1.1 	A bill for an act
1.2 	relating to civil actions; providing judgment debtors a standard exemption for 
1.3 	funds in bank or other deposit accounts;amending Minnesota Statutes 2018, 
1.4 	sections 550.135, subdivision 4; 550.143, subdivision 3c; 550.37, subdivision 20, 
1.5 	by adding a subdivision; 551.04, subdivision 3; 551.05, subdivision 1d; 571.912.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2018, section 550.135, subdivision 4, is amended to read:
1.8 		Subd. 4.Property not attachable. The following property is not subject to attachment 
1.9 	by a writ of execution served pursuant to this chapter:
1.10 	(1) any indebtedness or money due to the judgment debtor, unless at the time of the 
1.11 	service of the writ of execution the same is due absolutely or does not depend upon any 
1.12 	contingency;
1.13 	(2) any judgment owing by the third party to the judgment debtor, if the third party or 
1.14 	the third party's property is liable on an execution levy upon the judgment;
1.15 	(3) any debt owing by the third party to the judgment debtor for which any negotiable 
1.16 	instrument has been issued or endorsed by the third party;
1.17 	(4) any indebtedness or money due to the judgment debtor where the judgment debtor 
1.18 	is a bank, savings bank, trust company, credit union, savings association, or industrial loan 
1.19 	and thrift company with deposit liabilities;
1.20 	(5) any indebtedness or money due to the judgment debtor with a cumulative value of 
1.21 	less than $10 $25; and
2.1 	(6) any disposable earnings, indebtedness, or money that is exempt under Minnesota or 
2.2 	federal law.; and
2.3 	(7) an exemption under section 550.37, subdivision 20, of $....... total for bank or other 
2.4 	deposit accounts.

2.5 	Sec. 2. Minnesota Statutes 2018, section 550.143, subdivision 3c, is amended to read:
2.6 		Subd. 3c.Form of Exemption form claim. The exemption form claim required by this 
2.7 	subdivision must be sent as a separate form claim and must be in substantially the following 
2.8 	form as follows:

2.9	STATE OF MINNESOTA
		DISTRICT COURT
	
2.10	COUNTY OF  ........
		........JUDICIAL DISTRICT
	
2.11	........(Creditor)
			
2.12	........(Debtor)
			
2.13	........(Financial Bank or other deposit institution)
		
2.14 	BANK OR OTHER DEPOSIT ACCOUNT EXEMPTION FORM CLAIM

2.15	A.
	HOW MUCH MONEY IS PROTECTED
	
2.192.16
2.17
2.18
	........
	I claim ALL of the money being frozen by thein my bank is protected 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.
	
2.20	........
	I claim SOME of the money is protected. The amount I claim is protected is $.......
	
2.21		Your Choice
	
2.242.22
2.23
	........
	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.)
	
2.272.25
2.26
	........
	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.)
	
2.28	B.
	WHY THE MONEY IS PROTECTED
	
2.292.30	B.
	In addition, some of my money is protected because I get it from one or more of the 
following places: (Check all that apply)
	
2.31	........
	Government benefits
	
2.32		Government benefits include, but are not limited to, the following:
	
2.33		MFIP - Minnesota family investment program,
	
2.34		MFIP Diversionary Work Program,
	
2.35		Work participation cash benefit,
	
2.36		GA - general assistance,
	
2.37		EA - emergency assistance,
	
2.38		MA - medical assistance,
	
3.1		EGA - emergency general assistance,
	
3.2		MSA - Minnesota supplemental aid,
	
3.3		MSA-EA - MSA emergency assistance,
	
3.4		Food Support,
	
3.5		SSI - Supplemental Security Income,
	
3.6		MinnesotaCare,
	
3.7		Medicare Part B premium payments,
	
3.8		Medicare Part D extra help,
	
3.9		Energy or fuel assistance.
	
3.10	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
	
3.11	........
	
3.12	LIST THE CASE NUMBER AND COUNTY
	
3.13		Case Number: ........
	
3.14		County: ........
	
3.15		Government benefits also include:
	
3.16	........
	Social Security benefits
	
3.17	........
	Unemployment benefits
	
3.18	........
	Workers' compensation
	
3.19	........
	Veterans benefits
	
3.20
3.21
3.22		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.
	
