NM LF 5003-6(4-809) UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW MEXICO In re: Case No. Debtor(s). Plaintiff(s), v. Adv. Pro. No. Defendant(s). Garnishee. CLAIM OF EXEMPTION FROM GARNISHMENT Judgment debtor claims the following exemptions: (check box next to exemption) a. [ ] social security benefits (OASDI, SSI); b. [ ] public assistance benefits (AFDC, welfare, GA); c. [ ] life, accident or health insurance proceeds; d. [ ] workers' compensation awards; e. [ ] unemployment compensation benefits; f. [ ] veterans' benefits; g. [ ] pensions and retirement funds; h. [ ] crime victims' reparation fund payments; American LegalNet, Inc. www.FormsWorkFlow.com -2- i. [ ] allowances to surviving spouse and children from subject to the limitations of Sections 45-2- 401 and 1978; deceased's estate 45-2-402 NMSA j. [ ] the minimum amount of shares necessary for certain non-profit cooperative associations as provided by Section 53-4-28 NMSA 1978; k. [ ] fraternal benefit society payments as provided by Section 59A-44-18 NMSA 1978. A completed and signed copy of this form must be returned to the Clerk of the Court whose address is United States Bankruptcy Court District of New Mexico Pete V. Domenici U.S. Courthouse 333 Lomas Blvd. NW, Suite 360 Albuquerque, NM 87102 A completed and signed copy of the claim of exemption form shall be served on the judgment creditor and the garnishee named above. If the judgment creditor disputes a claimed exemption, a court hearing will be scheduled to consider the disputed exemptions. At this hearing you must bring evidence supporting each of your claims of exemption. Date Signature of judgment debtor Printed name of judgment debtor Number and street or P.O. box City, State, zip code Telephone number [The content of this NM LF 5003-6(4-809), with the addition of the Bankruptcy Court Clerk222s address, matches Form 4-809 NMRA, last amended January 1, 1996.] American LegalNet, Inc. www.FormsWorkFlow.com