FORM F-10 (revised 12/01/09) UNITED STATES BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA In re Case No.: Chapter: Debtor(s) MOTION TO AVOID NON-POSSESSORY, NON-PURCHASE MONEY SECURITY INTEREST The Debtor(s) moves the Court, pursuant to 11 U.S.C. Section 522(f), to enter an order avoiding a lien which is a non-possessory, non-purchase money security interest in household goods and furnishings maintained by the Debtors(s) for personal and family use. The name and address of the creditor holding the non-possessory, non-purchase money security interest are listed below: (Name) (Address) (City,State,Zip) The Debtor(s) further represents that the security interest held by the above-named creditor impairs an exemption to which the Debtor(s) would be entitled under West Virginia Code Section 38-10-4. The property subject to the creditor's non-possessory, non-purchase money security interest is property of the type described under 11 U.S.C. Section 522(f) and is listed below: The lien attached after the day of , 20 . Wherefore, the Debtor(s) moves the Court for an order determining the non-possessory, non-purchase money security interest to be null and void, and for such other and further relief as is just. Dated: Name(s) of Debtor(s) (printed) Counsel for Debtor(s) (printed) Signature American LegalNet, Inc. www.FormsWorkFlow.com