FO RM H-3 UNITED STATES DISTRICT COURT UNITED STATES BANK RUPTCY COU RT SOU TH ERN DIST RICT OF W EST VIRG INIA In re Case No. _______________________ Chapter ________________________ Debtor(s), Plaintiff(s), v. Adv. Proc. No. __________________ Defendant(s), v. Suggestee. NOTICE OF POSSIBILITY OF EXEMPTIONS TO SUGGESTION To: ________________________________________________________ NO TICE IS HER EBY GIVE N that in the above-styled case, a suggestion has been filed by the plaintiff for m oney owed to yo u by ________________________________________________________________ (suggestee) Please refer to the attached document for details for the suggestion req uested by the p laintiff. NOT ICE IS FURT HER G IVEN that under the laws of the State of West Virginia or the United States of America, there exist certain exemption rights that may be available to you which would relieve you of the obligation to pay all or part o f this judgment by means of the suggestion re quested by the plaintiff. You may con sult an attorney for more specific information on the nature and kind of these exemptions to see whether or not you are eligible to claim any of these exemptions. If you are eligible for such exemptions, your attorney (or you, if you have no attorney) may file a Request for Exemption with the United States Marshal, Robert C. B yrd United States Courthouse, 300 Virginia Street East, Charleston, W est Virginia, stating specifically your reason for an exemp tion and req uesting a hearing to determine your exemption rights. This Req uest for Exemption should be filed within twenty (20) days of receiving this notice. A copy of your Request for Exemption should also be sent to plaintiff's attorney, whose name and address are listed below: ______________________________________________ ______________________________________________ ______________________________________________ Date: UNITED STATES BANK RUPTCY CLERK by (Seal of the Court) _________________________________ Deputy Clerk American LegalNet, Inc. www.FormsWorkflow.com