CSD 1141 [12/01/15] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. JUDGMENT BY DEFAULT DISALLOWING CLAIM OF EXEMPTIONS After notice and hearing held on Exemptions and Objections thereto filed by to consider and act upon the Debtor's Claim of , the Objecting Party having appeared by and the debtor having failed to appear, the Court having considered the evidence presented, the papers and documents on file herein in support of the objections to claim of exemptions, and good cause appearing therefor, It is adjudged that the claim of exemption by this debtor of property of the estate is disallowed as to the following property, namely [description should be the same as contained on Schedule 104 (Individual Debtors)/204 (Non-Individual Debtors or Schedule 106C (Individual Debtors)]: DATED: Judge, United States Bankruptcy Court CSD 1141 American LegalNet, Inc. www.FormsWorkFlow.com