31	STATE OF MINNESOTA				DISTRICT COURT
13.32	COUNTY OF .....				..... JUDICIAL DISTRICT
13.33 13.34	.....	(Judgment Creditor)			REQUEST FOR HEARING
13.35	.....	(Judgment Debtor)				AND
13.36	.....	(Third Party)			NOTICE FOR HEARING

13.37I hereby request a hearing to resolve the exemption claim which has been made
13.38in this case regarding funds in the account of ............. (Judgment Debtor) at the .........
13.39(Financial Institution).
13.40    I believe the property being held is exempt because
..... 14.1    
..... 14.2

14.3	Dated: .....
14.4			(JUDGMENT DEBTOR)
14.5			.....
14.6			(ADDRESS)
14.7			.....
14.8			(DEBTOR PHONE NUMBER)
14.9			.....
14.10	HEARING DATE: .....		TIME: .....
14.11	HEARING PLACE: .....

14.12(Note to both parties: Bring with you to the hearing all documents and materials
14.13relevant to the exemption claim and objection. Failure to do so could delay the court's
14.14decision.)
14.15    Subd. 9. Release of funds. At any time during the procedure specified in this
14.16section, the judgment debtor or the judgment creditor may, by a writing dated after the
14.17service of the execution, direct the sheriff to release the funds in question to the other
14.18party. Upon receipt of a release, the sheriff shall release the funds as directed.
14.19    Subd. 10. Subsequent proceedings; bad faith claims. If in subsequent proceedings
14.20brought by the judgment debtor or the judgment creditor, the claim of exemption is
14.21not upheld, and the court finds that it was asserted in bad faith, the judgment creditor
14.22shall be awarded actual damages, costs, and reasonable attorney fees resulting from the
14.23additional proceedings, and an amount not to exceed $100. It is not considered bad faith
14.24for a judgment creditor to object to an improperly completed or incomplete exemption
14.25claim. If the claim of exemption is upheld, and the court finds that the judgment creditor
14.26disregarded the claim of exemption in bad faith, the judgment debtor shall be awarded
14.27costs, reasonable attorney fees, actual damages, and an amount not to exceed $100. The
14.28underlying judgment must be modified to reflect assessment of damages, costs, and
14.29attorney fees. However, if the party in whose favor a penalty assessment is made is not
14.30actually indebted to the party's attorney for fees, the attorney's fee award shall be made
14.31directly to the attorney and, if not paid, an appropriate judgment in favor of the attorney
14.32shall be entered. Upon motion of any party in interest, on notice, the court shall determine
14.33the validity of any claim of exemption, and may make any order necessary to protect the
14.34rights of those interested. No financial institution is liable for damages for complying with
14.35this section. Both copies of an exemption claim or an objection to an exemption claim
14.36must be mailed or delivered on the same date. The financial institution may rely on the
14.37date of mailing or delivery of a notice to it in computing any time periods in this section.

15.1    Sec. 2. Minnesota Statutes 2008, section 550.37, subdivision 14, is amended to read:
15.2    Subd. 14. Public assistance. All relief government assistance based on need, and
15.3the earnings or salary of a person who is a recipient of relief government assistance based
15.4on need, shall be exempt from all claims of creditors including any contractual setoff
15.5or security interest asserted by a financial institution. For the purposes of this chapter,
15.6relief government assistance based on need includes MFIP, work first, general assistance
15.7medical care, supplemental security income, medical assistance, Minnesota supplemental
15.8assistance, and general assistancebut is not limited to Minnesota Family Investment
15.9Program, General Assistance Medical Care, Supplemental Security Income, Medical
15.10Assistance, MinnesotaCare, payment of Medicare Part B premiums or receipt of Part D
15.11extra help, Diversionary Work Program, Work Participation Cash Benefit, Minnesota
15.12Supplemental Assistance, Emergency Minnesota Supplemental Assistance, and General
15.13Assistance, Emergency General Assistance, Emergency Assistance or county crisis funds,
15.14fuel assistance, and Food Support. . The salary or earnings of any debtor who is or has
15.15been an eligible recipient of relief government assistance based on need, or an inmate of a
15.16correctional institution shall, upon the debtor's return to private employment or farming
15.17after having been an eligible recipient of relief government assistance based on need, or an
15.18inmate of a correctional institution, be exempt from attachment, garnishment, or levy of
15.19execution for a period of six months after the debtor's return to employment or farming
15.20and after all public assistance for which eligibility existed has been terminated. The
15.21exemption provisions contained in this subdivision also apply for 60 days after deposit
15.22in any financial institution, whether in a single or joint account. In tracing the funds, the
15.23first-in first-out method of accounting shall be used. The burden of establishing that funds
15.24are exempt rests upon the debtor. Agencies distributing relief government assistance and
15.25the correctional institutions shall, at the request of creditors, inform them whether or not
15.26any debtor has been an eligible recipient of relief government assistance based on need, or
15.27an inmate of a correctional institution, within the preceding six months.

15.28    Sec. 3. Minnesota Statutes 2008, section 551.05, is amended to read:
15.29551.05 ATTORNEY'S SUMMARY EXECUTION UPON FUNDS AT A
15.30FINANCIAL INSTITUTION.
15.31    Subdivision 1. Procedure. When levying upon funds at a financial institution,
15.32this section must be complied with, in addition to the general provisions specified in
15.33section 551.04.
15.34    Subd. 1a. Exemption notice. If the writ of execution is being used by the attorney
15.35to levy funds of a judgment debtor who is a natural person and if the funds to be levied are
16.1held on deposit at any financial institution, the attorney for the judgment creditor shall
16.2serve with the writ of execution two copies of an exemption notice. The notice must be
16.3substantially in the form set forth below. Failure of the attorney for the judgment creditor
16.4to send the exemption notice renders the execution levy void, and the financial institution
16.5shall take no action. However, if this subdivision is being used to execute on funds that
16.6have previously been garnished in compliance with section 571.71, the attorney for
16.7judgment creditor is not required to serve an additional exemption notice. In that event,
16.8the execution levy shall only be effective as to the funds that were subject to the prior
16.9garnishment. Upon receipt of the writ of execution and exemption notices, the financial
16.10institution shall retain as much of the amount due under section 550.04 as the financial
16.11institution has on deposit owing to the judgment debtor, but not more than 100 percent of
16.12the amount remaining due on the judgment, or $10,000, whichever is less.
16.13The notice informing a judgment debtor that an execution levy has been used
16.14to attach funds of the judgment debtor to satisfy a claim must be substantially in the
16.15following form:

16.16	STATE OF MINNESOTA				DISTRICT COURT
16.17	County of .....				..... JUDICIAL DISTRICT
16.18 16.19	.....	(Judgment Creditor)
16.20	.....	(Judgment Debtor)
16.21	TO: Judgment Debtor				EXEMPTION NOTICE