3.23	........
	Other assistance based on need
	
3.24 	You may have assistance based on need from another source that is not on the list. If you 
3.25 	do, check this box, and fill in the source of your money on the line below:
3.26 	Source:........
3.27 	Include copies of any documents you have that show the source of this money.

3.28	C.
	EARNINGS
	
3.29		ALL or SOME of your earnings (wages) may also be protected.
	
3.30	........
	All of your earnings (wages) are protected if:
	
3.31	........
	You get government benefits (see list of government benefits)
	
3.32	........
	You currently receive other assistance based on need
	
3.33	........
	You have received government benefits in the last six months
	
3.34	........
	You were in jail or prison in the last six months
	
3.35
3.36
3.37
4.1
4.2		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 OR OTHER DEPOSIT ACCOUNT STATEMENTS that show what was 
in your account for the 60 days right before the bank or other deposit institution 
froze your money.
	
4.3	........
	Some of your earnings (wages) are protected.
	
4.4
4.5
4.6		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:
	
4.7		75 percent of your wages (after taxes are taken out); or
	
4.8		(insert the sum of the current hourly federal minimum wage) multiplied by 40.
	
4.9	D.
	OTHER EXEMPT FUNDS
	
4.10
4.11		The money from the following are also completely protected after they are deposited 
in your bank or other deposit account.
	
4.12	........
	An accident, disability, or retirement pension or annuity
	
4.13	........
	Payments to you from a life insurance policy
	
4.14	........
	Earnings of your child who is under 18 years of age
	
4.15	........
	Child support
	
4.194.16
4.17
4.18
	........
	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.
	
4.20	........
	Death benefits paid to you
	
4.21	E.
	PERMISSIONS
	
4.22 	I give permission to any agency that has given me cash benefits to give information 
4.23 	about my benefits to the above-named creditor, or its attorney. The information will ONLY 
4.24 	concern whether I get benefits or not, or whether I have gotten them in the past six months.

4.25	F.
	JAILED OR IMPRISONED
	
4.26 	If I was an inmate in the last six months, I give my permission to the correctional 
4.27 	institution to tell the above-named creditor that I was an inmate there.

4.28	G.
	SIGNATURES
	
4.29 	YOU MUST SIGN AND SEND THIS FORMCLAIM BACK TO THE 
4.30 	CREDITOR'S ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND 
4.31 	TO THE BANK OR OTHER DEPOSIT INSTITUTION. REMEMBER TO INCLUDE 
4.32 	A COPY OF YOUR BANK OR OTHER DEPOSIT ACCOUNT STATEMENTS FOR 
4.33 	THE PAST 60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE 
4.34 	INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
4.35 	I have mailed or delivered a copy of this form claim to:
4.36 	........
4.37 	(Insert name of creditor or creditor's attorney)
5.1 	........
5.2 	(Insert address of creditor or creditor's attorney)
5.3 	I have also mailed or delivered a copy of this exemption form claim to my bank or other 
5.4 	deposit institution at the address listed in the instructions.

5.5	DATED: ........
	........
	
5.6		DEBTOR
	
5.7		........
	
5.8		DEBTOR ADDRESS
	
5.9		........
	
5.10		DEBTOR TELEPHONE NUMBER

5.11 	Sec. 3. Minnesota Statutes 2018, section 550.37, subdivision 20, is amended to read:
5.12 		Subd. 20.Traceable funds Bank or other deposit account exemptions. A debtor's 
5.13 	deposits in bank or other deposit accounts, whether single or joint, up to $......., are exempt 
5.14 	from the claims of creditors and are not subject to garnishment under section 571.74 or 
5.15 	execution or levy under section 550.143. The direct exemption under this subdivision shall 
5.16 	be applied by a bank or other deposit institution without being claimed by the debtor under 
5.17 	section 550.143, subdivision 3c, or 551.05, subdivision 1d.
5.18 	In addition, the exemption of funds from creditors' claims, provided by subdivisions 9, 
5.19 	10, 11, 15, and 24, shall not be affected by the subsequent deposit of the funds in a bank or 
5.20 	any other financial deposit institution, whether in a single or joint account, if the funds are 
5.21 	traceable to their exempt source. In tracing the funds, the first-in first-out method of 
5.22 	accounting shall be used. The burden of establishing that traced funds are exempt rests upon 
5.23 	the debtor. No bank or other financial deposit institution shall be liable for damages for 
5.24 	complying with process duly issued out of any court for the collection of a debt even if the 
5.25 	funds affected by the process are subsequently determined to have been exempt.
5.26 	If the amount of the direct exemption applicable to a bank or other deposit account 
5.27 	exceeds the balance in the account, the institution shall notify the debtor that there has been 
5.28 	a garnishment or levy, of the fact that no funds have been frozen for the creditor or creditors, 
5.29 	and of the account balance remaining.

