Rev. 2/2000 UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF NORTH CAROLINA Division IN RE: CASE NUMBER:DEBTOR(S) ) ) JUDGMENT CREDITOR (PLAINTIFF) ) ) ) VS. ) ADVERSARY PROCEEDING ) NUMBER: ) JUDGMENT DEBTOR (DEFENDANT) ) ) ) ) NOTICE OF RIGHT TO HAVE EXEMPTIONS DESIGNATED A judgment has been entered against you in the case captioned above in which you have been ordered to:[ ] pay money over to the judgment creditor (Plaintiff). [ ] turn over various household belongings to the judgment creditor (Plaintiff). The judgment creditor (person who has the judgment against you) is now seeking to collect this judgment andhas asked me to give you notice of your rights. Under the Constitution and laws of North Carolina, you have the rightto exempt from the collection of the judgment certain of your property (in other words, to keep it from being taken fromyou). If you wish to keep your exempt property, you MUST fill out the attached schedule of property and mail or takeit to the Clerk at the address listed below. You MUST also mail or take a copy to the judgment creditor (plaintiff) athis address listed below. It is important that you respond to this notice no later than 20 days after it was served on you because you willlose valuable constitutional and statutory rights if you do nothing. If you do not respond, you will give up your rightto exemptions and the judgment creditor (plaintiff) may be able to take any or all of your property to satisfy thejudgment. You may wish to consider hiring an attorney to help you with this proceeding to make certain that youreceive all the protection to which you are entitled under the North Carolina Constitution and laws. Judgment Creditor (Plaintiff) or Attorney Date Address Signature Telephone Clerk, U.S. Bankruptcy Court, EDNC 9 P.O. Drawer 2807, Wilson, NC 27894-2807 9 P.O. Box 1441, Raleigh, NC 27602-1441 >>>> 2Notice to the Judgment Creditor (Plaintiff) You may serve this notice and the motion to claim exempt property by mailing a copy of each, registered orcertified mail, return receipt requested, addressed to the judgment debtor (defendant). To prove service, you must filean affidavit (notarized by a notary public) with the clerk asserting that (1) a copy of the notice or rights and motionto claim exempt property was deposited in the post office for mailing by registered or certified mail, return receiptrequested; (2) it was in fact received as evidenced by the attached registry receipt or other evidence of delivery; and(3) the genuine receipt or other evidence of delivery is attached. You must attach the post office delivery receipt to theaffidavit. Alternatively, you may choose to have this notice and the motion served by the U.S. Marshall. If you selectthis method, you must pay a service fee. The Marshalls service will be proven by his return. If your attempted service by certified or registered mail or personal service by the Marshall fails, you may thenserve the judgment debtor (defendant) by mailing a copy of notice and motion to him at his last known address. Toprove service, you must file a certificate with the clerk that the notice and motion were served indicating why you usedsuch service, the date the notice was mailed and the address to which it was mailed. Remember, you may NOT useservice by regular first class mail until you have tried first to serve the judgment debtor (defendant) personally or bycertified or registered mail and such service was unsuccessful. RETURN OF SERVICE BY U.S. MARSHALL I certify that this notice and a copy of a motion to claim exempt property were received and served as follows: Date Served Name of Judgment Debtor (Defendant) [ ] By delivering to the judgment debtor (defendant) named above a copy of the notice and motion to claim exempt property. [ ] By leaving a copy of the notice and motion to claim exempt property at the dwelling house or usual place of abode of the judgment debtor (defendant) named above with a person of suitable age and discretion. Name of person with whom copies left. Address where copies delivered or left. [ ] Debtor (Defendant) WAS NOT served for the following reason: Service Fee Paid Date Received Name of U.S. Marshall Making Return: Date of Return Address: