SF 1253

as introduced - 91st Legislature (2019 - 2020) Posted on 02/14/2019 03:50pm

A bill for an act
relating to civil actions; providing judgment debtors a standard exemption for
funds in bank or other deposit accounts; amending Minnesota Statutes 2018,
sections 550.135, subdivision 4; 550.143, subdivision 3c; 550.37, subdivision 20,
by adding a subdivision; 551.04, subdivision 3; 551.05, subdivision 1d; 571.912.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 550.135, subdivision 4, is amended to read:

Subd. 4.

Property not attachable.

The following property is not subject to attachment
by a writ of execution served pursuant to this chapter:

(1) any indebtedness or money due to the judgment debtor, unless at the time of the
service of the writ of execution the same is due absolutely or does not depend upon any
contingency;

(2) any judgment owing by the third party to the judgment debtor, if the third party or
the third party's property is liable on an execution levy upon the judgment;

(3) any debt owing by the third party to the judgment debtor for which any negotiable
instrument has been issued or endorsed by the third party;

(4) any indebtedness or money due to the judgment debtor where the judgment debtor
is a bank, savings bank, trust company, credit union, savings association, or industrial loan
and thrift company with deposit liabilities;

(5) any indebtedness or money due to the judgment debtor with a cumulative value of
less than deleted text begin $10 deleted text end new text begin $25 new text end ; deleted text begin and
deleted text end

(6) any disposable earnings, indebtedness, or money that is exempt under Minnesota or
federal law deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) an exemption under section 550.37, subdivision 20, of $....... total for bank or other
deposit accounts.
new text end

Sec. 2.

Minnesota Statutes 2018, section 550.143, subdivision 3c, is amended to read:

Subd. 3c.

deleted text begin Form of deleted text end Exemption deleted text begin form deleted text end new text begin claim new text end .

The exemption deleted text begin form deleted text end new text begin claim new text end required by this
subdivision must be sent as a separate deleted text begin form deleted text end new text begin claim new text end and must be deleted text begin in deleted text end substantially deleted text begin the following
form deleted text end new text begin as follows new text end :

STATE OF MINNESOTA		DISTRICT COURT
COUNTY OF .		. JUDICIAL DISTRICT
. (Creditor)
. (Debtor)
. ( deleted text begin Financial deleted text end new text begin Bank or other deposit new text end institution)

new text begin BANK OR OTHER DEPOSIT ACCOUNT new text end EXEMPTION deleted text begin FORM deleted text end new text begin CLAIM
new text end

A.	deleted text begin HOW MUCH MONEY IS PROTECTED deleted text end
.	I claim deleted text begin ALL of the deleted text end money being frozen deleted text begin by the deleted text end new text begin in my new text end bank deleted text begin is protected deleted text end new text begin or other deposit account is exempt because it is protected by the standard bank or other deposit account exemption under Minnesota Statutes, section 550.37, subdivision 20 new text end .
deleted text begin . deleted text end	deleted text begin I claim SOME of the money is protected. The amount I claim is protected is $....... deleted text end
	new text begin Your Choice new text end
.	new text begin The standard exemption of $....... will protect my account balance; or it is the only exemption I am entitled to; or it is the only exemption I choose to claim. (If you make this choice skip the rest of this form.) new text end
.	new text begin In addition to the standard exemption, I am entitled to the exemptions indicated below and I choose to claim them. (If you make this choice, mark below the additional exemption or exemptions you claim.) new text end
deleted text begin B. deleted text end	deleted text begin WHY THE MONEY IS PROTECTED deleted text end
new text begin B. new text end	new text begin In addition, some of new text end my money is protected because I get it from one or more of the following places: (Check all that apply)
.	Government benefits
	Government benefits include, but are not limited to, the following:
	MFIP - Minnesota family investment program,
	MFIP Diversionary Work Program,
	Work participation cash benefit,
	GA - general assistance,
	EA - emergency assistance,
	MA - medical assistance,
	EGA - emergency general assistance,
	MSA - Minnesota supplemental aid,
	MSA-EA - MSA emergency assistance,
	Food Support,
	SSI - Supplemental Security Income,
	MinnesotaCare,
	Medicare Part B premium payments,
	Medicare Part D extra help,
	Energy or fuel assistance.
LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
.
LIST THE CASE NUMBER AND COUNTY
	Case Number: .
	County: .
	Government benefits also include:
.	Social Security benefits
.	Unemployment benefits
.	Workers' compensation
.	Veterans benefits
	If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, unemployment, workers' compensation, or veterans benefits.
.	Other assistance based on need

You may have assistance based on need from another source that is not on the list. If you
do, check this box, and fill in the source of your money on the line below:

Source: .

