IN THE ___ ____ JUDICIAL CIRCUIT, ___ Judge or Division: Petitioner(s): vs. Respondent(s): Case Number: ________________________, MISSOURI Date Judgment Entered Against Debtor: Original Amount of Judgment: Please Issue: General Execution For: Real Estate Levy Replevin Vehicle Levy Other Personal Property Levy Other: __________________________________ (This form must be completed in full or your request will be returned unprocessed.) (Date File Stamp) Requested Return/End Date: 30 Days 60 Days 90 Days Execution Application and Order Judgment Balance To (County/City of St. Louis): Amount Remaining Unpaid (To be completed by Applicant) Total amount of the judgment awarded on the day judgment is entered including, but not limited to, principal, prejudgment interest, and all costs and/or fees. Debtor Name/Address: $ $ $ $ $ $ $ $ ($ ) Debtor SSN (last four digits): XXX-XXCreditor: Attorney: Missouri Bar No.: A judgment was entered on the above referenced date and remains unsatisfied. Signature: ________________________________________ Date: ____________________________________________ Address & Telephone Number: Post Judgment Interest Post Judgment Costs Service Fee for this Levy Taxes Child Support/Maint under 12 wks. Child Support/Maint over 12 wks. Other: ________________________ Less Credits TOTAL DUE $ Description/Address/Legal Description of property to be levied (To be completed by Applicant): Because a judgment was entered against the above debtor in this court and there is a balance, accrued interest, and costs as stated above unpaid from said judgment, you are commanded to execute this writ and on the return date shown below to certify to this court how you executed this writ. The State of Missouri to the Sheriff of any County in the State of Missouri Writ of Execution (To be completed by Court Clerk) Make Checks Payable To: Mail Funds To: Issue (County): (Seal) Date Issued: By (Clerk): Court Address: OSCA (10-15) CV91 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Document ID: Return Date: Rule 76; Section 452.350, RSMo Sheriff or Server's Return I certify that I have executed this writ: by collecting the amount owed. by levying on and selling the property of the debtor described below and returning to the court the balance shown below. Date of Levy Description of Property Levied On and Sold I did not serve this Writ of Execution because: I did not locate the property on which to levy. Other (specify): Served in ______________________________ (County/City of St. Louis), MO, on ______________ (date) at ______________ (time). _____________________________________ Service Fees Summons/Writ Non Est Sheriff's Deputy Salary Supplemental Surcharge Mileage Total Sheriff/Server $ $ $ $ $ 10.00 (______ miles @ $.______ per mile) General Execution You are commanded to execute this writ by levying upon the debtor's property. Instructions to Sheriff/Server OSCA (10-15) CV91 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Rule 76; Section 452.350, RSMo List of Exempt Property Certain property cannot be taken to satisfy a general execution. This is called exempt property. Pursuant to Supreme Court Rule 76.075, you are advised that sections, 513.430 and 513.440 RSMo, set forth below, make certain property exempt from execution, and you are advised that there are certain exemptions under state and federal law which you may be able to claim with respect to the property levied upon. See sections 452.140, 513.475, and 513.480, set forth below. You may claim any exemption by filing a claim of exemption with the levying officer within twenty days after being served with an execution. 452.140. No property shall be exempt from attachment or execution in a proceeding instituted by a person for maintenance, nor from attachment or execution upon a judgment or order issued to enforce a decree for alimony or for the support and maintenance of children. And all wages due to the defendant shall be subject to garnishment on attachment or execution in any proceedings mentioned in this section, whether the wages are due from the garnishee to the defendant for the last thirty days' service or not. 513.430.1. The following property shall be exempt from attachment and execution to the extent of any person's interest therein: (1) Household furnishings, household goods, wearing apparel, appliances, books, animals, crops or musical instruments that are held primarily for personal, family or household use of such person or a dependent of such person, not to exceed $3,000 in value in the aggregate; (2) A wedding ring not to exceed $1,500 in value and other jewelry held primarily for the personal, family or household use of such person or a dependent of such person, not to exceed $500 in value in the aggregate; (3) Any other property of any kind, not to exceed in value $600 in the aggregate; (4) Any implements or professional books or tools of the trade of such person or the trade of a dependent of such person not to exceed $3,000 in value in the aggregate; (5) Any motor vehicles, not to exceed $3,000 in value in the aggregate; (6) Any mobile home used as the principal residence but not attached to real property in which the debtor has a fee interest, not to exceed $5,000 in value; (7) Any one or more unmatured life insurance contracts owned by such person, other than a credit life insurance contract; (8) The amount of any accrued dividend or interest under, or loan value of, any one or more unmatured life insurance contracts owned by such person under which the insured is such person or an individual of whom such person is a dependent; provided, however, that if proceedings under Title 11 of the United States Code are commenced by or against such person, the amount exempt in such proceedings shall not exceed in value $150,000 in the aggregate less any amount of property of such person transferred by the life insurance company or fraternal benefit society to itself in good faith if such transfer is to pay a premium or to carry out a nonforfeiture insurance option and is required to be so transferred automatically under a life insurance contract with such company or society that was entered into before commencement of such proceedings. No amount of any accrued dividend or interest under, or loan value of, any such life insurance contracts shall be exempt from any claim for child support. Notwithstanding anything to the contrary, no such amount shall be exempt in such proceedings under any such insuranc