16.22An order for attachment, garnishment summons, or levy of execution (strike
16.23inapplicable language) has been served on ............. (bank or other financial institution
16.24where you have an account).
16.25Your account balance is $........
16.26The amount being held is $........
16.27However, all or a portion of the funds in your account will normally be exempt from
16.28creditors' claims if they are in one of the following categories:
16.29(1) relief based on need. This includes the Minnesota Family Investment Program
16.30(MFIP), Work First Program, Medical Assistance (MA), General Assistance (GA),
16.31General Assistance Medical Care (GAMC), Emergency General Assistance (EGA),
16.32Minnesota Supplemental Aid (MSA), MSA Emergency Assistance (MSA-EA),
16.33Supplemental Security Income (SSI), and Energy Assistance;
16.34(2) Social Security benefits (Old Age, Survivors, or Disability Insurance);
16.35(3) unemployment benefits, workers' compensation, or veterans' benefits;
16.36(4) an accident, disability, or retirement pension or annuity;
16.37(5) life insurance proceeds;
17.1(6) the earnings of your minor child and any child support paid to you; or
17.2(7) money from a claim for damage or destruction of exempt property (such as
17.3household goods, farm tools, business equipment, a mobile home, or a car).
17.4The following funds are also exempt:
17.5(8) all earnings of a person in category (1);
17.6(9) all earnings of a person who has received relief based on need, or who has been
17.7an inmate of a correctional institution, within the last six months;
17.8(10) 75 percent of every judgment debtor's after tax earnings; or
17.9(11) all of a judgment debtor's after tax earnings below 40 times the federal
17.10minimum wage.
17.11TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:
17.12Categories (10) and (11): 20 days
17.13Categories (8) and (9): 60 days
17.14All others: no time limit, as long as funds are traceable to the exempt source. (In
17.15tracing funds, the first-in, first-out method is used. This means money deposited first
17.16is spent first.) The money being sought by the judgment creditor is being held in your
17.17account to give you a chance to claim an exemption.
17.18TO CLAIM AN EXEMPTION:
17.19Fill out, sign, and mail or deliver one copy of the attached exemption claim form to
17.20the institution which sent you this notice and mail or deliver one copy to the judgment
17.21creditor's attorney. The address for the judgment creditor's attorney is set forth below.
17.22Both copies must be mailed or delivered on the same day.
17.23NOTE: You may help resolve your claim faster if you send to the creditor's
17.24attorney written proof or documents that show why your money is exempt. If
17.25you have questions regarding the documents to send as proof of an exemption,
17.26call the creditor's attorney. If you do not send written proof and the creditor's
17.27attorney has questions about your exemption claim, the creditor's attorney
17.28may object to your claim which may result in a further delay in releasing your
17.29exempt funds.
17.30If they do not get the exemption claim back from you within 14 days of the date
17.31they mailed or gave it to you, they will be free to turn the money over to the attorney for
17.32the judgment creditor. If you are going to claim an exemption, do so as soon as possible,
17.33because your money may be held until it is decided.
17.34IF YOU CLAIM AN EXEMPTION:
17.35(1) nonexempt money can be turned over to the judgment creditor or sheriff;
17.36(2) the financial institution will keep holding the money claimed to be exempt; and
18.1(3) seven days after receiving your exemption claim, the financial institution will
18.2release the money to you unless before then it receives an objection to your exemption
18.3claim.
18.4IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM:
18.5the institution will hold the money until a court decides if your exemption claim is
18.6valid, BUT ONLY IF the institution gets a copy of your court motion papers asserting the
18.7exemption WITHIN TEN DAYS after the objection is personally served on you, or within
18.813 days from the date the objection is mailed to you. You may wish to consult an attorney
18.9at once if the judgment creditor objects to your exemption claim.
18.10MOTION TO DETERMINE EXEMPTION:
18.11At any time after your funds have been held, you may ask for a court decision on the
18.12validity of your exemption claim by filing a request for hearing which may be obtained
18.13at the office of the court administrator of the above court.
18.14PENALTIES:
18.15If you claim an exemption in bad faith, or if the judgment creditor wrongly objects
18.16to an exemption in bad faith, the court may order the person who acted in bad faith to pay
18.17costs, actual damages, attorney fees, and an additional amount of up to $100.

18.18		.....
18.19		.....
18.20		.....
18.21		.....
18.22 18.23		Name and address of (Attorney for) Judgment Creditor

18.24EXEMPTION:
18.25(a) Amount of exemption claim.
18.26/ / I claim ALL the funds being held are exempt.
18.27/ / I claim SOME of the funds being held are exempt.

18.28

The exempt amount is $ .....

18.29(b) Basis for exemption.
18.30Of the 11 categories listed above, I am in category number ............ (If more than one
18.31category applies, you may fill in as many as apply.) The source of the exempt funds is
18.32the following:
..... 18.33
..... 18.34
..... 18.35
18.36(If the source is a type of relief based on need, list the case number and county:
18.37case number: ...............;
19.1county: ....................)
19.2I hereby authorize any agency that has distributed relief to me or any correctional
19.3institution in which I was an inmate to disclose to the above named judgment creditor's
19.4attorney only whether or not I am or have been a recipient of relief based on need or an
19.5inmate of a correctional institute within the last six months.
19.6I have mailed or delivered a copy of the exemption notice to the judgment creditor's
19.7attorney at the address indicated above.

19.8			.....
19.9			DEBTOR
19.10	DATED: .....		.....
19.11			.....
19.12			.....
19.13			DEBTOR ADDRESS
19.14			.....
19.15			DEBTOR TELEPHONE NUMBER

19.16	STATE OF MINNESOTA				DISTRICT COURT
19.17	COUNTY OF .....				JUDICIAL DISTRICT
19.18	.....	(Creditor)
19.19	.....	(Debtor)
19.20 19.21	.....	(Financial institution)

19.24The Creditor has frozen money in your account at your financial institution. The
19.25account is frozen for 14 days from the date of this notice.
19.26Some of your money in your account may be protected (the legal word is
19.27exempt). You may be able to get it sooner than 14 days if you act quickly and follow
19.28the instructions on the next page.
19.29The attached form lists some different sources of money in your account that are
19.30protected. If your money is from one or more of these sources, check the box on the
19.31form next to the sources of your money. If it is from one of these sources, the Creditor
19.32cannot take it.
19.33BUT, you must follow the instructions and return the exemption form and
19.34copies of your bank statements from the last 60 days to have the bank unfreeze your
19.35money. If you do not follow the instructions or your creditor gets an order from the court
19.36or writ of execution, your financial institution will give the money to the Creditor. If that
19.37happens and it is protected, you can still get it back from the creditor later, but that is not
19.38as easy to do as filling in the form now.
20.2    Subd. 1a. Form of instructions. The instructions must be substantially in the
20.3following form.
20.5Note: The creditor is who you owe the money to. You are the debtor.
20.61. Fill out the attached exemption form in this packet.
20.7If you check one of the boxes, you should also give proof that shows that some
20.8or all of the money in your account is from one or more of the protected sources.
20.9Creditors may ask for a hearing if they question your exemptions. To avoid a hearing:
20.10Case numbers should be added to the form. Copies of documents should be
20.11sent with the form.
20.12NOTICE: You must send copies of your bank statements for the past 60 days
20.13before the garnishment. If you do not send bank statements with your exemption
20.14claim the financial institution may release your money to the creditor.
20.152. Sign the exemption form. Make 3 copies. Keep 1 for yourself.
20.162. Mail or deliver the other copies of the form by (insert date).
20.17BOTH COPIES MUST BE MAILED OR DELIVERED THE SAME DAY.
20.181 copy of the form goes to:

20.19	.....
20.20	(Insert name of creditor or creditor's attorney)
20.21	.....
20.22	(Insert address of creditor or creditor's attorney)

20.231 copy goes to:

20.24	.....
20.25	(Insert name of bank)
20.26	.....
20.27	(Insert address of the bank)

20.29If You Do Not Send in the Exemption Form and Bank Statements:
20.3014 days after the date of this letter some or all of your money may be turned over to
20.31the creditor or to the sheriff pursuant to Minnesota Statute.
20.32If You Send in the Exemption Form and Bank Statements:
20.33Any money that is NOT protected can be turned over to the creditor or the sheriff.
20.34If the Creditor Does Not Object:
20.35The financial institution will unfreeze your money 6 business days after they get
20.36your completed form.
20.37If the Creditor Objects:
21.1The money you have said is protected on the form will be held by the bank. The
21.2creditor has 6 business days to object (disagree) and ask the court to hold a hearing. You
21.3will receive a Notice of Objection and a Notice of Hearing.
21.4The financial institution will hold the money until a court decides whether your
21.5money is protected or not.
21.6You may want to talk to a lawyer for advice about this process. If you are low
21.7income you can call Legal Aid.
21.8PENALTIES:
21.9If you claim that your money is protected and a court decides you made that claim
21.10in bad faith, the court can order you to pay costs, actual damages, attorney fees, and an
21.11additional amount of up to $100. For example: it may be bad faith if you claim you
21.12receive government benefits that you do not receive.
21.13If the creditor made a bad faith objection to your claim that your money is protected,
21.14the court can order them to pay costs, actual damages, attorney fees, and an additional
21.15amount of up to $100.
21.16    Subd. 1b. Form of exemption form. The exemption form must be substantially in
21.17the following form:

21.19	A.	HOW MUCH MONEY IS PROTECTED
21.20	.....	I claim ALL or SOME of the money being frozen by the bank is protected.
21.21	.....	The amount I claim is protected is $.......
21.22	B.	WHY THE MONEY IS PROTECTED
21.23 21.24		My money is protected because I get it from 1 or more of the following places (Check all that apply)
21.25	.....	Government benefits
21.26 21.27 21.28 21.29 21.30 21.31		Government benefits include: MFIP - Minnesota Family Investment Program, GA - General Assistance, EA - Emergency Assistance, MA - Medical Assistance, GAMC - General Assistance Medical Care, EGA - Emergency General Assistance, MSA - Minnesota Supplemental Aid, MSA-EA - MSA Emergency Assistance, SSI - Supplemental Security Income, MinnesotaCare, Medicare Part B Premium payments, Medicare Part D Extra Help, Energy Assistance.
21.32	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
21.33	.....
21.34	LIST THE CASE NUMBER AND COUNTY
21.35		Case Number: .....
21.36		County: .....
21.37	.....	Social Security benefits
21.38	.....	Unemployment benefits
21.39	.....	Workers' Compensation
21.40	.....	Veterans' benefits
22.1 22.2 22.3		If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, Unemployment, Workers Compensation or Veteran's benefits.
22.4	.....	Other Assistance based on need
22.5 22.6	You may have assistance based on need from another source that is not on the list. If you do, check this box, and fill in the source of your money in the line below:
22.7	Source:	.....
22.8	Include copies of any documents you have that show the source of this money.
22.9	.....	All of your earnings (Wages) because:
22.10		You get government benefits (see list of government benefits)
22.11		You currently receive other assistance based on need
22.12		You have received government benefits in the last 6 months
22.13		You were in jail or prison in the last 6 months
22.14 22.15 22.16 22.17		If you check this box, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK STATEMENTS that show what was in your account for the 60 days right before the bank froze your money.
22.18	.....	Some of your earnings (Wages)
22.19 22.20 22.21		If you did not check the box for all earnings, some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of the two below:
22.22		75% of your wages (after taxes are taken out); or
22.23		(insert the sum of the current federal minimum wage) multiplied by 40.
22.24 22.25		The money from the following may also be exempt for 20 days after they are deposited in your account.
22.26	.....	An accident, disability, or retirement pension or annuity
22.27	.....	Payments to you from a life insurance policy
22.28	.....	Earnings of your child who is under 18 years of age
22.29	.....	Child support
22.30 22.31 22.32 22.33	.....	Money paid to you from a claim for damage or destruction of property. Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture or appliances.
22.34	.....	Death benefits paid to you.

22.35I give permission to any agency that has given me cash benefits to give information
22.36about my benefits to the above named creditor, or its attorney. The information will ONLY
22.37concern whether I get benefits or not, or whether I have gotten them in the past 6 months.
22.38If I was an inmate in the last 6 months, I give my permission to the correctional
22.39institution to tell the above named creditor that I was an inmate there.
22.40YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S
22.41ATTORNEY AND THE BANK. FILL IN THE BLANKS BELOW AND GO BACK
22.42TO THE INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
22.43I have mailed or delivered a copy of this form to:

23.1	.....
23.2	(Insert name of creditor or creditor's attorney)
23.3	.....
23.4	(Insert address of creditor or creditor's attorney)

23.5I have also mailed or delivered a copy of this exemption form to my bank at the
23.6address listed in the instructions.

23.7	DATED: .....	.....
23.8		DEBTOR
23.9		.....
23.10		DEBTOR ADDRESS
23.11		.....
23.12		DEBTOR TELEPHONE NUMBER

23.13    Subd. 2. Effect of exemption notice. Within two business days after receipt of
23.14the execution levy and exemption notices, the financial institution shall serve upon the
23.15judgment debtor two copies of the exemption notice. The financial institution shall serve
23.16the notice by first class mail to the last known address of the judgment debtor. If no claim
23.17of exemption is received by the financial institution within 14 days after the exemption
23.18notices are mailed to the judgment debtor, the funds remain subject to the execution levy
23.19and shall be remitted to the judgment creditor's attorney within seven six business days. If
23.20the judgment debtor elects to claim an exemption, the judgment debtor shall complete the
23.21exemption notice, sign it under penalty of perjury, and deliver one copy to the financial
23.22institution and one copy to the attorney for the judgment creditor within 14 days of the
23.23date postmarked on the correspondence mailed to the judgment debtor containing the
23.24exemption notices. The debtor is also required to include copies of bank statements for
23.25the prior 60 days with the exemption notice. In the event that there is no attorney for the
23.26judgment creditor, then the notice must be sent directly to the judgment creditor. Failure
23.27of the judgment debtor to deliver the executed exemption notice or copies of the required
23.28bank statements for the prior 60 days does not constitute a waiver of any claimed right
23.29to an exemption. Upon timely receipt of a claim of exemption, funds not claimed to be
23.30exempt by the judgment debtor remain subject to the execution levy. All money claimed
23.31to be exempt shall be released to the judgment debtor upon the expiration of seven
23.32six business days after the date postmarked on the envelope containing the executed
23.33exemption notice mailed to the financial institution, or the date of personal delivery of the
23.34executed exemption notice to the financial institution, unless within that time the attorney
23.35for the judgment creditor interposes an objection to the exemption.
23.36    Subd. 3. Objection to exemption claim Objections and request for hearing.
23.37An objection shall be interposed, within six business days of receipt by the creditor of
24.1an exemption claim from the debtor, by mailing or delivering one copy of the written
24.2objection Notice of Objection and Notice of Hearing to the financial institution and one
24.3copy of the written objection Notice of Objection and Notice of Hearing to the judgment
24.4debtor along with a copy of the judgment debtor's claimed exemption form. Both copies
24.5of an objection to an exemption claim shall be mailed or delivered on the same date.
24.6The financial institution may rely on the date of mailing or delivery of a notice to it in
24.7computing any time periods in this section. The written objection Notice of Objection and
24.8Notice of Hearing forms must be substantially in the form specified set out in subdivision 5.
24.9The court administrator may charge a fee of $1 for the filing of a Notice of Objection
24.10and Notice of Hearing. Upon the filing of a Notice of Objection and Notice of Hearing,
24.11the court administrator shall schedule the matter for hearing no sooner than five business
24.12days but no later than seven business days from the date of filing. A debtor may request
24.13continuance of the hearing by notifying the creditor and the court. The court shall schedule
24.14the continued hearing within seven days of the original hearing date.
24.15An order stating whether the debtor's funds are exempt shall be issued by the court
24.16within three days of the date of the hearing.
24.17    Subd. 4. Duties of financial institution if objection is made to exemption claim.
24.18Upon receipt of a written objection Notice of Objection and Notice of Hearing from the
24.19judgment creditor within the specified seven-day six-day period, the financial institution
24.20shall retain the funds claimed to be exempt. Unless the financial institution receives a
24.21request for hearing and notice of hearing from the judgment debtor asserting exemption
24.22rights within ten days after receipt of a written objection to the exemption, the funds
24.23remain subject to the execution levy as if no claim of exemption had been made and shall
24.24be remitted to the judgment creditor's attorney within seven days. If a request for hearing
24.25and notice of hearing to determine the validity of a claim of exemption is received by the
24.26financial institution within the period provided, it shall retain the funds claimed to be
24.27exempt until otherwise ordered by the court. The financial institution shall retain the funds
24.28claimed to be exempt until otherwise ordered by the court, upon mutual agreement of the
24.29parties, or until the garnishment lapses pursuant to section 571.79.
24.30    Subd. 5. Form of Notice of Objection and Notice of Hearing. (a) The written
24.31objection to the judgment debtor's claim of exemption must be in substantially the
24.32following form:

