Rev. 01/13 UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF NORTH CAROLINA Division CASE NUMBER: IN RE: DEBTOR(S) ) ) ) ) ) ) ) ) ) ) ) ) ) JUDGMENT CREDITOR (PLAINTIFF) ADVERSARY PROCEEDING NUMBER: VS. JUDGMENT DEBTOR (DEFENDANT) ORDER DESIGNATING EXEMPT PROPERTY Upon notice and motion duly made, and for good cause shown, it is ORDERED: that all property listed in the motion and schedule attached is designated as exempt property. that the following property belonging to the judgment debtor, of the value as shown, is designated as exempt property [] [] Item Description Judgment Debtor's Interest Exemption Value Residence Burial Plot Household goods, furnishings, appliances, etc. Interest in Motor Vehicle List any other exempt property [ ] It is further ORDERED as follows: Dated: Clerk of Court American LegalNet, Inc. www.FormsWorkFlow.com