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SF 3116

3rd Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.
  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             550.143, subdivisions 7 and 8; 551.01; 551.04, 
  1.10            subdivisions 4, 6, and 9; 551.05, subdivision 5; 
  1.11            551.06, subdivision 9; 571.72, subdivision 2; 571.74; 
  1.12            571.79; 571.82, subdivision 1; and 571.914, 
  1.13            subdivision 2; Minnesota Statutes 1999 Supplement, 
  1.14            sections 550.136, subdivision 6; 550.143, subdivision 
  1.15            3; 551.05, subdivision 1a; 551.06, subdivision 10; 
  1.16            571.912; and 571.925; proposing coding for new law in 
  1.17            Minnesota Statutes, chapters 551; and 571; repealing 
  1.18            Minnesota Statutes 1998, section 571.80. 
  1.19  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.20     Section 1.  Minnesota Statutes 1998, section 550.051, 
  1.21  subdivision 1, is amended to read: 
  1.22     Subdivision 1.  [TIME PERIODS.] The writ of execution 
  1.23  expires 180 days after its issuance by the court administrator.  
  1.24  A levy that is served with a writ of execution that has expired 
  1.25  is void.  If the officer or creditor's attorney having the writ 
  1.26  levies upon property or earnings before the expiration of 180 
  1.27  days, the officer or creditor's attorney may retain the writ 
  1.28  until the officer sells the property or completes the levy upon 
  1.29  earnings in the manner prescribed by law.  Any levy properly 
  1.30  served in accordance with this chapter or chapter 551 prior to 
  1.31  the expiration of the writ shall be processed in accordance with 
  1.32  the appropriate statutory section until completion, without 
  2.1   regard for the date of expiration of the writ.  Upon a demand of 
  2.2   the judgment creditor or the creditor's attorney within 180 
  2.3   days, the officer shall pay to the judgment creditor or the 
  2.4   judgment creditor's attorney all money collected upon execution 
  2.5   after deducting the officer's fees.  Upon expiration of the writ 
  2.6   or full satisfaction of the judgment, if earlier, the officer 
  2.7   shall make a full inventory of the property levied on and return 
  2.8   it with the execution.  
  2.9      Sec. 2.  Minnesota Statutes 1999 Supplement, section 
  2.10  550.136, subdivision 6, is amended to read: 
  2.11     Subd. 6.  [EARNINGS EXEMPTION NOTICE.] Before the first 
  2.12  levy on earnings under this chapter, the judgment creditor shall 
  2.13  serve upon the judgment debtor no less than ten days before the 
  2.14  service of the writ of execution, a notice that the writ of 
  2.15  execution may be served on the judgment debtor's employer.  The 
  2.16  notice must:  (1) be substantially in the form set forth below; 
  2.17  (2) be served personally, in the manner of a summons and 
  2.18  complaint, or by first class mail to the last known address of 
  2.19  the judgment debtor; (3) inform the judgment debtor that an 
  2.20  execution levy may be served on the judgment debtor's employer 
  2.21  in ten days, and that the judgment debtor may, within that time, 
  2.22  cause to be served on the judgment creditor a signed statement 
  2.23  under penalties of perjury asserting an entitlement to an 
  2.24  exemption from execution; (4) inform the judgment debtor of the 
  2.25  earnings exemptions contained in section 550.37, subdivision 14; 
  2.26  and (5) advise the judgment debtor of the relief set forth in 
  2.27  this chapter to which the debtor may be entitled if a judgment 
  2.28  creditor in bad faith disregards a valid claim and the fee, 
  2.29  costs, and penalty that may be assessed against a judgment 
  2.30  debtor who in bad faith falsely claims an exemption or in bad 
  2.31  faith takes action to frustrate the execution process.  The 
  2.32  notice requirement of this subdivision does not apply to a levy 
  2.33  on earnings being retained by an employer pursuant to a 
  2.34  garnishment previously served in compliance with chapter 571.  
  2.35     The ten-day notice informing a judgment debtor that a writ 
  2.36  of execution may be used to levy the earnings of an individual 
  3.1   must be substantially in the following form: 
  3.2   STATE OF MINNESOTA                             DISTRICT COURT
  3.3   COUNTY OF .............         ........... JUDICIAL DISTRICT
  3.4   .............(Judgment Creditor)
  3.5   against
  3.6                                         EXECUTION EXEMPTION 
  3.7   .............(Judgment Debtor)        NOTICE AND NOTICE OF 
  3.8   and                                   INTENT TO LEVY ON EARNINGS 
  3.9                                         WITHIN TEN DAYS
  3.10  .............(Third Party)
  3.11     PLEASE TAKE NOTICE that a levy may be served upon your 
  3.12  employer or other third parties, without any further court 
  3.13  proceedings or notice to you, ten days or more from the date 
  3.14  hereof.  Your earnings are completely exempt from execution levy 
  3.15  if you are now a recipient of relief based on need, if you have 
  3.16  been a recipient of relief within the last six months, or if you 
  3.17  have been an inmate of a correctional institution in the last 
  3.18  six months. 
  3.19     Relief based on need includes Minnesota Family Investment 
  3.20  Program (MFIP), Emergency Assistance (EA), Work First, Medical 
  3.21  Assistance (MA), General Assistance (GA), General Assistance 
  3.22  Medical Care (GAMC), Emergency General Assistance (EGA), 
  3.23  Minnesota Supplemental Aid (MSA), MSA Emergency Assistance 
  3.24  (MSA-EA), Supplemental Security Income (SSI), and Energy 
  3.25  Assistance. 
  3.26     If you wish to claim an exemption, you should fill out the 
  3.27  appropriate form below, sign it, and send it to the judgment 
  3.28  creditor's attorney. 
  3.29     You may wish to contact the attorney for the judgment 
  3.30  creditor in order to arrange for a settlement of the debt or 
  3.31  contact an attorney to advise you about exemptions or other 
  3.32  rights. 
  3.33                             PENALTIES
  3.34     (1) Be advised that even if you claim an exemption, an 
  3.35     execution levy may still be served on your employer.  If 
  3.36     your earnings are levied on after you claim an exemption, 
  4.1      you may petition the court for a determination of your 
  4.2      exemption.  If the court finds that the judgment creditor 
  4.3      disregarded your claim of exemption in bad faith, you will 
  4.4      be entitled to costs, reasonable attorney fees, actual 
  4.5      damages, and an amount not to exceed $100. 
  4.6      (2) HOWEVER, BE WARNED if you claim an exemption, the 
  4.7      judgment creditor can also petition the court for a 
  4.8      determination of your exemption, and if the court finds 
  4.9      that you claimed an exemption in bad faith, you will be 
  4.10     assessed costs and reasonable attorney's fees plus an 
  4.11     amount not to exceed $100. 
  4.12     (3) If after receipt of this notice, you in bad faith take 
  4.13     action to frustrate the execution levy, thus requiring the 
  4.14     judgment creditor to petition the court to resolve the 
  4.15     problem, you will be liable to the judgment creditor for 
  4.16     costs and reasonable attorney's fees plus an amount not to 
  4.17     exceed $100. 
  4.18  DATED:  ............           ........................
  4.19                                 (Attorney for Judgment Creditor)
  4.20                                 ........................
  4.21                                 Address
  4.22                                 ........................
  4.23                                 Telephone
  4.24              JUDGMENT DEBTOR'S EXEMPTION CLAIM NOTICE
  4.25     I hereby claim that my earnings are exempt from execution 
  4.26  because: 
  4.27     (1) I am presently a recipient of relief based on need. 
  4.28     (Specify the program, case number, and the county from 
  4.29     which relief is being received.) 
  4.30  ................    ......................   ...............
  4.31  Program             Case Number (if known)   County
  4.32     (2) I am not now receiving relief based on need, but I have 
  4.33     received relief based on need within the last six months.  
  4.34     (Specify the program, case number, and the county from 
  4.35     which relief has been received.) 
  4.36  ................    ......................   ...............
  5.1   Program             Case Number (if known)   County
  5.2      (3) I have been an inmate of a correctional institution 
  5.3      within the last six months.  (Specify the correctional 
  5.4      institution and location.) 
  5.5   ...........................       ..........................
  5.6   Correctional Institution          Location
  5.7      I hereby authorize any agency that has distributed relief 
  5.8   to me or any correctional institution in which I was an inmate 
  5.9   to disclose to the above-named judgment creditor or the judgment 
  5.10  creditor's attorney only whether or not I am or have been a 
  5.11  recipient of relief based on need or an inmate of a correctional 
  5.12  institution within the last six months.  I have mailed or 
  5.13  delivered a copy of this form to the judgment creditor or 
  5.14  judgment creditor's attorney. 
  5.15  ...........................          .........................
  5.16                                       Debtor
  5.17                                       .........................
  5.18                                       Address
  5.19                                       .........................
  5.20                                       Debtor Telephone Number
  5.21     Sec. 3.  Minnesota Statutes 1999 Supplement, section 
  5.22  550.143, subdivision 3, is amended to read: 
  5.23     Subd. 3.  [EXEMPTION NOTICE.] If the levy is on funds of a 
  5.24  judgment debtor who is a natural person and if the funds to be 
  5.25  levied are held on deposit at any financial institution, the 
  5.26  judgment creditor or its attorney shall provide the sheriff with 
  5.27  two copies of an exemption notice, which must be substantially 
  5.28  in the form set forth below.  The sheriff shall serve both 
  5.29  copies of the exemption notice on the financial institution, 
  5.30  along with the writ of execution.  Failure of the sheriff to 
  5.31  serve the exemption notices renders the levy void, and the 
  5.32  financial institution shall take no action.  However, if this 
  5.33  subdivision is being used to execute on funds that have 
  5.34  previously been garnished in compliance with section 571.71, the 
  5.35  judgment creditor is not required to serve additional exemption 
  5.36  notices.  In that event, the execution levy shall only be 
  6.1   effective as to the funds that were subject to the prior 
  6.2   garnishment.  Upon receipt of the writ of execution and 
  6.3   exemption notices, the financial institution shall retain as 
  6.4   much of the amount due under section 550.04 as the financial 
  6.5   institution has on deposit owing to the judgment debtor, but not 
  6.6   more than 110 percent of the amount remaining due on the 
  6.7   judgment.  
  6.8   STATE OF MINNESOTA                             DISTRICT COURT
  6.9   COUNTY OF ................       .......... JUDICIAL DISTRICT
  6.10  .............(Judgment Creditor) 
  6.11  .............(Judgment Debtor) 
  6.12  TO:  Debtor                                  EXEMPTION NOTICE 
  6.13     An order for attachment, garnishment summons, or levy of 
  6.14  execution (strike inapplicable language) has been served on 
  6.15  ............. (Bank or other financial institution where you 
  6.16  have an account.)  
  6.17     Your account balance is $........  
  6.18     The amount being held is $........  
  6.19     However, all or a portion of the funds in your account will 
  6.20  normally be exempt from creditors' claims if they are in one of 
  6.21  the following categories:  
  6.22     (1) relief based on need.  This includes the Minnesota 
  6.23  Family Investment Program (MFIP), Emergency Assistance (EA), 
  6.24  Work First Program, Medical Assistance (MA), General Assistance 
  6.25  (GA), General Assistance Medical Care (GAMC), Emergency General 
  6.26  Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
  6.27  Emergency Assistance (MSA-EA), Supplemental Security Income 
  6.28  (SSI), and Energy Assistance; 
  6.29     (2) Social Security benefits (Old Age, Survivors, or 
  6.30  Disability Insurance); 
  6.31     (3) reemployment compensation, workers' compensation, or 
  6.32  veterans' benefits; 
  6.33     (4) an accident, disability, or retirement pension or 
  6.34  annuity; 
  6.35     (5) life insurance proceeds; 
  6.36     (6) the earnings of your minor child and any child support 
  7.1   paid to you; or 
  7.2      (7) money from a claim for damage or destruction of exempt 
  7.3   property (such as household goods, farm tools, business 
  7.4   equipment, a mobile home, or a car).  
  7.5      The following funds are also exempt: 
  7.6      (8) all earnings of a person in category (1); 
  7.7      (9) all earnings of a person who has received relief based 
  7.8   on need, or who has been an inmate of a correctional 
  7.9   institution, within the last six months; 
  7.10     (10) 75 percent of every debtor's after tax earnings; and 
  7.11     (11) all of a judgment debtor's after tax earnings below 40 
  7.12  times the federal minimum wage. 
  7.13     TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
  7.14     Categories (10) and (11):  20 days 
  7.15     Categories (8) and (9):  60 days 
  7.16     All others:  no time limit, as long as funds are traceable 
  7.17  to the exempt source.  (In tracing funds, the first-in, 
  7.18  first-out method is used.  This means money deposited first is 
  7.19  spent first.)  The money being sought by the judgment creditor 
  7.20  is being held in your account to give you a chance to claim an 
  7.21  exemption. 
  7.22     TO CLAIM AN EXEMPTION:  
  7.23     Fill out, sign, and mail or deliver one copy of the 
  7.24  attached exemption claim form to the institution which sent you 
  7.25  this notice and mail or deliver one copy to the judgment 
  7.26  creditor's attorney.  In the event that there is no attorney for 
  7.27  the judgment creditor, then the notice shall be sent directly to 
  7.28  the judgment creditor.  The address for the judgment creditor's 
  7.29  attorney or the judgment creditor is set forth below.  Both 
  7.30  copies must be mailed or delivered on the same day. 
  7.31     NOTE:  You may help resolve your claim faster if you send 
  7.32     to the creditor's attorney written proof or documents that 
  7.33     show why your money is exempt.  If you have questions 
  7.34     regarding the documents to send as proof of an exemption, 
  7.35     call the creditor's attorney.  If you do not send written 
  7.36     proof and the creditor's attorney has questions about your 
  8.1      exemption claim, the creditor's attorney may object to your 
  8.2      claim which may result in a further delay in releasing your 
  8.3      exempt funds. 
  8.4      If the financial institution does not get the exemption 
  8.5   claim back from you within 14 days of the date they mailed or 
  8.6   gave it to you, they will be free to turn the money over to the 
  8.7   sheriff or the judgment creditor.  If you are going to claim an 
  8.8   exemption, do so as soon as possible, because your money may be 
  8.9   held until it is decided. 
  8.10     IF YOU CLAIM AN EXEMPTION:  
  8.11     (1) nonexempt money can be turned over to the judgment 
  8.12  creditor or sheriff; 
  8.13     (2) the financial institution will keep holding the money 
  8.14  claimed to be exempt; and 
  8.15     (3) seven days after receiving your exemption claim, the 
  8.16  financial institution will release the money to you unless 
  8.17  before then it receives an objection to your exemption claim.  
  8.18     IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
  8.19     the institution will hold the money until a court decides 
  8.20  if your exemption claim is valid, BUT ONLY IF the institution 
  8.21  gets a copy of your court motion papers asserting the exemption 
  8.22  WITHIN TEN DAYS after the objection is personally served on you, 
  8.23  or within 13 days from the date the objection is mailed or given 
  8.24  to you.  You may wish to consult an attorney at once if the 
  8.25  creditor objects to your exemption claim.  
  8.26     MOTION TO DETERMINE EXEMPTION:  
  8.27     At any time after your funds have been held, you may ask 
  8.28  for a court decision on the validity of your exemption claim by 
  8.29  filing a request for hearing which may be obtained at the office 
  8.30  of the court administrator of the above court. 
  8.31     PENALTIES:  
  8.32     If you claim an exemption in bad faith, or if the judgment 
  8.33  creditor wrongly objects to an exemption in bad faith, the court 
  8.34  may order the person who acted in bad faith to pay costs, actual 
  8.35  damages, attorney fees, and an additional amount of up to $100.  
  8.36                                ............................. 
  9.1                                 ............................. 
  9.2                                 ............................. 
  9.3                                 ............................. 
  9.4                                 Name and address of (Attorney 
  9.5                                 for) Judgment Creditor
  9.6      EXEMPTION:  
  9.7      (a) Amount of exemption claim.  
  9.8      / / I claim ALL the funds being held are exempt.  
  9.9      / / I claim SOME of the funds being held are exempt.  
  9.10           The exempt amount is $............  
  9.11     (b) Basis for exemption.  
  9.12     Of the 11 categories listed above, I am in category number 
  9.13  ............  (If more than one category applies, you may fill 
  9.14  in as many as apply.)  The source of the exempt funds is the 
  9.15  following:  
  9.16  .............................................................
  9.17  .............................................................
  9.18  .............................................................
  9.19     (If the source is a type of relief based on need, list the 
  9.20  case number and county:  
  9.21     case number:  ...............; 
  9.22     county:  ....................) 
  9.23     I hereby authorize any agency that has distributed relief 
  9.24  to me or any correctional institution in which I was an inmate 
  9.25  to disclose to the above named creditor or its attorney only 
  9.26  whether or not I am or have been a recipient of relief based on 
  9.27  need or an inmate of a correctional institute within the last 
  9.28  six months.  
  9.29     I have mailed or delivered a copy of the exemption notice 
  9.30  to the judgment creditor or judgment creditor's attorney if 
  9.31  represented at the address indicated above. 
  9.32                               .............................
  9.33                               DEBTOR
  9.34  DATED:  .............        .............................
  9.35                               .............................
  9.36                               .............................
 10.1                                DEBTOR ADDRESS 
 10.2                                .............................
 10.3                                DEBTOR TELEPHONE NUMBER
 10.4      Sec. 4.  Minnesota Statutes 1998, section 550.143, 
 10.5   subdivision 7, is amended to read: 
 10.6      Subd. 7.  [NOTICE OF OBJECTION.] (a) The written objection 
 10.7   to the judgment debtor's claim of exemption must be in 
 10.8   substantially the following form:  
 10.9   STATE OF MINNESOTA                             DISTRICT COURT
 10.10  COUNTY OF ...............         ..........JUDICIAL DISTRICT
 10.11  ...................(Judgment Creditor)        OBJECTION TO
 10.12  ...................(Judgment Debtor)          EXEMPTION CLAIM
 10.13  ...................(Garnishee) (Third Party)
 10.14     The judgment creditor objects to your claim for exemption 
 10.15  from garnishment, levy of execution, order for attachment 
 10.16  (strike inapplicable language) for the following reason(s):  
 10.17  .................................................................
 10.18  .................................................................
 10.19  .................................................................
 10.20     Because of this objection, your financial institution will 
 10.21  retain the funds you claimed to be exempt for an additional ten 
 10.22  days.  If you wish to request a hearing on your exemption claim, 
 10.23  you should need to do so within ten days of your receipt of this 
 10.24  objection from the date the objection was personally served on 
 10.25  you, or within 13 days of the date the objection was mailed to 
 10.26  you.  You may request a hearing by completing the attached form 
 10.27  and filing it with the court administrator.  
 10.28     1.  The court administrator's office shall provide clerical 
 10.29  assistance to help with the writing and filing of a Request for 
 10.30  Hearing by any person not represented by counsel.  The court 
 10.31  administrator may charge a fee of $1 for the filing of a Request 
 10.32  for Hearing.  
 10.33     2.  Upon the filing of a Request for Hearing, the court 
 10.34  administrator shall schedule the matter for a hearing no later 
 10.35  than five business days from the date of filing.  The court 
 10.36  administrator shall forthwith send a completed copy of the 
 11.1   request, including the hearing date, time, and place to the 
 11.2   adverse party and to the financial institution by first class 
 11.3   mail. 
 11.4      3.  If it is possible that the financial institution might 
 11.5   not receive the request mailed from the court administrator 
 11.6   within ten days, then you may want to personally deliver a copy 
 11.7   of the request to the financial institution after you have filed 
 11.8   your request with the court. 
 11.9      4.  An order stating whether your funds are exempt shall be 
 11.10  issued by the court within three days of the date of the hearing.
 11.11     If you do not file a Request for Hearing within ten days of 
 11.12  the date you receive this objection the objection was personally 
 11.13  served on you, or within 13 days from the date the objection was 
 11.14  mailed to you, your financial institution may turn your funds 
 11.15  over to your creditor. 
 11.16     If you file a Request for Hearing and your financial 
 11.17  institution receives it within ten days of the date it received 
 11.18  this objection, your financial institution will retain your 
 11.19  funds claimed to be exempt until otherwise ordered by the court. 
 11.20                                     ............................
 11.21                                     Judgment Creditor or Attorney
 11.22     Sec. 5.  Minnesota Statutes 1998, section 550.143, 
 11.23  subdivision 8, is amended to read: 
 11.24     Subd. 8.  [REQUEST FOR HEARING AND NOTICE FOR HEARING.] The 
 11.25  request for hearing accompanying the objection notice must be in 
 11.26  substantially the following form: 
 11.27  STATE OF MINNESOTA                             DISTRICT COURT
 11.28  COUNTY OF ........                  ........JUDICIAL DISTRICT
 11.29  ..................(Judgment Creditor)    REQUEST FOR HEARING
 11.30  ..................(Judgment Debtor)             AND
 11.31  ..................(Third Party)          NOTICE FOR HEARING
 11.32     I hereby request a hearing to resolve the exemption claim 
 11.33  which has been made in this case regarding funds in the account 
 11.34  of ............. (Judgment Debtor) at the ......... (Financial 
 11.35  Institution). 
 11.36     I believe the property being held is exempt because 
 12.1   .................................................................
 12.2   .................................................................
 12.3   Dated:...........................................................
 12.4                                             (JUDGMENT DEBTOR)
 12.5                                             ...................
 12.6                                             (ADDRESS)
 12.7                                             ...................
 12.8                                             (DEBTOR PHONE NUMBER)
 12.9                                             ...................
 12.10  HEARING DATE:  ................    TIME:  ...................
 12.11  HEARING PLACE:  ...............
 12.12     (Note to both parties:  Bring with you to the hearing all 
 12.13  documents and materials relevant to the exemption claim and 
 12.14  objection.  Failure to do so could delay the court's decision.) 
 12.15     Sec. 6.  Minnesota Statutes 1998, section 551.01, is 
 12.16  amended to read: 
 12.17     551.01 [ATTORNEY'S SUMMARY EXECUTION OF JUDGMENT DEBTS; 
 12.18  WHEN AUTHORIZED.] 
 12.19     An attorney for a judgment creditor may execute on a money 
 12.20  judgment by levying on indebtedness owed to the judgment debtor 
 12.21  by a third party, pursuant to this chapter.  The attorney for 
 12.22  the judgment creditor must obtain a writ of execution issued 
 12.23  under section 550.04 before the attorney can execute pursuant to 
 12.24  this chapter.  No more than $5,000 $10,000 may be recovered by a 
 12.25  single notice of execution levy pursuant to this section.  No 
 12.26  more than one execution may be served on a single third party by 
 12.27  a judgment creditor each calendar day under this chapter.  
 12.28     Sec. 7.  Minnesota Statutes 1998, section 551.04, 
 12.29  subdivision 4, is amended to read: 
 12.30     Subd. 4.  [SERVICE OF THIRD PARTY LEVY; NOTICE AND 
 12.31  DISCLOSURE FORMS.] When levying upon money or earnings owed to 
 12.32  the judgment debtor by a third party, the attorney for the 
 12.33  judgment creditor shall serve a copy of the writ of execution 
 12.34  upon the third party either by registered or certified mail, or 
 12.35  by personal service.  A third party levy served by registered or 
 12.36  certified mail is effective if served at the third party's 
 13.1   regular place of business.  Along with a copy of the writ of 
 13.2   execution, the attorney shall serve upon the third party a 
 13.3   notice of third party levy and disclosure form that must be 
 13.4   substantially in the form set forth below.  If the levy is upon 
 13.5   earnings, the attorney shall serve upon the third party the 
 13.6   notice of third party levy and disclosure form as set forth in 
 13.7   section 551.06, subdivision 9. 
 13.8   STATE OF MINNESOTA                             DISTRICT COURT 
 13.9   County of .............           ..........JUDICIAL DISTRICT
 13.10                                    File No. .................. 
 13.11  ..............(Judgment Creditor) 
 13.12  against                                 NOTICE OF THIRD PARTY 
 13.13  ..............(Judgment Debtor)         LEVY AND DISCLOSURE 
 13.14  and                                     (OTHER THAN EARNINGS)
 13.15  ..............(Third Party)
 13.16     PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 13.17  chapter 551, the undersigned, as attorney for the judgment 
 13.18  creditor, hereby makes demand and levies execution upon all 
 13.19  money due and owing by you (up to $5,000 $10,000) to the 
 13.20  judgment debtor for the amount of the judgment specified below.  
 13.21  A copy of the writ of execution issued by the court is 
 13.22  enclosed.  The unpaid judgment balance is $.......  
 13.23     In responding to this levy, you are to complete the 
 13.24  attached disclosure form and mail it to the undersigned attorney 
 13.25  for the judgment creditor, together with your check payable to 
 13.26  the above-named judgment creditor, for the nonexempt amount owed 
 13.27  by you to the judgment debtor or for which you are obligated to 
 13.28  the judgment debtor, within the time limits set forth in chapter 
 13.29  551. 
 13.30     If you are a financial institution and the judgment debtor 
 13.31  is a natural person, two exemption notices are also enclosed 
 13.32  pursuant to Minnesota Statutes, section 551.02.  Only natural 
 13.33  persons are entitled to exemptions under this statute. 
 13.34                          Attorney for the Judgment Creditor
 13.35                          Address 
 14.2                           (...........)
 14.3                           Phone number 
 14.5                              DISCLOSURE
 14.6      On the ..... day of ............., ......., the time of 
 14.7   service of the execution levy herein, there was due and owing 
 14.8   the judgment debtor from the third party the following:  
 14.9      (1) Money.  Enter on the line below any amounts due and 
 14.10  owing the judgment debtor, except earnings, from the third party.
 14.11  ....................................................... 
 14.12     (2) Setoff.  Enter on the line below the amount of any 
 14.13  setoff, defense, lien, or claim which the third party claims 
 14.14  against the amount set forth on line (1).  State the facts by 
 14.15  which such setoff, defense, lien, or claim is claimed.  (Any 
 14.16  indebtedness to you incurred by the judgment debtor within ten 
 14.17  days prior to the receipt of the first execution levy on a debt 
 14.18  may not be claimed as a setoff, defense, lien, or claim against 
 14.19  the amount set forth on line (1).) 
 14.20  .............................................. 
 14.21     (3) Exemption.  Enter on the line below any amounts or 
 14.22  property claimed by the judgment debtor to be exempt from 
 14.23  execution.  
 14.24  .............................................. 
 14.25     (4) Adverse Interest.  Enter on the line below any amounts 
 14.26  claimed by other persons by reason of ownership or interest in 
 14.27  the judgment debtor's property.  
 14.28  .............................................. 
 14.29     (5) Enter on the line below the total of lines (2), (3), 
 14.30  and (4).  
 14.31  ................................................... 
 14.32     (6) Enter on the line below the difference obtained (never 
 14.33  less than zero when line (5) is subtracted from the amount on 
 14.34  line (1)). 
 14.35  ..................................................... 
 14.36     (7) Enter on the line below 100 percent of the amount of 
 15.1   the judgment creditor's claim which remains unpaid.  
 15.2   ..................................................... 
 15.3      (8) Enter on the line below the lesser of line (6) and line 
 15.4   (7).  You are hereby instructed to remit this amount only if it 
 15.5   is $10 or more.  
 15.6   ..................................................... 
 15.7                             AFFIRMATION 
 15.8      I, ....................... (person signing Affirmation), am 
 15.9   the third party or I am authorized by the third party to 
 15.10  complete this nonearnings disclosure, and have done so 
 15.11  truthfully and to the best of my knowledge.  
 15.12  Dated:  ................                     ..................
 15.13                                               Signature
 15.14                                               ..................
 15.15                                               Title
 15.16                                               ..................
 15.17                                               Telephone Number
 15.18     Sec. 8.  Minnesota Statutes 1998, section 551.04, 
 15.19  subdivision 6, is amended to read: 
 15.20     Subd. 6.  [THIRD PARTY DISCLOSURE AND REMITTANCE.] Within 
 15.21  15 days after receipt of the writ of execution, unless governed 
 15.22  by section 551.05 or 551.06, the third party shall disclose and 
 15.23  remit to the judgment creditor's attorney as much of the amount 
 15.24  due under section 550.04, but not more than $5,000 $10,000, as 
 15.25  the third party's own debt equals to the judgment debtor.  The 
 15.26  attorney for the judgment creditor shall proceed in all other 
 15.27  respects like the sheriff making a similar execution levy.  No 
 15.28  more than $5,000 $10,000 may be recovered by a single execution 
 15.29  levy pursuant to this section.  
 15.30     Sec. 9.  Minnesota Statutes 1998, section 551.04, 
 15.31  subdivision 9, is amended to read: 
 15.32     Subd. 9.  [JUDGMENT AGAINST THIRD PARTY UPON FAILURE TO 
 15.33  DISCLOSE OR REMIT.] Judgment may be entered against a third 
 15.34  party who has been served with a writ of execution and fails to 
 15.35  disclose or remit the levied funds as required in this chapter.  
 15.36  Upon order to show cause served on the third party and notice of 
 16.1   motion supported by affidavit of facts and affidavit of service 
 16.2   upon both the judgment debtor and third party, the court may 
 16.3   render judgment against the third party for an amount not 
 16.4   exceeding 100 percent of the amount claimed in the execution or 
 16.5   $5,000 $10,000, whichever is less.  Judgment against the third 
 16.6   party pursuant to this section shall not bar the judgment 
 16.7   creditor from further remedies under this chapter as a result of 
 16.8   any subsequent defaults by the third party.  The court upon good 
 16.9   cause shown may remove the default and permit the third party to 
 16.10  disclose or remit on just terms.  
 16.11     Sec. 10.  [551.041] [ATTORNEY'S SUMMARY EXECUTION OF FUNDS 
 16.12  BEING HELD PURSUANT TO GARNISHMENT SUMMONS.] 
 16.13     Pursuant to this section, an attorney for a judgment 
 16.14  creditor may execute on funds retained by a garnishee under a 
 16.15  garnishment summons served pursuant to chapter 571.  No more 
 16.16  than $10,000 may be recovered by a single execution levy 
 16.17  pursuant to this section.  When levying upon money or earnings 
 16.18  being retained by a garnishee pursuant to a garnishment summons, 
 16.19  the attorney shall serve a copy of the writ of execution upon 
 16.20  the garnishee by registered or certified mail, or by personal 
 16.21  service.  Along with a copy of the writ of execution, the 
 16.22  attorney shall serve upon the garnishee a notice of levy on 
 16.23  garnishee that must be substantially in the form set forth 
 16.24  below.  If the judgment creditor paid the garnishee the fee 
 16.25  required by chapter 571, no additional fee must be paid to the 
 16.26  garnishee for the levy.  The notice of levy on garnishee may not 
 16.27  be served until the judgment debtor's right to claim an 
 16.28  exemption has expired under chapter 571. 
 16.29  STATE OF MINNESOTA                             DISTRICT COURT
 16.30  County of .............           ..........JUDICIAL DISTRICT
 16.31                                    File No. ..................
 16.32  ............(Judgment Creditor)
 16.33  against
 16.34  ..............(Judgment Debtor)     NOTICE OF LEVY
 16.35  and                                 ON GARNISHEE
 16.36  ....................(Garnishee)
 17.1      PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 17.2   chapter 551, the undersigned as attorney for the judgment 
 17.3   creditor, hereby makes demand and levies execution upon all 
 17.4   money or earnings being retained by you (up to $10,000) pursuant 
 17.5   to the judgment creditor's garnishment summons dated 
 17.6   ................  A copy of the writ of execution issued by the 
 17.7   court is enclosed.  Upon receipt of this levy, you shall remit 
 17.8   to the judgment creditor's attorney all funds being held by you 
 17.9   pursuant to the garnishment summons.  The funds shall be 
 17.10  remitted within 15 days after receipt of this levy. 
 17.11  Date: ...............        Attorney for the Judgment Creditor
 17.12                               Address:  ........................
 17.13                               ..................................
 17.14                               Phone Number:  ...................
 17.15                               Attorney I.D. No.:  ..............
 17.16     Sec. 11.  [551.042] [MONEY DUE FROM STATE DEPARTMENTS.] 
 17.17     Money due or owing to any entity or person by the state on 
 17.18  account of any employment, work, contract with, or services 
 17.19  provided to any state department or agency is subject to 
 17.20  attachment.  The notice of third party levy and disclosure may 
 17.21  be served upon the head of the department or agency in the same 
 17.22  manner as other summons in that court of record, except that 
 17.23  service may not be made by publication.  Service of the notice 
 17.24  may also be made by certified mail, return receipt requested.  
 17.25  The disclosure shall be made by the head of the department or 
 17.26  agency, or by some person designated by the head of the 
 17.27  department or agency having knowledge of the facts.  If payment 
 17.28  is made pursuant to judgment against the state as a third party, 
 17.29  a certificate of satisfaction to the extent of the payment 
 17.30  endorsed on it shall be delivered to the head of the department 
 17.31  or agency as a voucher for the payment. 
 17.32     Sec. 12.  [551.043] [SALARY OF PUBLIC SERVANTS.] 
 17.33     The salary or wages of an official or employee of a county, 
 17.34  town, city, or school district, or any department of these 
 17.35  bodies, is subject to attachment.  The notice of third party 
 17.36  levy and disclosure shall be served upon the auditor, treasurer, 
 18.1   or clerk of the body, or head of the department of the body of 
 18.2   which that person is an official or employee.  The disclosure 
 18.3   shall be made by the officer or person so served, or by some 
 18.4   person designated by that person having knowledge of the facts.  
 18.5   If payment is made by the county, town, city, or school 
 18.6   district, or any department of these bodies pursuant to a 
 18.7   judgment against it as a third party, a certified copy of the 
 18.8   judgment with a certificate of satisfaction to the extent of the 
 18.9   payment endorsed on it shall be delivered to the treasurer as a 
 18.10  voucher for the payment. 
 18.11     Sec. 13.  Minnesota Statutes 1999 Supplement, section 
 18.12  551.05, subdivision 1a, is amended to read: 
 18.13     Subd. 1a.  [EXEMPTION NOTICE.] If the writ of execution is 
 18.14  being used by the attorney to levy funds of a judgment debtor 
 18.15  who is a natural person and if the funds to be levied are held 
 18.16  on deposit at any financial institution, the attorney for the 
 18.17  judgment creditor shall serve with the writ of execution two 
 18.18  copies of an exemption notice.  The notice must be substantially 
 18.19  in the form set forth below.  Failure of the attorney for the 
 18.20  judgment creditor to send the exemption notice renders the 
 18.21  execution levy void, and the financial institution shall take no 
 18.22  action.  However, if this subdivision is being used to execute 
 18.23  on funds that have previously been garnished in compliance with 
 18.24  section 571.71, the attorney for judgment creditor is not 
 18.25  required to serve an additional exemption notice.  In that 
 18.26  event, the execution levy shall only be effective as to the 
 18.27  funds that were subject to the prior garnishment.  Upon receipt 
 18.28  of the writ of execution and exemption notices, the financial 
 18.29  institution shall retain as much of the amount due under section 
 18.30  550.04 as the financial institution has on deposit owing to the 
 18.31  judgment debtor, but not more than 100 percent of the amount 
 18.32  remaining due on the judgment, or $5,000 $10,000, whichever is 
 18.33  less.  
 18.34     The notice informing a judgment debtor that an execution 
 18.35  levy has been used to attach funds of the judgment debtor to 
 18.36  satisfy a claim must be substantially in the following form: 
 19.1      
 19.2   STATE OF MINNESOTA                             DISTRICT COURT 
 19.3   County of ................         .........JUDICIAL DISTRICT 
 19.4   ................(Judgment Creditor)
 19.5   ................(Judgment Debtor) 
 19.6   TO:  Judgment Debtor                 EXEMPTION NOTICE 
 19.7      An order for attachment, garnishment summons, or levy of 
 19.8   execution (strike inapplicable language) has been served on 
 19.9   ............. (bank or other financial institution where you 
 19.10  have an account).  
 19.11     Your account balance is $........  
 19.12     The amount being held is $........  
 19.13     However, all or a portion of the funds in your account will 
 19.14  normally be exempt from creditors' claims if they are in one of 
 19.15  the following categories:  
 19.16     (1) relief based on need.  This includes the Minnesota 
 19.17  Family Investment Program (MFIP), Work First Program, Medical 
 19.18  Assistance (MA), General Assistance (GA), General Assistance 
 19.19  Medical Care (GAMC), Emergency General Assistance (EGA), 
 19.20  Minnesota Supplemental Aid (MSA), MSA Emergency Assistance 
 19.21  (MSA-EA), Supplemental Security Income (SSI), and Energy 
 19.22  Assistance; 
 19.23     (2) Social Security benefits (Old Age, Survivors, or 
 19.24  Disability Insurance); 
 19.25     (3) reemployment compensation, workers' compensation, or 
 19.26  veterans' benefits; 
 19.27     (4) an accident, disability, or retirement pension or 
 19.28  annuity; 
 19.29     (5) life insurance proceeds; 
 19.30     (6) the earnings of your minor child and any child support 
 19.31  paid to you; or 
 19.32     (7) money from a claim for damage or destruction of exempt 
 19.33  property (such as household goods, farm tools, business 
 19.34  equipment, a mobile home, or a car).  
 19.35     The following funds are also exempt: 
 19.36     (8) all earnings of a person in category (1); 
 20.1      (9) all earnings of a person who has received relief based 
 20.2   on need, or who has been an inmate of a correctional 
 20.3   institution, within the last six months; 
 20.4      (10) 75 percent of every judgment debtor's after tax 
 20.5   earnings; or 
 20.6      (11) all of a judgment debtor's after tax earnings below 40 
 20.7   times the federal minimum wage.  
 20.8      TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
 20.9      Categories (10) and (11):  20 days 
 20.10     Categories (8) and (9):  60 days 
 20.11     All others:  no time limit, as long as funds are traceable 
 20.12  to the exempt source.  (In tracing funds, the first-in, 
 20.13  first-out method is used.  This means money deposited first is 
 20.14  spent first.)  The money being sought by the judgment creditor 
 20.15  is being held in your account to give you a chance to claim an 
 20.16  exemption. 
 20.17     TO CLAIM AN EXEMPTION:  
 20.18     Fill out, sign, and mail or deliver one copy of the 
 20.19  attached exemption claim form to the institution which sent you 
 20.20  this notice and mail or deliver one copy to the judgment 
 20.21  creditor's attorney.  The address for the judgment creditor's 
 20.22  attorney is set forth below.  Both copies must be mailed or 
 20.23  delivered on the same day.  
 20.24     NOTE:  You may help resolve your claim faster if you send 
 20.25     to the creditor's attorney written proof or documents that 
 20.26     show why your money is exempt.  If you have questions 
 20.27     regarding the documents to send as proof of an exemption, 
 20.28     call the creditor's attorney.  If you do not send written 
 20.29     proof and the creditor's attorney has questions about your 
 20.30     exemption claim, the creditor's attorney may object to your 
 20.31     claim which may result in a further delay in releasing your 
 20.32     exempt funds. 
 20.33     If they do not get the exemption claim back from you within 
 20.34  14 days of the date they mailed or gave it to you, they will be 
 20.35  free to turn the money over to the attorney for the judgment 
 20.36  creditor.  If you are going to claim an exemption, do so as soon 
 21.1   as possible, because your money may be held until it is decided. 
 21.2      IF YOU CLAIM AN EXEMPTION:  
 21.3      (1) nonexempt money can be turned over to the judgment 
 21.4   creditor or sheriff; 
 21.5      (2) the financial institution will keep holding the money 
 21.6   claimed to be exempt; and 
 21.7      (3) seven days after receiving your exemption claim, the 
 21.8   financial institution will release the money to you unless 
 21.9   before then it receives an objection to your exemption claim.  
 21.10     IF THE JUDGMENT CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
 21.11     the institution will hold the money until a court decides 
 21.12  if your exemption claim is valid, BUT ONLY IF the institution 
 21.13  gets a copy of your court motion papers asserting the exemption 
 21.14  WITHIN TEN DAYS after the objection is personally served on you, 
 21.15  or within 13 days from the date the objection is mailed or given 
 21.16  to you.  You may wish to consult an attorney at once if the 
 21.17  judgment creditor objects to your exemption claim.  
 21.18     MOTION TO DETERMINE EXEMPTION:  
 21.19     At any time after your funds have been held, you may ask 
 21.20  for a court decision on the validity of your exemption claim by 
 21.21  filing a request for hearing which may be obtained at the office 
 21.22  of the court administrator of the above court. 
 21.23     PENALTIES:  
 21.24     If you claim an exemption in bad faith, or if the judgment 
 21.25  creditor wrongly objects to an exemption in bad faith, the court 
 21.26  may order the person who acted in bad faith to pay costs, actual 
 21.27  damages, attorney fees, and an additional amount of up to $100.  
 21.28                                 ............................. 
 21.29                                 ............................. 
 21.30                                 ............................. 
 21.31                                 ............................. 
 21.32                                 Name and address of (Attorney 
 21.33                                 for) Judgment Creditor 
 21.34     EXEMPTION:  
 21.35     (a) Amount of exemption claim.  
 21.36     / / I claim ALL the funds being held are exempt.  
 22.1      / / I claim SOME of the funds being held are exempt.  
 22.2            The exempt amount is $............  
 22.3      (b) Basis for exemption.  
 22.4      Of the 11 categories listed above, I am in category number 
 22.5   ............  (If more than one category applies, you may fill 
 22.6   in as many as apply.)  The source of the exempt funds is the 
 22.7   following:  
 22.8   .............................................................
 22.9   .............................................................
 22.10  .............................................................
 22.11     (If the source is a type of relief based on need, list the 
 22.12  case number and county:  
 22.13     case number:  ...............; 
 22.14     county:  ....................) 
 22.15     I hereby authorize any agency that has distributed relief 
 22.16  to me or any correctional institution in which I was an inmate 
 22.17  to disclose to the above named judgment creditor's attorney only 
 22.18  whether or not I am or have been a recipient of relief based on 
 22.19  need or an inmate of a correctional institute within the last 
 22.20  six months. 
 22.21     I have mailed or delivered a copy of the exemption notice 
 22.22  to the judgment creditor's attorney at the address indicated 
 22.23  above.  
 22.24                               .............................
 22.25                               DEBTOR
 22.26  DATED:  .............        .............................
 22.27                               .............................
 22.28                               .............................
 22.29                               DEBTOR ADDRESS
 22.30                               .............................
 22.31                               DEBTOR TELEPHONE NUMBER
 22.32     Sec. 14.  Minnesota Statutes 1998, section 551.05, 
 22.33  subdivision 5, is amended to read: 
 22.34     Subd. 5.  [NOTICE OF OBJECTION.] (a) The written objection 
 22.35  to the judgment debtor's claim of exemption must be in 
 22.36  substantially the following form:  
 23.1   STATE OF MINNESOTA                              DISTRICT COURT
 23.2   County of ...............          ..........JUDICIAL DISTRICT
 23.3   .................(Judgment Creditor)         OBJECTION TO
 23.4   .................(Judgment Debtor)           EXEMPTION CLAIM 
 23.5   .................(Garnishee) (Third Party)
 23.6      The judgment creditor objects to your claim for exemption 
 23.7   from garnishment, levy of execution, order for attachment 
 23.8   (strike inapplicable language) for the following reason(s):  
 23.9   .................................................................
 23.10  .................................................................
 23.11  .................................................................
 23.12     Because of this objection, your financial institution will 
 23.13  retain the funds you claimed to be exempt for an additional ten 
 23.14  days.  If you wish to request a hearing on your exemption claim, 
 23.15  you should need to do so within ten days of your receipt of this 
 23.16  objection from the date the objection was personally served on 
 23.17  you, or within 13 days from the date the objection was mailed to 
 23.18  you.  You may request a hearing by completing the attached form 
 23.19  and filing it with the court administrator.  
 23.20     1.  The court administrator's office shall provide clerical 
 23.21  assistance to help with the writing and filing of a Request for 
 23.22  Hearing by any person not represented by counsel.  The court 
 23.23  administrator may charge a fee of $1 for the filing of a Request 
 23.24  for Hearing.  
 23.25     2.  Upon the filing of a Request for Hearing, the court 
 23.26  administrator shall schedule the matter for a hearing no later 
 23.27  than five business days from the date of filing.  The court 
 23.28  administrator shall forthwith send a completed copy of the 
 23.29  request, including the hearing date, time, and place to the 
 23.30  adverse party and to the financial institution by first class 
 23.31  mail.  
 23.32     3.  If it is possible that the financial institution might 
 23.33  not receive the request mailed from the court administrator 
 23.34  within ten days, then you may want to personally deliver a copy 
 23.35  of the request to the financial institution after you have filed 
 23.36  your request with the court.  
 24.1      4.  An order stating whether your funds are exempt shall be 
 24.2   issued by the court within three days of the date of the hearing.
 24.3      If you do not file a Request for Hearing within ten days of 
 24.4   the date you receive this the objection was personally served on 
 24.5   you, or within 13 days from the date the objection was mailed to 
 24.6   you, your financial institution may turn your funds over to your 
 24.7   judgment creditor. 
 24.8      If you file a Request for Hearing and your financial 
 24.9   institution receives it within ten days of the date it received 
 24.10  this objection, your financial institution will retain your 
 24.11  funds claimed to be exempt until otherwise ordered by the court. 
 24.12                                  .............................. 
 24.13                                  Attorney for Judgment Creditor 
 24.14     Sec. 15.  Minnesota Statutes 1998, section 551.06, 
 24.15  subdivision 9, is amended to read: 
 24.16     Subd. 9.  [NOTICE OF LEVY ON EARNINGS, DISCLOSURE, AND 
 24.17  WORKSHEET.] The attorney for the judgment creditor shall serve 
 24.18  upon the judgment debtor's employer a notice of levy on earnings 
 24.19  and an execution earnings disclosure form and an earnings 
 24.20  disclosure worksheet with the writ of execution, that must be 
 24.21  substantially in the form set forth below.  
 24.22  STATE OF MINNESOTA                            DISTRICT COURT
 24.23  COUNTY OF ................       ......... JUDICIAL DISTRICT
 24.24                                            FILE NO. ..... 
 24.25  ............(Judgment Creditor)
 24.26  against                                   NOTICE OF LEVY ON 
 24.27                                         EARNINGS AND DISCLOSURE 
 24.28  ............(Judgment Debtor) 
 24.29  and 
 24.30  ............(Third Party)
 24.31     PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 24.32  sections 551.04 and 551.06, the undersigned, as attorney for the 
 24.33  judgment creditor, hereby makes demand and levies execution upon 
 24.34  all earnings due and owing by you (up to $5,000 $10,000) to the 
 24.35  judgment debtor for the amount of the judgment specified below.  
 24.36  A copy of the writ of execution issued by the court is 
 25.1   enclosed.  The unpaid judgment balance is $.....  
 25.2      This levy attaches all unpaid nonexempt disposable earnings 
 25.3   owing or to be owed by you and earned or to be earned by the 
 25.4   judgment debtor before and within the pay period in which the 
 25.5   writ of execution is served and within all subsequent pay 
 25.6   periods whose paydays occur within the 70 days after the service 
 25.7   of this levy. 
 25.8      In responding to this levy, you are to complete the 
 25.9   attached disclosure form and worksheet and mail it to the 
 25.10  undersigned attorney for the judgment creditor, together with 
 25.11  your check payable to the above-named judgment creditor, for the 
 25.12  nonexempt amount owed by you to the judgment debtor or for which 
 25.13  you are obligated to the judgment debtor, within the time limits 
 25.14  set forth in the aforementioned statutes. 
 25.15                            .................................. 
 25.16                            Attorney for the Judgment Creditor 
 25.17                            .................................. 
 25.18                            .................................. 
 25.19                            .................................. 
 25.20                            Address 
 25.21                            (...).......................... 
 25.22                            Phone Number 
 25.25                             DISCLOSURE
 25.26                            DEFINITIONS
 25.27     "EARNINGS":  For the purpose of execution, "earnings" means 
 25.28  compensation paid or payable to an employee for personal 
 25.29  services or compensation paid or payable to the producer for the 
 25.30  sale of agricultural products; milk or milk products; or fruit 
 25.31  or other horticultural products produced when the producer is 
 25.32  operating a family farm, a family farm corporation, or an 
 25.33  authorized farm corporation, as defined in section 500.24, 
 25.34  subdivision 2, whether denominated as wages, salary, commission, 
 25.35  bonus, or otherwise, and includes periodic payments pursuant to 
 25.36  a pension or retirement.  
 26.1      "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 26.2   an individual remaining after the deduction from those earnings 
 26.3   of amounts required by law to be withheld.  (Amounts required by 
 26.4   law to be withheld do not include items such as health 
 26.5   insurance, charitable contributions, or other voluntary wage 
 26.6   deductions.) 
 26.7      "PAYDAY":  For the purpose of execution, "payday(s)" means 
 26.8   the date(s) upon which the employer pays earnings to the 
 26.9   judgment debtor in the ordinary course of business.  If the 
 26.10  judgment debtor has no regular payday, payday(s) means the 15th 
 26.11  and the last day of each month.  
 26.12     THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING 
 26.13  QUESTIONS:  
 26.14     1.  Do you now owe, or within 70 days from the date the 
 26.15  execution levy was served on you, will you or may you owe money 
 26.16  to the judgment debtor for earnings?  
 26.17                           Yes .......      No .......
 26.18     2.  Does the judgment debtor earn more than $... per week?  
 26.19  (This amount is the federal minimum wage per week.) 
 26.20                           Yes .......      No .......
 26.21                  INSTRUCTIONS FOR COMPLETING THE 
 26.22                        EARNINGS DISCLOSURE 
 26.23     A.  If your answer to either question 1 or 2 is "No," then 
 26.24  you must sign the affirmation on page 2 and return this 
 26.25  disclosure to the judgment creditor's attorney within 20 days 
 26.26  after it was served on you, and you do not need to answer the 
 26.27  remaining questions.  
 26.28     B.  If your answers to both questions 1 and 2 are "Yes," 
 26.29  you must complete this form and the Earnings Disclosure 
 26.30  Worksheet as follows:  
 26.31     For each payday that falls within 70 days from the date the 
 26.32     execution levy was served on you, YOU MUST calculate the 
 26.33     amount of earnings to be retained by completing steps 3 
 26.34     through 11 on page 2, and enter the amounts on the Earnings 
 26.35     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 26.36     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 27.1      CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE.  
 27.2      Each payday, you must retain the amount of earnings listed 
 27.3      in column I on the Earnings Disclosure Worksheet.  
 27.4      You must pay the attached earnings and return this Earnings 
 27.5      Disclosure Form and the Earnings Disclosure Worksheet to 
 27.6      the judgment creditor's attorney and deliver a copy to the 
 27.7      judgment debtor within ten days after the last payday that 
 27.8      falls within the 70-day period. 
 27.9      If the judgment is wholly satisfied or if the judgment 
 27.10     debtor's employment ends before the expiration of the 
 27.11     70-day period, your disclosure and remittance should be 
 27.12     made within ten days after the last payday for which 
 27.13     earnings were attached. 
 27.14  For steps 3 through 11, "columns" refers to columns on the 
 27.15  Earnings Disclosure Worksheet.  
 27.16       3.  COLUMN A.  Enter the date of judgment debtor's 
 27.17                      payday.                        
 27.18       4.  COLUMN B.  Enter judgment debtor's gross earnings 
 27.19                      for each payday. 
 27.20       5.  COLUMN C.  Enter judgment debtor's disposable earnings 
 27.21                      for each payday. 
 27.22       6.  COLUMN D.  Enter 25 percent of disposable earnings.
 27.23                      (Multiply Column C by .25.) 
 27.24       7.  COLUMN E.  Enter here 40 times the hourly federal 
 27.25                      minimum wage ($...) times the number 
 27.26                      of work weeks included in each payday. 
 27.27                      (Note:  If a pay period includes days
 27.28                      in excess of whole work weeks, the additional
 27.29                      days should be counted as a fraction of a
 27.30                      work week equal to the number of work days in
 27.31                      excess of a whole work week divided by the
 27.32                      number of work days in a normal work week.)
 27.33       8.  COLUMN F.  Subtract the amount in Column E from the
 27.34                      amount in Column C, and enter here.
 27.35       9.  COLUMN G.  Enter here the lesser of the amount in
 27.36                      Column D and the amount in Column F.
 28.1       10.  COLUMN H.  Enter here any amount claimed by you as a
 28.2                       setoff, defense, lien, or claim, or any
 28.3                       amount claimed by any other person as an
 28.4                       exemption or adverse interest which would
 28.5                       reduce the amount of earnings owing to the
 28.6                       judgment debtor.  (Note:  Any indebtedness
 28.7                       to you incurred within ten days prior to your
 28.8                       receipt of the first execution levy on a debt
 28.9                       may not be set off against the earnings
 28.10                      otherwise subject to this levy.  Any wage
 28.11                      assignment made by the judgment debtor
 28.12                      within ten days prior to your receipt of
 28.13                      the first execution levy on a debt is void.)
 28.15                      You must also describe your claim(s) and the
 28.16                      claims of others, if known, in the space 
 28.17                      provided below the worksheet and state the
 28.18                      name(s) and address(es) of these persons.
 28.20                      Enter zero in Column H if there are no
 28.21                      claims by you or others which would reduce
 28.22                      the amount of earnings owing to the judgment
 28.23                      debtor. 
 28.25      11.  COLUMN I.  Subtract the amount in Column H from the 
 28.26                      amount in Column G and enter here.  This is
 28.27                      the amount of earnings that you must retain 
 28.28                      for the payday for which the calculations
 28.29                      were made.  The total of all amounts entered
 28.30                      in Column I is the amount to be remitted
 28.31                      to the attorney for the judgment creditor.
 28.32                            AFFIRMATION 
 28.33     I, ................... (person signing Affirmation), am the 
 28.34  third party/employer or I am authorized by the third 
 28.35  party/employer to complete this earnings disclosure, and have 
 28.36  done so truthfully and to the best of my knowledge.  
 29.1   Dated:  ............        ........................
 29.2                               Signature
 29.3                               ........................
 29.4                               Title
 29.5                               ........................
 29.6                               Telephone Number
 29.7                    EARNINGS DISCLOSURE WORKSHEET  
 29.8                         ...................
 29.9                        Judgment Debtor's Name
 29.10              A                  B                     C
 29.11            Payday             Gross                 Disposable
 29.12            Date               Earnings              Earnings
 29.13  1.  .................   $.................   $.................
 29.14  2.  .................   ..................   ..................
 29.15  3.  .................   ..................   ..................
 29.16  4.  .................   ..................   ..................
 29.17  5.  .................   ..................   ..................
 29.18  6.  .................   ..................   ..................
 29.19  7.  .................   ..................   ..................
 29.20  8.  .................   ..................   ..................
 29.21  9.  .................   ..................   ..................
 29.22  10. .................   ..................   ..................
 29.25             D                    E                  F
 29.26           25% of              40 X Min.            Column C
 29.27           Column C            Wage                 minus
 29.28                                                    Column E
 29.30  1.  .................   ..................   .................
 29.31  2.  .................   ..................   .................
 29.32  3.  .................   ..................   .................
 29.33  4.  .................   ..................   .................
 29.34  5.  .................   ..................   .................
 29.35  6.  .................   ..................   .................
 29.36  7.  .................   ..................   .................
 30.1   8.  .................   ..................   .................
 30.2   9.  .................   ..................   .................
 30.3   10. .................   ..................   .................
 30.4              G                     H                   I
 30.5           Lesser of           Setoff, Lien,         Column G
 30.6           Column D            Adverse               minus
 30.7           and                 Interest, or          Column H
 30.8           Column F            Other Claims
 30.9   1.  .................   ..................   .................
 30.10  2.  .................   ..................   .................
 30.11  3.  .................   ..................   .................
 30.12  4.  .................   ..................   .................
 30.13  5.  .................   ..................   .................
 30.14  6.  .................   ..................   .................
 30.15  7.  .................   ..................   .................
 30.16  8.  .................   ..................   .................
 30.17  9.  .................   ..................   .................
 30.18  10. .................   ..................   .................
 30.19                          TOTAL OF COLUMN I    $................
 30.20     *If you entered any amount in Column H for any payday(s), 
 30.21  you must describe below either your claims, or the claims of 
 30.22  others.  For amounts claimed by others, you must both state the 
 30.23  names and addresses of these persons, and the nature of their 
 30.24  claim, if known.  
 30.25  .................................................................
 30.26  .................................................................
 30.27  ..... ...........................................................
 30.28                            AFFIRMATION 
 30.29     I, ................. (person signing Affirmation), am the 
 30.30  third party or I am authorized by the third party to complete 
 30.31  this earnings disclosure worksheet, and have done so truthfully 
 30.32  and to the best of my knowledge.  
 30.33                                        .................
 30.34                                        Title
 30.35  Dated:  ........  ...............     (...)............
 30.36                    Signature           Phone Number 
 31.1      Sec. 16.  Minnesota Statutes 1999 Supplement, section 
 31.2   551.06, subdivision 10, is amended to read: 
 31.3      Subd. 10.  [NOTICE OF LEVY ON EARNINGS, DISCLOSURE, AND 
 31.4   WORKSHEET FOR CHILD SUPPORT JUDGMENT.] The attorney for the 
 31.5   judgment creditor shall serve upon the judgment debtor's 
 31.6   employer a notice of levy on earnings and an execution earnings 
 31.7   disclosure form and an earnings disclosure worksheet with the 
 31.8   writ of execution, that must be substantially in the form set 
 31.9   forth below.  
 31.10  STATE OF MINNESOTA                            DISTRICT COURT
 31.11  COUNTY OF ................       ......... JUDICIAL DISTRICT
 31.12                                            FILE NO. ..... 
 31.13  ............(Judgment Creditor)
 31.14  against                                   NOTICE OF LEVY ON 
 31.15                                         EARNINGS AND DISCLOSURE 
 31.16  ............(Judgment Debtor) 
 31.17  and 
 31.18  ............(Third Party)
 31.19     PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, 
 31.20  sections 551.04 and 551.06, the undersigned, as attorney for the 
 31.21  judgment creditor, hereby makes demand and levies execution upon 
 31.22  all earnings due and owing by you (up to $5,000 $10,000) to the 
 31.23  judgment debtor for the amount of the judgment specified below.  
 31.24  A copy of the writ of execution issued by the court is 
 31.25  enclosed.  The unpaid judgment balance is $.....  
 31.26     This levy attaches all unpaid nonexempt disposable earnings 
 31.27  owing or to be owed by you and earned or to be earned by the 
 31.28  judgment debtor before and within the pay period in which the 
 31.29  writ of execution is served and within all subsequent pay 
 31.30  periods whose paydays occur within the 70 days after the service 
 31.31  of this levy. 
 31.32     In responding to this levy, you are to complete the 
 31.33  attached disclosure form and worksheet and mail it to the 
 31.34  undersigned attorney for the judgment creditor, together with 
 31.35  your check payable to the above-named judgment creditor, for the 
 31.36  nonexempt amount owed by you to the judgment debtor or for which 
 32.1   you are obligated to the judgment debtor, within the time limits 
 32.2   set forth in the aforementioned statutes. 
 32.3                             .................................. 
 32.4                             Attorney for the Judgment Creditor 
 32.5                             .................................. 
 32.6                             .................................. 
 32.7                             .................................. 
 32.8                             Address 
 32.9                             (...).......................... 
 32.10                            Phone Number 
 32.13                             DISCLOSURE 
 32.14                            DEFINITIONS
 32.15     "EARNINGS":  For the purpose of execution, "earnings" means 
 32.16  compensation paid or payable to an employee for personal 
 32.17  services or compensation paid or payable to the producer for the 
 32.18  sale of agricultural products; milk or milk products; or fruit 
 32.19  or other horticultural products produced when the producer is 
 32.20  operating a family farm, a family farm corporation, or an 
 32.21  authorized farm corporation, as defined in section 500.24, 
 32.22  subdivision 2, whether denominated as wages, salary, commission, 
 32.23  bonus, or otherwise, and includes periodic payments pursuant to 
 32.24  a pension or retirement, workers' compensation, or reemployment 
 32.25  compensation.  
 32.26     "DISPOSABLE EARNINGS":  Means that part of the earnings of 
 32.27  an individual remaining after the deduction from those earnings 
 32.28  of amounts required by law to be withheld.  (Amounts required by 
 32.29  law to be withheld do not include items such as health 
 32.30  insurance, charitable contributions, or other voluntary wage 
 32.31  deductions.) 
 32.32     "PAYDAY":  For the purpose of execution, "payday(s)" means 
 32.33  the date(s) upon which the employer pays earnings to the debtor 
 32.34  in the ordinary course of business.  If the judgment debtor has 
 32.35  no regular payday, payday(s) means the 15th and the last day of 
 32.36  each month.  
 33.1      THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING QUESTION:
 33.2      (1) Do you now owe, or within 70 days from the date the 
 33.3   execution levy was served on you, will you or may you owe money 
 33.4   to the judgment debtor for earnings?  
 33.5                                .......         .......
 33.6                                Yes             No
 33.7                   INSTRUCTIONS FOR COMPLETING THE 
 33.8                         EARNINGS DISCLOSURE 
 33.9      A.  If your answer to question 1 is "No," then you must 
 33.10  sign the affirmation below and return this disclosure to the 
 33.11  judgment creditor's attorney within 20 days after it was served 
 33.12  on you, and you do not need to answer the remaining questions.  
 33.13     B.  If your answer to question 1 is "Yes," you must 
 33.14  complete this form and the Earnings Disclosure Worksheet as 
 33.15  follows:  
 33.16     For each payday that falls within 70 days from the date the 
 33.17     execution levy was served on you, YOU MUST calculate the 
 33.18     amount of earnings to be retained by completing steps 2 
 33.19     through 8 on page 2, and enter the amounts on the Earnings 
 33.20     Disclosure Worksheet.  UPON REQUEST, THE EMPLOYER MUST 
 33.21     PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE 
 33.22     CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. 
 33.23     Each payday, you must retain the amount of earnings listed 
 33.24     in column G on the Earnings Disclosure Worksheet.  
 33.25     You must pay the attached earnings and return this earnings 
 33.26     disclosure form and the Earnings Disclosure Worksheet to 
 33.27     the judgment creditor's attorney and deliver a copy of the 
 33.28     disclosure and worksheet to the judgment debtor within ten 
 33.29     days after the last payday that falls within the 70-day 
 33.30     period.  If the judgment is wholly satisfied or if the 
 33.31     judgment debtor's employment ends before the expiration of 
 33.32     the 70-day period, your disclosure and remittance should be 
 33.33     made within ten days after the last payday for which 
 33.34     earnings were attached. 
 33.35     For steps 2 through 8, "columns" refers to columns on the 
 33.36  Earnings Disclosure Worksheet.  
 34.1      (2) COLUMN A.  Enter the date of judgment debtor's payday.  
 34.2      (3) COLUMN B.  Enter judgment debtor's gross earnings for 
 34.3   each payday.  
 34.4      (4) COLUMN C.  Enter judgment debtor's disposable earnings 
 34.5   for each payday.  
 34.6      (5) COLUMN D.  Enter either 50, 55, 60, or 65 percent of 
 34.7   disposable earnings, based on which of the following 
 34.8   descriptions fits the child support judgment debtor:  
 34.9      (a) 50 percent of the judgment debtor's disposable income, 
 34.10  if the judgment debtor is supporting a spouse or dependent child 
 34.11  and the judgment is 12 weeks old or less (12 weeks to be 
 34.12  calculated to the beginning of the work week in which the 
 34.13  execution levy is received); 
 34.14     (b) 55 percent of the judgment debtor's disposable income, 
 34.15  if the judgment debtor is supporting a spouse or dependent 
 34.16  child, and the judgment is over 12 weeks old (12 weeks to be 
 34.17  calculated to the beginning of the work week in which the 
 34.18  execution levy is received); 
 34.19     (c) 60 percent of the judgment debtor's disposable income, 
 34.20  if the judgment debtor is not supporting a spouse or dependent 
 34.21  child and the judgment is 12 weeks old or less (12 weeks to be 
 34.22  calculated to the beginning of the work week in which the 
 34.23  execution levy is received); or 
 34.24     (d) 65 percent of the judgment debtor's disposable income, 
 34.25  if the judgment debtor is not supporting a spouse or dependent 
 34.26  child, and the judgment is over 12 weeks old (12 weeks to be 
 34.27  calculated to the beginning of the work week in which the 
 34.28  execution levy is received).  (Multiply column C by .50, .55, 
 34.29  .60, or .65, as appropriate.)  
 34.30     (6) COLUMN E.  Enter here any amount claimed by you as a 
 34.31  setoff, defense, lien, or claim, or any amount claimed by any 
 34.32  other person as an exemption or adverse interest that would 
 34.33  reduce the amount of earnings owing to the judgment debtor.  
 34.34  (Note:  Any indebtedness to you incurred within ten days prior 
 34.35  to your receipt of the first execution levy on a debt may not be 
 34.36  set off against the earnings otherwise subject to this levy.  
 35.1   Any wage assignment made by the judgment debtor within ten days 
 35.2   prior to your receipt of the first execution levy on a debt is 
 35.3   void.) 
 35.4      You must also describe your claim(s) and the claims of 
 35.5   others, if known, in the space provided below the worksheet and 
 35.6   state the name(s) and address(es) of these persons.  
 35.7      Enter zero in column E if there are no claims by you or 
 35.8   others that would reduce the amount of earnings owing to the 
 35.9   judgment debtor.  
 35.10     (7) COLUMN F.  Subtract the amount in column E from the 
 35.11  amount in column D and enter here.  This is the amount of 
 35.12  earnings that you must remit for the payday for which the 
 35.13  calculations were made.  
 35.14                            AFFIRMATION
 35.15     I, ................... (person signing Affirmation), am the 
 35.16  third party/employer or I am authorized by the third 
 35.17  party/employer to complete this earnings disclosure, and have 
 35.18  done so truthfully and to the best of my knowledge.  
 35.19  Dated:  ............                 ............................
 35.20                                       Signature
 35.21                                       ............................
 35.22                                       Title
 35.23                                       ............................
 35.24                                       Telephone Number
 35.25   EARNINGS DISCLOSURE WORKSHEET         ...................
 35.26                                               Debtor's Name
 35.27  A                      B                      C
 35.28  Payday                 Gross                  Disposable
 35.29  Date                   Earnings               Earnings
 35.30  1.  ........           $.......               $.........
 35.31  2.  ........           ........               ..........
 35.32  3.  ........           ........               ..........
 35.33  4.  ........           ........               ..........
 35.34  5.  ........           ........               ..........
 35.35  6.  ........           ........               ..........
 35.36  7.  ........           ........               ..........
 36.1   8.  ........           ........               ..........
 36.2   9.  ........           ........               ..........
 36.3   10. ........           ........               ..........
 36.4   D                      E                      F
 36.5   Either 50, 55,         Setoff, Lien,          Column D
 36.6   60, or 65% of          Adverse                minus
 36.7   Column C               Interest, or           Column E
 36.8                          Other Claims                    
 36.9   1.  ........           ..........             ..........
 36.10  2.  ........           ..........             ..........
 36.11  3.  ........           ..........             ..........
 36.12  4.  ........           ..........             ..........
 36.13  5.  ........           ..........             ..........
 36.14  6.  ........           ..........             ..........
 36.15  7.  ........           ..........             ..........
 36.16  8.  ........           ..........             ..........
 36.17  9.  ........           ..........             ..........
 36.18  10. ........           ..........             ..........
 36.19                           TOTAL OF COLUMN F $............
 36.20     *If you entered any amount in column E for any payday(s), 
 36.21  you must describe below either your claims, or the claims of 
 36.22  others.  For amounts claimed by others, you must both state the 
 36.23  names and addresses of such persons, and the nature of their 
 36.24  claim, if known.  
 36.25     
 36.26  .................................................................
 36.27  .................................................................
 36.28  .................................................................
 36.29                            AFFIRMATION 
 36.30     I, ................. (person signing Affirmation), am the 
 36.31  third party or I am authorized by the third party to complete 
 36.32  this earnings disclosure worksheet, and have done so truthfully 
 36.33  and to the best of my knowledge.  
 36.34                                        .................
 36.35                                        Signature
 36.36  Dated:  ........  ...............     (...)............
 37.1                     Title               Phone Number
 37.2      Sec. 17.  Minnesota Statutes 1998, section 571.72, 
 37.3   subdivision 2, is amended to read: 
 37.4      Subd. 2.  [SERVICE OF A GARNISHMENT SUMMONS.] To enforce a 
 37.5   claim asserted in a civil action venued in a court of record, a 
 37.6   garnishment summons may be issued by a creditor and served upon 
 37.7   the garnishee in the same manner as other summons in that court 
 37.8   of record, except that service may not be made by publication.  
 37.9   Service of a garnishment summons on the garnishee may also be 
 37.10  made by certified mail, return receipt requested.  A garnishment 
 37.11  summons served by certified mail is effective if served at the 
 37.12  garnishee's regular place of business.  The effective date of 
 37.13  service by certified mail is the time of receipt by the 
 37.14  garnishee.  A single garnishment summons may be addressed to two 
 37.15  or more garnishees but must state whether each is summoned 
 37.16  separately or jointly. 
 37.17     The garnishment summons must state: 
 37.18     (1) the full name of the debtor, the debtor's last known 
 37.19  mailing address, and the amount of the claim that remains 
 37.20  unpaid; 
 37.21     (2) the date of the entry of judgment against the debtor or 
 37.22  that the debtor is in default pursuant to Rule 55.01 of the 
 37.23  Minnesota Rules of Civil Procedure for the District Courts.  
 37.24  Where there is a prejudgment garnishment pursuant to section 
 37.25  571.93, the garnishment summons must include a copy of the court 
 37.26  order; 
 37.27     (3) if the garnishment is on any indebtedness, money, or 
 37.28  property other than earnings, the garnishee shall serve upon the 
 37.29  creditor and upon the debtor within 20 days after service of the 
 37.30  garnishment summons, a written disclosure, of the garnishee's 
 37.31  indebtedness, money, or other property owing to the debtor and 
 37.32  answers to all written interrogatories that are served with the 
 37.33  garnishment summons.  The garnishment summons shall also state 
 37.34  that if the garnishment is on earnings and the debtor has 
 37.35  garnishable earnings, the garnishee shall serve the disclosure 
 37.36  within ten days of the last payday to occur within the 70 days 
 38.1   after the date of service of the garnishment summons; 
 38.2      (4) that the creditor shall not require disclosure of the 
 38.3   disposable earnings, indebtedness, money, or property of debtor 
 38.4   in the garnishee's possession or under the garnishee's control 
 38.5   in excess of 110 percent of the amount of the claim that remains 
 38.6   unpaid; 
 38.7      (5) that the garnishee shall retain disposable earnings, 
 38.8   indebtedness, money, or property of the debtor in the 
 38.9   garnishee's possession or under the garnishee's control not in 
 38.10  excess of 110 percent of the amount of the claim that remains 
 38.11  unpaid, until the creditor causes a writ of execution to be 
 38.12  served upon the garnishee, until the debtor authorizes release 
 38.13  to the creditor, until the creditor authorizes release to the 
 38.14  debtor, upon court order, or by operation of law; 
 38.15     (6) that after the expiration of the period of time 
 38.16  specified in section 571.79 from the date of service of the 
 38.17  garnishment summons, the garnishee's retention obligation 
 38.18  automatically expires; 
 38.19     (7) that an assignment of wages made by the debtor within 
 38.20  ten days before the service of the first garnishment summons on 
 38.21  a debt is void and that any indebtedness to the garnishee 
 38.22  incurred with ten days before the service of the first 
 38.23  garnishment summons on a debt may not be set off against amounts 
 38.24  otherwise subject to the garnishment. 
 38.25     Sec. 18.  Minnesota Statutes 1998, section 571.74, is 
 38.26  amended to read: 
 38.27     571.74 [GARNISHMENT SUMMONS AND NOTICE TO DEBTOR.] 
 38.28     The garnishment summons and notice to debtor must be 
 38.29  substantially in the following form.  The notice to debtor must 
 38.30  be in no smaller than 14-point type.  
 38.31                       GARNISHMENT SUMMONS 
 38.32  STATE OF MINNESOTA                            DISTRICT COURT
 38.33  COUNTY OF .................      ..........JUDICIAL DISTRICT
 38.34  .......................(Creditor)
 38.35  .......................(Debtor)       UNPAID BALANCE........
 38.36  .......................(Debtor's Address)      Date of Entry
 39.1   .......................(Garnishee)  of Judgment (or) Subject
 39.2                                         to Minnesota Statutes,
 39.3                                        section 571.71, subd. 2
 39.4                         GARNISHMENT SUMMONS
 39.5   The State of Minnesota 
 39.6   To the Garnishee named above: 
 39.7      You are hereby summoned and required to serve upon the 
 39.8   creditor's attorney (or the creditor if not represented by an 
 39.9   attorney) and on the debtor within 20 days after service of this 
 39.10  garnishment summons upon you, a written disclosure, of the 
 39.11  indebtedness, money, or other property that you owe to the 
 39.12  debtor the nonexempt indebtedness, money, or other property due 
 39.13  or belonging to the debtor and owing by you or in your 
 39.14  possession or under your control and answers to all written 
 39.15  interrogatories that are served with the garnishment summons.  
 39.16  However, if the garnishment is on earnings and the debtor has 
 39.17  garnishable earnings, you shall serve the completed disclosure 
 39.18  form on the creditor's attorney, or the creditor if not 
 39.19  represented by an attorney, within ten days of the last payday 
 39.20  to occur within the 70 days after the date of the service of 
 39.21  this garnishment summons.  "Payday" means the day which you pay 
 39.22  earnings in the ordinary course of business.  If the debtor has 
 39.23  no regular paydays, "payday" means the 15th day and the last day 
 39.24  of each month. 
 39.25     Your disclosure need not exceed 110 percent of the amount 
 39.26  of the creditor's claim that remains unpaid. 
 39.27     You shall retain garnishable earnings, other indebtedness, 
 39.28  money, or other property in your possession in an amount not to 
 39.29  exceed 110 percent of the creditor's claim until such time as 
 39.30  the creditor causes a writ of execution to be served upon you, 
 39.31  until the debtor authorizes you in writing to release the 
 39.32  property to the creditor, or until the expiration of ...... days 
 39.33  from the date of service of this garnishment summons upon you, 
 39.34  at which time you shall return the disposable earnings, other 
 39.35  indebtedness, money, or other property to the debtor. 
 39.36                              EARNINGS 
 40.1      In the event you are summoned as a garnishee because you 
 40.2   owe "earnings" (as defined on the Earnings Garnishment 
 40.3   Disclosure form attached to this Garnishment Summons, if 
 40.4   applicable) to the debtor, then you are required to serve upon 
 40.5   the creditor's attorney, or the creditor if not represented by 
 40.6   an attorney, a written earnings disclosure form within the time 
 40.7   limit set forth above. 
 40.8      In the case of earnings you are further required to retain 
 40.9   in your possession all unpaid nonexempt disposable earnings owed 
 40.10  or to be owed by you and earned or to be earned to the debtor 
 40.11  within the pay period in which this garnishment summons is 
 40.12  served and within all subsequent pay periods whose paydays 
 40.13  (defined above) occur within the 70 days after the date of 
 40.14  service of this garnishment summons. 
 40.15     Any assignment of earnings made by the debtor to any party 
 40.16  within ten days before the receipt of the first garnishment on a 
 40.17  debt is void.  Any indebtedness to you incurred by the debtor 
 40.18  within the ten days before the receipt of the first garnishment 
 40.19  on a debt may not be set off against amounts otherwise subject 
 40.20  to the garnishment. 
 40.21     You are prohibited by law from discharging or disciplining 
 40.22  the debtor because the debtor's earnings have been subject to 
 40.23  garnishment. 
 40.24     This Garnishment Summons includes: 
 40.25     (check applicable box) 
 40.26  .....  Earnings garnishment
 40.27         (see attached Earnings Disclosure Form)
 40.28  .....  Nonearnings garnishment
 40.29         (see attached Nonearnings Disclosure Form)
 40.30  .....  Both Earnings and Nonearnings garnishment
 40.31         (see both attached Earnings and Nonearnings
 40.32         Disclosure Form)
 40.33                          NOTICE TO DEBTOR
 40.34     A Garnishment Summons, Earnings Garnishment Disclosure 
 40.35  form, Nonwage Garnishment Disclosure form, Garnishment Exemption 
 40.36  Notices and/or written Interrogatories (strike out if not 
 41.1   applicable), copies of which are hereby served on you, were 
 41.2   served upon the Garnishee by delivering copies to the 
 41.3   Garnishee.  The Garnishee was paid $15. 
 41.4   Dated:  ...............    ...............................
 41.5                              Attorney for Creditor
 41.6                              (or creditor)
 41.7                              ...............................
 41.8                              ...............................
 41.9                              ...............................
 41.10                             Address
 41.11                             ...............................
 41.12                             Telephone
 41.13                             ...............................
 41.14                             Attorney I.D. No.
 41.15     Sec. 19.  [571.771] [MONEY DUE FROM STATE DEPARTMENTS.] 
 41.16     Money due or owing to any entity or person by the state on 
 41.17  account of any employment, work, contract with, or services 
 41.18  provided to any state department or agency is subject to 
 41.19  garnishment.  The garnishment summons may be served upon the 
 41.20  head of the department or agency in the same manner as other 
 41.21  summons in that court of record except that service may not be 
 41.22  made by publication.  Service of the garnishment summons may 
 41.23  also be made by certified mail, return receipt requested.  The 
 41.24  disclosure must be made by the head of the department or agency, 
 41.25  or by some person designated by the head having knowledge of the 
 41.26  facts.  If payment is made pursuant to judgment against the 
 41.27  state as garnishee, a certificate of satisfaction to the extent 
 41.28  of the payment endorsed on it must be delivered to the head of 
 41.29  the department or agency as a voucher for the payment. 
 41.30     Sec. 20.  Minnesota Statutes 1998, section 571.79, is 
 41.31  amended to read: 
 41.32     571.79 [DISCHARGE OF A GARNISHEE.] 
 41.33     Subject to sections 571.78 and 571.80 Except as provided in 
 41.34  paragraph (h), the garnishee, after disclosure, shall be 
 41.35  discharged of any further retention obligation to the creditor 
 41.36  with respect to a specific garnishment summons when one of the 
 42.1   following conditions are met: 
 42.2      (a) The garnishee discloses that the garnishee is not 
 42.3   indebted to the debtor or does not possess any money or other 
 42.4   property belonging to the debtor that is attachable as defined 
 42.5   in section 571.73, subdivision 3.  The disclosure is conclusive 
 42.6   against the creditor and discharges the garnishee from any 
 42.7   further obligation to the creditor other than to retain all 
 42.8   nonexempt disposable earnings, indebtedness, money, and property 
 42.9   of the debtor which was disclosed. 
 42.10     (b) The garnishee discloses that the garnishee is indebted 
 42.11  to the debtor as indicated on the garnishment disclosure form.  
 42.12  The disclosure is conclusive against the creditor and discharges 
 42.13  the garnishee from any further obligation to the creditor other 
 42.14  than to retain all nonexempt disposable earnings, indebtedness, 
 42.15  money, and property of the debtor that was disclosed.  
 42.16     (c) If the garnishee was served with a garnishment summons 
 42.17  before entry of judgment against the debtor by the creditor in 
 42.18  the civil action and the garnishee has retained any disposable 
 42.19  earnings, indebtedness, money, or property of the debtor, 270 
 42.20  days after the garnishment summons is served the garnishee is 
 42.21  discharged and the garnishee shall return any disposable 
 42.22  earnings, indebtedness, money, and property to the debtor. 
 42.23     (d) If the garnishee was served with a garnishment summons 
 42.24  after entry of judgment against the debtor by the creditor in 
 42.25  the civil action and the garnishee has retained any disposable 
 42.26  earnings, indebtedness, money, or property of the debtor, 180 
 42.27  days after the garnishment summons is served the garnishee is 
 42.28  discharged and the garnishee shall return any disposable 
 42.29  earnings, other indebtedness, money, and property to the debtor. 
 42.30     (e) If the garnished indebtedness, money, or other property 
 42.31  is destroyed without any negligence of the garnishee, the 
 42.32  garnishee is discharged of any liability to the creditor for 
 42.33  nondelivery of the garnished indebtedness, money, and other 
 42.34  property. 
 42.35     (f) The court may, upon motion of an interested person, 
 42.36  discharge the garnishee as to any disposable earnings, other 
 43.1   indebtedness, money, and property in excess of the amount that 
 43.2   may be required to satisfy the creditor's claim. 
 43.3      (g) The discharge of the garnishee pursuant to paragraph 
 43.4   (a), (b), (c), or (d) is not determinative of the rights of the 
 43.5   creditor, debtor, or garnishee with respect to any other 
 43.6   garnishment summons, even another garnishment summons involving 
 43.7   the same parties, unless and to the extent adjudicated pursuant 
 43.8   to the procedures described in paragraph (h). 
 43.9      (h) The garnishee is not discharged if within 20 days of 
 43.10  the service of the garnishee's disclosure or the return to the 
 43.11  debtor of any disposable earnings, indebtedness money, or other 
 43.12  property of the debtor, whichever is later, an interested person 
 43.13  (1) serves a motion scheduled to be heard within 30 days of the 
 43.14  service of the motion relating to the garnishment, or (2) serves 
 43.15  a motion scheduled to be heard within 30 days of the service of 
 43.16  the motion for leave to file a supplemental complaint against 
 43.17  the garnishee, as provided under section 571.75, subdivision 4, 
 43.18  and the court upon proper showing vacates the discharge of the 
 43.19  garnishee. 
 43.20     Sec. 21.  Minnesota Statutes 1998, section 571.82, 
 43.21  subdivision 1, is amended to read: 
 43.22     Subdivision 1.  [JUDGMENT UPON FAILURE TO DISCLOSE.] If a 
 43.23  garnishee fails to serve a disclosure as required in this 
 43.24  chapter, the court may render judgment against the garnishee, 
 43.25  upon motion by the creditor, for an amount not exceeding the 
 43.26  creditor's claim against the debtor or 110 percent of the amount 
 43.27  claimed in the garnishment summons, whichever is less.  The 
 43.28  motion shall be supported by an affidavit of the facts and shall 
 43.29  be served upon both the debtor and the garnishee.  The court 
 43.30  upon good cause shown may remove the default and permit the 
 43.31  garnishee to disclose on just terms.  
 43.32     Sec. 22.  Minnesota Statutes 1999 Supplement, section 
 43.33  571.912, is amended to read: 
 43.34     571.912 [FORM OF EXEMPTION NOTICE.] 
 43.35     The notice informing a debtor that an order for attachment, 
 43.36  garnishment summons, or levy by execution has been used to 
 44.1   attach funds of the debtor to satisfy a claim must be 
 44.2   substantially in the following form:  
 44.3   STATE OF MINNESOTA                            DISTRICT COURT 
 44.4   COUNTY OF ................         ........JUDICIAL DISTRICT
 44.5   ........................(Creditor)
 44.6   ........................(Debtor)
 44.7   TO:  Debtor                                EXEMPTION NOTICE
 44.8      An order for attachment, garnishment summons, or levy of 
 44.9   execution (strike inapplicable language) has been served on 
 44.10  ............ (bank or other financial institution) 
 44.11  ............... where you have an account.  
