SC-303, 11/17 Non-Earnings Garnishment (Small Claims) 247247799.01(1)(d)2, 812.15, 812.18(3), and 815.18(1), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Non - Earnings Garnishment (Small Claims) Case No. Creditor: - vs - Debtor: and Garnishee: To the garnishee: 1. My income or assets are completely exempt from garnishment because A. the judgment has been paid. B. the judgment has been discharged in bankruptcy. C. I have filed bankruptcy and enforcement of the judgment has been stayed. Name of bankruptcy court: . Bankruptcy court file number: . D. the judgment is void. E. I have another defense to this non-earnings garnishment. [Explain briefly] 2. My income or assets are completely exempt or $ is exempt under the exemption checked below: A. for each one week pay period [Wis. Stats. 247815.18(3)(h)]. B. Depository accounts in the aggregate value of $5,000 [Wis. Stats. 247815.18(3)(k)]. C. 24745.03(8)(b) or 38 USC 501-562]. D. Assistance grants [Wis. Stats. 24749.96]. E. Pension funds and benefits from 1st class cities and counties of populations over 500,000 [Wis. Stats. 24762.63(4) and Ch. 201, Laws 1937, s. 11]. F. 247102.27(1)]. G. Unemployment insurance benefits [Wis. Stats. 247108.13(2)]. H. y [Wis. Stats. 247178.21(3)(c)]. I. Tenants housing corporation lease and stock interests [Wis. Stats. 247182.004(6)]. J. Income or assets required to be paid by customers as restitution [Wis. Stats. 247425.106(1)(d)]. K. Insurance company deposits with the State Treasurer [Wis. Stats. 247601.13(7)]. L. Fraternal benefits [Wis. Stats. 247614.96]. M. Child support, family support or maintenance payments [Wis. Stats. 247815.18(3)(c)]. N. Federal disability insurance payments [Wis. Stats. 247815.18(3)(ds)]. O. Fire and casualty insurance proceeds [Wis. Stats. 247815.18(3)(e)]. P. Fire and police pension and benefits [Wis. Stats. 247815.18(3)(ef)]. Q. Life insurance contract and accrued dividends, interest or loan value as provided by statute [Wis. Stats. 247815.18(3)(f)]. R. Life insurance claims, personal injury or wrongful death claims [Wis. Stats. 247815.18(3)(i)]. S. Retirement and public employee trust funds [Wis. Stats. 24724740.08(1) and 815.18(3)(j)]. T. Federal war pensions [Wis. Stats. 247815.18(3)(n)]. U. Crime victim award [Wis. Stats. 247949.07]. V. College savings accounts [Wis. Stats. 247815.18(3)(p)]. W. Clothing, jewelry, household furniture and furnishings [Wis. Stats. 247425.106(1)(b)]. X. Consumer goods held primarily for personal, family, or household use not to exceed $12,000 [Wis. Stats. 247815.18(3)(d)]. Y. Any other exemptions permitted under the law. [Explain briefly] American LegalNet, Inc. www.FormsWorkFlow.com SC-303, 11/17 Non-Earnings Garnishment (Small Claims) 247247799.01(1)(d)2, 812.15, 812.18(3), and 815.18(1), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 I understand that if I claim a complete exemption, limitation or defense in bad faith, I may be held liable for court costs. The debtor is required to deliver or mail a copy of this form within 20 days of service of the summons to the court, the creditor, and the garnishee . Mailed/delivered on [ D ate ] . Debtor Name Printed or Typed Date Address Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com