Include copies of deleted text begin any deleted text end documents you have that show the source of this money.

new text begin C. new text end	EARNINGS
	ALL or SOME of your earnings (wages) may also be protected.
.	All of your earnings (wages) are protected if:
.	You get government benefits (see list of government benefits)
.	You currently receive other assistance based on need
.	You have received government benefits in the last six months
.	You were in jail or prison in the last six months
	If you check one of these lines, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS that show what was in your account for the 60 days right before the bank new text begin or other deposit institution new text end froze your money.
.	Some of your earnings (wages) are protected.
	If all of your earnings are not exempt, then some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of:
	75 percent of your wages (after taxes are taken out); or
	deleted text begin (insert the sum of deleted text end the deleted text begin current deleted text end new text begin hourly new text end federal minimum wage deleted text begin ) deleted text end multiplied by 40.
new text begin D. new text end	OTHER EXEMPT FUNDS
	The money from the following are also completely protected after they are deposited in your new text begin bank or other deposit new text end account.
.	An accident, disability, or retirement pension or annuity
.	Payments to you from a life insurance policy
.	Earnings of your child who is under 18 years of age
.	Child support
.	Money paid to you from a claim for damage or destruction of property Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture, or appliances.
.	Death benefits paid to you
new text begin E. new text end	new text begin PERMISSIONS new text end

I give permission to any agency that has given me cash benefits to give information
about my benefits to the above-named creditor, or its attorney. The information will ONLY
concern whether I get benefits or not, or whether I have gotten them in the past six months.

new text begin F. new text end

new text begin JAILED OR IMPRISONED new text end

If I was an inmate in the last six months, I give deleted text begin my deleted text end permission to the correctional
institution to tell the above-named creditor that I was an inmate there.

new text begin G. new text end

new text begin SIGNATURES new text end

YOU MUST SIGN AND SEND THIS deleted text begin FORM deleted text end new text begin CLAIM new text end BACK TO THE
CREDITOR'S ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND
new text begin TO new text end THE BANK new text begin OR OTHER DEPOSIT INSTITUTION new text end . REMEMBER TO INCLUDE
A COPY OF YOUR BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS FOR
THE PAST 60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE
INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.

I have mailed or delivered a copy of this deleted text begin form deleted text end new text begin claim new text end to:

.

(Insert name of creditor or creditor's attorney)

.

(Insert address of creditor or creditor's attorney)

I have also mailed or delivered a copy of this exemption deleted text begin form deleted text end new text begin claim new text end to my bank new text begin or other
deposit institution new text end at the address listed in the instructions.

DATED: .	.
	DEBTOR
	.
	DEBTOR ADDRESS
	.
	DEBTOR TELEPHONE NUMBER

Sec. 3.

Minnesota Statutes 2018, section 550.37, subdivision 20, is amended to read:

Subd. 20.

deleted text begin Traceable funds deleted text end new text begin Bank or other deposit account exemptions new text end .

new text begin A debtor's
deposits in bank or other deposit accounts, whether single or joint, up to $......., are exempt
from the claims of creditors and are not subject to garnishment under section 571.74 or
execution or levy under section 550.143. The direct exemption under this subdivision shall
be applied by a bank or other deposit institution without being claimed by the debtor under
section 550.143, subdivision 3c, or 551.05, subdivision 1d.
new text end

new text begin In addition, new text end the exemption of funds from creditors' claims, provided by subdivisions 9,
10, 11, 15, and 24, shall not be affected by the subsequent deposit of the funds in a bank or
any other deleted text begin financial deleted text end new text begin deposit new text end institution, whether in a single or joint account, if the funds are
traceable to their exempt source. In tracing the funds, the first-in first-out method of
accounting shall be used. The burden of establishing that new text begin traced new text end funds are exempt rests upon
the debtor. No bank or other deleted text begin financial deleted text end new text begin deposit new text end institution shall be liable for damages for
complying with process duly issued out of any court for the collection of a debt even if the
funds affected by the process are subsequently determined to have been exempt.

new text begin If the amount of the direct exemption applicable to a bank or other deposit account
exceeds the balance in the account, the institution shall notify the debtor that there has been
a garnishment or levy, of the fact that no funds have been frozen for the creditor or creditors,
and of the account balance remaining.
new text end

Sec. 4.