6.1 	Sec. 4. Minnesota Statutes 2018, section 550.37, is amended by adding a subdivision to 
6.2 	read:
6.3 		Subd. 20a.Multiple bank or other deposit accounts. If, within a seven-day period, a 
6.4 	creditor garnishes or levies on more than one bank or other deposit institution to collect an 
6.5 	individual's debts, the creditor may direct all the garnished or levied-on institutions not to 
6.6 	apply the standard exemption, but rather to freeze all of the funds in the accounts of the 
6.7 	debtor. The bank or other deposit institution that freezes the funds shall notify the debtor 
6.8 	that the debtor's funds have been frozen and that the debtor may, within 14 days of receipt 
6.9 	of the notice, direct institutions how to apply the exemption. If the debtor fails to specify 
6.10 	how to apply the exemption to the accounts, the bank and other deposit institutions shall 
6.11 	notify the creditor, and the creditor may direct how the exemption is to be applied to the 
6.12 	accounts.

6.13 	Sec. 5. Minnesota Statutes 2018, section 551.04, subdivision 3, is amended to read:
6.14 		Subd. 3.Property not attachable. The following property is not subject to attachment 
6.15 	by a writ of execution served pursuant to this chapter:
6.16 	(1) any indebtedness or money due to the judgment debtor, unless at the time of the 
6.17 	service of the writ of execution the same is due absolutely or does not depend upon any 
6.18 	contingency;
6.19 	(2) any judgment owing by the third party to the judgment debtor, if the third party or 
6.20 	the third party's property is liable on an execution levy upon the judgment;
6.21 	(3) any debt owing by the third party to the judgment debtor for which any negotiable 
6.22 	instrument has been issued or endorsed by the third party;
6.23 	(4) any indebtedness or money due to the judgment debtor where the judgment debtor 
6.24 	is a bank, savings bank, trust company, credit union, savings association, or industrial loan 
6.25 	and thrift company with deposit liabilities;
6.26 	(5) any indebtedness or money due to the judgment debtor with a cumulative value of 
6.27 	less than $10 $25; and
6.28 	(6) any disposable earnings, indebtedness, or money that is exempt under Minnesota or 
6.29 	federal law.; and
6.30 	(7) one standard bank or other deposit account exemption that totals $......., regardless 
6.31 	of the number of existing separate bank or other deposit accounts.

7.1 	Sec. 6. Minnesota Statutes 2018, section 551.05, subdivision 1d, is amended to read:
7.2 		Subd. 1d.Form of Exemption form claim. The exemption form claim required by this 
7.3 	subdivision must be a separate form claim and must be in substantially the following form
7.4 	as follows:

7.5	STATE OF MINNESOTA
		DISTRICT COURT
	
7.6	COUNTY OF  ........
		........JUDICIAL DISTRICT
	
7.7	........(Creditor)
			
7.8	........(Debtor)
			
7.9	........(Financial Bank or other deposit institution)
		
7.10 	ACCOUNT EXEMPTION FORM CLAIM

7.11	A.
	HOW MUCH MONEY IS PROTECTED
	
7.147.12
7.13
	........
	I claim ALL of the money being frozen by thein my bank is protected 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.
	
7.15	........
	I claim SOME of the money is protected. The amount I claim is protected is $.......
	
7.16		Your Choice
		
7.197.17
7.18
	........
	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.)
		
7.227.20
7.21
	........
	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.
		