24.33	STATE OF MINNESOTA				DISTRICT COURT
24.34	County of .....				..... JUDICIAL DISTRICT
24.35 24.36	.....	(Judgment Creditor)			OBJECTION TO
25.1	.....	(Judgment Debtor)			EXEMPTION CLAIM
25.2 25.3	.....	(Garnishee) (Third Party)

25.4The judgment creditor objects to your claim for exemption from garnishment, levy of
25.5execution, order for attachment (strike inapplicable language) for the following reason(s):
..... 25.6
..... 25.7
..... 25.8
25.9Because of this objection, your financial institution will retain the funds you claimed
25.10to be exempt for an additional ten days. If you wish to request a hearing on your exemption
25.11claim, you need to do so within ten days from the date the objection was personally served
25.12on you, or within 13 days from the date the objection was mailed to you. You may request
25.13a hearing by completing the attached form and filing it with the court administrator.
25.141. The court administrator's office shall provide clerical assistance to help with the
25.15writing and filing of a Request for Hearing by any person not represented by counsel. The
25.16court administrator may charge a fee of $1 for the filing of a Request for Hearing.
25.172. Upon the filing of a Request for Hearing, the court administrator shall schedule
25.18the matter for a hearing no later than five business days from the date of filing. The court
25.19administrator shall forthwith send a completed copy of the request, including the hearing
25.20date, time, and place to the adverse party and to the financial institution by first class mail.
25.213. If it is possible that the financial institution might not receive the request mailed
25.22from the court administrator within ten days, then you may want to personally deliver a
25.23copy of the request to the financial institution after you have filed your request with the
25.24court.
25.254. An order stating whether your funds are exempt shall be issued by the court
25.26within three days of the date of the hearing.
25.27If you do not file a Request for Hearing within ten days of the date the objection was
25.28personally served on you, or within 13 days from the date the objection was mailed to you,
25.29your financial institution may turn your funds over to your judgment creditor.
25.30If you file a Request for Hearing and your financial institution receives it within ten
25.31days of the date it received this objection, your financial institution will retain your funds
25.32claimed to be exempt until otherwise ordered by the court.

25.33		.....
25.34		Attorney for Judgment Creditor

25.35(a) The Written Objection and Notice of Hearing must be in substantially the
25.36following form:

26.1	STATE OF MINNESOTA	DISTRICT COURT
26.2	COUNTY OF	.....
26.3	.....	JUDICIAL DISTRICT
26.4	.....
26.5	(Creditor)
26.6 26.7	.....	CREDITOR'S NOTICE OF OBJECTION AND NOTICE OF HEARING
26.8	(Debtor)
26.9	.....	ON EXEMPTION CLAIM
26.10	(Financial Institution)
26.11		(DEBTOR)
26.12		.....
26.13		ADDRESS
26.14		.....
26.15	.....	.....
26.16	.....
26.17	.....
26.18 26.19	(CREDITOR OR CREDITOR'S ATTORNEY)
26.20		.....
26.21 26.22 26.23 26.24		This Notice of Objection and Notice of Hearing is made by the creditor objecting to your exemption claim. This hearing is to resolve your exemption claim.
26.25	Hearing Date:	.....
26.26	Time:
26.27	Hearing Place:	.....

26.28The creditor objects to your claim of exemption from garnishment, levy of execution,
26.29order for attachment (strike inapplicable language) for the following reason(s):

26.30	.....
26.31	.....
26.32	.....

26.33(Note to both parties: Bring with you to the hearing all documents and materials
26.34relevant to the exemption claim. Failure to do so could delay the court's decision.)
26.35If the creditor receives all documents and materials relevant to the exemption claim
26.36before the hearing date they may agree with your exemption claim and you can avoid
26.37a hearing.
26.38Because a court hearing will be held on your claim that your funds are protected,
26.39your financial institution will retain the funds until it receives an Order from the court.
26.40    Subd. 6. Request for hearing and notice for hearing. The request for hearing
26.41accompanying the objection notice must be in substantially the following form:

27.1	STATE OF MINNESOTA				DISTRICT COURT
27.2	County of .....				..... JUDICIAL DISTRICT
27.3 27.4	.....	(Judgment Creditor)			REQUEST FOR HEARING
27.5	.....	(Judgment Debtor)			AND NOTICE FOR HEARING
27.6 27.7	.....	(Garnishee) (Third Party)

27.8I hereby request a hearing to resolve the exemption claim which has been made
27.9in this case regarding funds in the account of ............. (Judgment Debtor) at the .........
27.10(Financial Institution).
27.11I believe the property being held is exempt because
..... 27.12
..... 27.13

27.14	Dated: .....		.....
27.15			(JUDGMENT DEBTOR)
27.16			.....
27.17			(ADDRESS)
27.18			.....
27.19	HEARING DATE: .....		TIME: .....
27.20	HEARING PLACE: .....

27.21(Note to both parties: Bring with you to the hearing all documents and materials
27.22relevant to the exemption claim and objection. Failure to do so could delay the court's
27.23decision.)
27.24    Subd. 7. Release of funds. At any time during the procedure specified in this
27.25section, the judgment debtor or the attorney for the judgment creditor may, by a writing
27.26dated after the service of the writ of execution, direct the financial institution to release the
27.27funds in question to the other party. Upon receipt of a release, the financial institution
27.28shall release the funds as directed.
27.29    Subd. 8. Subsequent proceedings; bad faith claims. If in subsequent proceedings
27.30brought by the judgment debtor or the judgment creditor, the claim of exemption is not
27.31upheld, and the court finds that it was asserted in bad faith, the judgment creditor shall be
27.32awarded actual damages, costs, and reasonable attorney fees resulting from the additional
27.33proceedings, and an amount not to exceed $100. If the claim of exemption is upheld, and
27.34the court finds that the judgment creditor disregarded the claim of exemption in bad faith,
27.35the judgment debtor shall be awarded costs, reasonable attorney fees, actual damages, and
27.36an amount not to exceed $100. It is not considered bad faith for a judgment creditor
27.37to object to an improperly completed or incomplete exemption claim. The underlying
27.38judgment must be modified to reflect assessment of damages, costs, and attorney fees.
28.1However, if the party in whose favor a penalty assessment is made is not actually indebted
28.2to the party's attorney for fees, the attorney's fee award shall be made directly to the
28.3attorney and if not paid, an appropriate judgment in favor of the attorney shall be entered.
28.4Upon motion of any party in interest, on notice, the court shall determine the validity of
28.5any claim of exemption, and may make any order necessary to protect the rights of those
28.6interested. No financial institution is liable for damages for complying with this section.
28.7Both copies of an exemption claim or an objection to an exemption claim must be mailed
28.8or delivered on the same date. The financial institution may rely on the date of mailing or
28.9delivery of a notice to it in computing any time periods in this section.

28.10    Sec. 4. Minnesota Statutes 2008, section 571.71, is amended to read:
28.11571.71 GARNISHMENT; WHEN AUTHORIZED.
28.12As an ancillary proceeding to a civil action for the recovery of money, a creditor
28.13may issue a garnishment summons as provided in this chapter against any third party in
28.14the following instances:
28.15(1) at the time the civil action is commenced or at any time after the commencement
28.16of the civil action, but before the entry of a judgment, if the court orders the issuance of
28.17the garnishment summons pursuant to section 571.93;
28.18(2) at any time 40 45 days or more after service of the summons and complaint
28.19upon the debtor in the civil action when a judgment by default could have, but has not,
28.20been entered pursuant to rule 55.01(a) of the Minnesota Rules of Civil Procedure for the
28.21District Courts. Garnishment under this subdivision is effective only after the Notice of
28.22Intent to Garnish form and the Exemption form is served on the debtor at any time 20 or
28.23more days after the service of the Summons and Complaint and, in addition, the creditor
28.24does not receive an answer from the debtor within 25 days after service of the Notice of
28.25Intent to Garnish. The Notice of Intent to Garnish form and the Exemption form must be
28.26substantially in the form set forth in section 571.72 subdivision 10. If a creditor sends a
28.27Notice of Intent to Garnish form to a debtor under this subdivision the creditor cannot
28.28obtain a default judgment against the debtor under rule 55.01(a) of the Minnesota Rules of
28.29Civil Procedure for the District Court until 25 days after the service of the Notice of Intent
28.30to Garnish form. No filing of a pleading or other documents by the creditor is required to
28.31issue a garnishment summons under this clause; however, the creditor must comply with
28.32the service requirement of section 571.72, subdivision 4; or
28.33(3) at any time after entry of a money judgment in the civil action.

28.34    Sec. 5. Minnesota Statutes 2008, section 571.72, is amended by adding a subdivision
28.35to read:
29.1    Subd. 10. Exemption notice for prejudgment garnishment.
29.3IMPORTANT NOTICE: a garnishment summons may be served on your
29.4employer, bank, or other third parties, without any further court proceeding or
29.5notice to you. See the attached Notice of Intent to Garnish for more information.
29.6The following money and wages may be protected (the legal word is exempt)
29.7from garnishment:
29.81. Financial Institutions/Bank
29.9Some of the money in your account may be protected because you receive
29.10government benefits from one or more of the following places:
29.11MFIP- Minnesota Family Investment Program
29.12GA- General Assistance
29.13EA- Emergency Assistance
29.14MA- Medical Assistance
29.15GAMC- General Assistance Medical Care
29.16EGA- Emergency General Assistance
29.17MSA- Minnesota Supplemental Aid
29.18MSA-EA – MSA Emergency Assistance
29.19SSI- Supplemental Security Income
29.20MinnesotaCare
29.21Medicare Part B Premium payments
29.22Medicare Part D Extra Help
29.23Energy Assistance
29.24Social Security benefits
29.25Unemployment benefits
29.26Workers Compensation
29.27Veterans' benefits
29.28Sending the undersigned creditor a copy of BANK STATEMENTS that
29.29show what was in your account for the past 60 days may give the creditor enough
29.30information about your exemption claim to avoid a garnishment.
29.312. Earnings
29.32Your earnings are completely protected from garnishment because:
29.33All of your earnings (Wages) because:
29.34You get government benefits (see list of government benefits)
29.35You currently receive other assistance based on need
29.36You have received government benefits in the last 6 months
30.1You were in jail or prison in the last 6 months
30.2Your wages are only protected for 60 days after they are deposited in your account
30.3so it would be helpful if you immediately send the undersigned creditor a copy of
30.4BANK STATEMENTS that show what was in your account for the past 60 days.
30.5Some of your earnings (Wages)
30.6If you did not check the box for all earnings, some of your earnings are still protected
30.7for 20 days after they were deposited in your account. The amount protected is the larger
30.8amount of the two below:
30.975% of your wages (after taxes are taken out); or
30.10(insert the sum of the current federal minimum wage) multiplied by 40.
30.11The money from the following may also be exempt for 20 days after they are
30.12deposited in your account.
30.13An accident, disability, or retirement pension or annuity
30.14Payments to you from a life insurance policy
30.15Earnings of your child who is under 18 years of age
30.16Child support
30.17Money paid to you from a claim for damage or destruction of property.
30.18Property includes household goods, farm tools or machinery, tools for your job, business
30.19equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes,
30.20furniture or appliances
30.21Death benefits paid to you
30.22YOU WILL BE ABLE TO CLAIM THESE EXEMPTIONS WHEN YOU
30.23RECEIVE NOTICE OF THE GARNISHMENT (OR 10 DAYS PRIOR TO A WAGE
30.24GARNISHMENT.) BUT IF YOU BELIEVE THE MONEY IN YOUR BANK
30.25ACCOUNT IS EXEMPT OR YOUR WAGES ARE EXEMPT YOU SHOULD
30.26IMMEDIATELY CONTACT THE PERSON BELOW TO DISCUSS YOUR
30.27EXEMPTION AND POSSIBLY AVOID GARNISHMENT.

