Official Form 106C Schedule C: The Property You Claim as Exempt page 1 of 106C Schedule C: The Property You Claim as Exempt Be as complete and accurate as possible. If two married people are filing together, both are equally responsible for supplying correct information. Using the property you listed on Schedule A/B: Property (Official Form 106A/B) as your source, list the property that you claim as exempt. If more space is needed, fill out and attach to this page as many copies of Part 2: Additional Page as necessary. On the top of any additional pages, write your name and case number (if known). For each item of property you claim as exempt, you must specify the amount of the exemption you claim. One way of doing so is to state a specific dollar amount as exempt. Alternatively, you may claim the full fair market value of the property being exempted up to the amount of any applicable statutory limit. Some exemptions227such as those for health aids, rights to receive certain benefits, and tax-exempt retirement funds227may be unlimited in dollar amount. However, if you claim an exemption of 100% of fair market value under a law that limits the exemption to a particular dollar amount and the value of the property is determined to exceed that amount, your exemption would be limited to the applicable statutory amount. Part 1: Identify the Property You Claim as Exempt 1.Which set of exemptions are you claiming? Check one only, even if your spouse is filing with you. You are claiming state and federal nonbankruptcy exemptions. 11 U.S.C. 247 522(b)(3) You are claiming federal exemptions. 11 U.S.C. 247 522(b)(2) 2.For any property you list on Schedule A/B that you claim as exempt, fill in the information below. Brief description of the property and line on Schedule A/B that lists this property Current value of the portion you own Copy the value from Schedule A/B Amount of the exemption you claim Check only one box for each exemption. Specific laws that allow exemption Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up to any applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: $ $ 100% of fair market value, up toany applicable statutory limit Line from Schedule A/B: Are you claiming a homestead exemption of more than $1?(Subject to adjustment on 4/01/ and every 3 years after that for cases filed on or after the date of adjustment.)NoYes. Did you acquire the property covered by the exemption within 1,215 days before you filed this case?NoYes Debtor 1 First Name Middle Name Last Name Debtor 2 (Spouse, if filing) First Name Middle Name Last Name United States Bankruptcy Court for the: District of Case number (If known) Fill in this information to identify your case: Check if this is anamended filing American LegalNet, Inc. www.FormsWorkFlow.com Debtor 1 Case number (if known) First Name Middle Name Last Name Schedule C: The Property You Claim as Exemptpage of Part 2: Additional Page Brief description of the property and line on Schedule A/B that lists this property Current value of the portion you own Copy the value from Schedule A/B Amount of the exemption you claim Check only one box for each exemption Specific laws that allow exemption Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up to any applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up to any applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up to any applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up to any applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit Brief description: Line from Schedule A/B: $ $ 100% of fair market value, up toany applicable statutory limit American LegalNet, Inc. www.FormsWorkFlow.com