7.23	B.
	WHY THE MONEY IS PROTECTED
	
7.247.25	B.
	In addition, some of my money is protected because I get it from one or more of the 
following places: (Check all that apply)
	
7.26	........
	Government benefits
	
7.27		Government benefits include, but are not limited to, the following:
	
7.28		MFIP - Minnesota family investment program,
	
7.29		MFIP Diversionary Work Program,
	
7.30		Work participation cash benefit,
	
7.31		GA - general assistance,
	
7.32		EA - emergency assistance,
	
7.33		MA - medical assistance,
	
7.34		EGA - emergency general assistance,
	
7.35		MSA - Minnesota supplemental aid,
	
7.36		MSA-EA - MSA emergency assistance,
	
7.37		Food Support,
	
7.38		SSI - Supplemental Security Income,
	
7.39		MinnesotaCare,
	
8.1		Medicare Part B premium payments,
	
8.2		Medicare Part D extra help,
	
8.3		Energy or fuel assistance.
	
8.4	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
	
8.5	........
	
8.6	LIST THE CASE NUMBER AND COUNTY
	
8.7		Case Number: ........
	
8.8		County: ........
	
8.9		Government benefits also include:
	
8.10	........
	Social Security benefits
	
8.11	........
	Unemployment benefits
	
8.12	........
	Workers' compensation
	
8.13	........
	Veterans benefits
	
8.14
8.15
8.16		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.
	
8.17	........
	Other assistance based on need
	
8.18 	You may have assistance based on need from another source that is not on the list. If you 
8.19 	do, check this box, and fill in the source of your money on the line below:
8.20 	Source:........
8.21 	Include copies of any documents you have that show the source of this money.

8.22	C.
	EARNINGS
		
8.23		ALL or SOME of your earnings (wages) may also be protected.
	
8.24	........
	All of your earnings (wages) are protected if:
	
8.25	........
	You get government benefits (see list of government benefits)
	
8.26	........
	You currently receive other assistance based on need
	
8.27	........
	You have received government benefits in the last six months
	
8.28	........
	You were in jail or prison in the last six months
	
8.29
8.30
8.31
8.32
8.33		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 
OR OTHER DEPOSIT ACCOUNT STATEMENTS that show what was in your 
account for the 60 days right before the bank or other deposit account froze your 
money.
	
8.34	........
	Some of your earnings (wages) are protected.
	
8.35
8.36
8.37		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:
	
8.38		75 percent of your wages (after taxes are taken out); or
	
8.39		(insert the sum of the current hourly federal minimum wage) multiplied by 40.
	
9.1	D.
	OTHER EXEMPT FUNDS
	
9.2
9.3		The money from the following are also completely protected after they are deposited 
in your account.
	
9.4	........
	An accident, disability, or retirement pension or annuity
	
9.5	........
	Payments to you from a life insurance policy
	
9.6	........
	Earnings of your child who is under 18 years of age
	
9.7	........
	Child support
	
9.89.99.10
9.11
	........
	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.
	
9.12	........
	Death benefits paid to you
	
9.13	E.
	PERMISSIONS
		
9.14 	I give permission to any agency that has given me cash benefits to give information 
9.15 	about my benefits to the above-named creditor, or its attorney. The information will ONLY 
9.16 	concern whether I get benefits or not, or whether I have gotten them in the past six months.

9.17	F.
	JAILED OR IMPRISONED
	
9.18 	If I was an inmate in the last six months, I give my permission to the correctional 
9.19 	institution to tell the above-named creditor that I was an inmate there.

9.20	G.
	SIGNATURE
	
9.21 	YOU MUST SIGN AND SEND THIS FORM CLAIM BACK TO THE 
9.22 	CREDITOR'S ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND 
9.23 	TO THE BANK OR OTHER DEPOSIT INSTITUTION. REMEMBER TO INCLUDE 
9.24 	A COPY OF YOUR BANK OR OTHER DEPOSIT ACCOUNT STATEMENTS FOR 
9.25 	THE PAST 60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE 
9.26 	INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
9.27 	I have mailed or delivered a copy of this form claim to:

9.28	........
	
9.29	(Insert name of creditor or creditor's attorney)
	
9.30	........
	