Minnesota Statutes 2018, section 550.37, is amended by adding a subdivision to
read:

new text begin Subd. 20a. new text end

new text begin Multiple bank or other deposit accounts. new text end

new text begin If, within a seven-day period, a
creditor garnishes or levies on more than one bank or other deposit institution to collect an
individual's debts, the creditor may direct all the garnished or levied-on institutions not to
apply the standard exemption, but rather to freeze all of the funds in the accounts of the
debtor. The bank or other deposit institution that freezes the funds shall notify the debtor
that the debtor's funds have been frozen and that the debtor may, within 14 days of receipt
of the notice, direct institutions how to apply the exemption. If the debtor fails to specify
how to apply the exemption to the accounts, the bank and other deposit institutions shall
notify the creditor, and the creditor may direct how the exemption is to be applied to the
accounts.
new text end

Sec. 5.

Minnesota Statutes 2018, section 551.04, subdivision 3, is amended to read:

Subd. 3.

Property not attachable.

The following property is not subject to attachment
by a writ of execution served pursuant to this chapter:

(1) any indebtedness or money due to the judgment debtor, unless at the time of the
service of the writ of execution the same is due absolutely or does not depend upon any
contingency;

(2) any judgment owing by the third party to the judgment debtor, if the third party or
the third party's property is liable on an execution levy upon the judgment;

(3) any debt owing by the third party to the judgment debtor for which any negotiable
instrument has been issued or endorsed by the third party;

(4) any indebtedness or money due to the judgment debtor where the judgment debtor
is a bank, savings bank, trust company, credit union, savings association, or industrial loan
and thrift company with deposit liabilities;

(5) any indebtedness or money due to the judgment debtor with a cumulative value of
less than deleted text begin $10 deleted text end new text begin $25 new text end ; deleted text begin and
deleted text end

(6) any disposable earnings, indebtedness, or money that is exempt under Minnesota or
federal law deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) one standard bank or other deposit account exemption that totals $......., regardless
of the number of existing separate bank or other deposit accounts.
new text end

Sec. 6.

Minnesota Statutes 2018, section 551.05, subdivision 1d, is amended to read:

Subd. 1d.

deleted text begin Form of deleted text end Exemption deleted text begin form deleted text end new text begin claim new text end .

The exemption deleted text begin form deleted text end new text begin claim new text end required by this
subdivision must be a separate deleted text begin form deleted text end new text begin claim new text end and must be deleted text begin in deleted text end substantially deleted text begin the following form deleted text end new text begin
as follows new text end :

STATE OF MINNESOTA		DISTRICT COURT
COUNTY OF .		. JUDICIAL DISTRICT
. (Creditor)
. (Debtor)
. ( deleted text begin Financial deleted text end new text begin Bank or other deposit new text end institution)

new text begin ACCOUNT new text end EXEMPTION deleted text begin FORM deleted text end new text begin CLAIM
new text end

A.	deleted text begin HOW MUCH deleted text end MONEY IS PROTECTED
.	I claim deleted text begin ALL of the deleted text end money being frozen deleted text begin by the deleted text end new text begin in my new text end bank deleted text begin is protected deleted text end new text begin or other deposit account is exempt because it is protected by the standard bank or other deposit account exemption under Minnesota Statutes, section 550.37, subdivision 20 new text end .
deleted text begin . deleted text end	deleted text begin I claim SOME of the money is protected. The amount I claim is protected is $....... deleted text end
	new text begin Your Choice new text end
.	new text begin The standard exemption of $....... will protect my account balance; or it is the only exemption I am entitled to; or it is the only exemption I choose to claim. (If you make this choice skip the rest of this form.) new text end
.	new text begin In addition to the standard exemption, I am entitled to the exemptions indicated below and I choose to claim them. (If you make this choice, mark below the additional exemption or exemptions you claim. new text end
deleted text begin B. deleted text end	deleted text begin WHY THE MONEY IS PROTECTED deleted text end
new text begin B. new text end	new text begin In addition, some of new text end my money is protected because I get it from one or more of the following places: (Check all that apply)
.	Government benefits
	Government benefits include, but are not limited to, the following:
	MFIP - Minnesota family investment program,
	MFIP Diversionary Work Program,
	Work participation cash benefit,
	GA - general assistance,
	EA - emergency assistance,
	MA - medical assistance,
	EGA - emergency general assistance,
	MSA - Minnesota supplemental aid,
	MSA-EA - MSA emergency assistance,
	Food Support,
	SSI - Supplemental Security Income,
	MinnesotaCare,
	Medicare Part B premium payments,
	Medicare Part D extra help,
	Energy or fuel assistance.
LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
.
LIST THE CASE NUMBER AND COUNTY
	Case Number: .
	County: .
	Government benefits also include:
.	Social Security benefits
.	Unemployment benefits
.	Workers' compensation
.	Veterans benefits
	If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, unemployment, workers' compensation, or veterans benefits.
.	Other assistance based on need

You may have assistance based on need from another source that is not on the list. If you
do, check this box, and fill in the source of your money on the line below:

Source: .

Include copies of deleted text begin any deleted text end documents you have that show the source of this money.

new text begin C. new text end	EARNINGS
	deleted text begin ALL or SOME of your earnings (wages) may also be protected. deleted text end
.	All of your earnings (wages) are protected if:
.	You get government benefits (see list of government benefits)
.	You currently receive other assistance based on need
.	You have received government benefits in the last six months
.	You were in jail or prison in the last six months
	If you check one of these lines, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS that show what was in your account for the 60 days right before the bank new text begin or other deposit account new text end froze your money.
.	Some of your earnings (wages) are protected.
	If all of your earnings are not exempt, then some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of:
	75 percent of your wages (after taxes are taken out); or
	deleted text begin (insert the sum of deleted text end the deleted text begin current deleted text end new text begin hourly new text end federal minimum wage deleted text begin ) deleted text end multiplied by 40.
new text begin D. new text end	OTHER EXEMPT FUNDS
	The money from the following are also completely protected after they are deposited in your account.
.	An accident, disability, or retirement pension or annuity
.	Payments to you from a life insurance policy
.	Earnings of your child who is under 18 years of age
.	Child support
.	Money paid to you from a claim for damage or destruction of property Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture, or appliances.
.	Death benefits paid to you
new text begin E. new text end	new text begin PERMISSIONS new text end

I give permission to any agency that has given me cash benefits to give information
about my benefits to the above-named creditor, or its attorney. The information will ONLY
concern whether I get benefits or not, or whether I have gotten them in the past six months.

new text begin F. new text end

new text begin JAILED OR IMPRISONED new text end

If I was an inmate in the last six months, I give deleted text begin my deleted text end permission to the correctional
institution to tell the above-named creditor that I was an inmate there.

new text begin G. new text end

new text begin SIGNATURE new text end

YOU MUST SIGN AND SEND THIS deleted text begin FORM deleted text end new text begin CLAIM new text end BACK TO THE
CREDITOR'S ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND
new text begin TO new text end THE BANK new text begin OR OTHER DEPOSIT INSTITUTION new text end . REMEMBER TO INCLUDE
A COPY OF YOUR BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS FOR
THE PAST 60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE
INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.

I have mailed or delivered a copy of this deleted text begin form deleted text end new text begin claim new text end to:

.

(Insert name of creditor or creditor's attorney)

.

(Insert address of creditor or creditor's attorney)

I have also mailed or delivered a copy of this exemption deleted text begin form deleted text end new text begin claim new text end to my bank new text begin or other
deposit institution new text end at the address listed in the instructions.

DATED: .	.
	DEBTOR
	.
	DEBTOR ADDRESS
	.
	DEBTOR TELEPHONE NUMBER

Sec. 7.

Minnesota Statutes 2018, section 571.912, is amended to read:

571.912 deleted text begin FORM OF deleted text end NOTICE, INSTRUCTIONS, AND EXEMPTION NOTICE.

Subdivision 1.

deleted text begin Form of deleted text end Notice.

The notice, instructions, and exemption notice informing
a debtor that a garnishment summons has been used to attach funds of the debtor to satisfy
a claim must be a separate notice and must be substantially deleted text begin in the following form deleted text end new text begin as follows new text end :

STATE OF MINNESOTA		DISTRICT COURT
COUNTY OF .		. JUDICIAL DISTRICT
. (Creditor)
. (Debtor)
. ( deleted text begin Financial deleted text end new text begin Bank or other deposit new text end institution)

IMPORTANT NOTICE

YOUR FUNDS HAVE BEEN GARNISHED

The Creditor has frozen money in your deleted text begin account at your financial institution deleted text end new text begin bank or other
deposit account new text end .

Your account balance is $.......

The amount being held is $.......

The amount being held will be frozen for 14 days from the date of this notice.

Some of your money in your account may be protected (the legal word is exempt).
You may be able to get it sooner than 14 days if you act quickly and follow the
instructions on the next page.

The attached exemption deleted text begin form deleted text end new text begin claim new text end lists some different sources of money in your account
that may be protected. If your money is from one or more of these sources, place a check
on the line on the form next to the sources of your money. If it is from one of these sources,
the Creditor cannot take it.

BUT, you must follow the instructions and return the exemption deleted text begin form deleted text end new text begin claim new text end and
copies of your bank new text begin or other deposit account new text end statements from the last 60 days to have
the bank new text begin or other deposit institution new text end unfreeze your money. If you do not follow the
instructions or your Creditor gets an order from the court or writ of execution, new text begin the money
in new text end your deleted text begin financial institution deleted text end new text begin bank or other deposit account new text end will deleted text begin give the money deleted text end new text begin be given new text end to
your Creditor. If that happens and it is protected, you can still get it back from the Creditor
later, but that is not as easy to do as filling in the deleted text begin form deleted text end new text begin exemption claim new text end now.

See next pages for instructions and the exemption deleted text begin form deleted text end new text begin claim new text end .

Subd. 2.

deleted text begin Form of deleted text end Instructions.

The instructions deleted text begin required deleted text end must be in a separate form
and must be substantially deleted text begin in the following form deleted text end new text begin as follows new text end :

INSTRUCTIONS

Note: The creditor is who you owe the money to. You are the debtor.

1. Fill out both of the attached exemption deleted text begin forms deleted text end new text begin claims new text end in this packet.

If you check one of the lines, you should also give proof that shows that some or all
of the money in your account is from one or more of the protected sources. Creditors
may ask for a hearing if they question your exemptions.

To avoid a hearing:

Case numbers should be added to the form.

Copies of documents should be sent with the form.

NOTICE: YOU MUST SEND TO THE CREDITOR'S ATTORNEY (OR TO THE
CREDITOR, IF NO ATTORNEY) COPIES OF YOUR BANK new text begin OR OTHER DEPOSIT
ACCOUNT new text end STATEMENTS FOR THE PAST 60 DAYS BEFORE THE
GARNISHMENT. Keep a copy of your bank new text begin or other deposit account new text end statements in
case there are questions about your claim. If you do not send to the creditor's attorney
(or to the creditor, if no attorney) bank new text begin or other deposit account new text end statements with your
exemption claim, the deleted text begin financial deleted text end new text begin bank or other deposit new text end institution may release your
money to the creditor once the creditor gives the deleted text begin financial deleted text end new text begin bank or other deposit
new text end institution a court order directing it to turn over the funds.

2. Sign the exemption deleted text begin forms deleted text end new text begin claims new text end . Make one copy to keep for yourself.

3. Mail or deliver the other copies of the deleted text begin form deleted text end new text begin claim new text end by (insert date).

BOTH COPIES MUST BE MAILED OR DELIVERED THE SAME DAY.

One copy of the deleted text begin form deleted text end new text begin claim new text end and the copies of your bank new text begin or other deposit account
new text end statements go to:

.

(Insert name of creditor or creditor's attorney)

.