30.28	Creditor .....
30.29	Creditor address .....
30.30	Creditor phone number .....

30.33	.....	against	.....
30.34	Plaintiff/Creditor		Defendant/Debtor

31.1Your money, property, or earnings are in danger of being garnished because
31.2you did not send a written "Answer" to the Summons and Complaint served on you
31.3over 20 days ago.
31.4There is no case filed in court, but because you did not send a written "Answer" the
31.5creditor may serve a garnishment summons on your employer, bank or other third parties.
31.6This means that your money or wages can be garnished (held or taken). Under Minnesota
31.7Law, this can happen anytime 20 days after the date you receive this notice.
31.8There will be NO COURT HEARING or any further notice to you prior to a
31.9garnishment if you do nothing. There may not be a file open at the Clerk of the Court's
31.10office. There are things you can do to avoid a garnishment, but you must act quickly.
31.11Please read these instructions carefully. You have 20 days to do one of the following:
31.121. Send an Answer. If you do not think you owe the money or if you have a legal
31.13reason that you did not pay, send a written "Answer" to the Summons and Complaint.
31.14Your "Answer" should tell the creditor why you think you do not owe some or all of the
31.15money. Contact a lawyer if you do not know what to do, need help or have any questions
31.16about the debt.
31.172. Claim an Exemption. Even if you do not have a defense to the complaint, some
31.18of your money may be protected (the legal word is exempt) from garnishment. This
31.19means it is protected and cannot be taken. Prior to garnishment the creditor will send you
31.20a form to claim these exemptions but you can possibly avoid the garnishment action by
31.21contacting the person below immediately to claim your exemption. Attached to this
31.22notice is a list of exemptions you may be able to claim.
31.233. If you do not have a defense and your money is not exempt you can call the
31.24person below before the 20 days are up and try to set up a payment plan that works for
31.25both you and your creditor. You can contact the person below at any time to try to work
31.26out a payment plan, but if you wait too long or cannot agree about a payment plan, they
31.27may garnish or levy your money or wages.
31.28If you do not do any of these things, your money can be garnished. The creditor
31.29can garnish your wages, bank accounts or other assets. They do not have to go to court to
31.30let you know when they start taking your money.

31.31		LAW FIRM
31.32	Dated: .....	By: .....
31.33		Attorney, #
31.34		Attorneys for Plaintiff
31.35		Address
31.36		Phone

32.1    Sec. 6. Minnesota Statutes 2008, section 571.913, is amended to read:
32.2571.913 EFFECT OF EXEMPTION NOTICE.
32.3Within two business days after receipt of the garnishment summons and exemption
32.4notices, the financial institution shall serve upon the debtor two copies of the exemption
32.5notice. The financial institution shall serve the notice by first class mail to the last known
32.6address of the debtor. If no claim of exemption is received by the financial institution
32.7within 14 days after the exemption notices are mailed to the debtor, the funds remain
32.8subject to the garnishment summons. If the debtor elects to claim an exemption, the debtor
32.9shall complete the exemption notice, sign it under penalty of perjury, and deliver one copy
32.10to the financial institution and one copy to the attorney for the creditor within 14 days of
32.11the date postmarked on the correspondence mailed to the debtor containing the exemption
32.12notices. The debtor is also required to include copies of bank statements for the prior 60
32.13days with the exemption notice. In the event that there is no attorney for the creditor,
32.14then the notice must be sent directly to the creditor. Failure of the debtor to deliver the
32.15executed exemption notice or copies of the required bank statements for the prior 60 days
32.16does not constitute a waiver of a claimed right to an exemption. Upon timely receipt of a
32.17claim of exemption, funds not claimed to be exempt by the debtor remain subject to the
32.18garnishment summons. All money claimed to be exempt shall be released to the debtor
32.19upon the expiration of seven six business days after the date postmarked on the envelope
32.20containing the executed exemption notice mailed to the financial institution, or the date
32.21of personal delivery of the executed exemption notice to the financial institution, unless
32.22within that time the creditor interposes an objection to the exemption.

32.23    Sec. 7. Minnesota Statutes 2008, section 571.914, is amended to read:
32.24571.914 OBJECTION TO EXEMPTION CLAIM.
32.25    Subdivision 1. Objections and request for hearing. An objection shall be
32.26interposed, within six business days of receipt by the creditor of an exemption claim from
32.27the debtor, by mailing or delivering one copy of the written objection Notice of Objection
32.28and Notice of Hearing to the financial institution and one copy of the written objection
32.29Notice of Objection and Notice of Hearing to the debtor. A Request for Hearing and
32.30Notice of Hearing form must accompany each copy of the written objection.
32.31Both copies of an objection to an exemption claim must be mailed or delivered on
32.32the same date. The financial institution may rely on the date of mailing or delivery of a
32.33notice to it in computing any time periods in this section.
33.1The written objection, and Request for Hearing Notice of Objection and Notice of
33.2Hearing, forms must be substantially in the forms form set out in subdivisions subdivision
33.32 and 3.
33.4The court shall provide clerical assistance to help with the writing and filing of a
33.5Request for Hearing by any person not represented by counsel. The court administrator
33.6may charge a fee of $1 for the filing of a Request for Notice of Objection and Notice of
33.7Hearing. Upon the filing of a Request for Notice of Objection and Notice of Hearing, the
33.8court administrator shall schedule the matter for hearing no sooner than five business
33.9days but no later than five seven business days from the date of filing. A debtor may
33.10request continuance of the hearing by notifying the creditor and the court. The court
33.11shall schedule the continued hearing within seven days of the original hearing date. The
33.12court administrator shall immediately send a completed copy of the request, including
33.13the hearing date, time, and place to the adverse party and to the financial institution by
33.14first class mail.
33.15An order stating whether the debtor's funds are exempt shall be issued by the court
33.16within three days of the date of the hearing.
33.17    Subd. 2. Form of Notice of Objection and Notice of Hearing. (a) The written
33.18objection to the debtor Written Objection and Notice of Hearing must be in substantially
33.19the following form:

33.20	STATE OF MINNESOTA		DISTRICT COURT
33.21	COUNTY OF .....		..... JUDICIAL DISTRICT
33.22	..... (Creditor)
33.23 33.24 33.25	..... (Debtor)		CREDITOR'S NOTICE OF OBJECTION AND NOTICE OF HEARING
33.26	..... (Garnishee)		TO ON EXEMPTION CLAIM
33.27			(DEBTOR
33.28			.....
33.29			(ADDRESS)
33.30			.....
33.31	.....		.....
33.32	.....
33.33	.....
33.34 33.35	(CREDITOR OR CREDITOR'S ATTORNEY)
33.36			.....
33.37 33.38 33.39 33.40			This Notice of Objection and Notice of Hearing is made by the creditor objecting to your exemption claim. This hearing is to resolve you exemption claim.
33.41	Hearing Date:		.....
34.1	Time:
34.2	Hearing Place:		.....

34.3The creditor objects to your claim for of exemption from garnishment, levy of
34.4execution, order for attachment (strike inapplicable language) for the following reason(s):

34.5	.....
34.6	.....
34.7	.....