9.31	(Insert address of creditor or creditor's attorney)
	
9.32 	I have also mailed or delivered a copy of this exemption form claim to my bank or other 
9.33 	deposit institution at the address listed in the instructions.

9.34	DATED: ........
	........
	
9.35		DEBTOR
	
10.1		........
	
10.2		DEBTOR ADDRESS
	
10.3		........
	
10.4		DEBTOR TELEPHONE NUMBER

10.5 	Sec. 7. Minnesota Statutes 2018, section 571.912, is amended to read:
10.6 	571.912 FORM OF NOTICE, INSTRUCTIONS, AND EXEMPTION NOTICE.
10.7 		Subdivision 1.Form of Notice. The notice, instructions, and exemption notice informing 
10.8 	a debtor that a garnishment summons has been used to attach funds of the debtor to satisfy 
10.9 	a claim must be a separate notice and must be substantially in the following form as follows:

10.10	STATE OF MINNESOTA
		DISTRICT COURT
	
10.11	COUNTY OF  ........
		........JUDICIAL DISTRICT
	
10.12	........(Creditor)
			
10.13	........(Debtor)
			
10.14	........(Financial Bank or other deposit institution)
		
10.15 	IMPORTANT NOTICE
10.16 	YOUR FUNDS HAVE BEEN GARNISHED
10.17 	The Creditor has frozen money in your account at your financial institution bank or other 
10.18 	deposit account.
10.19 	Your account balance is $.......
10.20 	The amount being held is $.......
10.21 	The amount being held will be frozen for 14 days from the date of this notice.
10.22 	Some of your money in your account may be protected (the legal word is exempt). 
10.23 	You may be able to get it sooner than 14 days if you act quickly and follow the 
10.24 	instructions on the next page.
10.25 	The attached exemption form claim lists some different sources of money in your account 
10.26 	that may be protected. If your money is from one or more of these sources, place a check 
10.27 	on the line on the form next to the sources of your money. If it is from one of these sources, 
10.28 	the Creditor cannot take it.
10.29 	BUT, you must follow the instructions and return the exemption form claim and 
10.30 	copies of your bank or other deposit account statements from the last 60 days to have 
10.31 	the bank or other deposit institution unfreeze your money. If you do not follow the 
10.32 	instructions or your Creditor gets an order from the court or writ of execution, the money 
11.1 	in your financial institution bank or other deposit account will give the money be given to 
11.2 	your Creditor. If that happens and it is protected, you can still get it back from the Creditor 
11.3 	later, but that is not as easy to do as filling in the form exemption claim now.
11.4 	See next pages for instructions and the exemption form claim.
11.5 		Subd. 2.Form of Instructions. The instructions required must be in a separate form 
11.6 	and must be substantially in the following form as follows:
11.7 	INSTRUCTIONS
11.8 	Note: The creditor is who you owe the money to. You are the debtor.
11.9 	1. Fill out both of the attached exemption forms claims in this packet.
11.10 	If you check one of the lines, you should also give proof that shows that some or all 
11.11 	of the money in your account is from one or more of the protected sources. Creditors 
11.12 	may ask for a hearing if they question your exemptions.
11.13 	To avoid a hearing:
11.14 	Case numbers should be added to the form.
11.15 	Copies of documents should be sent with the form.
11.16 	NOTICE: YOU MUST SEND TO THE CREDITOR'S ATTORNEY (OR TO THE 
11.17 	CREDITOR, IF NO ATTORNEY) COPIES OF YOUR BANK OR OTHER DEPOSIT 
11.18 	ACCOUNT STATEMENTS FOR THE PAST 60 DAYS BEFORE THE 
11.19 	GARNISHMENT. Keep a copy of your bank or other deposit account statements in 
11.20 	case there are questions about your claim. If you do not send to the creditor's attorney 
11.21 	(or to the creditor, if no attorney) bank or other deposit account statements with your 
11.22 	exemption claim, the financial bank or other deposit institution may release your 
11.23 	money to the creditor once the creditor gives the financialbank or other deposit 
11.24 	institution a court order directing it to turn over the funds.
11.25 	2. Sign the exemption forms claims. Make one copy to keep for yourself.
11.26 	3. Mail or deliver the other copies of the form claim by (insert date).
11.27 	BOTH COPIES MUST BE MAILED OR DELIVERED THE SAME DAY.
11.28 	One copy of the form claim and the copies of your bank or other deposit account 
11.29 	statements go to:

11.30	........
	
