1.1                          A bill for an act 
  1.2             relating to creditors' remedies; regulating 
  1.3             garnishments, executions, and levies; revising forms; 
  1.4             regulating service; defining terms; providing 
  1.5             notification; increasing the dollar amount of 
  1.6             attorneys' execution levies; making various 
  1.7             housekeeping and technical changes; amending Minnesota 
  1.8             Statutes 1998, sections 550.051, subdivision 1; 
  1.9             550.136, subdivisions 2 and 9; 550.143, subdivisions 7 
  1.10            and 8; 551.01; 551.04, subdivisions 4, 6, and 9; 
  1.11            551.05, subdivision 5; 551.06, subdivision 9; 571.72, 
  1.12            subdivision 2; 571.74; 571.79; 571.82, subdivision 1; 
  1.13            571.914, subdivision 2; and 571.921; Minnesota 
  1.14            Statutes 1999 Supplement, sections 550.136, 
  1.15            subdivisions 6 and 10; 550.143, subdivision 3; 551.05, 
  1.16            subdivision 1a; 551.06, subdivision 10; 571.75, 
  1.17            subdivision 2; 571.912; and 571.925; proposing coding 
  1.18            for new law in Minnesota Statutes, chapters 550; 551; 
  1.19            and 571; repealing Minnesota Statutes 1998, section 
  1.20            571.80. 
  1.21  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.22     Section 1.  [550.031] [JUDGMENT CREDITOR DISCLOSURE; 
  1.23  SATISFACTION OF OUTSTANDING JUDGMENTS.] 
  1.24     Subdivision 1.  [DISCLOSURE.] An application for a writ of 
  1.25  execution must be accompanied by a sworn affidavit from the 
  1.26  judgment creditor stating whether the judgment creditor is a 
  1.27  judgment debtor in the county where the writ is being obtained 
  1.28  or executed, to the extent known by the judgment creditor.  The 
  1.29  affidavit must include an itemized list of any outstanding 
  1.30  judgments and the persons to whom the judgments are owed.  The 
  1.31  state court administrator shall prepare and distribute forms for 
  1.32  making the disclosure required under this subdivision.  
  1.33     Subd. 2.  [SATISFACTION.] If a judgment creditor discloses 
  2.1   outstanding judgment debts under subdivision 1, the sheriff or 
  2.2   other officer executing the writ shall first apply the proceeds 
  2.3   that are recovered to payment of those debts of the judgment 
  2.4   creditor and any remainder shall be remitted to the judgment 
  2.5   creditor. 
  2.6      Sec. 2.  Minnesota Statutes 1998, section 550.051, 
  2.7   subdivision 1, is amended to read: 
  2.8      Subdivision 1.  [TIME PERIODS.] The writ of execution 
  2.9   expires 180 days after its issuance by the court administrator.  
  2.10  A levy that is served with a writ of execution that has expired 
  2.11  is void.  If the officer or creditor's attorney having the writ 
  2.12  levies upon property or earnings before the expiration of 180 
  2.13  days, the officer or creditor's attorney may retain the writ 
  2.14  until the officer sells the property or completes the levy upon 
  2.15  earnings in the manner prescribed by law.  Any levy properly 
  2.16  served in accordance with this chapter or chapter 551 prior to 
  2.17  the expiration of the writ shall be processed in accordance with 
  2.18  the appropriate statutory section until completion, without 
  2.19  regard for the date of expiration of the writ.  Upon a demand of 
  2.20  the judgment creditor or the creditor's attorney within 180 
  2.21  days, the officer shall pay to the judgment creditor or the 
  2.22  judgment creditor's attorney all money collected upon execution 
  2.23  after deducting the officer's fees.  Upon expiration of the writ 
  2.24  or full satisfaction of the judgment, if earlier, the officer 
  2.25  shall make a full inventory of the property levied on and return 
  2.26  it with the execution.  
  2.27     Sec. 3.  Minnesota Statutes 1998, section 550.136, 
  2.28  subdivision 2, is amended to read: 
  2.29     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
  2.30  following terms have the meanings given them: 
  2.31     (a) "earnings" means: 
  2.32     (1) compensation paid or payable to an employee for 
  2.33  personal service whether denominated as wages, salary, 
  2.34  commissions, bonus, or otherwise, and includes periodic payments 
  2.35  pursuant to a pension or retirement program; 
  2.36     (2) compensation paid or payable to the producer for the 
  3.1   sale of agricultural products; livestock or livestock products; 
  3.2   milk or milk products; or fruit or other horticultural products 
  3.3   produced when the producer is operating a family farm, a family 
  3.4   farm corporation, or an authorized farm corporation, as defined 
  3.5   in section 500.24, subdivision 2; or 
  3.6      (3) maintenance as defined in section 518.54, subdivision 3.
  3.7      (b) "disposable earnings" means that part of the earnings 
  3.8   of an individual remaining after the deduction from those 
  3.9   earnings of amounts required by law to be withheld, including 
  3.10  amounts required by court order to be withheld for child support 
  3.11  obligations; 
  3.12     (c) "employee" means an individual who performs services 
  3.13  subject to the right of the employer to control both what is 
  3.14  done and how it is done; and 
  3.15     (d) "employer" means a person for whom an individual 
  3.16  performs services as an employee. 
  3.17     Sec. 4.  Minnesota Statutes 1999 Supplement, section 
  3.18  550.136, subdivision 6, is amended to read: 
  3.19     Subd. 6.  [EARNINGS EXEMPTION NOTICE.] Before the first 
  3.20  levy on earnings under this chapter, the judgment creditor shall 
  3.21  serve upon the judgment debtor no less than ten days before the 
  3.22  service of the writ of execution, a notice that the writ of 
  3.23  execution may be served on the judgment debtor's employer.  The 
  3.24  notice must:  (1) be substantially in the form set forth below; 
  3.25  (2) be served personally, in the manner of a summons and 
  3.26  complaint, or by first class mail to the last known address of 
  3.27  the judgment debtor; (3) inform the judgment debtor that an 
  3.28  execution levy may be served on the judgment debtor's employer 
  3.29  in ten days, and that the judgment debtor may, within that time, 
  3.30  cause to be served on the judgment creditor a signed statement 
  3.31  under penalties of perjury asserting an entitlement to an 
  3.32  exemption from execution; (4) inform the judgment debtor of the 
  3.33  earnings exemptions contained in section 550.37, subdivision 14; 
  3.34  and (5) advise the judgment debtor of the relief set forth in 
  3.35  this chapter to which the debtor may be entitled if a judgment 
  3.36  creditor in bad faith disregards a valid claim and the fee, 
  4.1   costs, and penalty that may be assessed against a judgment 
  4.2   debtor who in bad faith falsely claims an exemption or in bad 
  4.3   faith takes action to frustrate the execution process.  The 
  4.4   notice requirement of this subdivision does not apply to a levy 
  4.5   on earnings being retained by an employer pursuant to a 
  4.6   garnishment previously served in compliance with chapter 571.  
  4.7      The ten-day notice informing a judgment debtor that a writ 
  4.8   of execution may be used to levy the earnings of an individual 
  4.9   must be substantially in the following form: 
  4.10  STATE OF MINNESOTA                             DISTRICT COURT
  4.11  COUNTY OF .............         ........... JUDICIAL DISTRICT
  4.12  .............(Judgment Creditor)
  4.13  against
  4.14                                        EXECUTION EXEMPTION 
  4.15  .............(Judgment Debtor)        NOTICE AND NOTICE OF 
  4.16  and                                   INTENT TO LEVY ON EARNINGS 
  4.17                                        WITHIN TEN DAYS
  4.18  .............(Third Party)
  4.19     PLEASE TAKE NOTICE that a levy may be served upon your 
  4.20  employer or other third parties, without any further court 
  4.21  proceedings or notice to you, ten days or more from the date 
  4.22  hereof.  Your earnings are completely exempt from execution levy 
  4.23  if you are now a recipient of relief based on need, if you have 
  4.24  been a recipient of relief within the last six months, or if you 
  4.25  have been an inmate of a correctional institution in the last 
  4.26  six months. 
  4.27     Relief based on need includes Minnesota Family Investment 
  4.28  Program (MFIP), Emergency Assistance (EA), Work First, Medical 
  4.29  Assistance (MA), General Assistance (GA), General Assistance 
  4.30  Medical Care (GAMC), Emergency General Assistance (EGA), 
  4.31  Minnesota Supplemental Aid (MSA), MSA Emergency Assistance 
  4.32  (MSA-EA), Supplemental Security Income (SSI), and Energy 
  4.33  Assistance. 
  4.34     If you wish to claim an exemption, you should fill out the 
  4.35  appropriate form below, sign it, and send it to the judgment 
  4.36  creditor's attorney. 
  5.1      You may wish to contact the attorney for the judgment 
  5.2   creditor in order to arrange for a settlement of the debt or 
  5.3   contact an attorney to advise you about exemptions or other 
  5.4   rights. 
  5.5                              PENALTIES
  5.6      (1) Be advised that even if you claim an exemption, an 
  5.7      execution levy may still be served on your employer.  If 
  5.8      your earnings are levied on after you claim an exemption, 
  5.9      you may petition the court for a determination of your 
  5.10     exemption.  If the court finds that the judgment creditor 
  5.11     disregarded your claim of exemption in bad faith, you will 
  5.12     be entitled to costs, reasonable attorney fees, actual 
  5.13     damages, and an amount not to exceed $100. 
  5.14     (2) HOWEVER, BE WARNED if you claim an exemption, the 
  5.15     judgment creditor can also petition the court for a 
  5.16     determination of your exemption, and if the court finds 
  5.17     that you claimed an exemption in bad faith, you will be 
  5.18     assessed costs and reasonable attorney's fees plus an 
  5.19     amount not to exceed $100. 
  5.20     (3) If after receipt of this notice, you in bad faith take 
  5.21     action to frustrate the execution levy, thus requiring the 
  5.22     judgment creditor to petition the court to resolve the 
  5.23     problem, you will be liable to the judgment creditor for 
  5.24     costs and reasonable attorney's fees plus an amount not to 
  5.25     exceed $100. 
  5.26  DATED:  ............           ........................
  5.27                                 (Attorney for Judgment Creditor)
  5.28                                 ........................
  5.29                                 Address
  5.30                                 ........................
  5.31                                 Telephone
  5.32              JUDGMENT DEBTOR'S EXEMPTION CLAIM NOTICE
  5.33     I hereby claim that my earnings are exempt from execution 
  5.34  because: 
  5.35     (1) I am presently a recipient of relief based on need. 
  5.36     (Specify the program, case number, and the county from 
  6.1      which relief is being received.) 
  6.2   ................    ......................   ...............
  6.3   Program             Case Number (if known)   County
  6.4      (2) I am not now receiving relief based on need, but I have 
  6.5      received relief based on need within the last six months.  
  6.6      (Specify the program, case number, and the county from 
  6.7      which relief has been received.) 
  6.8   ................    ......................   ...............
  6.9   Program             Case Number (if known)   County
  6.10     (3) I have been an inmate of a correctional institution 
  6.11     within the last six months.  (Specify the correctional 
  6.12     institution and location.) 
  6.13  ...........................       ..........................
  6.14  Correctional Institution          Location
  6.15     I hereby authorize any agency that has distributed relief 
  6.16  to me or any correctional institution in which I was an inmate 
  6.17  to disclose to the above-named judgment creditor or the judgment 
  6.18  creditor's attorney only whether or not I am or have been a 
  6.19  recipient of relief based on need or an inmate of a correctional 
  6.20  institution within the last six months.  I have mailed or 
  6.21  delivered a copy of this form to the judgment creditor or 
  6.22  judgment creditor's attorney. 
  6.23  ...........................          .........................
  6.24                                       Debtor
  6.25                                       .........................
  6.26                                       Address
  6.27                                       .........................
  6.28                                       Debtor Telephone Number
  6.29     Sec. 5.  Minnesota Statutes 1998, section 550.136, 
  6.30  subdivision 9, is amended to read: 
  6.31     Subd. 9.  [EXECUTION EARNINGS DISCLOSURE FORM AND 
  6.32  WORKSHEET.] The judgment creditor shall provide to the sheriff 
  6.33  for service upon the judgment debtor's employer an execution 
  6.34  earnings disclosure form and an earnings disclosure worksheet 
  6.35  with the writ of execution, that must be substantially in the 
  6.36  form set forth below. 
  7.1   STATE OF MINNESOTA                              DISTRICT COURT
  7.2   COUNTY OF .............          ........... JUDICIAL DISTRICT
  7.3                                             FILE NO. ..... 
  7.4   ................ (Judgment Creditor)
  7.5   against                                   EARNINGS 
  7.6   ................ (Judgment Debtor)        EXECUTION
  7.7   and                                       DISCLOSURE
  7.8   ................ (Third Party)
  7.9                             DEFINITIONS
  7.10     "EARNINGS":  For the purpose of execution, "earnings" means 
  7.11  compensation paid or payable to an employee for personal 
  7.12  services or compensation paid or payable to the producer for the 
  7.13  sale of agricultural products; milk or milk products; or fruit 
  7.14  or other horticultural products produced when the producer is 
  7.15  operating a family farm, a family farm corporation, or an 
  7.16  authorized farm corporation, as defined in section 500.24, 
  7.17  subdivision 2, whether denominated as wages, salary, commission, 
  7.18  bonus, or otherwise, and includes periodic payments pursuant to 
  7.19  a pension or retirement.  
  7.20     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
  7.21  an individual remaining after the deduction from those earnings 
  7.22  of amounts required by law to be withheld, including amounts 
  7.23  required by court order to be withheld for child support 
  7.24  obligations.  (Amounts required by law to be withheld do not 
  7.25  include items such as health insurance, charitable 
  7.26  contributions, or other voluntary wage deductions.) 
  7.27     "PAYDAY":  For the purpose of execution, "payday(s)" means 
  7.28  the date(s) upon which the employer pays earnings to the debtor 
  7.29  in the ordinary course of business.  If the judgment debtor has 
  7.30  no regular payday, payday(s) means the 15th and the last day of 
  7.31  each month.  
  7.32     THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING 
  7.33  QUESTIONS:  
  7.34     (1) Do you now owe, or within 70 days from the date the 
  7.35  execution levy was served on you, will you or may you owe money 
  7.36  to the judgment debtor for earnings?  
  8.1                                .......         .......
  8.2                                Yes             No
  8.3      (2) Does the judgment debtor earn more than $... per week? 
  8.4   (this amount is the federal minimum wage per week)  
  8.5                                .......         .......
  8.6                                Yes             No
  8.7                   INSTRUCTIONS FOR COMPLETING THE 
  8.8                         EARNINGS DISCLOSURE 
  8.9      A.  If your answer to either question 1 or 2 is "No," then 
  8.10  you must sign the affirmation below and return this disclosure 
  8.11  to the sheriff within 20 days after it was served on you, and 
  8.12  you do not need to answer the remaining questions.  
  8.13     B.  If your answers to both questions 1 and 2 are "Yes," 
  8.14  you must complete this form and the Earnings Disclosure 
  8.15  Worksheet as follows:  
  8.16     For each payday that falls within 70 days from the date the 
  8.17     execution levy was served on you, YOU MUST calculate the 
  8.18     amount of earnings to be retained by completing steps 3 
  8.19     through 11 on page 2, and enter the amounts on the Earnings 
  8.20     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
  8.21     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
  8.22     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. 
  8.23     Each payday, you must retain the amount of earnings listed 
  8.24     in column I on the Earnings Disclosure Worksheet.  
  8.25     You must pay the attached earnings and return this earnings 
  8.26     disclosure form and the Earnings Disclosure Worksheet to 
  8.27     the sheriff and deliver a copy of the disclosure and 
  8.28     worksheet to the judgment debtor within ten days after the 
  8.29     last payday that falls within the 70-day period.  If the 
  8.30     judgment is wholly satisfied or if the judgment debtor's 
  8.31     employment ends before the expiration of the 70-day period, 
  8.32     your disclosure and remittance should be made within ten 
  8.33     days after the last payday for which earnings were attached.
  8.34     For steps 3 through 11, "columns" refers to columns on the 
  8.35  Earnings Disclosure Worksheet.  
  8.36     (3) COLUMN A.  Enter the date of judgment debtor's payday.  
  9.1      (4) COLUMN B.  Enter judgment debtor's gross earnings for 
  9.2   each payday.  
  9.3      (5) COLUMN C.  Enter judgment debtor's disposable earnings 
  9.4   for each payday.  
  9.5      (6) COLUMN D.  Enter 25 percent of disposable earnings.  
  9.6   (Multiply column C by .25.)  
  9.7      (7) COLUMN E.  Enter here 40 times the hourly federal 
  9.8   minimum wage ($...) times the number of work weeks included in 
  9.9   each payday.  (Note:  if a payday includes days in excess of 
  9.10  whole work weeks, the additional days should be counted as a 
  9.11  fraction of a work week equal to the number of work days in 
  9.12  excess of a whole work week divided by the number of work days 
  9.13  in a normal work week.)  
  9.14     (8) COLUMN F.  Subtract the amount in column E from the 
  9.15  amount in column C, and enter here.  
  9.16     (9) COLUMN G.  Enter here the lesser of the amount in 
  9.17  column D and the amount in column F.  
  9.18     (10) COLUMN H.  Enter here any amount claimed by you as a 
  9.19  setoff, defense, lien, or claim, or any amount claimed by any 
  9.20  other person as an exemption or adverse interest which would 
  9.21  reduce the amount of earnings owing to the judgment debtor.  
  9.22  (Note:  Any indebtedness to you incurred within ten days prior 
  9.23  to your receipt of the first execution levy on a debt may not be 
  9.24  set off against the earnings otherwise subject to this levy.  
  9.25  Any wage assignment made by the judgment debtor within ten days 
  9.26  prior to your receipt of the first execution levy on a debt is 
  9.27  void.) 
  9.28     You must also describe your claim(s) and the claims of 
  9.29  others, if known, in the space provided below the worksheet and 
  9.30  state the name(s) and address(es) of these persons.  
  9.31     Enter zero in column H if there are no claims by you or 
  9.32  others which would reduce the amount of earnings owing to the 
  9.33  judgment debtor.  
  9.34     (11) COLUMN I.  Subtract the amount in column H from the 
  9.35  amount in column G and enter here.  This is the amount of 
  9.36  earnings that you must remit for the payday for which the 
 10.1   calculations were made.  