34.8(Note to both parties: Bring with you to the hearing all documents and materials
34.9relevant to the exemption claim. Failure to do so could delay the court's decision.)
34.10If the creditor receives all documents and materials relevant to the exemption claim
34.11before the hearing date they may agree with your exemption claim and you can avoid
34.12a hearing.
34.13Because of this objection a court hearing will be held on your claim that your funds
34.14are protected, your financial institution will retain the funds you claimed to be exempt
34.15for an additional ten days. If you wish to request a hearing on your exemption claim,
34.16you need to do so within ten days from the date the objection was personally served on
34.17you, or within 13 days of the date the objection was mailed to you. You may request a
34.18hearing by completing the attached form and filing it with the court administrator until it
34.19receives an Order from the court.
34.201. The court shall provide clerical assistance to help with the writing and filing of a
34.21Request for Hearing by any person not represented by counsel. The court administrator
34.22may charge a fee of $1 for the filing of a Request for Hearing.
34.232. Upon the filing of a Request for Hearing, the clerk shall schedule the matter for a
34.24hearing no later than five business days from the date of filing. The court administrator
34.25shall forthwith send a completed copy of the request, including the hearing date, time, and
34.26place to the adverse party and to the financial institution by first class mail.
34.273. If it is possible that the financial institution might not receive the request mailed
34.28from the court administrator within ten days, then you may want to personally deliver a
34.29copy of the request to the financial institution after you have filed your request with the
34.30court.
34.314. An order stating whether your funds are exempt shall be issued by the court
34.32within three days of the date of the hearing.
34.33If you do not file a Request for Hearing within ten days of the date the objection was
34.34personally served on you, or within 13 days from the date the objection was mailed to you,
34.35your financial institution may turn your funds over to your creditor.
35.1If you file a Request for Hearing and your financial institution receives it within ten
35.2days of the date it received this objection, your financial institution will retain your funds
35.3claimed to be exempt until otherwise ordered by the court, or until the garnishment lapses
35.4pursuant to Minnesota Statutes, section 571.79.

35.5		.....
35.6		(CREDITOR OR CREDITOR'S ATTORNEY.)

35.7    Subd. 3. Request for hearing and notice for hearing. The request for hearing
35.8accompanying the objection notice must be in substantially the following form:

35.9	STATE OF MINNESOTA		DISTRICT COURT
35.10	COUNTY OF .....		..... JUDICIAL DISTRICT
35.11	..... (Creditor)
35.12 35.13	..... (Debtor)		REQUEST FOR HEARING AND NOTICE FOR HEARING
35.14	..... (Garnishee)

35.15I hereby request a hearing to resolve the exemption claim which has been made in
35.16this case regarding funds in the account of ............. (Debtor) at the ......... (Financial
35.17Institution).
35.18    I believe the property being held is exempt because

35.19	.....
35.20	.....
35.21	Dated: .....
35.22 35.23		(DEBTOR) .....
35.24 35.25		(ADDRESS) .....

35.26	HEARING DATE: .....		TIME: .....
35.27	HEARING PLACE: .....

35.28(Note to both parties: Bring with you to the hearing all documents and materials
35.29relevant to the exemption claim. Failure to do so could delay the court's decision.)
35.30    Subd. 4. Duties of financial institution if objection is made to exemption claim.
35.31Upon receipt of a written objection Notice of Objection and Notice of Hearing from the
35.32creditor within the specified seven-day period, the financial institution shall retain the
35.33funds claimed to be exempt. Unless the financial institution receives a request for hearing
35.34from the debtor asserting exemption rights within ten days after receipt of the written
35.35objection to the exemption, the funds remain subject to the garnishment summons as if
35.36no claim of exemption had been made. If a notice of motion and motion to determine
35.37the validity of a claim of exemption is received by the financial institution within the
35.38period provided, The financial institution shall retain the funds claimed to be exempt
36.1until otherwise ordered by the court, upon mutual agreement of the parties, or until the
36.2garnishment lapses pursuant to section 571.79.

36.3    Sec. 8. Minnesota Statutes 2008, section 571.925, is amended to read:
36.4571.925 FORM OF NOTICE.
36.5    Subdivision 1. Exemption notice. The ten-day notice informing a debtor that a
36.6garnishment summons may be used to garnish the earnings of an individual must be
36.7substantially in the following form:

36.8	STATE OF MINNESOTA		DISTRICT COURT
36.9	COUNTY OF .....		..... JUDICIAL DISTRICT
36.10 36.11	..... (Creditor) against
36.12			GARNISHMENT EXEMPTION
36.13	..... (Debtor)		NOTICE AND NOTICE OF
36.14	and		INTENT TO GARNISH EARNINGS
36.15	..... (Garnishee)

36.16PLEASE TAKE NOTICE that a garnishment summons or levy may be served upon
36.17your employer or other third parties, without any further court proceedings or notice to
36.18you, ten days or more from the date hereof. Some or all of your earnings are exempt
36.19from garnishment. If your earnings are garnished, your employer must show you how
36.20the amount that is garnished from your earnings was calculated. You have the right to
36.21request a hearing if you claim the garnishment is incorrect.
36.22Your earnings are completely exempt from garnishment if you are now a recipient of
36.23relief based on need, if you have been a recipient of relief within the last six months, or if
36.24you have been an inmate of a correctional institution in the last six months.
36.25Relief based on need includes the Minnesota Family Investment Program (MFIP),
36.26Emergency Assistance (EA), Work First Program, Medical Assistance (MA), General
36.27Assistance (GA), General Assistance Medical Care (GAMC), Emergency General
36.28Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA Emergency Assistance
36.29(MSA-EA), Supplemental Security Income (SSI), and Energy Assistance.
36.30If you wish to claim an exemption, you should fill out the appropriate form below,
36.31sign it, and send it to the creditor's attorney and the garnishee.
36.32You may wish to contact the attorney for the creditor in order to arrange for a
36.33settlement of the debt or contact an attorney to advise you about exemptions or other rights.
36.35(1) Be advised that even if you claim an exemption, a garnishment summons may
36.36still be served on your employer. If your earnings are garnished after you claim an
37.1exemption, you may petition the court for a determination of your exemption. If the
37.2court finds that the creditor disregarded your claim of exemption in bad faith, you
37.3will be entitled to costs, reasonable attorney fees, actual damages, and an amount
37.4not to exceed $100.
37.5(2) HOWEVER, BE WARNED if you claim an exemption, the creditor can also
37.6petition the court for a determination of your exemption, and if the court finds that
37.7you claimed an exemption in bad faith, you will be assessed costs and reasonable
37.8attorney's fees plus an amount not to exceed $100.
37.9(3) If after receipt of this notice, you in bad faith take action to frustrate the
37.10garnishment, thus requiring the creditor to petition the court to resolve the problem,
37.11you will be liable to the creditor for costs and reasonable attorney's fees plus an
37.12amount not to exceed $100.

37.13 37.14	Dated: .....		..... (Attorney for) Creditor
37.15 37.16			..... Address
37.17 37.18			..... Telephone

37.20I hereby claim that my earnings are exempt from garnishment because:
37.21(1) I am presently a recipient of relief based on need. (Specify the program, case
37.22number, and the county from which relief is being received.)

37.23 37.24 37.25

..... Program

..... Case Number (if known)

..... County

37.26(2) I am not now receiving relief based on need, but I have received relief based on
37.27need within the last six months. (Specify the program, case number, and the county
37.28from which relief has been received.)

37.29 37.30 37.31

..... Program

..... Case Number (if known)

..... County

37.32(3) I have been an inmate of a correctional institution within the last six months.
37.33(Specify the correctional institution and location.)

37.34 37.35

..... Correctional Institution

..... Location

37.36I hereby authorize any agency that has distributed relief to me or any correctional
37.37institution in which I was an inmate to disclose to the above-named creditor or the
37.38creditor's attorney only whether or not I am or have been a recipient of relief based on
38.1need or an inmate of a correctional institution within the last six months. I have mailed or
38.2delivered a copy of this form to the creditor or creditor's attorney.