11.31	(Insert name of creditor or creditor's attorney)
	
12.1	........
	
12.2	(Insert address of creditor or creditor's attorney)
	
12.3 	One copy goes to:

12.4	........
	
12.5	(Insert name of bank or other deposit institution)
	
12.6	........
	
12.7	(Insert address of bank or other deposit institution)
	
12.8 	HOW THE PROCESS WORKS
12.9 	If You Do Not Send in the Exemption Form Claim and Bank or Other Deposit 
12.10 	Account Statements:
12.11 	14 days after the date of this letter some or all of your money may be turned over to the 
12.12 	creditor once they get an order from the court telling the financialbank or other deposit 
12.13 	institution to do this.
12.14 	If You Send in the Exemption Form Claim and Bank or Other Deposit Account 
12.15 	Statements:
12.16 	Any money that is NOT protected can may be turned over to the creditor once they get 
12.17 	an order from the court.
12.18 	If the Creditor Does Not Object:
12.19 	The financial bank or other deposit institution will unfreeze your money six business 
12.20 	days after the bank or other deposit institution gets your completed form exemption claim.
12.21 	If the Creditor Objects:
12.22 	The money that you have said is protected on the form exemption claim will be held by 
12.23 	the in your bank or other deposit account. The creditor has six business days to object 
12.24 	(disagree) and ask the court to hold a hearing. You will receive a Notice of Objection and 
12.25 	a Notice of Hearing.
12.26 	The financial bank or other deposit institution will hold the money until a court decides 
12.27 	whether your money is protected or not. Some reasons a creditor may object are because 
12.28 	you did not send copies of your bank or other deposit account statements or other proof of 
12.29 	the benefits you received. Be sure to include these when you send your exemption form
12.30 	claim.
12.31 	You may want to talk to contact a lawyer for advice about this process. If you are low
12.32 	your income is low, you can call contact Legal Aid.
13.1 	PENALTIES:
13.2 	If you claim that your money is protected and a court decides you made that claim in 
13.3 	bad faith, the court can order you to pay costs, actual damages, attorney fees, and an 
13.4 	additional amount of up to $100. For example, it may be bad faith if you claim you receive 
13.5 	government benefits that you do not receive.
13.6 	If the creditor made a bad faith objection to your claim that your money is protected, 
13.7 	the court can order them to pay costs, actual damages, attorney fees, and an additional 
13.8 	amount of up to $100.
13.9 		Subd. 3.Exemption notice claim. The exemption notice claim must be a separate form
13.10 	and must be in substantially the following form as follows:

13.11	STATE OF MINNESOTA
		DISTRICT COURT
	
13.12	COUNTY OF  ........
		........JUDICIAL DISTRICT
	
13.13	........(Creditor)
			
13.14	........(Debtor)
			
13.15	........(Financial Bank or other deposit institution)
		
13.16 	BANK OR OTHER DEPOSIT ACCOUNT EXEMPTION FORM CLAIM

13.17	A.
		HOW MUCH MONEY IS PROTECTED
	
13.2013.18
13.19
	........
		I claim ALL of the money being frozen by the bankin my deposit account is 
protected exempt because it is protected by the standard bank or other deposit account 
exemption under Minnesota Statutes, section 550.37, subdivision 20.
	
13.21	........
		I claim SOME of the money is protected. The amount I claim is protected is $.......
	
13.22			Your Choice
	
13.2513.23
13.24
	........
		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.)
	
13.2813.26
13.27
	........
		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.)
	
13.29	B.
		WHY THE MONEY IS PROTECTED
	
13.3013.31	B.
		In addition, some of my money is protected because I get it from one or more of the 
following places: (Check all that apply)
	
13.32	........
		Government benefits
	
13.33			Government benefits include, but are not limited to, the following:
	
13.34			MFIP - Minnesota family investment program,
	
13.35			MFIP Diversionary Work Program,
	
13.36			Work participation cash benefit,
	
13.37			GA - general assistance,
	
13.38			EA - emergency assistance,
	
14.1			MA - medical assistance,
	
14.2			EGA - emergency general assistance,
	
14.3			MSA - Minnesota supplemental aid,
	
14.4			MSA-EA - MSA emergency assistance,
	
14.5			Food Support,
	
14.6			SSI - Supplemental Security Income,
	
14.7			MinnesotaCare,
	
14.8			Medicare Part B premium payments,
	
14.9			Medicare Part D extra help,
	
14.10			Energy or fuel assistance.
	
14.11	LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
	
14.12	........
	
14.13	LIST THE CASE NUMBER AND COUNTY
	
14.14			Case Number: ........
	
14.15			County: ........
	
14.16			Government benefits also include:
	
14.17	........
		Social Security benefits
	
14.18	........
		Unemployment benefits
	
14.19	........
		Workers' compensation
	
14.20	........
		Veterans benefits
	
14.21
14.22
14.23			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.
	
14.24	........
		Other assistance based on need
	
14.25 	You may have assistance based on need from another source that is not on the list. If you 
14.26 	do, check this box, and fill in the source of your money on the line below:
14.27 	Source:........
14.28 	Include copies of any documents you have that show the source of this money.

14.29	C.
		EARNINGS
	
14.30			ALL or SOME of your earnings (wages) may also be protected.
	
14.31	........
		All of your earnings (wages) are protected if:
	
14.32	........
		You get government benefits (see list of government benefits)
	
14.33	........
		You currently receive other assistance based on need
	
14.34	........
		You have received government benefits in the last six months
	
14.35	........
		You were in jail or prison in the last six months
	
14.36
14.37
14.38
15.1
15.2			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 OR OTHER DEPOSIT ACCOUNT STATEMENTS that show what was 
in your account for the 60 days right before the bank or other deposit institution 
froze your money.
	
15.3	........
		Some of your earnings (wages) are protected.
	
15.4
15.5
15.6			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:
	
15.7			75 percent of your wages (after taxes are taken out); or
	
15.8			(insert the sum of the current hourly federal minimum wage) multiplied by 40.
	
15.9	D.
		OTHER EXEMPT FUNDS
	
15.10
15.11			The money from the following are also completely protected after they are deposited 
in your bank or other deposit account.
	
15.12	........
		An accident, disability, or retirement pension or annuity
	
15.13	........
		Payments to you from a life insurance policy
	
15.14	........
		Earnings of your child who is under 18 years of age
	
15.15	........
		Child support
	
15.1615.17
15.18
15.19	........
		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.
	
15.20	........
		Death benefits paid to you
	
15.21	E.
		PERMISSION
	
15.22 	I give permission to any agency that has given me cash benefits to give information 
15.23 	about my benefits to the above-named creditor, or its attorney. The information will ONLY 
15.24 	concern whether I get benefits or not, or whether I have gotten them in the past six months.

15.25	F.
	JAILED OR IMPRISONED
	
15.26 	If I was an inmate in the last six months, I give my permission to the correctional 
15.27 	institution to tell the above-named creditor that I was an inmate there.

15.28	G.
	SIGNATURE
	
15.29 	YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S 
15.30 	ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND TO THE BANK
15.31 	OR OTHER DEPOSIT INSTITUTION. REMEMBER TO INCLUDE A COPY OF 
15.32 	YOUR BANK OR OTHER DEPOSIT ACCOUNT STATEMENTS FOR THE PAST 
15.33 	60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE 
15.34 	INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
15.35 	I have mailed or delivered a copy of this form claim to:

15.36	........
	
15.37	(Insert name of creditor or creditor's attorney)
	
16.1	........
	
16.2	(Insert address of creditor or creditor's attorney)
	
16.3 	I have also mailed or delivered a copy of this exemption form claim to my bank or other 
16.4 	deposit institution at the address listed in the instructions.

16.5	DATED: ........
	........
	
16.6		DEBTOR
	
16.7		........
	
16.8		DEBTOR ADDRESS
	
16.9		........
	
16.10		DEBTOR TELEPHONE NUMBER