 10.2                             AFFIRMATION
 10.3      I, ................... (person signing Affirmation), am the 
 10.4   third party/employer or I am authorized by the third 
 10.5   party/employer to complete this earnings disclosure, and have 
 10.6   done so truthfully and to the best of my knowledge.  
 10.7   Dated:  ............                 ............................
 10.8                                        Signature
 10.9                                        ............................
 10.10                                       Title
 10.11                                       ............................
 10.12                                       Telephone Number
 10.13   EARNINGS DISCLOSURE WORKSHEET                ...................
 10.14                                                      Debtor's Name
 10.15  A                     B                      C
 10.16  Payday                Gross                  Disposable
 10.17  Date                  Earnings               Earnings
 10.18  1.  ........          $.......               $.........
 10.19  2.  ........          ........               ..........
 10.20  3.  ........          ........               ..........
 10.21  4.  ........          ........               ..........
 10.22  5.  ........          ........               ..........
 10.23  6.  ........          ........               ..........
 10.24  7.  ........          ........               ..........
 10.25  8.  ........          ........               ..........
 10.26  9.  ........          ........               ..........
 10.27  10. ........          ........               ..........
 10.28  D                     E                      F
 10.29  25% of                40 X Min.              Column C
 10.30  Column C              Wage                   minus
 10.31                                               Column E
 10.32  1.  ........          ........               ..........
 10.33  2.  ........          ........               ..........
 10.34  3.  ........          ........               ..........
 10.35  4.  ........          ........               ..........
 10.36  5.  ........          ........               ..........
 11.1   6.  ........          ........               ..........
 11.2   7.  ........          ........               ..........
 11.3   8.  ........          ........               ..........
 11.4   9.  ........          ........               ..........
 11.5   10. ........          ........               ..........
 11.6    G                     H                      I
 11.7   Lesser of             Setoff, Lien,          Column G
 11.8   Column D              Adverse                minus
 11.9   and                   Interest, or           Column H
 11.10  Column F              Other Claims
 11.11  1.  ........          ........               ..........
 11.12  2.  ........          ........               ..........
 11.13  3.  ........          ........               ..........
 11.14  4.  ........          ........               ..........
 11.15  5.  ........          ........               ..........
 11.16  6.  ........          ........               ..........
 11.17  7.  ........          ........               ..........
 11.18  8.  ........          ........               ..........
 11.19  9.  ........          ........               ..........
 11.20  10. ........          ........               ..........
 11.21                           TOTAL OF COLUMN I $............
 11.22     *If you entered any amount in column H for any payday(s), 
 11.23  you must describe below either your claims, or the claims of 
 11.24  others.  For amounts claimed by others, you must both state the 
 11.25  names and addresses of such persons, and the nature of their 
 11.26  claim, if known.  
 11.27     
 11.28  .................................................................
 11.29  .................................................................
 11.30  .................................................................
 11.31                            AFFIRMATION 
 11.32     I, ................. (person signing Affirmation), am the 
 11.33  third party or I am authorized by the third party to complete 
 11.34  this earnings disclosure worksheet, and have done so truthfully 
 11.35  and to the best of my knowledge.  
 11.36                                        .................
 12.1                                         Signature
 12.2   Dated:            ...............     (...)............
 12.3                     Title               Phone Number
 12.4      Sec. 6.  Minnesota Statutes 1999 Supplement, section 
 12.5   550.136, subdivision 10, is amended to read: 
 12.6      Subd. 10.  [EXECUTION EARNINGS DISCLOSURE FORM AND 
 12.7   WORKSHEET FOR CHILD SUPPORT JUDGMENTS.] The judgment creditor 
 12.8   shall provide to the sheriff for service upon a child support 
 12.9   judgment debtor's employer an execution earnings disclosure form 
 12.10  and an earnings disclosure worksheet with the writ of execution, 
 12.11  that must be substantially in the form set forth below. 
 12.12  STATE OF MINNESOTA                              DISTRICT COURT
 12.13  COUNTY OF .............          ........... JUDICIAL DISTRICT
 12.14                                            FILE NO. ..... 
 12.15  ................ (Judgment Creditor)
 12.16  against                                   EARNINGS 
 12.17  ................ (Judgment Debtor)        EXECUTION
 12.18  and                                       DISCLOSURE
 12.19  ................ (Third Party)
 12.20                            DEFINITIONS
 12.21     "EARNINGS":  For the purpose of execution, "earnings" means 
 12.22  compensation paid or payable to an employee for personal 
 12.23  services or compensation paid or payable to the producer for the 
 12.24  sale of agricultural products; milk or milk products; or fruit 
 12.25  or other horticultural products produced when the producer is 
 12.26  operating a family farm, a family farm corporation, or an 
 12.27  authorized farm corporation, as defined in section 500.24, 
 12.28  subdivision 2, whether denominated as wages, salary, commission, 
 12.29  bonus, or otherwise, and includes periodic payments pursuant to 
 12.30  a pension or retirement, workers' compensation, or reemployment 
 12.31  compensation.  
 12.32     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 12.33  an individual remaining after the deduction from those earnings 
 12.34  of amounts required by law to be withheld, including amounts 
 12.35  required by court order to be withheld for child support 
 12.36  obligations.  (Amounts required by law to be withheld do not 
 13.1   include items such as health insurance, charitable 
 13.2   contributions, or other voluntary wage deductions.) 
 13.3      "PAYDAY":  For the purpose of execution, "payday(s)" means 
 13.4   the date(s) upon which the employer pays earnings to the debtor 
 13.5   in the ordinary course of business.  If the judgment debtor has 
 13.6   no regular payday, payday(s) means the 15th and the last day of 
 13.7   each month.  
 13.8      THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING QUESTION:
 13.9      (1) Do you now owe, or within 70 days from the date the 
 13.10  execution levy was served on you, will you or may you owe money 
 13.11  to the judgment debtor for earnings?  
 13.12                               .......         .......
 13.13                               Yes             No
 13.14                  INSTRUCTIONS FOR COMPLETING THE 
 13.15                        EARNINGS DISCLOSURE 
 13.16     A.  If your answer to question 1 is "No," then you must 
 13.17  sign the affirmation below and return this disclosure to the 
 13.18  sheriff within 20 days after it was served on you, and you do 
 13.19  not need to answer the remaining questions.  
 13.20     B.  If your answer to question 1 is "Yes," you must 
 13.21  complete this form and the Earnings Disclosure Worksheet as 
 13.22  follows:  
 13.23     For each payday that falls within 70 days from the date the 
 13.24     execution levy was served on you, YOU MUST calculate the 
 13.25     amount of earnings to be retained by completing steps 2 
 13.26     through 8 on page 2, and enter the amounts on the Earnings 
 13.27     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 13.28     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 13.29     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. 
 13.30     Each payday, you must retain the amount of earnings listed 
 13.31     in column G on the Earnings Disclosure Worksheet.  
 13.32     You must pay the attached earnings and return this earnings 
 13.33     disclosure form and the Earnings Disclosure Worksheet to 
 13.34     the sheriff and deliver a copy of the disclosure and 
 13.35     worksheet to the judgment debtor within ten days after the 
 13.36     last payday that falls within the 70-day period.  If the 
 14.1      judgment is wholly satisfied or if the judgment debtor's 
 14.2      employment ends before the expiration of the 70-day period, 
 14.3      your disclosure and remittance should be made within ten 
 14.4      days after the last payday for which earnings were attached.
 14.5      For steps 2 through 8, "columns" refers to columns on the 
 14.6   Earnings Disclosure Worksheet.  
 14.7      (2) COLUMN A.  Enter the date of judgment debtor's payday.  
 14.8      (3) COLUMN B.  Enter judgment debtor's gross earnings for 
 14.9   each payday.  
 14.10     (4) COLUMN C.  Enter judgment debtor's disposable earnings 
 14.11  for each payday. 
 14.12     (5) COLUMN D.  Enter either 50, 55, 60, or 65 percent of 
 14.13  disposable earnings, based on which of the following 
 14.14  descriptions fits the child support judgment debtor:  
 14.15     (a) 50 percent of the judgment debtor's disposable income, 
 14.16  if the judgment debtor is supporting a spouse or dependent child 
 14.17  and the judgment is 12 weeks old or less (12 weeks to be 
 14.18  calculated to the beginning of the work week in which the 
 14.19  execution levy is received); 
 14.20     (b) 55 percent of the judgment debtor's disposable income, 
 14.21  if the judgment debtor is supporting a spouse or dependent 
 14.22  child, and the judgment is over 12 weeks old (12 weeks to be 
 14.23  calculated to the beginning of the work week in which the 
 14.24  execution levy is received); 
 14.25     (c) 60 percent of the judgment debtor's disposable income, 
 14.26  if the judgment debtor is not supporting a spouse or dependent 
 14.27  child and the judgment is 12 weeks old or less (12 weeks to be 
 14.28  calculated to the beginning of the work week in which the 
 14.29  execution levy is received); or 
 14.30     (d) 65 percent of the judgment debtor's disposable income, 
 14.31  if the judgment debtor is not supporting a spouse or dependent 
 14.32  child, and the judgment is over 12 weeks old (12 weeks to be 
 14.33  calculated to the beginning of the work week in which the 
 14.34  execution levy is received).  (Multiply column C by .50, .55, 
 14.35  .60, or .65, as appropriate.)  
 14.36     (6) COLUMN E.  Enter here any amount claimed by you as a 
 15.1   setoff, defense, lien, or claim, or any amount claimed by any 
 15.2   other person as an exemption or adverse interest that would 
 15.3   reduce the amount of earnings owing to the judgment debtor.  
 15.4   (Note:  Any indebtedness to you incurred within ten days prior 
 15.5   to your receipt of the first execution levy may not be set off 
 15.6   against the earnings otherwise subject to this levy.  Any wage 
 15.7   assignment made by the judgment debtor within ten days prior to 
 15.8   your receipt of the first execution levy is void.) 
 15.9      You must also describe your claim(s) and the claims of 
 15.10  others, if known, in the space provided below the worksheet and 
 15.11  state the name(s) and address(es) of these persons.  
 15.12     Enter zero in column E if there are no claims by you or 
 15.13  others that would reduce the amount of earnings owing to the 
 15.14  judgment debtor.  
 15.15     (7) COLUMN F.  Subtract the amount in column E from the 
 15.16  amount in column D and enter here.  This is the amount of 
 15.17  earnings that you must remit for the payday for which the 
 15.18  calculations were made.  
 15.19                            AFFIRMATION
 15.20     I, ................... (person signing Affirmation), am the 
 15.21  third party/employer or I am authorized by the third 
 15.22  party/employer to complete this earnings disclosure, and have 
 15.23  done so truthfully and to the best of my knowledge. 
 15.24  Dated:  ............                 ............................
 15.25                                       Signature
 15.26                                       ............................
 15.27                                       Title
 15.28                                       ............................
 15.29                                       Telephone Number
 15.30   EARNINGS DISCLOSURE WORKSHEET            ...................
 15.31                                                  Debtor's Name
 15.32  A                      B                      C
 15.33  Payday                 Gross                  Disposable
 15.34  Date                   Earnings               Earnings
 15.35  1.  ........           $.......               $.........
 15.36  2.  ........           ........               ..........
 16.1   3.  ........           ........               ..........
 16.2   4.  ........           ........               ..........
 16.3   5.  ........           ........               ..........
 16.4   6.  ........           ........               ..........
 16.5   7.  ........           ........               ..........
 16.6   8.  ........           ........               ..........
 16.7   9.  ........           ........               ..........
 16.8   10. ........           ........               ..........
 16.9   D                      E                      F
 16.10  Either 50, 55,         Setoff, Lien,          Column D
 16.11  60, or 65% of          Adverse                minus
 16.12  Column C               Interest, or           Column E
 16.13                         Other Claims 
 16.14  1.  ........           ..........             ..........
 16.15  2.  ........           ..........             ..........
 16.16  3.  ........           ..........             ..........
 16.17  4.  ........           ..........             ..........
 16.18  5.  ........           ..........             ..........
 16.19  6.  ........           ..........             ..........
 16.20  7.  ........           ..........             ..........
 16.21  8.  ........           ..........             ..........
 16.22  9.  ........           ..........             ..........
 16.23  10. ........           ..........             ..........
 16.24                           TOTAL OF COLUMN F $............
 16.25     *If you entered any amount in column E for any payday(s), 
 16.26  you must describe below either your claims, or the claims of 
 16.27  others.  For amounts claimed by others, you must both state the 
 16.28  names and addresses of such persons, and the nature of their 
 16.29  claim, if known.  
 16.30     
 16.31  .................................................................
 16.32  .................................................................
 16.33  .................................................................
 16.34                            AFFIRMATION 
 16.35     I, ................. (person signing Affirmation), am the 
 16.36  third party or I am authorized by the third party to complete 
 17.1   this earnings disclosure worksheet, and have done so truthfully 
 17.2   and to the best of my knowledge.  
 17.3                                         .................
 17.4                                         Signature
 17.5   Dated:            ...............     (...)............
 17.6                     Title               Phone Number
 17.7      Sec. 7.  Minnesota Statutes 1999 Supplement, section 
 17.8   550.143, subdivision 3, is amended to read: 
 17.9      Subd. 3.  [EXEMPTION NOTICE.] If the levy is on funds of a 
 17.10  judgment debtor who is a natural person and if the funds to be 
 17.11  levied are held on deposit at any financial institution, the 
 17.12  judgment creditor or its attorney shall provide the sheriff with 
 17.13  two copies of an exemption notice, which must be substantially 
 17.14  in the form set forth below.  The sheriff shall serve both 
 17.15  copies of the exemption notice on the financial institution, 
 17.16  along with the writ of execution.  Failure of the sheriff to 
 17.17  serve the exemption notices renders the levy void, and the 
 17.18  financial institution shall take no action.  However, if this 
 17.19  subdivision is being used to execute on funds that have 
 17.20  previously been garnished in compliance with section 571.71, the 
 17.21  judgment creditor is not required to serve additional exemption 
 17.22  notices.  In that event, the execution levy shall only be 
 17.23  effective as to the funds that were subject to the prior 
 17.24  garnishment.  Upon receipt of the writ of execution and 
 17.25  exemption notices, the financial institution shall retain as 
 17.26  much of the amount due under section 550.04 as the financial 
 17.27  institution has on deposit owing to the judgment debtor, but not 
 17.28  more than 110 percent of the amount remaining due on the 
 17.29  judgment.  
 17.30  STATE OF MINNESOTA                             DISTRICT COURT
 17.31  COUNTY OF ................       .......... JUDICIAL DISTRICT
 17.32  .............(Judgment Creditor) 
 17.33  .............(Judgment Debtor) 
 17.34  TO:  Debtor                                  EXEMPTION NOTICE 
 17.35     An order for attachment, garnishment summons, or levy of 
 17.36  execution (strike inapplicable language) has been served on 
 18.1   ............. (Bank or other financial institution where you 
 18.2   have an account.)  
 18.3      Your account balance is $........  
 18.4      The amount being held is $........  
 18.5      However, all or a portion of the funds in your account will 
 18.6   normally be exempt from creditors' claims if they are in one of 
 18.7   the following categories:  
 18.8      (1) relief based on need.  This includes the Minnesota 
 18.9   Family Investment Program (MFIP), Emergency Assistance (EA), 
 18.10  Work First Program, Medical Assistance (MA), General Assistance 
 18.11  (GA), General Assistance Medical Care (GAMC), Emergency General 
 18.12  Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
 18.13  Emergency Assistance (MSA-EA), Supplemental Security Income 
 18.14  (SSI), and Energy Assistance; 
 18.15     (2) Social Security benefits (Old Age, Survivors, or 
 18.16  Disability Insurance); 
 18.17     (3) reemployment compensation, workers' compensation, or 
 18.18  veterans' benefits; 
 18.19     (4) an accident, disability, or retirement pension or 
 18.20  annuity; 
 18.21     (5) life insurance proceeds; 
 18.22     (6) the earnings of your minor child and any child support 
 18.23  paid to you; or 
 18.24     (7) money from a claim for damage or destruction of exempt 
 18.25  property (such as household goods, farm tools, business 
 18.26  equipment, a mobile home, or a car).  
 18.27     The following funds are also exempt: 
 18.28     (8) all earnings of a person in category (1); 
 18.29     (9) all earnings of a person who has received relief based 
 18.30  on need, or who has been an inmate of a correctional 
 18.31  institution, within the last six months; 
 18.32     (10) 75 percent of every debtor's after tax earnings; and 
 18.33     (11) all of a judgment debtor's after tax earnings below 40 
 18.34  times the federal minimum wage. 
 18.35     TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
 18.36     Categories (10) and (11):  20 days 
 19.1      Categories (8) and (9):  60 days 
 19.2      All others:  no time limit, as long as funds are traceable 
 19.3   to the exempt source.  (In tracing funds, the first-in, 
 19.4   first-out method is used.  This means money deposited first is 
 19.5   spent first.)  The money being sought by the judgment creditor 
 19.6   is being held in your account to give you a chance to claim an 
 19.7   exemption. 
 19.8      TO CLAIM AN EXEMPTION:  
 19.9      Fill out, sign, and mail or deliver one copy of the 
 19.10  attached exemption claim form to the institution which sent you 
 19.11  this notice and mail or deliver one copy to the judgment 
 19.12  creditor's attorney.  In the event that there is no attorney for 
 19.13  the judgment creditor, then the notice shall be sent directly to 
 19.14  the judgment creditor.  The address for the judgment creditor's 
 19.15  attorney or the judgment creditor is set forth below.  <b>Both</b> 
 19.16  <b>copies must be mailed or delivered on the same day.</b> 
 19.17     <b>NOTE:  You may help resolve your claim faster if you send</b> 
 19.18     <b>to the creditor's attorney written proof or documents that</b> 
 19.19     <b>show why your money is exempt.  If you have questions</b> 
 19.20     <b>regarding the documents to send as proof of an exemption,</b> 
 19.21     <b>call the creditor's attorney.  If you do not send written</b> 
 19.22     <b>proof and the creditor's attorney has questions about your</b> 
 19.23     <b>exemption claim, the creditor's attorney may object to your</b> 
 19.24     <b>claim which may result in a further delay in releasing your</b> 
 19.25     <b>exempt funds.</b> 
 19.26     If the financial institution does not get the exemption 
 19.27  claim back from you within 14 days of the date they mailed or 
 19.28  gave it to you, they will be free to turn the money over to the 
 19.29  sheriff or the judgment creditor.  If you are going to claim an 
 19.30  exemption, do so as soon as possible, because your money may be 
 19.31  held until it is decided. 