(Insert address of creditor or creditor's attorney)

One copy goes to:

.

(Insert name of bank new text begin or other deposit institution new text end )

.

(Insert address of bank new text begin or other deposit institution new text end )

HOW THE PROCESS WORKS

If You Do Not Send in the Exemption deleted text begin Form deleted text end new text begin Claim new text end and Bank new text begin or Other Deposit
Account new text end Statements:

14 days after the date of this letter some or all of your money may be turned over to the
creditor once they get an order from the court telling the deleted text begin financial deleted text end new text begin bank or other deposit
new text end institution to do this.

If You Send in the Exemption deleted text begin Form deleted text end new text begin Claim new text end and Bank new text begin or Other Deposit Account
new text end Statements:

Any money that is NOT protected deleted text begin can deleted text end new text begin may new text end be turned over to the creditor once they get
an order from the court.

If the Creditor Does Not Object:

The deleted text begin financial deleted text end new text begin bank or other deposit new text end institution will unfreeze your money six business
days after the new text begin bank or other deposit new text end institution gets your completed deleted text begin form deleted text end new text begin exemption claim new text end .

If the Creditor Objects:

The money new text begin that new text end you have said is protected on the deleted text begin form deleted text end new text begin exemption claim new text end will be held deleted text begin by
the deleted text end new text begin in your new text end bank new text begin or other deposit account new text end . The creditor has six business days to object
(disagree) and ask the court to hold a hearing. You will receive a Notice of Objection and
a Notice of Hearing.

The deleted text begin financial deleted text end new text begin bank or other deposit new text end institution will hold the money until a court decides
whether your money is protected or not. Some reasons a creditor may object are because
you did not send copies of your bank new text begin or other deposit account new text end statements or other proof of
the benefits you received. Be sure to include these when you send your exemption deleted text begin form deleted text end new text begin
claim new text end .

You may want to deleted text begin talk to deleted text end new text begin contact new text end a lawyer for advice about this process. If deleted text begin you are low deleted text end
new text begin your new text end income new text begin is low, new text end you can deleted text begin call deleted text end new text begin contact new text end Legal Aid.

PENALTIES:

If you claim that your money is protected and a court decides you made that claim in
bad faith, the court can order you to pay costs, actual damages, attorney fees, and an
additional amount of up to $100. For example, it may be bad faith if you claim you receive
government benefits that you do not receive.

If the creditor made a bad faith objection to your claim that your money is protected,
the court can order them to pay costs, actual damages, attorney fees, and an additional
amount of up to $100.

Subd. 3.

Exemption deleted text begin notice deleted text end new text begin claim new text end .

The exemption deleted text begin notice deleted text end new text begin claim new text end must be deleted text begin a deleted text end separate deleted text begin form deleted text end
and must be deleted text begin in deleted text end substantially deleted text begin the following form deleted text end new text begin as follows new text end :

STATE OF MINNESOTA		DISTRICT COURT
COUNTY OF .		. JUDICIAL DISTRICT
. (Creditor)
. (Debtor)
. ( deleted text begin Financial deleted text end new text begin Bank or other deposit new text end institution)

new text begin BANK OR OTHER DEPOSIT ACCOUNT new text end EXEMPTION deleted text begin FORM deleted text end new text begin CLAIM
new text end

A.		deleted text begin HOW MUCH deleted text end MONEY IS PROTECTED
.		I claim deleted text begin ALL of the deleted text end money being frozen deleted text begin by the bank deleted text end new text begin in my deposit account new text end is deleted text begin protected deleted text end new text begin exempt because it is protected by the standard bank or other deposit account exemption under Minnesota Statutes, section 550.37, subdivision 20 new text end .
deleted text begin . deleted text end		deleted text begin I claim SOME of the money is protected. The amount I claim is protected is $....... deleted text end
		new text begin Your Choice new text end
.		new text begin The standard exemption of $....... will protect my account balance; or it is the only exemption I am entitled to; or it is the only exemption I choose to claim. (If you make this choice skip the rest of this form.) new text end
.		new text begin In addition to the standard exemption, I am entitled to the exemptions indicated below and I choose to claim them. (If you make this choice, mark below the additional exemption or exemptions you claim.) new text end
deleted text begin B. deleted text end		deleted text begin WHY THE MONEY IS PROTECTED deleted text end
new text begin B. new text end		new text begin In addition, some of new text end my money is protected because I get it from one or more of the following places: (Check all that apply)
.		Government benefits
		Government benefits include, but are not limited to, the following:
		MFIP - Minnesota family investment program,
		MFIP Diversionary Work Program,
		Work participation cash benefit,
		GA - general assistance,
		EA - emergency assistance,
		MA - medical assistance,
		EGA - emergency general assistance,
		MSA - Minnesota supplemental aid,
		MSA-EA - MSA emergency assistance,
		Food Support,
		SSI - Supplemental Security Income,
		MinnesotaCare,
		Medicare Part B premium payments,
		Medicare Part D extra help,
		Energy or fuel assistance.
LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
.
LIST THE CASE NUMBER AND COUNTY
		Case Number: .
		County: .
		Government benefits also include:
.		Social Security benefits
.		Unemployment benefits
.		Workers' compensation
.		Veterans benefits
		If you receive any of these government benefits, include copies of any documents you have that show you receive Social Security, unemployment, workers' compensation, or veterans benefits.
.		Other assistance based on need

You may have assistance based on need from another source that is not on the list. If you
do, check this box, and fill in the source of your money on the line below:

Source: .

Include copies of deleted text begin any deleted text end documents you have that show the source of this money.

new text begin C. new text end		EARNINGS
		ALL or SOME of your earnings (wages) may also be protected.
.		All of your earnings (wages) are protected if:
.		You get government benefits (see list of government benefits)
.		You currently receive other assistance based on need
.		You have received government benefits in the last six months
.		You were in jail or prison in the last six months
		If you check one of these lines, your wages are only protected for 60 days after they are deposited in your account so you MUST send the creditor a copy of BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS that show what was in your account for the 60 days right before the bank new text begin or other deposit institution new text end froze your money.
.		Some of your earnings (wages) are protected.
		If all of your earnings are not exempt, then some of your earnings are still protected for 20 days after they were deposited in your account. The amount protected is the larger amount of:
		75 percent of your wages (after taxes are taken out); or
		deleted text begin (insert the sum of deleted text end the deleted text begin current deleted text end new text begin hourly new text end federal minimum wage deleted text begin ) deleted text end multiplied by 40.
new text begin D. new text end		OTHER EXEMPT FUNDS
		The money from the following are also completely protected after they are deposited in your new text begin bank or other deposit new text end account.
.		An accident, disability, or retirement pension or annuity
.		Payments to you from a life insurance policy
.		Earnings of your child who is under 18 years of age
.		Child support
.		Money paid to you from a claim for damage or destruction of property Property includes household goods, farm tools or machinery, tools for your job, business equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture, or appliances.
.		Death benefits paid to you
new text begin E. new text end		new text begin PERMISSION new text end

I give permission to any agency that has given me cash benefits to give information
about my benefits to the above-named creditor, or its attorney. The information will ONLY
concern whether I get benefits or not, or whether I have gotten them in the past six months.

new text begin F. new text end

new text begin JAILED OR IMPRISONED new text end

If I was an inmate in the last six months, I give deleted text begin my deleted text end permission to the correctional
institution to tell the above-named creditor that I was an inmate there.

new text begin G. new text end

new text begin SIGNATURE new text end

YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S
ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND new text begin TO new text end THE BANK new text begin
OR OTHER DEPOSIT INSTITUTION new text end . REMEMBER TO INCLUDE A COPY OF
YOUR BANK new text begin OR OTHER DEPOSIT ACCOUNT new text end STATEMENTS FOR THE PAST
60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE
INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.

I have mailed or delivered a copy of this deleted text begin form deleted text end new text begin claim new text end to:

.

(Insert name of creditor or creditor's attorney)

.

(Insert address of creditor or creditor's attorney)

I have also mailed or delivered a copy of this exemption deleted text begin form deleted text end new text begin claim new text end to my bank new text begin or other
deposit institution new text end at the address listed in the instructions.

DATED: .	.
	DEBTOR
	.
	DEBTOR ADDRESS
	.
	DEBTOR TELEPHONE NUMBER