AOC Form Garnishment Claim for Exemption & Request for Hearing Revised 0 4 /15 /2019 In the District Court of County State of Oklahoma ) Plaintiff /Judgment Creditor ) ) vs. ) ) ) Case No. Defendant /Judgment Debtor ) ) and ) ) ) Garnishee ) Claim for Exemption and Request for Hearing 1. I claim that f unds sought in this garnishment action are exempt from execution because they are (check applicable box): A. Social Security benefits 42 U.S.C. 247 407. B. Supplemental security income 42 U.S.C. 247 1383(d). C. Unemployment benefits 40 O.S. 247 2 - 303. D. 85 A O.S. 247 10 . E. Welfare benefits 56 O.S. 247 173. F. 38 U.S.C. 247 5 101, 31 O.S. 247 7. G. Monies in Possession of Police Pensions 11 O.S. 247 50 - 124. H. 11 O.S. 247 49 - 126. I. 19 O.S. 247 959. J. Monies in Possession of Publ 74 O.S. 247 923. K. 70 O.S. 247 17 - 109. L. Annuities and pension payments under Railroad Retirement Act 45 U.S.C. 247 231m M. United States Civil Service Retirement and Disability Pension Fund Payment s 5 U.S.C. 247 8346. N. United States Civil Service Survivor Annuities 5 U.S.C. 247 8346. O. Interest in Retirement, Pension and Profit S haring Plans 60 O.S. 247 327, 60 O.S. 247 328. P. The Wages of Masters and Seamen 46 U.S.C. 247 11109 . Q. Funds vested in the Alien Property Custodian 50 U.S.C. 4309 (f). R. Prepaid Burial Benefits 36 O.S. 247 6125. S. Proceeds of Group - Life Insurance Policy 36 O.S. 3632, and 36 O.S. 247 4026. T. Alimony, support, separate mainten ance, or child support necessary for support of judgment debtor or dependent 31 O.S. 247 1.1. U. Personal wage exemption because of undue hardship 31 O.S. 247 1.1. American LegalNet, Inc. www.FormsWorkFlow.com AOC Form Garnishment Claim for Exemption & Request for Hearing Revised 0 4 /15 /2019 V. 33 U.S.C. 247 916 W. Foreign Service Retirement and Disability Benefits 22 U.S.C. 247 4060 X. Compensation for Injury, Death, or Detent ion of Employees of Contractors with the US Outside of the US 42 U.S.C. 247 1717 Y. Student loans or work assistance 20 U.S.C. 247 1095a Z. FEMA Assistance 44 CFR 206.110 AA . Other ( please state ): 2. Check one box: I claim that a ll funds are exempt, or, I claim that the following amount of money is exempt: $ (Fill in the amount of funds claimed to be exempt) . 3. Check if applicable: I have attached copies of the documents that show that my money is exempt. 4. If garnishment is for wages, this claim and request is filed for the pay period through , inclusive. 5. I request a court hearing to decide my claim for exemption . Notice of the hearing should be given to me at: ( Address) In accordance with 12 O.S. 247 426, I state under penalty of perjury under the laws of Oklahoma that the foregoing is true and correct. Signature Date Mailing Instructions Defendant must mail the original Claim for Exemption and Request for Hearing to the Court Clerk of County at the following address: A copy of the Claim for Exemption and Request for Hearing should be mailed at the following address : American LegalNet, Inc. www.FormsWorkFlow.com