38.3 38.4	..... Date		..... Debtor
38.5 38.6			..... Address
38.7 38.8			..... Debtor Telephone Number

38.9	STATE OF MINNESOTA				DISTRICT COURT
38.10	COUNTY OF .....				JUDICIAL DISTRICT
38.11	.....	(Creditor)
38.12	.....	(Debtor)
38.13 38.14	.....	(Financial institution)

38.17The Creditor has frozen money in your account at your financial institution. The
38.18account is frozen for 14 days from the date of this notice.
38.19Some of your money in your account may be protected (the legal word is
38.20exempt). You may be able to get it sooner than 14 days if you act quickly and follow
38.21the instructions on the next page.
38.22The attached form lists some different sources of money in your account that are
38.23protected. If your money is from one or more of these sources, check the box on the
38.24form next to the sources of your money. If it is from one of these sources, the Creditor
38.25cannot take it.
38.26BUT, you must follow the instructions and return the exemption form and
38.27copies of your bank statements from the last 60 days to have the bank unfreeze your
38.28money. If you do not follow the instructions or your creditor gets an order from the court
38.29or writ of execution, your financial institution will give the money to the Creditor. If that
38.30happens and it is protected, you can still get it back from the creditor later, but that is not
38.31as easy to do as filling in the form now.
38.33    Subd. 2. Form of Instructions. The instructions must be substantially in the
38.34following form.
38.36Note: The creditor is who you owe the money to. You are the debtor.
38.371. Fill out the attached exemption form in this packet.
39.1If you check one of the boxes, you should also give proof that shows that some
39.2or all of the money in your account is from one or more of the protected sources.
39.3Creditors may ask for a hearing if they question your exemptions. To avoid a hearing:
39.4Case numbers should be added to the form. Copies of documents should be
39.5sent with the form.
39.6NOTICE: You must send copies of your bank statements for the past 60 days
39.7before the garnishment. If you do not send bank statements with your exemption
39.8claim the financial institution may release your money to the creditor.
39.92. Sign the exemption form. Make 3 copies. Keep 1 for yourself.
39.102. Mail or deliver the other copies of the form by (insert date).
39.11BOTH COPIES MUST BE MAILED OR DELIVERED THE SAME DAY.
39.121 copy of the form goes to:

39.13	.....
39.14	(Insert name of creditor or creditor's attorney)
39.15	.....
39.16	(Insert address of creditor or creditor's attorney)

39.171 copy goes to:

39.18	.....
39.19	(Insert name of bank)
39.20	.....
39.21	(Insert address of the bank)

39.23If You Do Not Send in the Exemption Form and Bank Statements:
39.2414 days after the date of this letter some or all of your money may be turned over to
39.25the creditor or to the sheriff pursuant to Minnesota Statute.
39.26If You Send in the Exemption Form and Bank Statements:
39.27Any money that is NOT protected can be turned over to the creditor or the sheriff.
39.28If the Creditor Does Not Object:
39.29The financial institution will unfreeze your money 6 business days after they get
39.30your completed form.
39.31If the Creditor Objects:
39.32The money you have said is protected on the form will be held by the bank. The
39.33creditor has 6 business days to object (disagree) and ask the court to hold a hearing. You
39.34will receive a Notice of Objection and a Notice of Hearing.
39.35The financial institution will hold the money until a court decides whether your
39.36money is protected or not.
40.1You may want to talk to a lawyer for advice about this process. If you are low
40.2income you can call Legal Aid.
40.3PENALTIES:
40.4If you claim that your money is protected and a court decides you made that claim
40.5in bad faith, the court can order you to pay costs, actual damages, attorney fees, and an
40.6additional amount of up to $100. For example: it may be bad faith if you claim you
40.7receive government benefits that you do not receive.
40.8If the creditor made a bad faith objection to your claim that your money is protected,
40.9the court can order them to pay costs, actual damages, attorney fees, and an additional
40.10amount of up to $100.
40.11    Subd. 3. Form of exemption form. The exemption form must be substantially in
40.12the following form:

40.14	A.	HOW MUCH MONEY IS PROTECTED
40.15	.....	I claim ALL or SOME of the money being frozen by the bank is protected.
40.16	.....	The amount I claim is protected is $.......
40.17	B.	WHY THE MONEY IS PROTECTED
40.18 40.19		My money is protected because I get it from 1 or more of the following places (Check all that apply)
40.20	.....	Government benefits
40.21 40.22 40.23 40.24 40.25 40.26		Government benefits include: MFIP - Minnesota Family Investment Program, GA - General Assistance, EA - Emergency Assistance, MA - Medical Assistance, GAMC - General Assistance Medical Care, EGA - Emergency General Assistance, MSA - Minnesota Supplemental Aid, MSA-EA - MSA Emergency Assistance, SSI - Supplemental Security Income, MinnesotaCare, Medicare Part B Premium payments, Medicare Part D Extra Help, Energy Assistance.
40.27	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
40.28	.....
40.29	LIST THE CASE NUMBER AND COUNTY
40.30		Case Number: .....
40.31		County: .....
40.32	.....	Social Security benefits
40.33	.....	Unemployment benefits
40.34	.....	Workers' Compensation
40.35	.....	Veterans' benefits
40.36 40.37 40.38		If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, Unemployment, Workers Compensation or Veteran's benefits.
40.39	.....	Other Assistance based on need
40.40 40.41	You may have assistance based on need from another source that is not on the list. If you do, check this box, and fill in the source of your money in the line below:
40.42	Source:	.....
40.43	Include copies of any documents you have that show the source of this money.
41.1	.....	All of your earnings (Wages) because:
41.2		You get government benefits (see list of government benefits)
41.3		You currently receive other assistance based on need
41.4		You have received government benefits in the last 6 months
41.5		You were in jail or prison in the last 6 months
41.6 41.7 41.8 41.9		If you check this box, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK STATEMENTS that show what was in your account for the 60 days right before the bank froze your money.
41.10	.....	Some of your earnings (Wages)
41.11 41.12 41.13		If you did not check the box for all earnings, some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of the two below:
41.14		75% of your wages (after taxes are taken out); or
41.15		(insert the sum of the current federal minimum wage) multiplied by 40.
41.16 41.17		The money from the following may also be exempt for 20 days after they are deposited in your account.
41.18	.....	An accident, disability, or retirement pension or annuity
41.19	.....	Payments to you from a life insurance policy
41.20	.....	Earnings of your child who is under 18 years of age
41.21	.....	Child support
41.22 41.23 41.24 41.25	.....	Money paid to you from a claim for damage or destruction of property. Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture or appliances.
41.26	.....	Death benefits paid to you.

41.27I give permission to any agency that has given me cash benefits to give information
41.28about my benefits to the above named creditor, or its attorney. The information will ONLY
41.29concern whether I get benefits or not, or whether I have gotten them in the past 6 months.
41.30If I was an inmate in the last 6 months, I give my permission to the correctional
41.31institution to tell the above named creditor that I was an inmate there.
41.32YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S
41.33ATTORNEY AND THE BANK. FILL IN THE BLANKS BELOW AND GO BACK
41.34TO THE INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
41.35I have mailed or delivered a copy of this form to:

41.36	.....
41.37	(Insert name of creditor or creditor's attorney)
41.38	.....
41.39	(Insert address of creditor or creditor's attorney)

41.40I have also mailed or delivered a copy of this exemption form to my bank at the
41.41address listed in the instructions.

42.1	DATED: .....	.....
42.2		DEBTOR
42.3		.....
42.4		DEBTOR ADDRESS
42.5		.....
42.6		DEBTOR TELEPHONE NUMBER"