 19.32     IF YOU CLAIM AN EXEMPTION:  
 19.33     (1) nonexempt money can be turned over to the judgment 
 19.34  creditor or sheriff; 
 19.35     (2) the financial institution will keep holding the money 
 19.36  claimed to be exempt; and 
 20.1      (3) seven days after receiving your exemption claim, the 
 20.2   financial institution will release the money to you unless 
 20.3   before then it receives an objection to your exemption claim.  
 20.4      IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
 20.5      the institution will hold the money until a court decides 
 20.6   if your exemption claim is valid, BUT ONLY IF the institution 
 20.7   gets a copy of your court motion papers asserting the exemption 
 20.8   WITHIN TEN DAYS after the objection is personally served on you, 
 20.9   or within 13 days from the date the objection is mailed or given 
 20.10  to you.  You may wish to consult an attorney at once if the 
 20.11  creditor objects to your exemption claim.  
 20.12     MOTION TO DETERMINE EXEMPTION:  
 20.13     At any time after your funds have been held, you may ask 
 20.14  for a court decision on the validity of your exemption claim by 
 20.15  filing a request for hearing which may be obtained at the office 
 20.16  of the court administrator of the above court. 
 20.17     PENALTIES:  
 20.18     If you claim an exemption in bad faith, or if the judgment 
 20.19  creditor wrongly objects to an exemption in bad faith, the court 
 20.20  may order the person who acted in bad faith to pay costs, actual 
 20.21  damages, attorney fees, and an additional amount of up to $100.  
 20.22                                ............................. 
 20.23                                ............................. 
 20.24                                ............................. 
 20.25                                ............................. 
 20.26                                Name and address of (Attorney 
 20.27                                for) Judgment Creditor
 20.28     EXEMPTION:  
 20.29     (a) Amount of exemption claim.  
 20.30     / / I claim ALL the funds being held are exempt.  
 20.31     / / I claim SOME of the funds being held are exempt.  
 20.32           The exempt amount is $............  
 20.33     (b) Basis for exemption.  
 20.34     Of the 11 categories listed above, I am in category number 
 20.35  ............  (If more than one category applies, you may fill 
 20.36  in as many as apply.)  The source of the exempt funds is the 
 21.1   following:  
 21.2   .............................................................
 21.3   .............................................................
 21.4   .............................................................
 21.5      (If the source is a type of relief based on need, list the 
 21.6   case number and county:  
 21.7      case number:  ...............; 
 21.8      county:  ....................) 
 21.9      I hereby authorize any agency that has distributed relief 
 21.10  to me or any correctional institution in which I was an inmate 
 21.11  to disclose to the above named creditor or its attorney only 
 21.12  whether or not I am or have been a recipient of relief based on 
 21.13  need or an inmate of a correctional institute within the last 
 21.14  six months.  
 21.15     I have mailed or delivered a copy of the exemption notice 
 21.16  to the judgment creditor or judgment creditor's attorney if 
 21.17  represented at the address indicated above. 
 21.18                               .............................
 21.19                               DEBTOR
 21.20  DATED:  .............        .............................
 21.21                               .............................
 21.22                               .............................
 21.23                               DEBTOR ADDRESS 
 21.24                               .............................
 21.25                               DEBTOR TELEPHONE NUMBER
 21.26     Sec. 8.  Minnesota Statutes 1998, section 550.143, 
 21.27  subdivision 7, is amended to read: 
 21.28     Subd. 7.  [NOTICE OF OBJECTION.] (a) The written objection 
 21.29  to the judgment debtor's claim of exemption must be in 
 21.30  substantially the following form:  
 21.31  STATE OF MINNESOTA                             DISTRICT COURT
 21.32  COUNTY OF ...............         ..........JUDICIAL DISTRICT
 21.33  ...................(Judgment Creditor)        OBJECTION TO
 21.34  ...................(Judgment Debtor)          EXEMPTION CLAIM
 21.35  ...................(Garnishee) (Third Party)
 21.36     The judgment creditor objects to your claim for exemption 
 22.1   from garnishment, levy of execution, order for attachment 
 22.2   (strike inapplicable language) for the following reason(s):  
 22.3   .................................................................
 22.4   .................................................................
 22.5   .................................................................
 22.6      Because of this objection, your financial institution will 
 22.7   retain the funds you claimed to be exempt for an additional ten 
 22.8   days.  If you wish to request a hearing on your exemption claim, 
 22.9   you should need to do so within ten days of your receipt of this 
 22.10  objection from the date the objection was personally served on 
 22.11  you, or within 13 days of the date the objection was mailed to 
 22.12  you.  You may request a hearing by completing the attached form 
 22.13  and filing it with the court administrator.  
 22.14     1.  The court administrator's office shall provide clerical 
 22.15  assistance to help with the writing and filing of a Request for 
 22.16  Hearing by any person not represented by counsel.  The court 
 22.17  administrator may charge a fee of $1 for the filing of a Request 
 22.18  for Hearing.  
 22.19     2.  Upon the filing of a Request for Hearing, the court 
 22.20  administrator shall schedule the matter for a hearing no later 
 22.21  than five business days from the date of filing.  The court 
 22.22  administrator shall forthwith send a completed copy of the 
 22.23  request, including the hearing date, time, and place to the 
 22.24  adverse party and to the financial institution by first class 
 22.25  mail. 
 22.26     3.  If it is possible that the financial institution might 
 22.27  not receive the request mailed from the court administrator 
 22.28  within ten days, then you may want to personally deliver a copy 
 22.29  of the request to the financial institution after you have filed 
 22.30  your request with the court. 
 22.31     4.  An order stating whether your funds are exempt shall be 
 22.32  issued by the court within three days of the date of the hearing.
 22.33     If you do not file a Request for Hearing within ten days of 
 22.34  the date you receive this objection the objection was personally 
 22.35  served on you, or within 13 days from the date the objection was 
 22.36  mailed to you, your financial institution may turn your funds 
 23.1   over to your creditor. 
 23.2      If you file a Request for Hearing and your financial 
 23.3   institution receives it within ten days of the date it received 
 23.4   this objection, your financial institution will retain your 
 23.5   funds claimed to be exempt until otherwise ordered by the court. 
 23.6                                      ............................
 23.7                                      Judgment Creditor or Attorney
 23.8      Sec. 9.  Minnesota Statutes 1998, section 550.143, 
 23.9   subdivision 8, is amended to read: 
 23.10     Subd. 8.  [REQUEST FOR HEARING AND NOTICE FOR HEARING.] The 
 23.11  request for hearing accompanying the objection notice must be in 
 23.12  substantially the following form: 
 23.13  STATE OF MINNESOTA                             DISTRICT COURT
 23.14  COUNTY OF ........                  ........JUDICIAL DISTRICT
 23.15  ..................(Judgment Creditor)    REQUEST FOR HEARING
 23.16  ..................(Judgment Debtor)             AND
 23.17  ..................(Third Party)          NOTICE FOR HEARING
 23.18     I hereby request a hearing to resolve the exemption claim 
 23.19  which has been made in this case regarding funds in the account 
 23.20  of ............. (Judgment Debtor) at the ......... (Financial 
 23.21  Institution). 
 23.22     I believe the property being held is exempt because 
 23.23  .................................................................
 23.24  .................................................................
 23.25  Dated:...........................................................
 23.26                                            (JUDGMENT DEBTOR)
 23.27                                            ...................
 23.28                                            (ADDRESS)
 23.29                                            ...................
 23.30                                            (DEBTOR PHONE NUMBER)
 23.31                                            ...................
 23.32  HEARING DATE:  ................    TIME:  ...................
 23.33  HEARING PLACE:  ...............
 23.34     (Note to both parties:  Bring with you to the hearing all 
 23.35  documents and materials relevant to the exemption claim and 
 23.36  objection.  Failure to do so could delay the court's decision.) 
 24.1      Sec. 10.  Minnesota Statutes 1998, section 551.01, is 
 24.2   amended to read: 
 24.3      551.01 [ATTORNEY'S SUMMARY EXECUTION OF JUDGMENT DEBTS; 
 24.4   WHEN AUTHORIZED.] 
 24.5      An attorney for a judgment creditor may execute on a money 
 24.6   judgment by levying on indebtedness owed to the judgment debtor 
 24.7   by a third party, pursuant to this chapter.  The attorney for 
 24.8   the judgment creditor must obtain a writ of execution issued 
 24.9   under section 550.04 before the attorney can execute pursuant to 
 24.10  this chapter.  No more than $5,000 $10,000 may be recovered by a 
 24.11  single notice of execution levy pursuant to this section.  No 
 24.12  more than one execution may be served on a single third party by 
 24.13  a judgment creditor each calendar day under this chapter.  
 24.14     Sec. 11.  Minnesota Statutes 1998, section 551.04, 
 24.15  subdivision 4, is amended to read: 
 24.16     Subd. 4.  [SERVICE OF THIRD PARTY LEVY; NOTICE AND 
 24.17  DISCLOSURE FORMS.] When levying upon money or earnings owed to 
 24.18  the judgment debtor by a third party, the attorney for the 
 24.19  judgment creditor shall serve a copy of the writ of execution 
 24.20  upon the third party either by registered or certified mail, or 
 24.21  by personal service.  A third party levy served by registered or 
 24.22  certified mail is effective if served at the third party's 
 24.23  regular place of business.  Along with a copy of the writ of 
 24.24  execution, the attorney shall serve upon the third party a 
 24.25  notice of third party levy and disclosure form that must be 
 24.26  substantially in the form set forth below.  If the levy is upon 
 24.27  earnings, the attorney shall serve upon the third party the 
 24.28  notice of third party levy and disclosure form as set forth in 
 24.29  section 551.06, subdivision 9. 
 24.30  STATE OF MINNESOTA                             DISTRICT COURT 
 24.31  County of .............           ..........JUDICIAL DISTRICT
 24.32                                    File No. .................. 
 24.33  ..............(Judgment Creditor) 
 24.34  against                                 NOTICE OF THIRD PARTY 
 24.35  ..............(Judgment Debtor)         LEVY AND DISCLOSURE 
 24.36  and                                     (OTHER THAN EARNINGS)
 25.1   ..............(Third Party)
 25.2      PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 25.3   chapter 551, the undersigned, as attorney for the judgment 
 25.4   creditor, hereby makes demand and levies execution upon all 
 25.5   money due and owing by you (up to $5,000 $10,000) to the 
 25.6   judgment debtor for the amount of the judgment specified below.  
 25.7   A copy of the writ of execution issued by the court is 
 25.8   enclosed.  The unpaid judgment balance is $.......  
 25.9      In responding to this levy, you are to complete the 
 25.10  attached disclosure form and mail it to the undersigned attorney 
 25.11  for the judgment creditor, together with your check payable to 
 25.12  the above-named judgment creditor, for the nonexempt amount owed 
 25.13  by you to the judgment debtor or for which you are obligated to 
 25.14  the judgment debtor, within the time limits set forth in chapter 
 25.15  551. 
 25.16     If you are a financial institution and the judgment debtor 
 25.17  is a natural person, two exemption notices are also enclosed 
 25.18  pursuant to Minnesota Statutes, section 551.02.  Only natural 
 25.19  persons are entitled to exemptions under this statute. 
 25.20                          Attorney for the Judgment Creditor
 25.21                          Address 
 25.24                          (...........)
 25.25                          Phone number 
 25.27                             DISCLOSURE
 25.28     On the ..... day of ............., ......., the time of 
 25.29  service of the execution levy herein, there was due and owing 
 25.30  the judgment debtor from the third party the following:  
 25.31     (1) Money.  Enter on the line below any amounts due and 
 25.32  owing the judgment debtor, except earnings, from the third party.
 25.33  ....................................................... 
 25.34     (2) Setoff.  Enter on the line below the amount of any 
 25.35  setoff, defense, lien, or claim which the third party claims 
 25.36  against the amount set forth on line (1).  State the facts by 
 26.1   which such setoff, defense, lien, or claim is claimed.  (Any 
 26.2   indebtedness to you incurred by the judgment debtor within ten 
 26.3   days prior to the receipt of the first execution levy on a debt 
 26.4   may not be claimed as a setoff, defense, lien, or claim against 
 26.5   the amount set forth on line (1).) 
 26.6   .............................................. 
 26.7      (3) Exemption.  Enter on the line below any amounts or 
 26.8   property claimed by the judgment debtor to be exempt from 
 26.9   execution.  
 26.10  .............................................. 
 26.11     (4) Adverse Interest.  Enter on the line below any amounts 
 26.12  claimed by other persons by reason of ownership or interest in 
 26.13  the judgment debtor's property.  
 26.14  .............................................. 
 26.15     (5) Enter on the line below the total of lines (2), (3), 
 26.16  and (4).  
 26.17  ................................................... 
 26.18     (6) Enter on the line below the difference obtained (never 
 26.19  less than zero when line (5) is subtracted from the amount on 
 26.20  line (1)). 
 26.21  ..................................................... 
 26.22     (7) Enter on the line below 100 percent of the amount of 
 26.23  the judgment creditor's claim which remains unpaid.  
 26.24  ..................................................... 
 26.25     (8) Enter on the line below the lesser of line (6) and line 
 26.26  (7).  You are hereby instructed to remit this amount only if it 
 26.27  is $10 or more.  
 26.28  ..................................................... 
 26.29                            AFFIRMATION 
 26.30     I, ....................... (person signing Affirmation), am 
 26.31  the third party or I am authorized by the third party to 
 26.32  complete this nonearnings disclosure, and have done so 
 26.33  truthfully and to the best of my knowledge.  
 26.34  Dated:  ................                     ..................
 26.35                                               Signature
 26.36                                               ..................
 27.1                                                Title
 27.2                                                ..................
 27.3                                                Telephone Number
 27.4      Sec. 12.  Minnesota Statutes 1998, section 551.04, 
 27.5   subdivision 6, is amended to read: 
 27.6      Subd. 6.  [THIRD PARTY DISCLOSURE AND REMITTANCE.] Within 
 27.7   15 days after receipt of the writ of execution, unless governed 
 27.8   by section 551.05 or 551.06, the third party shall disclose and 
 27.9   remit to the judgment creditor's attorney as much of the amount 
 27.10  due under section 550.04, but not more than $5,000 $10,000, as 
 27.11  the third party's own debt equals to the judgment debtor.  The 
 27.12  attorney for the judgment creditor shall proceed in all other 
 27.13  respects like the sheriff making a similar execution levy.  No 
 27.14  more than $5,000 $10,000 may be recovered by a single execution 
 27.15  levy pursuant to this section.  
 27.16     Sec. 13.  Minnesota Statutes 1998, section 551.04, 
 27.17  subdivision 9, is amended to read: 
 27.18     Subd. 9.  [JUDGMENT AGAINST THIRD PARTY UPON FAILURE TO 
 27.19  DISCLOSE OR REMIT.] Judgment may be entered against a third 
 27.20  party who has been served with a writ of execution and fails to 
 27.21  disclose or remit the levied funds as required in this chapter.  
 27.22  Upon order to show cause served on the third party and notice of 
 27.23  motion supported by affidavit of facts and affidavit of service 
 27.24  upon both the judgment debtor and third party, the court may 
 27.25  render judgment against the third party for an amount not 
 27.26  exceeding 100 percent of the amount claimed in the execution or 
 27.27  $5,000 $10,000, whichever is less.  Judgment against the third 
 27.28  party pursuant to this section shall not bar the judgment 
 27.29  creditor from further remedies under this chapter as a result of 
 27.30  any subsequent defaults by the third party.  The court upon good 
 27.31  cause shown may remove the default and permit the third party to 
 27.32  disclose or remit on just terms.  
 27.33     Sec. 14.  [551.041] [ATTORNEY'S SUMMARY EXECUTION OF FUNDS 
 27.34  BEING HELD PURSUANT TO GARNISHMENT SUMMONS.] 
 27.35     Pursuant to this section, an attorney for a judgment 
 27.36  creditor may execute on funds retained by a garnishee under a 
 28.1   garnishment summons served pursuant to chapter 571.  No more 
 28.2   than $10,000 may be recovered by a single execution levy 
 28.3   pursuant to this section.  When levying upon money or earnings 
 28.4   being retained by a garnishee pursuant to a garnishment summons, 
 28.5   the attorney shall serve a copy of the writ of execution upon 
 28.6   the garnishee by registered or certified mail, or by personal 
 28.7   service.  Along with a copy of the writ of execution, the 
 28.8   attorney shall serve upon the garnishee a notice of levy on 
 28.9   garnishee that must be substantially in the form set forth 
 28.10  below.  If the judgment creditor paid the garnishee the fee 
 28.11  required by chapter 571, no additional fee must be paid to the 
 28.12  garnishee for the levy.  The notice of levy on garnishee may not 
 28.13  be served until the judgment debtor's right to claim an 
 28.14  exemption has expired under chapter 571. 
 28.15  STATE OF MINNESOTA                             DISTRICT COURT
 28.16  County of .............           ..........JUDICIAL DISTRICT
 28.17                                    File No. ..................
 28.18  ............(Judgment Creditor)
 28.19  against
 28.20  ..............(Judgment Debtor)     NOTICE OF LEVY
 28.21  and                                 ON GARNISHEE
 28.22  ....................(Garnishee)
 28.23     PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 28.24  chapter 551, the undersigned as attorney for the judgment 
 28.25  creditor, hereby makes demand and levies execution upon all 
 28.26  money or earnings being retained by you (up to $10,000) pursuant 
 28.27  to the judgment creditor's garnishment summons dated 
 28.28  ................  A copy of the writ of execution issued by the 
 28.29  court is enclosed.  Upon receipt of this levy, you shall remit 
 28.30  to the judgment creditor's attorney all funds being held by you 
 28.31  pursuant to the garnishment summons.  The funds shall be 
 28.32  remitted within 15 days after receipt of this levy. 
 28.33  Date: ...............        Attorney for the Judgment Creditor
 28.34                               Address:  ........................
 28.35                               ..................................
 28.36                               Phone Number:  ...................
 29.1                                Attorney I.D. No.:  ..............
 29.2      Sec. 15.  [551.042] [MONEY DUE FROM STATE DEPARTMENTS.] 
 29.3      Money due or owing to any entity or person by the state on 
 29.4   account of any employment, work, contract with, or services 
 29.5   provided to any state department or agency is subject to 
 29.6   attachment.  The notice of third party levy and disclosure may 
 29.7   be served upon the head of the department or agency in the same 
 29.8   manner as other summons in that court of record, except that 
 29.9   service may not be made by publication.  Service of the notice 
 29.10  may also be made by certified mail, return receipt requested.  
 29.11  The disclosure shall be made by the head of the department or 
 29.12  agency, or by some person designated by the head of the 
 29.13  department or agency having knowledge of the facts.  If payment 
 29.14  is made pursuant to judgment against the state as a third party, 
 29.15  a certificate of satisfaction to the extent of the payment 
 29.16  endorsed on it shall be delivered to the head of the department 
 29.17  or agency as a voucher for the payment. 
 29.18     Sec. 16.  [551.043] [SALARY OF PUBLIC SERVANTS.] 
 29.19     The salary or wages of an official or employee of a county, 
 29.20  town, city, or school district, or any department of these 
 29.21  bodies, is subject to attachment.  The notice of third party 
 29.22  levy and disclosure shall be served upon the auditor, treasurer, 
 29.23  or clerk of the body, or head of the department of the body of 
 29.24  which that person is an official or employee.  The disclosure 
 29.25  shall be made by the officer or person so served, or by some 
 29.26  person designated by that person having knowledge of the facts.  
 29.27  If payment is made by the county, town, city, or school 
 29.28  district, or any department of these bodies pursuant to a 
 29.29  judgment against it as a third party, a certified copy of the 
 29.30  judgment with a certificate of satisfaction to the extent of the 
 29.31  payment endorsed on it shall be delivered to the treasurer as a 
 29.32  voucher for the payment. 
 29.33     Sec. 17.  Minnesota Statutes 1999 Supplement, section 
 29.34  551.05, subdivision 1a, is amended to read: 
 29.35     Subd. 1a.  [EXEMPTION NOTICE.] If the writ of execution is 
 29.36  being used by the attorney to levy funds of a judgment debtor 
 30.1   who is a natural person and if the funds to be levied are held 
 30.2   on deposit at any financial institution, the attorney for the 
 30.3   judgment creditor shall serve with the writ of execution two 
 30.4   copies of an exemption notice.  The notice must be substantially 
 30.5   in the form set forth below.  Failure of the attorney for the 
 30.6   judgment creditor to send the exemption notice renders the 
 30.7   execution levy void, and the financial institution shall take no 
 30.8   action.  However, if this subdivision is being used to execute 
 30.9   on funds that have previously been garnished in compliance with 
 30.10  section 571.71, the attorney for judgment creditor is not 
 30.11  required to serve an additional exemption notice.  In that 
 30.12  event, the execution levy shall only be effective as to the 
 30.13  funds that were subject to the prior garnishment.  Upon receipt 
 30.14  of the writ of execution and exemption notices, the financial 
 30.15  institution shall retain as much of the amount due under section 
 30.16  550.04 as the financial institution has on deposit owing to the 
 30.17  judgment debtor, but not more than 100 percent of the amount 
 30.18  remaining due on the judgment, or $5,000 $10,000, whichever is 
 30.19  less.  
 30.20     The notice informing a judgment debtor that an execution 
 30.21  levy has been used to attach funds of the judgment debtor to 
 30.22  satisfy a claim must be substantially in the following form: 
 30.23     
 30.24  STATE OF MINNESOTA                             DISTRICT COURT 
 30.25  County of ................         .........JUDICIAL DISTRICT 
 30.26  ................(Judgment Creditor)
 30.27  ................(Judgment Debtor) 
 30.28  TO:  Judgment Debtor                 EXEMPTION NOTICE 
 30.29     An order for attachment, garnishment summons, or levy of 
 30.30  execution (strike inapplicable language) has been served on 
 30.31  ............. (bank or other financial institution where you 
 30.32  have an account).  
 30.33     Your account balance is $........  
 30.34     The amount being held is $........  
 30.35     However, all or a portion of the funds in your account will 
 30.36  normally be exempt from creditors' claims if they are in one of 
 31.1   the following categories:  
 31.2      (1) relief based on need.  This includes the Minnesota 
 31.3   Family Investment Program (MFIP), Work First Program, Medical 
 31.4   Assistance (MA), General Assistance (GA), General Assistance 
 31.5   Medical Care (GAMC), Emergency General Assistance (EGA), 
 31.6   Minnesota Supplemental Aid (MSA), MSA Emergency Assistance 
 31.7   (MSA-EA), Supplemental Security Income (SSI), and Energy 
 31.8   Assistance; 
 31.9      (2) Social Security benefits (Old Age, Survivors, or 
 31.10  Disability Insurance); 
 31.11     (3) reemployment compensation, workers' compensation, or 
 31.12  veterans' benefits; 
 31.13     (4) an accident, disability, or retirement pension or 
 31.14  annuity; 
 31.15     (5) life insurance proceeds; 
 31.16     (6) the earnings of your minor child and any child support 
 31.17  paid to you; or 
 31.18     (7) money from a claim for damage or destruction of exempt 
 31.19  property (such as household goods, farm tools, business 
 31.20  equipment, a mobile home, or a car).  
 31.21     The following funds are also exempt: 
 31.22     (8) all earnings of a person in category (1); 
 31.23     (9) all earnings of a person who has received relief based 
 31.24  on need, or who has been an inmate of a correctional 
 31.25  institution, within the last six months; 
 31.26     (10) 75 percent of every judgment debtor's after tax 
 31.27  earnings; or 
 31.28     (11) all of a judgment debtor's after tax earnings below 40 
 31.29  times the federal minimum wage.  
 31.30     TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
 31.31     Categories (10) and (11):  20 days 
 31.32     Categories (8) and (9):  60 days 
 31.33     All others:  no time limit, as long as funds are traceable 
 31.34  to the exempt source.  (In tracing funds, the first-in, 
 31.35  first-out method is used.  This means money deposited first is 
 31.36  spent first.)  The money being sought by the judgment creditor 
 32.1   is being held in your account to give you a chance to claim an 
 32.2   exemption. 
 32.3      TO CLAIM AN EXEMPTION:  
 32.4      Fill out, sign, and mail or deliver one copy of the 
 32.5   attached exemption claim form to the institution which sent you 
 32.6   this notice and mail or deliver one copy to the judgment 
 32.7   creditor's attorney.  The address for the judgment creditor's 
 32.8   attorney is set forth below.  <b>Both copies must be mailed or</b> 
 32.9   <b>delivered on the same day.</b>  
 32.10     <b>NOTE:  You may help resolve your claim faster if you send</b> 
 32.11     <b>to the creditor's attorney written proof or documents that</b> 
 32.12     <b>show why your money is exempt.  If you have questions</b> 
 32.13     <b>regarding the documents to send as proof of an exemption,</b> 
 32.14     <b>call the creditor's attorney.  If you do not send written</b> 
 32.15     <b>proof and the creditor's attorney has questions about your</b> 
 32.16     <b>exemption claim, the creditor's attorney may object to your</b> 
 32.17     <b>claim which may result in a further delay in releasing your</b> 
 32.18     <b>exempt funds.</b> 
 32.19     If they do not get the exemption claim back from you within 
 32.20  14 days of the date they mailed or gave it to you, they will be 
 32.21  free to turn the money over to the attorney for the judgment 
 32.22  creditor.  If you are going to claim an exemption, do so as soon 
 32.23  as possible, because your money may be held until it is decided. 
 32.24     IF YOU CLAIM AN EXEMPTION:  
 32.25     (1) nonexempt money can be turned over to the judgment 
 32.26  creditor or sheriff; 
 32.27     (2) the financial institution will keep holding the money 
 32.28  claimed to be exempt; and 
 32.29     (3) seven days after receiving your exemption claim, the 
 32.30  financial institution will release the money to you unless 
 32.31  before then it receives an objection to your exemption claim.  
 32.32     IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
 32.33     the institution will hold the money until a court decides 
 32.34  if your exemption claim is valid, BUT ONLY IF the institution 
 32.35  gets a copy of your court motion papers asserting the exemption 
 32.36  WITHIN TEN DAYS after the objection is personally served on you, 
 33.1   or within 13 days from the date the objection is mailed or given 
 33.2   to you.  You may wish to consult an attorney at once if the 
 33.3   judgment creditor objects to your exemption claim.  
 33.4      MOTION TO DETERMINE EXEMPTION:  
 33.5      At any time after your funds have been held, you may ask 
 33.6   for a court decision on the validity of your exemption claim by 
 33.7   filing a request for hearing which may be obtained at the office 
 33.8   of the court administrator of the above court. 
 33.9      PENALTIES:  
 33.10     If you claim an exemption in bad faith, or if the judgment 
 33.11  creditor wrongly objects to an exemption in bad faith, the court 
 33.12  may order the person who acted in bad faith to pay costs, actual 
 33.13  damages, attorney fees, and an additional amount of up to $100.  
 33.14                                 ............................. 
 33.15                                 ............................. 
 33.16                                 ............................. 
 33.17                                 ............................. 
 33.18                                 Name and address of (Attorney 
 33.19                                 for) Judgment Creditor 
 33.20     EXEMPTION:  
 33.21     (a) Amount of exemption claim.  
 33.22     / / I claim ALL the funds being held are exempt.  
 33.23     / / I claim SOME of the funds being held are exempt.  
 33.24           The exempt amount is $............  
 33.25     (b) Basis for exemption.  
 33.26     Of the 11 categories listed above, I am in category number 
 33.27  ............  (If more than one category applies, you may fill 
 33.28  in as many as apply.)  The source of the exempt funds is the 
 33.29  following:  
 33.30  .............................................................
 33.31  .............................................................
 33.32  .............................................................
 33.33     (If the source is a type of relief based on need, list the 
 33.34  case number and county:  
 33.35     case number:  ...............; 
 33.36     county:  ....................) 
 34.1      I hereby authorize any agency that has distributed relief 
 34.2   to me or any correctional institution in which I was an inmate 
 34.3   to disclose to the above named judgment creditor's attorney only 
 34.4   whether or not I am or have been a recipient of relief based on 
 34.5   need or an inmate of a correctional institute within the last 
 34.6   six months. 
 34.7      I have mailed or delivered a copy of the exemption notice 
 34.8   to the judgment creditor's attorney at the address indicated 
 34.9   above.  
 34.10                               .............................
 34.11                               DEBTOR
 34.12  DATED:  .............        .............................
 34.13                               .............................
 34.14                               .............................
 34.15                               DEBTOR ADDRESS
 34.16                               .............................
 34.17                               DEBTOR TELEPHONE NUMBER
 34.18     Sec. 18.  Minnesota Statutes 1998, section 551.05, 
 34.19  subdivision 5, is amended to read: 
 34.20     Subd. 5.  [NOTICE OF OBJECTION.] (a) The written objection 
 34.21  to the judgment debtor's claim of exemption must be in 
 34.22  substantially the following form:  
 34.23  STATE OF MINNESOTA                              DISTRICT COURT
 34.24  County of ...............          ..........JUDICIAL DISTRICT
 34.25  .................(Judgment Creditor)         OBJECTION TO
 34.26  .................(Judgment Debtor)           EXEMPTION CLAIM 
 34.27  .................(Garnishee) (Third Party)
 34.28     The judgment creditor objects to your claim for exemption 
 34.29  from garnishment, levy of execution, order for attachment 
 34.30  (strike inapplicable language) for the following reason(s):  
 34.31  .................................................................
 34.32  .................................................................
 34.33  .................................................................
 34.34     Because of this objection, your financial institution will 
 34.35  retain the funds you claimed to be exempt for an additional ten 
 34.36  days.  If you wish to request a hearing on your exemption claim, 
 35.1   you should need to do so within ten days of your receipt of this 
 35.2   objection from the date the objection was personally served on 
 35.3   you, or within 13 days from the date the objection was mailed to 
 35.4   you.  You may request a hearing by completing the attached form 
 35.5   and filing it with the court administrator.  
 35.6      1.  The court administrator's office shall provide clerical 
 35.7   assistance to help with the writing and filing of a Request for 
 35.8   Hearing by any person not represented by counsel.  The court 
 35.9   administrator may charge a fee of $1 for the filing of a Request 
 35.10  for Hearing.  
 35.11     2.  Upon the filing of a Request for Hearing, the court 
 35.12  administrator shall schedule the matter for a hearing no later 
 35.13  than five business days from the date of filing.  The court 
 35.14  administrator shall forthwith send a completed copy of the 
 35.15  request, including the hearing date, time, and place to the 
 35.16  adverse party and to the financial institution by first class 
 35.17  mail.  
 35.18     3.  If it is possible that the financial institution might 
 35.19  not receive the request mailed from the court administrator 
 35.20  within ten days, then you may want to personally deliver a copy 
 35.21  of the request to the financial institution after you have filed 
 35.22  your request with the court.  
 35.23     4.  An order stating whether your funds are exempt shall be 
 35.24  issued by the court within three days of the date of the hearing.
 35.25     If you do not file a Request for Hearing within ten days of 
 35.26  the date you receive this the objection was personally served on 
 35.27  you, or within 13 days from the date the objection was mailed to 
 35.28  you, your financial institution may turn your funds over to your 
 35.29  judgment creditor. 
 35.30     If you file a Request for Hearing and your financial 
 35.31  institution receives it within ten days of the date it received 
 35.32  this objection, your financial institution will retain your 
 35.33  funds claimed to be exempt until otherwise ordered by the court. 
 35.34                                  .............................. 
 35.35                                  Attorney for Judgment Creditor 
 35.36     Sec. 19.  Minnesota Statutes 1998, section 551.06, 
 36.1   subdivision 9, is amended to read: 
 36.2      Subd. 9.  [NOTICE OF LEVY ON EARNINGS, DISCLOSURE, AND 
 36.3   WORKSHEET.] The attorney for the judgment creditor shall serve 
 36.4   upon the judgment debtor's employer a notice of levy on earnings 
 36.5   and an execution earnings disclosure form and an earnings 
 36.6   disclosure worksheet with the writ of execution, that must be 
 36.7   substantially in the form set forth below.  
 36.8   STATE OF MINNESOTA                            DISTRICT COURT
 36.9   COUNTY OF ................       ......... JUDICIAL DISTRICT
 36.10                                            FILE NO. ..... 
 36.11  ............(Judgment Creditor)
 36.12  against                                   NOTICE OF LEVY ON 
 36.13                                         EARNINGS AND DISCLOSURE 
 36.14  ............(Judgment Debtor) 
 36.15  and 
 36.16  ............(Third Party)
 36.17     PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 36.18  sections 551.04 and 551.06, the undersigned, as attorney for the 
 36.19  judgment creditor, hereby makes demand and levies execution upon 
 36.20  all earnings due and owing by you (up to $5,000 $10,000) to the 
 36.21  judgment debtor for the amount of the judgment specified below.  
 36.22  A copy of the writ of execution issued by the court is 
 36.23  enclosed.  The unpaid judgment balance is $.....  
 36.24     This levy attaches all unpaid nonexempt disposable earnings 
 36.25  owing or to be owed by you and earned or to be earned by the 
 36.26  judgment debtor before and within the pay period in which the 
 36.27  writ of execution is served and within all subsequent pay 
 36.28  periods whose paydays occur within the 70 days after the service 
 36.29  of this levy. 
 36.30     In responding to this levy, you are to complete the 
 36.31  attached disclosure form and worksheet and mail it to the 
 36.32  undersigned attorney for the judgment creditor, together with 
 36.33  your check payable to the above-named judgment creditor, for the 
 36.34  nonexempt amount owed by you to the judgment debtor or for which 
 36.35  you are obligated to the judgment debtor, within the time limits 
 36.36  set forth in the aforementioned statutes. 
 37.1                             .................................. 
 37.2                             Attorney for the Judgment Creditor 
 37.3                             .................................. 
 37.4                             .................................. 
 37.5                             .................................. 
 37.6                             Address 
 37.7                             (...).......................... 
 37.8                             Phone Number 
 37.11                             DISCLOSURE
 37.12                            DEFINITIONS
 37.13     "EARNINGS":  For the purpose of execution, "earnings" means 
 37.14  compensation paid or payable to an employee for personal 
 37.15  services or compensation paid or payable to the producer for the 
 37.16  sale of agricultural products; milk or milk products; or fruit 
 37.17  or other horticultural products produced when the producer is 
 37.18  operating a family farm, a family farm corporation, or an 
 37.19  authorized farm corporation, as defined in section 500.24, 
 37.20  subdivision 2, whether denominated as wages, salary, commission, 
 37.21  bonus, or otherwise, and includes periodic payments pursuant to 
 37.22  a pension or retirement.  
 37.23     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 37.24  an individual remaining after the deduction from those earnings 
 37.25  of amounts required by law to be withheld, including amounts 
 37.26  required by court order to be withheld for child support 
 37.27  obligations.  (Amounts required by law to be withheld do not 
 37.28  include items such as health insurance, charitable 
 37.29  contributions, or other voluntary wage deductions.) 
 37.30     "PAYDAY":  For the purpose of execution, "payday(s)" means 
 37.31  the date(s) upon which the employer pays earnings to the 
 37.32  judgment debtor in the ordinary course of business.  If the 
 37.33  judgment debtor has no regular payday, payday(s) means the 15th 
 37.34  and the last day of each month.  
 37.35     THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING 
 37.36  QUESTIONS:  
 38.1      1.  Do you now owe, or within 70 days from the date the 
 38.2   execution levy was served on you, will you or may you owe money 
 38.3   to the judgment debtor for earnings?  
 38.4                            Yes .......      No .......
 38.5      2.  Does the judgment debtor earn more than $... per week?  
 38.6   (This amount is the federal minimum wage per week.) 
 38.7                            Yes .......      No .......
 38.8                   INSTRUCTIONS FOR COMPLETING THE 
 38.9                         EARNINGS DISCLOSURE 
 38.10     A.  If your answer to either question 1 or 2 is "No," then 
 38.11  you must sign the affirmation on page 2 and return this 
 38.12  disclosure to the judgment creditor's attorney within 20 days 
 38.13  after it was served on you, and you do not need to answer the 
 38.14  remaining questions.  
 38.15     B.  If your answers to both questions 1 and 2 are "Yes," 
 38.16  you must complete this form and the Earnings Disclosure 
 38.17  Worksheet as follows:  
 38.18     For each payday that falls within 70 days from the date the 
 38.19     execution levy was served on you, YOU MUST calculate the 
 38.20     amount of earnings to be retained by completing steps 3 
 38.21     through 11 on page 2, and enter the amounts on the Earnings 
 38.22     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 38.23     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 38.24     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE.  
 38.25     Each payday, you must retain the amount of earnings listed 
 38.26     in column I on the Earnings Disclosure Worksheet.  
 38.27     You must pay the attached earnings and return this Earnings 
 38.28     Disclosure Form and the Earnings Disclosure Worksheet to 
 38.29     the judgment creditor's attorney and deliver a copy to the 
 38.30     judgment debtor within ten days after the last payday that 
 38.31     falls within the 70-day period. 
 38.32     If the judgment is wholly satisfied or if the judgment 
 38.33     debtor's employment ends before the expiration of the 
 38.34     70-day period, your disclosure and remittance should be 
 38.35     made within ten days after the last payday for which 
 38.36     earnings were attached. 
 39.1   For steps 3 through 11, "columns" refers to columns on the 
 39.2   Earnings Disclosure Worksheet.  
 39.3        3.  COLUMN A.  Enter the date of judgment debtor's 
 39.4                       payday.                        
 39.5        4.  COLUMN B.  Enter judgment debtor's gross earnings 
 39.6                       for each payday. 
 39.7        5.  COLUMN C.  Enter judgment debtor's disposable earnings 
 39.8                       for each payday. 
 39.9        6.  COLUMN D.  Enter 25 percent of disposable earnings.
 39.10                      (Multiply Column C by .25.) 
 39.11       7.  COLUMN E.  Enter here 40 times the hourly federal 
 39.12                      minimum wage ($...) times the number 
 39.13                      of work weeks included in each payday. 
 39.14                      (Note:  If a pay period includes days
 39.15                      in excess of whole work weeks, the additional
 39.16                      days should be counted as a fraction of a
 39.17                      work week equal to the number of work days in
 39.18                      excess of a whole work week divided by the
 39.19                      number of work days in a normal work week.)
 39.20       8.  COLUMN F.  Subtract the amount in Column E from the
 39.21                      amount in Column C, and enter here.
 39.22       9.  COLUMN G.  Enter here the lesser of the amount in
 39.23                      Column D and the amount in Column F.
 39.24      10.  COLUMN H.  Enter here any amount claimed by you as a
 39.25                      setoff, defense, lien, or claim, or any
 39.26                      amount claimed by any other person as an
 39.27                      exemption or adverse interest which would
 39.28                      reduce the amount of earnings owing to the
 39.29                      judgment debtor.  (Note:  Any indebtedness
 39.30                      to you incurred within ten days prior to your
 39.31                      receipt of the first execution levy on a debt
 39.32                      may not be set off against the earnings
 39.33                      otherwise subject to this levy.  Any wage
 39.34                      assignment made by the judgment debtor
 39.35                      within ten days prior to your receipt of
 39.36                      the first execution levy on a debt is void.)
 40.2                       You must also describe your claim(s) and the
 40.3                       claims of others, if known, in the space 
 40.4                       provided below the worksheet and state the
 40.5                       name(s) and address(es) of these persons.
 40.7                       Enter zero in Column H if there are no
 40.8                       claims by you or others which would reduce
 40.9                       the amount of earnings owing to the judgment
 40.10                      debtor. 
 40.12      11.  COLUMN I.  Subtract the amount in Column H from the 
 40.13                      amount in Column G and enter here.  This is
 40.14                      the amount of earnings that you must retain 
 40.15                      for the payday for which the calculations
 40.16                      were made.  The total of all amounts entered
 40.17                      in Column I is the amount to be remitted
 40.18                      to the attorney for the judgment creditor.
 40.19                            AFFIRMATION 
 40.20     I, ................... (person signing Affirmation), am the 
 40.21  third party/employer or I am authorized by the third 
 40.22  party/employer to complete this earnings disclosure, and have 
 40.23  done so truthfully and to the best of my knowledge.  
 40.24  Dated:  ............        ........................
 40.25                              Signature
 40.26                              ........................
 40.27                              Title
 40.28                              ........................
 40.29                              Telephone Number
 40.30                   EARNINGS DISCLOSURE WORKSHEET  
 40.31                        ...................
 40.32                       Judgment Debtor's Name
 40.33              A                  B                     C
 40.34            Payday             Gross                 Disposable
 40.35            Date               Earnings              Earnings
 40.36  1.  .................   $.................   $.................
 41.1   2.  .................   ..................   ..................
 41.2   3.  .................   ..................   ..................
 41.3   4.  .................   ..................   ..................
 41.4   5.  .................   ..................   ..................
 41.5   6.  .................   ..................   ..................
 41.6   7.  .................   ..................   ..................
 41.7   8.  .................   ..................   ..................
 41.8   9.  .................   ..................   ..................
 41.9   10. .................   ..................   ..................
 41.12             D                    E                  F
 41.13           25% of              40 X Min.            Column C
 41.14           Column C            Wage                 minus
 41.15                                                    Column E
 41.17  1.  .................   ..................   .................
 41.18  2.  .................   ..................   .................
 41.19  3.  .................   ..................   .................
 41.20  4.  .................   ..................   .................
 41.21  5.  .................   ..................   .................
 41.22  6.  .................   ..................   .................
 41.23  7.  .................   ..................   .................
 41.24  8.  .................   ..................   .................
 41.25  9.  .................   ..................   .................
 41.26  10. .................   ..................   .................
 41.27             G                     H                   I
 41.28          Lesser of           Setoff, Lien,         Column G
 41.29          Column D            Adverse               minus
 41.30          and                 Interest, or          Column H
 41.31          Column F            Other Claims
 41.32  1.  .................   ..................   .................
 41.33  2.  .................   ..................   .................
 41.34  3.  .................   ..................   .................
 41.35  4.  .................   ..................   .................
 41.36  5.  .................   ..................   .................
 42.1   6.  .................   ..................   .................
 42.2   7.  .................   ..................   .................
 42.3   8.  .................   ..................   .................
 42.4   9.  .................   ..................   .................
 42.5   10. .................   ..................   .................
 42.6                           TOTAL OF COLUMN I    $................
 42.7      *If you entered any amount in Column H for any payday(s), 
 42.8   you must describe below either your claims, or the claims of 
 42.9   others.  For amounts claimed by others, you must both state the 
 42.10  names and addresses of these persons, and the nature of their 
 42.11  claim, if known.  
 42.12  .................................................................
 42.13  .................................................................
 42.14  ..... ...........................................................
 42.15                            AFFIRMATION 
 42.16     I, ................. (person signing Affirmation), am the 
 42.17  third party or I am authorized by the third party to complete 
 42.18  this earnings disclosure worksheet, and have done so truthfully 
 42.19  and to the best of my knowledge.  
 42.20                                        .................
 42.21                                        Title
 42.22  Dated:  ........  ...............     (...)............
 42.23                    Signature           Phone Number 
 42.24     Sec. 20.  Minnesota Statutes 1999 Supplement, section 
 42.25  551.06, subdivision 10, is amended to read: 
 42.26     Subd. 10.  [NOTICE OF LEVY ON EARNINGS, DISCLOSURE, AND 
 42.27  WORKSHEET FOR CHILD SUPPORT JUDGMENT.] The attorney for the 
 42.28  judgment creditor shall serve upon the judgment debtor's 
 42.29  employer a notice of levy on earnings and an execution earnings 
 42.30  disclosure form and an earnings disclosure worksheet with the 
 42.31  writ of execution, that must be substantially in the form set 
 42.32  forth below.  
 42.33  STATE OF MINNESOTA                            DISTRICT COURT
 42.34  COUNTY OF ................       ......... JUDICIAL DISTRICT
 42.35                                            FILE NO. ..... 
 42.36  ............(Judgment Creditor)
 43.1   against                                   NOTICE OF LEVY ON 
 43.2                                          EARNINGS AND DISCLOSURE 
 43.3   ............(Judgment Debtor) 
 43.4   and 
 43.5   ............(Third Party)
 43.6      PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 43.7   sections 551.04 and 551.06, the undersigned, as attorney for the 
 43.8   judgment creditor, hereby makes demand and levies execution upon 
 43.9   all earnings due and owing by you (up to $5,000 $10,000) to the 
 43.10  judgment debtor for the amount of the judgment specified below.  
 43.11  A copy of the writ of execution issued by the court is 
 43.12  enclosed.  The unpaid judgment balance is $.....  
 43.13     This levy attaches all unpaid nonexempt disposable earnings 
 43.14  owing or to be owed by you and earned or to be earned by the 
 43.15  judgment debtor before and within the pay period in which the 
 43.16  writ of execution is served and within all subsequent pay 
 43.17  periods whose paydays occur within the 70 days after the service 
 43.18  of this levy. 
 43.19     In responding to this levy, you are to complete the 
 43.20  attached disclosure form and worksheet and mail it to the 
 43.21  undersigned attorney for the judgment creditor, together with 
 43.22  your check payable to the above-named judgment creditor, for the 
 43.23  nonexempt amount owed by you to the judgment debtor or for which 
 43.24  you are obligated to the judgment debtor, within the time limits 
 43.25  set forth in the aforementioned statutes. 
 43.26                            .................................. 
 43.27                            Attorney for the Judgment Creditor 
 43.28                            .................................. 
 43.29                            .................................. 
 43.30                            .................................. 
 43.31                            Address 
 43.32                            (...).......................... 
 43.33                            Phone Number 
 43.36                             DISCLOSURE 
 44.1                             DEFINITIONS
 44.2      "EARNINGS":  For the purpose of execution, "earnings" means 
 44.3   compensation paid or payable to an employee for personal 
 44.4   services or compensation paid or payable to the producer for the 
 44.5   sale of agricultural products; milk or milk products; or fruit 
 44.6   or other horticultural products produced when the producer is 
 44.7   operating a family farm, a family farm corporation, or an 
 44.8   authorized farm corporation, as defined in section 500.24, 
 44.9   subdivision 2, whether denominated as wages, salary, commission, 
 44.10  bonus, or otherwise, and includes periodic payments pursuant to 
 44.11  a pension or retirement, workers' compensation, or reemployment 
 44.12  compensation.  
 44.13     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 44.14  an individual remaining after the deduction from those earnings 
 44.15  of amounts required by law to be withheld, including amounts 
 44.16  required by court order to be withheld for child support 
 44.17  obligations.  (Amounts required by law to be withheld do not 
 44.18  include items such as health insurance, charitable 
 44.19  contributions, or other voluntary wage deductions.) 
 44.20     "PAYDAY":  For the purpose of execution, "payday(s)" means 
 44.21  the date(s) upon which the employer pays earnings to the debtor 
 44.22  in the ordinary course of business.  If the judgment debtor has 
 44.23  no regular payday, payday(s) means the 15th and the last day of 
 44.24  each month.  
 44.25     THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING QUESTION:
 44.26     (1) Do you now owe, or within 70 days from the date the 
 44.27  execution levy was served on you, will you or may you owe money 
 44.28  to the judgment debtor for earnings?  
 44.29                               .......         .......
 44.30                               Yes             No
 44.31                  INSTRUCTIONS FOR COMPLETING THE 
 44.32                        EARNINGS DISCLOSURE 
 44.33     A.  If your answer to question 1 is "No," then you must 
 44.34  sign the affirmation below and return this disclosure to the 
 44.35  judgment creditor's attorney within 20 days after it was served 
 44.36  on you, and you do not need to answer the remaining questions.  
 45.1      B.  If your answer to question 1 is "Yes," you must 
 45.2   complete this form and the Earnings Disclosure Worksheet as 
 45.3   follows:  
 45.4      For each payday that falls within 70 days from the date the 
 45.5      execution levy was served on you, YOU MUST calculate the 
 45.6      amount of earnings to be retained by completing steps 2 
 45.7      through 8 on page 2, and enter the amounts on the Earnings 
 45.8      Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 45.9      PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 45.10     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. 
 45.11     Each payday, you must retain the amount of earnings listed 
 45.12     in column G on the Earnings Disclosure Worksheet.  
 45.13     You must pay the attached earnings and return this earnings 
 45.14     disclosure form and the Earnings Disclosure Worksheet to 
 45.15     the judgment creditor's attorney and deliver a copy of the 
 45.16     disclosure and worksheet to the judgment debtor within ten 
 45.17     days after the last payday that falls within the 70-day 
 45.18     period.  If the judgment is wholly satisfied or if the 
 45.19     judgment debtor's employment ends before the expiration of 
 45.20     the 70-day period, your disclosure and remittance should be 
 45.21     made within ten days after the last payday for which 
 45.22     earnings were attached. 
 45.23     For steps 2 through 8, "columns" refers to columns on the 
 45.24  Earnings Disclosure Worksheet.  
 45.25     (2) COLUMN A.  Enter the date of judgment debtor's payday.  
 45.26     (3) COLUMN B.  Enter judgment debtor's gross earnings for 
 45.27  each payday.  
 45.28     (4) COLUMN C.  Enter judgment debtor's disposable earnings 
 45.29  for each payday.  
 45.30     (5) COLUMN D.  Enter either 50, 55, 60, or 65 percent of 
 45.31  disposable earnings, based on which of the following 
 45.32  descriptions fits the child support judgment debtor:  
 45.33     (a) 50 percent of the judgment debtor's disposable income, 
 45.34  if the judgment debtor is supporting a spouse or dependent child 
 45.35  and the judgment is 12 weeks old or less (12 weeks to be 
 45.36  calculated to the beginning of the work week in which the 
 46.1   execution levy is received); 
 46.2      (b) 55 percent of the judgment debtor's disposable income, 
 46.3   if the judgment debtor is supporting a spouse or dependent 
 46.4   child, and the judgment is over 12 weeks old (12 weeks to be 
 46.5   calculated to the beginning of the work week in which the 
 46.6   execution levy is received); 
 46.7      (c) 60 percent of the judgment debtor's disposable income, 
 46.8   if the judgment debtor is not supporting a spouse or dependent 
 46.9   child and the judgment is 12 weeks old or less (12 weeks to be 
 46.10  calculated to the beginning of the work week in which the 
 46.11  execution levy is received); or 
 46.12     (d) 65 percent of the judgment debtor's disposable income, 
 46.13  if the judgment debtor is not supporting a spouse or dependent 
 46.14  child, and the judgment is over 12 weeks old (12 weeks to be 
 46.15  calculated to the beginning of the work week in which the 
 46.16  execution levy is received).  (Multiply column C by .50, .55, 
 46.17  .60, or .65, as appropriate.)  
 46.18     (6) COLUMN E.  Enter here any amount claimed by you as a 
 46.19  setoff, defense, lien, or claim, or any amount claimed by any 
 46.20  other person as an exemption or adverse interest that would 
 46.21  reduce the amount of earnings owing to the judgment debtor.  
 46.22  (Note:  Any indebtedness to you incurred within ten days prior 
 46.23  to your receipt of the first execution levy on a debt may not be 
 46.24  set off against the earnings otherwise subject to this levy.  
 46.25  Any wage assignment made by the judgment debtor within ten days 
 46.26  prior to your receipt of the first execution levy on a debt is 
 46.27  void.) 
 46.28     You must also describe your claim(s) and the claims of 
 46.29  others, if known, in the space provided below the worksheet and 
 46.30  state the name(s) and address(es) of these persons.  
 46.31     Enter zero in column E if there are no claims by you or 
 46.32  others that would reduce the amount of earnings owing to the 
 46.33  judgment debtor.  
 46.34     (7) COLUMN F.  Subtract the amount in column E from the 
 46.35  amount in column D and enter here.  This is the amount of 
 46.36  earnings that you must remit for the payday for which the 
 47.1   calculations were made.  
 47.2                             AFFIRMATION
 47.3      I, ................... (person signing Affirmation), am the 
 47.4   third party/employer or I am authorized by the third 
 47.5   party/employer to complete this earnings disclosure, and have 
 47.6   done so truthfully and to the best of my knowledge.  
 47.7   Dated:  ............                 ............................
 47.8                                        Signature
 47.9                                        ............................
 47.10                                       Title
 47.11                                       ............................
 47.12                                       Telephone Number
 47.13   EARNINGS DISCLOSURE WORKSHEET         ...................
 47.14                                               Debtor's Name
 47.15  A                      B                      C
 47.16  Payday                 Gross                  Disposable
 47.17  Date                   Earnings               Earnings
 47.18  1.  ........           $.......               $.........
 47.19  2.  ........           ........               ..........
 47.20  3.  ........           ........               ..........
 47.21  4.  ........           ........               ..........
 47.22  5.  ........           ........               ..........
 47.23  6.  ........           ........               ..........
 47.24  7.  ........           ........               ..........
 47.25  8.  ........           ........               ..........
 47.26  9.  ........           ........               ..........
 47.27  10. ........           ........               ..........
 47.28  D                      E                      F
 47.29  Either 50, 55,         Setoff, Lien,          Column D
 47.30  60, or 65% of          Adverse                minus
 47.31  Column C               Interest, or           Column E
 47.32                         Other Claims                    
 47.33  1.  ........           ..........             ..........
 47.34  2.  ........           ..........             ..........
 47.35  3.  ........           ..........             ..........
 47.36  4.  ........           ..........             ..........
 48.1   5.  ........           ..........             ..........
 48.2   6.  ........           ..........             ..........
 48.3   7.  ........           ..........             ..........
 48.4   8.  ........           ..........             ..........
 48.5   9.  ........           ..........             ..........
 48.6   10. ........           ..........             ..........
 48.7                            TOTAL OF COLUMN F $............
 48.8      *If you entered any amount in column E for any payday(s), 
 48.9   you must describe below either your claims, or the claims of 
 48.10  others.  For amounts claimed by others, you must both state the 
 48.11  names and addresses of such persons, and the nature of their 
 48.12  claim, if known.  
 48.13     
 48.14  .................................................................
 48.15  .................................................................
 48.16  .................................................................
 48.17                            AFFIRMATION 
 48.18     I, ................. (person signing Affirmation), am the 
 48.19  third party or I am authorized by the third party to complete 
 48.20  this earnings disclosure worksheet, and have done so truthfully 
 48.21  and to the best of my knowledge.  
 48.22                                        .................
 48.23                                        Signature
 48.24  Dated:  ........  ...............     (...)............
 48.25                    Title               Phone Number
 48.26     Sec. 21.  Minnesota Statutes 1998, section 571.72, 
 48.27  subdivision 2, is amended to read: 
 48.28     Subd. 2.  [SERVICE OF A GARNISHMENT SUMMONS.] To enforce a 
 48.29  claim asserted in a civil action venued in a court of record, a 
 48.30  garnishment summons may be issued by a creditor and served upon 
 48.31  the garnishee in the same manner as other summons in that court 
 48.32  of record, except that service may not be made by publication.  
 48.33  Service of a garnishment summons on the garnishee may also be 
 48.34  made by certified mail, return receipt requested.  A garnishment 
 48.35  summons served by certified mail is effective if served at the 
 48.36  garnishee's regular place of business.  The effective date of 
 49.1   service by certified mail is the time of receipt by the 
 49.2   garnishee.  A single garnishment summons may be addressed to two 
 49.3   or more garnishees but must state whether each is summoned 
 49.4   separately or jointly. 
 49.5      The garnishment summons must state: 
 49.6      (1) the full name of the debtor, the debtor's last known 
 49.7   mailing address, and the amount of the claim that remains 
 49.8   unpaid; 
 49.9      (2) the date of the entry of judgment against the debtor or 
 49.10  that the debtor is in default pursuant to Rule 55.01 of the 
 49.11  Minnesota Rules of Civil Procedure for the District Courts.  
 49.12  Where there is a prejudgment garnishment pursuant to section 
 49.13  571.93, the garnishment summons must include a copy of the court 
 49.14  order; 
 49.15     (3) if the garnishment is on any indebtedness, money, or 
 49.16  property other than earnings, the garnishee shall serve upon the 
 49.17  creditor and upon the debtor within 20 days after service of the 
 49.18  garnishment summons, a written disclosure, of the garnishee's 
 49.19  indebtedness, money, or other property owing to the debtor and 
 49.20  answers to all written interrogatories that are served with the 
 49.21  garnishment summons.  The garnishment summons shall also state 
 49.22  that if the garnishment is on earnings and the debtor has 
 49.23  garnishable earnings, the garnishee shall serve the disclosure 
 49.24  within ten days of the last payday to occur within the 70 days 
 49.25  after the date of service of the garnishment summons; 
 49.26     (4) that the creditor shall not require disclosure of the 
 49.27  disposable earnings, indebtedness, money, or property of debtor 
 49.28  in the garnishee's possession or under the garnishee's control 
 49.29  in excess of 110 percent of the amount of the claim that remains 
 49.30  unpaid; 
 49.31     (5) that the garnishee shall retain disposable earnings, 
 49.32  indebtedness, money, or property of the debtor in the 
 49.33  garnishee's possession or under the garnishee's control not in 
 49.34  excess of 110 percent of the amount of the claim that remains 
 49.35  unpaid, until the creditor causes a writ of execution to be 
 49.36  served upon the garnishee, until the debtor authorizes release 
 50.1   to the creditor, until the creditor authorizes release to the 
 50.2   debtor, upon court order, or by operation of law; 
 50.3      (6) that after the expiration of the period of time 
 50.4   specified in section 571.79 from the date of service of the 
 50.5   garnishment summons, the garnishee's retention obligation 
 50.6   automatically expires; 
 50.7      (7) that an assignment of wages made by the debtor within 
 50.8   ten days before the service of the first garnishment summons on 
 50.9   a debt is void and that any indebtedness to the garnishee 
 50.10  incurred with ten days before the service of the first 
 50.11  garnishment summons on a debt may not be set off against amounts 
 50.12  otherwise subject to the garnishment. 
 50.13     Sec. 22.  Minnesota Statutes 1998, section 571.74, is 
 50.14  amended to read: 
 50.15     571.74 [GARNISHMENT SUMMONS AND NOTICE TO DEBTOR.] 
 50.16     The garnishment summons and notice to debtor must be 
 50.17  substantially in the following form.  The notice to debtor must 
 50.18  be in no smaller than 14-point type.  
 50.19                       GARNISHMENT SUMMONS 
 50.20  STATE OF MINNESOTA                            DISTRICT COURT
 50.21  COUNTY OF .................      ..........JUDICIAL DISTRICT
 50.22  .......................(Creditor)
 50.23  .......................(Debtor)       UNPAID BALANCE........
 50.24  .......................(Debtor's Address)      Date of Entry
 50.25  .......................(Garnishee)  of Judgment (or) Subject
 50.26                                        to Minnesota Statutes,
 50.27                                       section 571.71, subd. 2
 50.28                        GARNISHMENT SUMMONS
 50.29  The State of Minnesota 
 50.30  To the Garnishee named above: 
 50.31     You are hereby summoned and required to serve upon the 
 50.32  creditor's attorney (or the creditor if not represented by an 
 50.33  attorney) and on the debtor within 20 days after service of this 
 50.34  garnishment summons upon you, a written disclosure, of the 
 50.35  indebtedness, money, or other property that you owe to the 
 50.36  debtor the nonexempt indebtedness, money, or other property due 
 51.1   or belonging to the debtor and owing by you or in your 
 51.2   possession or under your control and answers to all written 
 51.3   interrogatories that are served with the garnishment summons.  
 51.4   However, if the garnishment is on earnings and the debtor has 
 51.5   garnishable earnings, you shall serve the completed disclosure 
 51.6   form on the creditor's attorney, or the creditor if not 
 51.7   represented by an attorney, within ten days of the last payday 
 51.8   to occur within the 70 days after the date of the service of 
 51.9   this garnishment summons.  "Payday" means the day which you pay 
 51.10  earnings in the ordinary course of business.  If the debtor has 
 51.11  no regular paydays, "payday" means the 15th day and the last day 
 51.12  of each month. 
 51.13     Your disclosure need not exceed 110 percent of the amount 
 51.14  of the creditor's claim that remains unpaid. 
 51.15     You shall retain garnishable earnings, other indebtedness, 
 51.16  money, or other property in your possession in an amount not to 
 51.17  exceed 110 percent of the creditor's claim until such time as 
 51.18  the creditor causes a writ of execution to be served upon you, 
 51.19  until the debtor authorizes you in writing to release the 
 51.20  property to the creditor, or until the expiration of ...... days 
 51.21  from the date of service of this garnishment summons upon you, 
 51.22  at which time you shall return the disposable earnings, other 
 51.23  indebtedness, money, or other property to the debtor. 
 51.24                              EARNINGS 
 51.25     In the event you are summoned as a garnishee because you 
 51.26  owe "earnings" (as defined on the Earnings Garnishment 
 51.27  Disclosure form attached to this Garnishment Summons, if 
 51.28  applicable) to the debtor, then you are required to serve upon 
 51.29  the creditor's attorney, or the creditor if not represented by 
 51.30  an attorney, a written earnings disclosure form within the time 
 51.31  limit set forth above. 
 51.32     In the case of earnings you are further required to retain 
 51.33  in your possession all unpaid nonexempt disposable earnings owed 
 51.34  or to be owed by you and earned or to be earned to the debtor 
 51.35  within the pay period in which this garnishment summons is 
 51.36  served and within all subsequent pay periods whose paydays 
 52.1   (defined above) occur within the 70 days after the date of 
 52.2   service of this garnishment summons. 
 52.3      Any assignment of earnings made by the debtor to any party 
 52.4   within ten days before the receipt of the first garnishment on a 
 52.5   debt is void.  Any indebtedness to you incurred by the debtor 
 52.6   within the ten days before the receipt of the first garnishment 
 52.7   on a debt may not be set off against amounts otherwise subject 
 52.8   to the garnishment. 
 52.9      You are prohibited by law from discharging or disciplining 
 52.10  the debtor because the debtor's earnings have been subject to 
 52.11  garnishment. 
 52.12     This Garnishment Summons includes: 
 52.13     (check applicable box) 
 52.14  .....  Earnings garnishment
 52.15         (see attached Earnings Disclosure Form)
 52.16  .....  Nonearnings garnishment
 52.17         (see attached Nonearnings Disclosure Form)
 52.18  .....  Both Earnings and Nonearnings garnishment
 52.19         (see both attached Earnings and Nonearnings
 52.20         Disclosure Form)
 52.21                          NOTICE TO DEBTOR
 52.22     A Garnishment Summons, Earnings Garnishment Disclosure 
 52.23  form, Nonwage Garnishment Disclosure form, Garnishment Exemption 
 52.24  Notices and/or written Interrogatories (strike out if not 
 52.25  applicable), copies of which are hereby served on you, were 
 52.26  served upon the Garnishee by delivering copies to the 
 52.27  Garnishee.  The Garnishee was paid $15. 
 52.28  Dated:  ...............    ...............................
 52.29                             Attorney for Creditor
 52.30                             (or creditor)
 52.31                             ...............................
 52.32                             ...............................
 52.33                             ...............................
 52.34                             Address
 52.35                             ...............................
 52.36                             Telephone
 53.1                              ...............................
 53.2                              Attorney I.D. No.
 53.3      Sec. 23.  Minnesota Statutes 1999 Supplement, section 
 53.4   571.75, subdivision 2, is amended to read: 
 53.5      Subd. 2.  [CONTENTS OF DISCLOSURE.] The disclosure must 
 53.6   state: 
 53.7      (a) If an earnings garnishment disclosure, the amount of 
 53.8   disposable earnings earned by the debtor within the debtor's pay 
 53.9   periods as specified in section 571.921. 
 53.10     (b) If a nonearnings garnishment disclosure, a description 
 53.11  of any personal property or any instrument or papers relating to 
 53.12  this property belonging to the judgment debtor or in which the 
 53.13  debtor is interested or other indebtedness of the garnishee to 
 53.14  the debtor. 
 53.15     (c) If the garnishee asserts any setoff, defense, claim, or 
 53.16  lien on disposable earnings, other indebtedness, money, or 
 53.17  property, the garnishee shall disclose the amount and the facts 
 53.18  concerning the same. 
 53.19     (d) Whether the debtor asserts any exemption, or any other 
 53.20  objection, known to the garnishee against the right of the 
 53.21  creditor to garnish the disposable earnings, other indebtedness, 
 53.22  money, or property disclosed. 
 53.23     (e) If other persons assert claims to any disposable 
 53.24  earnings, other indebtedness, money, or property disclosed, the 
 53.25  garnishee shall disclose the names and addresses of these 
 53.26  claimants and, so far as known by the garnishee, the nature of 
 53.27  their claims. 
 53.28     (f) The garnishment disclosure forms and earnings 
 53.29  disclosure worksheet must be the same or substantially similar 
 53.30  to the following forms.  If the garnishment affects earnings of 
 53.31  the debtor, the creditor shall use the earnings garnishment 
 53.32  disclosure form.  If the garnishment affects any indebtedness, 
 53.33  money, or property of the debtor, other than earnings, the 
 53.34  creditor shall use the nonearnings garnishment disclosure form.  
 53.35  Nothing contained in this paragraph limits the simultaneous use 
 53.36  of the earnings and nonearnings garnishment disclosure forms. 
 54.1                EARNINGS DISCLOSURE FORM AND WORKSHEET
 54.2   STATE OF MINNESOTA                                 DISTRICT COURT
 54.3   COUNTY OF ..................             ...... JUDICIAL DISTRICT
 54.4   .................(Creditor)
 54.5   .................(Debtor)                             GARNISHMENT
 54.6   .................(Garnishee)                  EARNINGS DISCLOSURE
 54.7                             DEFINITIONS
 54.8      "EARNINGS":  For the purpose of garnishment, "earnings" 
 54.9   means compensation paid or payable to an employee for personal 
 54.10  services or compensation paid or payable to the producer for the 
 54.11  sale of agricultural products; milk or milk products; or fruit 
 54.12  or other horticultural products produced when the producer is 
 54.13  operating a family farm, a family farm corporation, or an 
 54.14  authorized farm corporation, as defined in section 500.24, 
 54.15  subdivision 2, whether denominated as wages, salary, commission, 
 54.16  bonus, or otherwise, and includes periodic payments pursuant to 
 54.17  a pension or retirement. 
 54.18     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 54.19  an individual remaining after the deduction from those earnings 
 54.20  of amounts required by law to be withheld, including amounts 
 54.21  required by court order to be withheld for child support 
 54.22  obligations.  (Amounts required by law to be withheld do not 
 54.23  include items such as health insurance, charitable 
 54.24  contributions, or other voluntary wage deductions.) 
 54.25     "PAYDAY":  For the purpose of garnishment, "payday(s)" 
 54.26  means the date(s) upon which the employer pays earnings to the 
 54.27  debtor in the ordinary course of business.  If the debtor has no 
 54.28  regular payday, payday(s) means the fifteenth and the last day 
 54.29  of each month. 
 54.30     THE GARNISHEE MUST ANSWER THE FOLLOWING QUESTIONS: 
 54.31     1.  Do you now owe, or within 70 days from the date the 
 54.32  garnishment summons was served on you, will you or do you expect 
 54.33  to owe money to the debtor for earnings? 
 54.34                        Yes .......    No ........
 54.35     2.  Does the debtor earn more than $........ per week?  
 54.36  (This amount is the federal minimum wage per week.) 
 55.1                         Yes .......    No ........
 55.2                   INSTRUCTIONS FOR COMPLETING THE
 55.3                         EARNINGS DISCLOSURE
 55.4      A.  If your answer to either question 1 or 2 is "No," then 
 55.5   you must sign the affirmation on Page 2 and return this 
 55.6   disclosure to the creditor's attorney (or the creditor if not 
 55.7   represented by an attorney) within 20 days after it was served 
 55.8   on you, and you do not need to answer the remaining questions. 
 55.9      B.  If your answers to both questions 1 and 2 are "Yes," 
 55.10  you must complete this form and the Earnings Disclosure 
 55.11  Worksheet as follows: 
 55.12     For each payday that falls within 70 days from the date the 
 55.13     garnishment summons was served on you, YOU MUST calculate 
 55.14     the amount of earnings to be retained by completing Steps 3 
 55.15     through 11, and enter the amounts on the Earnings 
 55.16     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 55.17     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 55.18     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE.  
 55.19     Each payday, you must retain the amount of earnings listed 
 55.20     in Column I on the Earnings Disclosure Worksheet. 
 55.21     You must return this Earnings Disclosure Form and the 
 55.22     Earnings Disclosure Worksheet to the creditor's attorney 
 55.23     (or the creditor if not represented by an attorney) and 
 55.24     deliver a copy to the debtor within ten days after the last 
 55.25     payday that falls within the 70-day period. 
 55.26     If the claim is wholly satisfied or if the debtor's 
 55.27     employment ends before the expiration of the 70-day period, 
 55.28     your disclosure should be made within ten days after the 
 55.29     last payday for which earnings were attached. 
 55.30  For Steps 3 through 11, "Columns" refers to columns on the 
 55.31  Earnings Disclosure Worksheet. 
 55.32      3.  COLUMN A.  Enter the date of debtor's 
 55.33                     payday.
 55.34      4.  COLUMN B.  Enter debtor's gross earnings for 
 55.35                     each payday.
 55.36      5.  COLUMN C.  Enter debtor's disposable earnings 
 56.1                      for each payday.
 56.2       6.  COLUMN D.  Enter 25 percent of disposable earnings.
 56.3                      (Multiply Column C by .25.)
 56.4       7.  COLUMN E.  Enter here 40 times the hourly federal
 56.5                      minimum wage ($....) times the number
 56.6                      of work weeks included in each payday.  (Note:
 56.7                      If a pay period includes days in excess of 
 56.8                      whole work weeks, the additional days should 
 56.9                      be counted as a fraction of a work week equal
 56.10                     to the number of work days in excess of a 
 56.11                     whole work week divided by the number of work
 56.12                     days in a normal work week.)
 56.13      8.  COLUMN F.  Subtract the amount in Column E from the
 56.14                     amount in Column C, and enter here.
 56.15      9.  COLUMN G.  Enter here the lesser of the amount in
 56.16                     Column D and the amount in Column F.
 56.17     10.  COLUMN H.  Enter here any amount claimed by you as a
 56.18                     setoff, defense, lien, or claim, or any
 56.19                     amount claimed by any other person as an
 56.20                     exemption or adverse interest which would
 56.21                     reduce the amount of earnings owing to the
 56.22                     debtor.  (Note:  Any indebtedness to you 
 56.23                     incurred by the debtor within the ten
 56.24                     days before the receipt of the first 
 56.25                     garnishment on a debt may not be set
 56.26                     off against amounts otherwise subject to
 56.27                     the garnishment.  Any assignment of earnings
 56.28                     made by the debtor to any party within ten
 56.29                     days before the receipt of the first
 56.30                     garnishment on a debt is void.)
 56.32                     You must also describe your claim(s) and the
 56.33                     claims of others, if known, in the space
 56.34                     provided below the worksheet and state the
 56.35                     name(s) and address(es) of these persons.
 57.1                      Enter zero in Column H if there are no
 57.2                      claims by you or others which would reduce
 57.3                      the amount of earnings owing to the debtor. 
 57.4      11.  COLUMN I.  Subtract the amount in Column H from the
 57.5                      amount in Column G and enter here.  This is
 57.6                      the amount of earnings that you must retain
 57.7                      for the payday for which the calculations
 57.8                      were made. 
 57.9                             AFFIRMATION
 57.10     I, ...................... (person signing Affirmation), am 
 57.11  the garnishee or I am authorized by the garnishee to complete 
 57.12  this earnings disclosure, and have done so truthfully and to the 
 57.13  best of my knowledge. 
 57.14  Dated:  ..................    ................................
 57.15                                Signature
 57.16                                ................................
 57.17                                Title 
 57.18                                ................................ 
 57.19                                Telephone Number 
 57.20                   EARNINGS DISCLOSURE WORKSHEET 
 57.21                   ............................. 
 57.22                           Debtor's Name 
 57.23               A                  B                  C  
 57.24             Payday             Gross            Disposable 
 57.25             Date               Earnings         Earnings  
 57.27  1.   .................   .................   ................. 
 57.28  2.   .................   .................   ................. 
 57.29  3.   .................   .................   ................. 
 57.30  4.   .................   .................   ................. 
 57.31  5.   .................   .................   ................. 
 57.32  6.   .................   .................   ................. 
 57.33  7.   .................   .................   ................. 
 57.34  8.   .................   .................   ................. 
 57.35  9.   .................   .................   ................. 
 57.36  10.  .................   .................   ................. 
 58.3                D                   E                 F 
 58.4              25% of              40 X Min.        Column C 
 58.5              Column C            Wage             minus 
 58.6                                                   Column E 
 58.8   1.   .................   .................   ................ 
 58.9   2.   .................   .................   ................ 
 58.10  3.   .................   .................   ................ 
 58.11  4.   .................   .................   ................ 
 58.12  5.   .................   .................   ................ 
 58.13  6.   .................   .................   ................ 
 58.14  7.   .................   .................   ................ 
 58.15  8.   .................   .................   ................ 
 58.16  9.   .................   .................   ................ 
 58.17  10.  .................   .................   ................ 
 58.20               G                  H                  I 
 58.21            Lesser of        Setoff, Lien,       Column G 
 58.22            Column D         Adverse             minus  
 58.23            and              Interest, or        Column H 
 58.24            Column F         Other Claims   
 58.26  1.   .................   .................   ................. 
 58.27  2.   .................   .................   ................. 
 58.28  3.   .................   .................   ................. 
 58.29  4.   .................   .................   ................. 
 58.30  5.   .................   .................   ................. 
 58.31  6.   .................   .................   ................. 
 58.32  7.   .................   .................   ................. 
 58.33  8.   .................   .................   ................. 
 58.34  9.   .................   .................   ................. 
 58.35  10.  .................   .................   ................. 
 58.36                           TOTAL OF COLUMN I   $................ 
 59.2      *If you entered any amount in Column H for any payday(s), 
 59.3   you must describe below either your claims, or the claims of 
 59.4   others.  For amounts claimed by others you must both state the 
 59.5   names and addresses of these persons, and the nature of their 
 59.6   claim, if known. 
 59.7   ........................................................... 
 59.8   .......................................................... 
 59.9   .......................................................... 
 59.10                            AFFIRMATION 
 59.11     I, ........................ (person signing Affirmation), 
 59.12  am the third party or I am authorized by the third party to 
 59.13  complete this earnings disclosure worksheet, and have done so 
 59.14  truthfully and to the best of my knowledge. 
 59.15  Dated:  ............................... 
 59.16  Signature .............................  
 59.17  Title ................................. 
 59.18  Telephone Number (...)................. 
 59.19               EARNINGS DISCLOSURE FORM AND WORKSHEET
 59.20                      FOR CHILD SUPPORT DEBTOR
 59.21  STATE OF MINNESOTA                                 DISTRICT COURT
 59.22  COUNTY OF ..................             ...... JUDICIAL DISTRICT
 59.23  .................(Creditor)
 59.24  .................(Debtor)                             GARNISHMENT
 59.25  .................(Garnishee)                  EARNINGS DISCLOSURE
 59.26                            DEFINITIONS
 59.27     "EARNINGS":  For the purpose of execution, "earnings" means 
 59.28  compensation paid or payable to an employee for personal 
 59.29  services or compensation paid or payable to the producer for the 
 59.30  sale of agricultural products; milk or milk products; or fruit 
 59.31  or other horticultural products produced when the producer is 
 59.32  operating a family farm, a family farm corporation, or an 
 59.33  authorized farm corporation, as defined in section 500.24, 
 59.34  subdivision 2, whether denominated as wages, salary, commission, 
 59.35  bonus, or otherwise, and includes periodic payments pursuant to 
 59.36  a pension or retirement, workers' compensation, or reemployment 
 60.1   compensation.  
 60.2      "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 60.3   an individual remaining after the deduction from those earnings 
 60.4   of amounts required by law to be withheld, including amounts 
 60.5   required by court order to be withheld for child support 
 60.6   obligations.  (Amounts required by law to be withheld do not 
 60.7   include items such as health insurance, charitable 
 60.8   contributions, or other voluntary wage deductions.) 
 60.9      "PAYDAY":  For the purpose of execution, "payday(s)" means 
 60.10  the date(s) upon which the employer pays earnings to the debtor 
 60.11  in the ordinary course of business.  If the judgment debtor has 
 60.12  no regular payday, payday(s) means the 15th and the last day of 
 60.13  each month.  
 60.14     THE GARNISHEE MUST ANSWER THE FOLLOWING QUESTION: 
 60.15     (1) Do you now owe, or within 70 days from the date the 
 60.16  execution levy was served on you, will you or may you owe money 
 60.17  to the debtor for earnings?  
 60.18                               .......         .......
 60.19                               Yes             No
 60.20                  INSTRUCTIONS FOR COMPLETING THE 
 60.21                        EARNINGS DISCLOSURE 
 60.22     A.  If your answer to question 1 is "No," then you must 
 60.23  sign the affirmation below and return this disclosure to the 
 60.24  creditor's attorney (or the creditor if not represented by an 
 60.25  attorney) within 20 days after it was served on you, and you do 
 60.26  not need to answer the remaining questions.  
 60.27     B.  If your answer to question 1 is "Yes," you must 
 60.28  complete this form and the Earnings Disclosure Worksheet as 
 60.29  follows:  
 60.30     For each payday that falls within 70 days from the date the 
 60.31     garnishment summons was served on you, YOU MUST calculate 
 60.32     the amount of earnings to be retained by completing steps 2 
 60.33     through 8 on page 2, and enter the amounts on the Earnings 
 60.34     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 60.35     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 60.36     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. 
 61.1      Each payday, you must retain the amount of earnings listed 
 61.2      in column G on the Earnings Disclosure Worksheet.  
 61.3      You must pay the attached earnings and return this earnings 
 61.4      disclosure form and the Earnings Disclosure Worksheet to 
 61.5      the creditor's attorney (or the creditor if not represented 
 61.6      by an attorney) and deliver a copy to the debtor within ten 
 61.7      days after the last payday that falls within the 70-day 
 61.8      period.  If the claim is wholly satisfied or if the 
 61.9      debtor's employment ends before the expiration of the 
 61.10     70-day period, your disclosure should be made within ten 
 61.11     days after the last payday for which earnings were attached.
 61.12     For steps 2 through 8, "columns" refers to columns on the 
 61.13  Earnings Disclosure Worksheet.  
 61.14     (2) COLUMN A.  Enter the date of debtor's payday.  
 61.15     (3) COLUMN B.  Enter debtor's gross earnings for each 
 61.16  payday.  
 61.17     (4) COLUMN C.  Enter debtor's disposable earnings for each 
 61.18  payday.  
 61.19     (5) COLUMN D.  Enter either 50, 55, 60, or 65 percent of 
 61.20  disposable earnings, based on which of the following 
 61.21  descriptions fits the child support judgment debtor:  
 61.22     (a) 50 percent of the judgment debtor's disposable income, 
 61.23  if the judgment debtor is supporting a spouse or dependent child 
 61.24  and the judgment is 12 weeks old or less (12 weeks to be 
 61.25  calculated to the beginning of the work week in which the 
 61.26  execution levy is received); 
 61.27     (b) 55 percent of the judgment debtor's disposable income, 
 61.28  if the judgment debtor is supporting a spouse or dependent 
 61.29  child, and the judgment is over 12 weeks old (12 weeks to be 
 61.30  calculated to the beginning of the work week in which the 
 61.31  execution levy is received); 
 61.32     (c) 60 percent of the judgment debtor's disposable income, 
 61.33  if the judgment debtor is not supporting a spouse or dependent 
 61.34  child and the judgment is 12 weeks old or less (12 weeks to be 
 61.35  calculated to the beginning of the work week in which the 
 61.36  execution levy is received); or 
 62.1      (d) 65 percent of the judgment debtor's disposable income, 
 62.2   if the judgment debtor is not supporting a spouse or dependent 
 62.3   child, and the judgment is over 12 weeks old (12 weeks to be 
 62.4   calculated to the beginning of the work week in which the 
 62.5   execution levy is received).  (Multiply column C by .50, .55, 
 62.6   .60, or .65, as appropriate.)  
 62.7      (6) COLUMN E.  Enter here any amount claimed by you as a 
 62.8   setoff, defense, lien, or claim, or any amount claimed by any 
 62.9   other person as an exemption or adverse interest that would 
 62.10  reduce the amount of earnings owing to the debtor.  (Note:  Any 
 62.11  assignment of earnings made by the debtor to any party within 
 62.12  ten days before the receipt of the first garnishment on a debt 
 62.13  is void.  Any indebtedness to you incurred by the debtor within 
 62.14  the ten days before the receipt of the first garnishment on a 
 62.15  debt may not be set off against amounts otherwise subject to the 
 62.16  garnishment.) 
 62.17     You must also describe your claim(s) and the claims of 
 62.18  others, if known, in the space provided below the worksheet and 
 62.19  state the name(s) and address(es) of these persons.  
 62.20     Enter zero in column E if there are no claims by you or 
 62.21  others that would reduce the amount of earnings owing to the 
 62.22  judgment debtor.  
 62.23     (7) COLUMN F.  Subtract the amount in column E from the 
 62.24  amount in column D and enter here.  This is the amount of 
 62.25  earnings that you must remit for the payday for which the 
 62.26  calculations were made.  
 62.27                            AFFIRMATION
 62.28     I, ................... (person signing Affirmation), am the 
 62.29  garnishee or I am authorized by the garnishee to complete this 
 62.30  earnings disclosure, and have done so truthfully and to the best 
 62.31  of my knowledge.  
 62.32  Dated:  ............                 ............................
 62.33                                       Signature
 62.34                                       ............................
 62.35                                       Title
 62.36                                       ............................
 63.1                                        Telephone Number
 63.2    EARNINGS DISCLOSURE WORKSHEET         ...................
 63.3                                                Debtor's Name
 63.4   A                      B                      C
 63.5   Payday                 Gross                  Disposable
 63.6   Date                   Earnings               Earnings
 63.7   1.  ........           $.......               $.........
 63.8   2.  ........           ........               ..........
 63.9   3.  ........           ........               ..........
 63.10  4.  ........           ........               ..........
 63.11  5.  ........           ........               ..........
 63.12  6.  ........           ........               ..........
 63.13  7.  ........           ........               ..........
 63.14  8.  ........           ........               ..........
 63.15  9.  ........           ........               ..........
 63.16  10. ........           ........               ..........
 63.17  D                      E                      F
 63.18  Either 50, 55,         Setoff, Lien,          Column D
 63.19  60, or 65% of          Adverse                minus
 63.20  Column C               Interest, or           Column E
 63.21                         Other Claims 
 63.22  1.  ........           ..........             ..........
 63.23  2.  ........           ..........             ..........
 63.24  3.  ........           ..........             ..........
 63.25  4.  ........           ..........             ..........
 63.26  5.  ........           ..........             ..........
 63.27  6.  ........           ..........             ..........
 63.28  7.  ........           ..........             ..........
 63.29  8.  ........           ..........             ..........
 63.30  9.  ........           ..........             ..........
 63.31  10. ........           ..........             ..........
 63.32                           TOTAL OF COLUMN   F $............
 63.33     *If you entered any amount in column E for any payday(s), 
 63.34  you must describe below either your claims, or the claims of 
 63.35  others.  For amounts claimed by others, you must both state the 
 63.36  names and addresses of such persons, and the nature of their 
 64.1   claim, if known.  
 64.2      
 64.3   .................................................................
 64.4   .................................................................
 64.5   .................................................................
 64.6                             AFFIRMATION 
 64.7      I, ................. (person signing Affirmation), am the 
 64.8   third party or I am authorized by the third party to complete 
 64.9   this earnings disclosure worksheet, and have done so truthfully 
 64.10  and to the best of my knowledge.  
 64.11                                        .................
 64.12                                        Signature
 64.13  Dated:  ........  ...............     (...)............
 64.14                    Title               Phone Number
 64.15                    NONEARNINGS DISCLOSURE FORM 
 64.16     
 64.17  STATE OF MINNESOTA                            DISTRICT COURT
 64.18  COUNTY OF ............              ...... JUDICIAL DISTRICT
 64.19  ...................(Creditor)
 64.20  against 
 64.21  ...................(Debtor)           NONEARNINGS DISCLOSURE
 64.22  and 
 64.23  ...................(Garnishee) 
 64.24     On the .... day of ........., ......., the time of service 
 64.25  of garnishment summons herein, there was due and owing the 
 64.26  debtor from the garnishee the following: 
 64.27     (1) Money.  Enter on the line below any amounts due and 
 64.28  owing the debtor, except earnings, from the garnishee. 
 64.29  .......................................................  
 64.30     (2) Property.  Describe on the line below any personal 
 64.31  property, instruments, or papers belonging to the debtor and in 
 64.32  the possession of the garnishee. 
 64.33  ....................................................... 
 64.34     (3) Setoff.  Enter on the line below the amount of any 
 64.35  setoff, defense, lien, or claim which the garnishee claims 
 64.36  against the amount set forth on lines (1) and (2) above.  State 
 65.1   the facts by which the setoff, defense, lien, or claim is 
 65.2   claimed.  (Any indebtedness to a garnishee incurred by the 
 65.3   debtor within the ten days before the receipt of the first 
 65.4   garnishment on a debt may not be set off against amounts 
 65.5   otherwise subject to the garnishment.) 
 65.6   ....................................................... 
 65.7      (4) Exemption.  Enter on the line below any amounts or 
 65.8   property claimed by the debtor to be exempt from execution.  
 65.9   ........................................................ 
 65.10     (5) Adverse Interest.  Enter on the line below any amounts 
 65.11  claimed by other persons by reason of ownership or interest in 
 65.12  the debtor's property. 
 65.13  ....................................................... 
 65.14     (6) Enter on the line below the total of lines (3), (4), 
 65.15  and (5). 
 65.16  ....................................................... 
 65.17     (7) Enter on the line below the difference obtained (never 
 65.18  less than zero) when line (6) is subtracted from the sum of 
 65.19  lines (1) and (2). 
 65.20  ........................................................ 
 65.21     (8) Enter on the line below 110 percent of the amount of 
 65.22  the creditor's claim which remains unpaid. 
 65.23  ....................................................... 
 65.24     (9) Enter on the line below the lesser of line (7) and line 
 65.25  (8).  Retain this amount only if it is $10 or more. 
 65.26  ....................................................... 
 65.27                            AFFIRMATION 
 65.28     I, ..................... (person signing Affirmation), am 
 65.29  the garnishee or I am authorized by the garnishee to complete 
 65.30  this nonearnings garnishment disclosure, and have done so 
 65.31  truthfully and to the best of my knowledge. 
 65.32  Dated:  ............                .............................
 65.33                                      Signature
 65.34                                      .............................
 65.35                                      Title
 65.36                                      .............................
 66.1                                       Telephone Number 
 66.2      Sec. 24.  [571.771] [MONEY DUE FROM STATE DEPARTMENTS.] 
 66.3      Money due or owing to any entity or person by the state on 
 66.4   account of any employment, work, contract with, or services 
 66.5   provided to any state department or agency is subject to 
 66.6   garnishment.  The garnishment summons may be served upon the 
 66.7   head of the department or agency in the same manner as other 
 66.8   summons in that court of record except that service may not be 
 66.9   made by publication.  Service of the garnishment summons may 
 66.10  also be made by certified mail, return receipt requested.  The 
 66.11  disclosure must be made by the head of the department or agency, 
 66.12  or by some person designated by the head having knowledge of the 
 66.13  facts.  If payment is made pursuant to judgment against the 
 66.14  state as garnishee, a certificate of satisfaction to the extent 
 66.15  of the payment endorsed on it must be delivered to the head of 
 66.16  the department or agency as a voucher for the payment. 
 66.17     Sec. 25.  Minnesota Statutes 1998, section 571.79, is 
 66.18  amended to read: 
 66.19     571.79 [DISCHARGE OF A GARNISHEE.] 
 66.20     Subject to sections 571.78 and 571.80 Except as provided in 
 66.21  paragraph (h), the garnishee, after disclosure, shall be 
 66.22  discharged of any further retention obligation to the creditor 
 66.23  with respect to a specific garnishment summons when one of the 
 66.24  following conditions are met: 
 66.25     (a) The garnishee discloses that the garnishee is not 
 66.26  indebted to the debtor or does not possess any money or other 
 66.27  property belonging to the debtor that is attachable as defined 
 66.28  in section 571.73, subdivision 3.  The disclosure is conclusive 
 66.29  against the creditor and discharges the garnishee from any 
 66.30  further obligation to the creditor other than to retain all 
 66.31  nonexempt disposable earnings, indebtedness, money, and property 
 66.32  of the debtor which was disclosed. 
 66.33     (b) The garnishee discloses that the garnishee is indebted 
 66.34  to the debtor as indicated on the garnishment disclosure form.  
 66.35  The disclosure is conclusive against the creditor and discharges 
 66.36  the garnishee from any further obligation to the creditor other 
 67.1   than to retain all nonexempt disposable earnings, indebtedness, 
 67.2   money, and property of the debtor that was disclosed.  
 67.3      (c) If the garnishee was served with a garnishment summons 
 67.4   before entry of judgment against the debtor by the creditor in 
 67.5   the civil action and the garnishee has retained any disposable 
 67.6   earnings, indebtedness, money, or property of the debtor, 270 
 67.7   days after the garnishment summons is served the garnishee is 
 67.8   discharged and the garnishee shall return any disposable 
 67.9   earnings, indebtedness, money, and property to the debtor. 
 67.10     (d) If the garnishee was served with a garnishment summons 
 67.11  after entry of judgment against the debtor by the creditor in 
 67.12  the civil action and the garnishee has retained any disposable 
 67.13  earnings, indebtedness, money, or property of the debtor, 180 
 67.14  days after the garnishment summons is served the garnishee is 
 67.15  discharged and the garnishee shall return any disposable 
 67.16  earnings, other indebtedness, money, and property to the debtor. 
 67.17     (e) If the garnished indebtedness, money, or other property 
 67.18  is destroyed without any negligence of the garnishee, the 
 67.19  garnishee is discharged of any liability to the creditor for 
 67.20  nondelivery of the garnished indebtedness, money, and other 
 67.21  property. 
 67.22     (f) The court may, upon motion of an interested person, 
 67.23  discharge the garnishee as to any disposable earnings, other 
 67.24  indebtedness, money, and property in excess of the amount that 
 67.25  may be required to satisfy the creditor's claim. 
 67.26     (g) The discharge of the garnishee pursuant to paragraph 
 67.27  (a), (b), (c), or (d) is not determinative of the rights of the 
 67.28  creditor, debtor, or garnishee with respect to any other 
 67.29  garnishment summons, even another garnishment summons involving 
 67.30  the same parties, unless and to the extent adjudicated pursuant 
 67.31  to the procedures described in paragraph (h). 
 67.32     (h) The garnishee is not discharged if within 20 days of 
 67.33  the service of the garnishee's disclosure or the return to the 
 67.34  debtor of any disposable earnings, indebtedness money, or other 
 67.35  property of the debtor, whichever is later, an interested person 
 67.36  (1) serves a motion scheduled to be heard within 30 days of the 
 68.1   service of the motion relating to the garnishment, or (2) serves 
 68.2   a motion scheduled to be heard within 30 days of the service of 
 68.3   the motion for leave to file a supplemental complaint against 
 68.4   the garnishee, as provided under section 571.75, subdivision 4, 
 68.5   and the court upon proper showing vacates the discharge of the 
 68.6   garnishee. 
 68.7      Sec. 26.  Minnesota Statutes 1998, section 571.82, 
 68.8   subdivision 1, is amended to read: 
 68.9      Subdivision 1.  [JUDGMENT UPON FAILURE TO DISCLOSE.] If a 
 68.10  garnishee fails to serve a disclosure as required in this 
 68.11  chapter, the court may render judgment against the garnishee, 
 68.12  upon motion by the creditor, for an amount not exceeding the 
 68.13  creditor's claim against the debtor or 110 percent of the amount 
 68.14  claimed in the garnishment summons, whichever is less.  The 
 68.15  motion shall be supported by an affidavit of the facts and shall 
 68.16  be served upon both the debtor and the garnishee.  The court 
 68.17  upon good cause shown may remove the default and permit the 
 68.18  garnishee to disclose on just terms.  
 68.19     Sec. 27.  Minnesota Statutes 1999 Supplement, section 
 68.20  571.912, is amended to read: 
 68.21     571.912 [FORM OF EXEMPTION NOTICE.] 
 68.22     The notice informing a debtor that an order for attachment, 
 68.23  garnishment summons, or levy by execution has been used to 
 68.24  attach funds of the debtor to satisfy a claim must be 
 68.25  substantially in the following form:  
 68.26  STATE OF MINNESOTA                            DISTRICT COURT 
 68.27  COUNTY OF ................         ........JUDICIAL DISTRICT
 68.28  ........................(Creditor)
 68.29  ........................(Debtor)
 68.30  TO:  Debtor                                EXEMPTION NOTICE
 68.31     An order for attachment, garnishment summons, or levy of 
 68.32  execution (strike inapplicable language) has been served on 
 68.33  ............ (bank or other financial institution) 
 68.34  ............... where you have an account.  
 68.35     Your account balance is $.............  
 68.36     The amount being held is $............  
 69.1      However, all or a portion of the funds in your account will 
 69.2   normally be exempt from creditors' claims if they are in one of 
 69.3   the following categories: 
 69.4      (1) relief based on need.  This includes the Minnesota 
 69.5   Family Investment Program (MFIP), Emergency Assistance (EA), 
 69.6   Work First Program, Medical Assistance (MA), General Assistance 
 69.7   (GA), General Assistance Medical Care (GAMC), Emergency General 
 69.8   Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
 69.9   Emergency Assistance (MSA-EA), Supplemental Security Income 
 69.10  (SSI), and Energy Assistance; 
 69.11     (2) Social Security benefits (Old Age, Survivors, or 
 69.12  Disability Insurance); 
 69.13     (3) reemployment compensation, workers' compensation, or 
 69.14  veterans' benefits; 
 69.15     (4) an accident, disability, or retirement pension or 
 69.16  annuity; 
 69.17     (5) life insurance proceeds; 
 69.18     (6) the earnings of your minor child and any child support 
 69.19  paid to you; or 
 69.20     (7) money from a claim for damage or destruction of exempt 
 69.21  property (such as household goods, farm tools, business 
 69.22  equipment, a mobile home, or a car).  
 69.23     The following funds are also exempt: 
 69.24     (8) all earnings of a person in category (1); 
 69.25     (9) all earnings of a person who has received relief based 
 69.26  on need, or who has been an inmate of a correctional 
 69.27  institution, within the last six months; 
 69.28     (10) 75 percent of every debtor's after tax earnings; and 
 69.29     (11) all of a debtor's after tax earnings below 40 times 
 69.30  the federal minimum wage. 
 69.31     TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
 69.32     Categories (10) and (11):  20 days 
 69.33     Categories (8) and (9):  60 days 
 69.34     All others:  no time limit, as long as funds are traceable 
 69.35  to the exempt source.  (In tracing funds, the first-in, 
 69.36  first-out method is used.  This means money deposited first is 
 70.1   spent first.)  The money being sought by the creditor is being 
 70.2   held in your account to give you a chance to claim an exemption. 
 70.3      TO CLAIM AN EXEMPTION:  
 70.4      Fill out, sign, and mail or deliver one copy of the 
 70.5   attached exemption claim form to the institution which sent you 
 70.6   this notice and mail or deliver one copy to the creditor's 
 70.7   attorney.  In the event that there is no attorney for the 
 70.8   creditor, then such notice shall be sent directly to the 
 70.9   creditor.  The address for the creditor's attorney or the 
 70.10  creditor is set forth below.  <b>Both copies must be mailed or</b> 
 70.11  <b>delivered on the same day.</b>  
 70.12     <b>NOTE:  You may help resolve your claim faster if you send</b> 
 70.13     <b>to the creditor's attorney written proof or documents that</b> 
 70.14     <b>show why your money is exempt.  If you have questions</b> 
 70.15     <b>regarding the documents to send as proof of an exemption,</b> 
 70.16     <b>call the creditor's attorney.  If you do not send written</b> 
 70.17     <b>proof and the creditor's attorney has questions about your</b> 
 70.18     <b>exemption claim, the creditor's attorney may object to your</b> 
 70.19     <b>claim which may result in a further delay in releasing your</b> 
 70.20     <b>exempt funds.</b> 
 70.21     If they do not get the exemption claim back from you within 
 70.22  14 days of the date they mailed or gave it to you, they will be 
 70.23  free to turn the money over to the sheriff or the creditor.  If 
 70.24  you are going to claim an exemption, do so as soon as possible, 
 70.25  because your money may be held until it is decided. 
 70.26     IF YOU CLAIM AN EXEMPTION:  
 70.27     (1) nonexempt money can be turned over to the creditor or 
 70.28  sheriff; 
 70.29     (2) the financial institution will keep holding the money 
 70.30  claimed to be exempt; and 
 70.31     (3) seven days after receiving your exemption claim, the 
 70.32  financial institution will release the money to you unless 
 70.33  before then it receives an objection to your exemption claim.  
 70.34     IF THE CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
 70.35     The institution will hold the money until a court decides 
 70.36  if your exemption claim is valid, BUT ONLY IF the institution 
 71.1   gets a copy of your court motion papers asserting the exemption 
 71.2   WITHIN TEN DAYS after the objection is personally served on you, 
 71.3   or within 13 days from the date the objection is mailed or given 
 71.4   to you.  You may wish to consult an attorney at once if the 
 71.5   creditor objects to your exemption claim.  
 71.6      MOTION TO DETERMINE EXEMPTION:  
 71.7      At any time after your funds have been held, you may ask 
 71.8   for a court decision on the validity of your exemption claim by 
 71.9   filing a request for hearing which may be obtained at the office 
 71.10  of the court administrator of the above court. 
 71.11     PENALTIES:  
 71.12     If you claim an exemption in bad faith, or if the creditor 
 71.13  wrongly objects to an exemption in bad faith, the court may 
 71.14  order the person who acted in bad faith to pay costs, actual 
 71.15  damages, attorney fees, and an additional amount of up to $100.  
 71.16                                .............................
 71.17                                .............................
 71.18                                ............................. 
 71.19                                ............................. 
 71.20                                Name and address of (Attorney
 71.21                                for) Judgment Creditor
 71.22     EXEMPTION:  
 71.23     (If you claim an exemption complete the following): 
 71.24     (a) Amount of exemption claim.  
 71.25     / / I claim ALL the funds being held are exempt.  
 71.26     / / I claim SOME of the funds being held are exempt.  
 71.27           The exempt amount is $............  
 71.28     (b) Basis for exemption.  
 71.29     Of the eleven categories listed above, I am in category 
 71.30  number ............  (If more than one category applies, you may 
 71.31  fill in as many as apply.)  The source of the exempt funds is 
 71.32  the following:  
 71.33  .............................................................
 71.34  .............................................................
 71.35  .............................................................
 71.36     (If the source is a type of relief based on need, list the 
 72.1   case number and county:  
 72.2      case number:  ...............; 
 72.3      county:  ....................) 
 72.4      I hereby authorize any agency that has distributed relief 
 72.5   to me or any correctional institution in which I was an inmate 
 72.6   to disclose to the above named creditor or its attorney only 
 72.7   whether or not I am or have been a recipient of relief based on 
 72.8   need or an inmate of a correctional institute within the last 
 72.9   six months.  
 72.10     I have mailed or delivered a copy of the exemption notice 
 72.11  to the creditor's attorney at the address indicated above.  
 72.12  DATED:  .............        .............................
 72.13                               DEBTOR 
 72.14                               .............................
 72.15                               DEBTOR ADDRESS
 72.16                               .............................
 72.17                               DEBTOR TELEPHONE NUMBER 
 72.18     Sec. 28.  Minnesota Statutes 1998, section 571.914, 
 72.19  subdivision 2, is amended to read: 
 72.20     Subd. 2.  [NOTICE OF OBJECTION.] (a) The written objection 
 72.21  to the debtor must be in substantially the following form:  
 72.22  STATE OF MINNESOTA                             DISTRICT COURT
 72.23  COUNTY OF ....................    ..........JUDICIAL DISTRICT
 72.24  ....................(Creditor) 
 72.25  ....................(Debtor)             CREDITOR'S OBJECTION
 72.26  ....................(Garnishee)            TO EXEMPTION CLAIM
 72.27     The creditor objects to your claim for exemption from 
 72.28  garnishment, levy of execution, order for attachment (strike 
 72.29  inapplicable language) for the following reason(s):  
 72.30  .................................................................
 72.31  .................................................................
 72.32  .................................................................
 72.33     Because of this objection, your financial institution will 
 72.34  retain the funds you claimed to be exempt for an additional ten 
 72.35  days.  If you wish to request a hearing on your exemption claim, 
 72.36  you should need to do so within ten days of your receipt of this 
 73.1   from the date the objection was personally served on you, or 
 73.2   within 13 days of the date the objection was mailed to you.  You 
 73.3   may request a hearing by completing the attached form and filing 
 73.4   it with the court administrator.  
 73.5      1.  The court shall provide clerical assistance to help 
 73.6   with the writing and filing of a Request for Hearing by any 
 73.7   person not represented by counsel.  The court administrator may 
 73.8   charge a fee of $1 for the filing of a Request for Hearing.  
 73.9      2.  Upon the filing of a Request for Hearing, the clerk 
 73.10  shall schedule the matter for a hearing no later than five 
 73.11  business days from the date of filing.  The court administrator 
 73.12  shall forthwith send a completed copy of the request, including 
 73.13  the hearing date, time, and place to the adverse party and to 
 73.14  the financial institution by first class mail.  
 73.15     3.  If it is possible that the financial institution might 
 73.16  not receive the request mailed from the court administrator 
 73.17  within ten days, then you may want to personally deliver a copy 
 73.18  of the request to the financial institution after you have filed 
 73.19  your request with the court.  
 73.20     4.  An order stating whether your funds are exempt shall be 
 73.21  issued by the court within three days of the date of the hearing.
 73.22     If you do not file a Request for Hearing within ten days of 
 73.23  the date you receive this objection the objection was personally 
 73.24  served on you, or within 13 days from the date the objection was 
 73.25  mailed to you, your financial institution may turn your funds 
 73.26  over to your creditor. 
 73.27     If you file a Request for Hearing and your financial 
 73.28  institution receives it within ten days of the date it received 
 73.29  this objection, your financial institution will retain your 
 73.30  funds claimed to be exempt until otherwise ordered by the court, 
 73.31  or until the garnishment lapses pursuant to Minnesota Statutes, 
 73.32  section 571.79. 
 73.33                            ..................................
 73.34                            (CREDITOR OR CREDITOR'S ATTORNEY.) 
 73.35     Sec. 29.  Minnesota Statutes 1998, section 571.921, is 
 73.36  amended to read: 
 74.1      571.921 [DEFINITIONS.] 
 74.2      For purposes of sections 571.921 to 571.926, the following 
 74.3   terms have the meanings given them: 
 74.4      (a) "Earnings" means: 
 74.5      (1) compensation paid or payable to an employee for 
 74.6   personal service whether denominated as wages, salary, 
 74.7   commissions, bonus, or otherwise, and includes periodic payments 
 74.8   pursuant to a pension or retirement program; 
 74.9      (2) compensation paid or payable to the producer for the 
 74.10  sale of agricultural products; livestock or livestock products; 
 74.11  milk or milk products; or fruit or other horticultural products 
 74.12  produced when the producer is operating a family farm, a family 
 74.13  farm corporation, or an authorized farm corporation, as defined 
 74.14  in section 500.24, subdivision 2; or 
 74.15     (3) maintenance as defined in section 518.54, subdivision 
 74.16  3; 
 74.17     (b) "Disposable earnings" means that part of the earnings 
 74.18  of an individual remaining after the deduction from those 
 74.19  earnings of amounts required by law to be withheld, including 
 74.20  amounts required by court order to be withheld for child support 
 74.21  obligations. 
 74.22     (c) "Employee" means an individual who performs services 
 74.23  subject to the right of the employer to control both what is 
 74.24  done and how it is done. 
 74.25     (d) "Employer" means a person for whom an individual 
 74.26  performs services as an employee.  
 74.27     Sec. 30.  Minnesota Statutes 1999 Supplement, section 
 74.28  571.925, is amended to read: 
 74.29     571.925 [FORM OF NOTICE.] 
 74.30     The ten-day notice informing a debtor that a garnishment 
 74.31  summons may be used to garnish the earnings of an individual 
 74.32  must be substantially in the following form: 
 74.33  STATE OF MINNESOTA                             DISTRICT COURT
 74.34  COUNTY OF .............         ........... JUDICIAL DISTRICT
 74.35  ....................(Creditor)
 74.36  against
 75.1                                      GARNISHMENT EXEMPTION 
 75.2   ....................(Debtor)       NOTICE AND NOTICE OF 
 75.3   and                                INTENT TO GARNISH EARNINGS 
 75.4                                      WITHIN TEN DAYS
 75.5   ....................(Garnishee)
 75.6      PLEASE TAKE NOTICE that a garnishment summons or levy may 
 75.7   be served upon your employer or other third parties, without any 
 75.8   further court proceedings or notice to you, ten days or more 
 75.9   from the date hereof.  Some or all of your earnings are exempt 
 75.10  from garnishment.  If your earnings are garnished, your employer 
 75.11  must show you how the amount that is garnished from your 
 75.12  earnings was calculated.  You have the right to request a 
 75.13  hearing if you claim the garnishment is incorrect. 
 75.14     Your earnings are completely exempt from garnishment if you 
 75.15  are now a recipient of relief based on need, if you have been a 
 75.16  recipient of relief within the last six months, or if you have 
 75.17  been an inmate of a correctional institution in the last six 
 75.18  months. 
 75.19     Relief based on need includes the Minnesota Family 
 75.20  Investment Program (MFIP), Emergency Assistance (EA), Work First 
 75.21  Program, Medical Assistance (MA), General Assistance (GA), 
 75.22  General Assistance Medical Care (GAMC), Emergency General 
 75.23  Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
 75.24  Emergency Assistance (MSA-EA), Supplemental Security Income 
 75.25  (SSI), and Energy Assistance. 
 75.26     If you wish to claim an exemption, you should fill out the 
 75.27  appropriate form below, sign it, and send it to the creditor's 
 75.28  attorney and the garnishee. 
 75.29     You may wish to contact the attorney for the creditor in 
 75.30  order to arrange for a settlement of the debt or contact an 
 75.31  attorney to advise you about exemptions or other rights. 
 75.32                             PENALTIES
 75.33     (1) Be advised that even if you claim an exemption, a 
 75.34     garnishment summons may still be served on your employer.  
 75.35     If your earnings are garnished after you claim an 
 75.36     exemption, you may petition the court for a determination 
 76.1      of your exemption.  If the court finds that the creditor 
 76.2      disregarded your claim of exemption in bad faith, you will 
 76.3      be entitled to costs, reasonable attorney fees, actual 
 76.4      damages, and an amount not to exceed $100. 
 76.5      (2) HOWEVER, BE WARNED if you claim an exemption, the 
 76.6      creditor can also petition the court for a determination of 
 76.7      your exemption, and if the court finds that you claimed an 
 76.8      exemption in bad faith, you will be assessed costs and 
 76.9      reasonable attorney's fees plus an amount not to exceed 
 76.10     $100. 
 76.11     (3) If after receipt of this notice, you in bad faith take 
 76.12     action to frustrate the garnishment, thus requiring the 
 76.13     creditor to petition the court to resolve the problem, you 
 76.14     will be liable to the creditor for costs and reasonable 
 76.15     attorney's fees plus an amount not to exceed $100. 
 76.16  DATED:  ............           ........................
 76.17                                 (Attorney for) Creditor
 76.18                                 ........................
 76.19                                 Address
 76.20                                 ........................
 76.21                                 Telephone
 76.22                  DEBTOR'S EXEMPTION CLAIM NOTICE
 76.23     I hereby claim that my earnings are exempt from garnishment 
 76.24  because: 
 76.25     (1) I am presently a recipient of relief based on need. 
 76.26     (Specify the program, case number, and the county from 
 76.27     which relief is being received.) 
 76.28  ................    ......................   ...............
 76.29  Program             Case Number (if known)   County
 76.30     (2) I am not now receiving relief based on need, but I have 
 76.31     received relief based on need within the last six months.  
 76.32     (Specify the program, case number, and the county from 
 76.33     which relief has been received.) 
 76.34  ................    ......................   ...............
 76.35  Program             Case Number (if known)   County
 76.36     (3) I have been an inmate of a correctional institution 
 77.1      within the last six months.  (Specify the correctional 
 77.2      institution and location.) 
 77.3   ...........................       ..........................
 77.4   Correctional Institution          Location
 77.5      I hereby authorize any agency that has distributed relief 
 77.6   to me or any correctional institution in which I was an inmate 
 77.7   to disclose to the above-named creditor or the creditor's 
 77.8   attorney only whether or not I am or have been a recipient of 
 77.9   relief based on need or an inmate of a correctional institution 
 77.10  within the last six months.  I have mailed or delivered a copy 
 77.11  of this form to the creditor or creditor's attorney. 
 77.12  ...........................          .........................
 77.13  Date                                 Debtor
 77.14                                       .........................
 77.15                                       Address
 77.16                                       .........................
 77.17                                       Debtor Telephone Number
 77.18     Sec. 31.  [REPEALER.] 
 77.19     Minnesota Statutes 1998, section 571.80, is repealed.