 44.12     Your account balance is $.............  
 44.13     The amount being held is $............  
 44.14     However, all or a portion of the funds in your account will 
 44.15  normally be exempt from creditors' claims if they are in one of 
 44.16  the following categories: 
 44.17     (1) relief based on need.  This includes the Minnesota 
 44.18  Family Investment Program (MFIP), Emergency Assistance (EA), 
 44.19  Work First Program, Medical Assistance (MA), General Assistance 
 44.20  (GA), General Assistance Medical Care (GAMC), Emergency General 
 44.21  Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
 44.22  Emergency Assistance (MSA-EA), Supplemental Security Income 
 44.23  (SSI), and Energy Assistance; 
 44.24     (2) Social Security benefits (Old Age, Survivors, or 
 44.25  Disability Insurance); 
 44.26     (3) reemployment compensation, workers' compensation, or 
 44.27  veterans' benefits; 
 44.28     (4) an accident, disability, or retirement pension or 
 44.29  annuity; 
 44.30     (5) life insurance proceeds; 
 44.31     (6) the earnings of your minor child and any child support 
 44.32  paid to you; or 
 44.33     (7) money from a claim for damage or destruction of exempt 
 44.34  property (such as household goods, farm tools, business 
 44.35  equipment, a mobile home, or a car).  
 44.36     The following funds are also exempt: 
 45.1      (8) all earnings of a person in category (1); 
 45.2      (9) all earnings of a person who has received relief based 
 45.3   on need, or who has been an inmate of a correctional 
 45.4   institution, within the last six months; 
 45.5      (10) 75 percent of every debtor's after tax earnings; and 
 45.6      (11) all of a debtor's after tax earnings below 40 times 
 45.7   the federal minimum wage. 
 45.8      TIME LIMIT ON EXEMPTIONS AFTER DEPOSIT IN BANK:  
 45.9      Categories (10) and (11):  20 days 
 45.10     Categories (8) and (9):  60 days 
 45.11     All others:  no time limit, as long as funds are traceable 
 45.12  to the exempt source.  (In tracing funds, the first-in, 
 45.13  first-out method is used.  This means money deposited first is 
 45.14  spent first.)  The money being sought by the creditor is being 
 45.15  held in your account to give you a chance to claim an exemption. 
 45.16     TO CLAIM AN EXEMPTION:  
 45.17     Fill out, sign, and mail or deliver one copy of the 
 45.18  attached exemption claim form to the institution which sent you 
 45.19  this notice and mail or deliver one copy to the creditor's 
 45.20  attorney.  In the event that there is no attorney for the 
 45.21  creditor, then such notice shall be sent directly to the 
 45.22  creditor.  The address for the creditor's attorney or the 
 45.23  creditor is set forth below.  Both copies must be mailed or 
 45.24  delivered on the same day.  
 45.25     NOTE:  You may help resolve your claim faster if you send 
 45.26     to the creditor's attorney written proof or documents that 
 45.27     show why your money is exempt.  If you have questions 
 45.28     regarding the documents to send as proof of an exemption, 
 45.29     call the creditor's attorney.  If you do not send written 
 45.30     proof and the creditor's attorney has questions about your 
 45.31     exemption claim, the creditor's attorney may object to your 
 45.32     claim which may result in a further delay in releasing your 
 45.33     exempt funds. 
 45.34     If they do not get the exemption claim back from you within 
 45.35  14 days of the date they mailed or gave it to you, they will be 
 45.36  free to turn the money over to the sheriff or the creditor.  If 
 46.1   you are going to claim an exemption, do so as soon as possible, 
 46.2   because your money may be held until it is decided. 
 46.3      IF YOU CLAIM AN EXEMPTION:  
 46.4      (1) nonexempt money can be turned over to the creditor or 
 46.5   sheriff; 
 46.6      (2) the financial institution will keep holding the money 
 46.7   claimed to be exempt; and 
 46.8      (3) seven days after receiving your exemption claim, the 
 46.9   financial institution will release the money to you unless 
 46.10  before then it receives an objection to your exemption claim.  
 46.11     IF THE CREDITOR OBJECTS TO YOUR EXEMPTION CLAIM: 
 46.12     The institution will hold the money until a court decides 
 46.13  if your exemption claim is valid, BUT ONLY IF the institution 
 46.14  gets a copy of your court motion papers asserting the exemption 
 46.15  WITHIN TEN DAYS after the objection is personally served on you, 
 46.16  or within 13 days from the date the objection is mailed or given 
 46.17  to you.  You may wish to consult an attorney at once if the 
 46.18  creditor objects to your exemption claim.  
 46.19     MOTION TO DETERMINE EXEMPTION:  
 46.20     At any time after your funds have been held, you may ask 
 46.21  for a court decision on the validity of your exemption claim by 
 46.22  filing a request for hearing which may be obtained at the office 
 46.23  of the court administrator of the above court. 
 46.24     PENALTIES:  
 46.25     If you claim an exemption in bad faith, or if the creditor 
 46.26  wrongly objects to an exemption in bad faith, the court may 
 46.27  order the person who acted in bad faith to pay costs, actual 
 46.28  damages, attorney fees, and an additional amount of up to $100.  
 46.29                                .............................
 46.30                                .............................
 46.31                                ............................. 
 46.32                                ............................. 
 46.33                                Name and address of (Attorney
 46.34                                for) Judgment Creditor
 46.35     EXEMPTION:  
 46.36     (If you claim an exemption complete the following): 
 47.1      (a) Amount of exemption claim.  
 47.2      / / I claim ALL the funds being held are exempt.  
 47.3      / / I claim SOME of the funds being held are exempt.  
 47.4            The exempt amount is $............  
 47.5      (b) Basis for exemption.  
 47.6      Of the eleven categories listed above, I am in category 
 47.7   number ............  (If more than one category applies, you may 
 47.8   fill in as many as apply.)  The source of the exempt funds is 
 47.9   the following:  
 47.10  .............................................................
 47.11  .............................................................
 47.12  .............................................................
 47.13     (If the source is a type of relief based on need, list the 
 47.14  case number and county:  
 47.15     case number:  ...............; 
 47.16     county:  ....................) 
 47.17     I hereby authorize any agency that has distributed relief 
 47.18  to me or any correctional institution in which I was an inmate 
 47.19  to disclose to the above named creditor or its attorney only 
 47.20  whether or not I am or have been a recipient of relief based on 
 47.21  need or an inmate of a correctional institute within the last 
 47.22  six months.  
 47.23     I have mailed or delivered a copy of the exemption notice 
 47.24  to the creditor's attorney at the address indicated above.  
 47.25  DATED:  .............        .............................
 47.26                               DEBTOR 
 47.27                               .............................
 47.28                               DEBTOR ADDRESS
 47.29                               .............................
 47.30                               DEBTOR TELEPHONE NUMBER 
 47.31     Sec. 23.  Minnesota Statutes 1998, section 571.914, 
 47.32  subdivision 2, is amended to read: 
 47.33     Subd. 2.  [NOTICE OF OBJECTION.] (a) The written objection 
 47.34  to the debtor must be in substantially the following form:  
 47.35  STATE OF MINNESOTA                             DISTRICT COURT
 47.36  COUNTY OF ....................    ..........JUDICIAL DISTRICT
 48.1   ....................(Creditor) 
 48.2   ....................(Debtor)             CREDITOR'S OBJECTION
 48.3   ....................(Garnishee)            TO EXEMPTION CLAIM
 48.4      The creditor objects to your claim for exemption from 
 48.5   garnishment, levy of execution, order for attachment (strike 
 48.6   inapplicable language) for the following reason(s):  
 48.7   .................................................................
 48.8   .................................................................
 48.9   .................................................................
 48.10     Because of this objection, your financial institution will 
 48.11  retain the funds you claimed to be exempt for an additional ten 
 48.12  days.  If you wish to request a hearing on your exemption claim, 
 48.13  you should need to do so within ten days of your receipt of this 
 48.14  from the date the objection was personally served on you, or 
 48.15  within 13 days of the date the objection was mailed to you.  You 
 48.16  may request a hearing by completing the attached form and filing 
 48.17  it with the court administrator.  
 48.18     1.  The court shall provide clerical assistance to help 
 48.19  with the writing and filing of a Request for Hearing by any 
 48.20  person not represented by counsel.  The court administrator may 
 48.21  charge a fee of $1 for the filing of a Request for Hearing.  
 48.22     2.  Upon the filing of a Request for Hearing, the clerk 
 48.23  shall schedule the matter for a hearing no later than five 
 48.24  business days from the date of filing.  The court administrator 
 48.25  shall forthwith send a completed copy of the request, including 
 48.26  the hearing date, time, and place to the adverse party and to 
 48.27  the financial institution by first class mail.  
 48.28     3.  If it is possible that the financial institution might 
 48.29  not receive the request mailed from the court administrator 
 48.30  within ten days, then you may want to personally deliver a copy 
 48.31  of the request to the financial institution after you have filed 
 48.32  your request with the court.  
 48.33     4.  An order stating whether your funds are exempt shall be 
 48.34  issued by the court within three days of the date of the hearing.
 48.35     If you do not file a Request for Hearing within ten days of 
 48.36  the date you receive this objection the objection was personally 
 49.1   served on you, or within 13 days from the date the objection was 
 49.2   mailed to you, your financial institution may turn your funds 
 49.3   over to your creditor. 
 49.4      If you file a Request for Hearing and your financial 
 49.5   institution receives it within ten days of the date it received 
 49.6   this objection, your financial institution will retain your 
 49.7   funds claimed to be exempt until otherwise ordered by the court, 
 49.8   or until the garnishment lapses pursuant to Minnesota Statutes, 
 49.9   section 571.79. 
 49.10                            ..................................
 49.11                            (CREDITOR OR CREDITOR'S ATTORNEY.) 
 49.12     Sec. 24.  Minnesota Statutes 1999 Supplement, section 
 49.13  571.925, is amended to read: 
 49.14     571.925 [FORM OF NOTICE.] 
 49.15     The ten-day notice informing a debtor that a garnishment 
 49.16  summons may be used to garnish the earnings of an individual 
 49.17  must be substantially in the following form: 
 49.18  STATE OF MINNESOTA                             DISTRICT COURT
 49.19  COUNTY OF .............         ........... JUDICIAL DISTRICT
 49.20  ....................(Creditor)
 49.21  against
 49.22                                     GARNISHMENT EXEMPTION 
 49.23  ....................(Debtor)       NOTICE AND NOTICE OF 
 49.24  and                                INTENT TO GARNISH EARNINGS 
 49.25                                     WITHIN TEN DAYS
 49.26  ....................(Garnishee)
 49.27     PLEASE TAKE NOTICE that a garnishment summons or levy may 
 49.28  be served upon your employer or other third parties, without any 
 49.29  further court proceedings or notice to you, ten days or more 
 49.30  from the date hereof.  Some or all of your earnings are exempt 
 49.31  from garnishment.  If your earnings are garnished, your employer 
 49.32  must show you how the amount that is garnished from your 
 49.33  earnings was calculated.  You have the right to request a 
 49.34  hearing if you claim the garnishment is incorrect. 
 49.35     Your earnings are completely exempt from garnishment if you 
 49.36  are now a recipient of relief based on need, if you have been a 
 50.1   recipient of relief within the last six months, or if you have 
 50.2   been an inmate of a correctional institution in the last six 
 50.3   months. 
 50.4      Relief based on need includes the Minnesota Family 
 50.5   Investment Program (MFIP), Emergency Assistance (EA), Work First 
 50.6   Program, Medical Assistance (MA), General Assistance (GA), 
 50.7   General Assistance Medical Care (GAMC), Emergency General 
 50.8   Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA 
 50.9   Emergency Assistance (MSA-EA), Supplemental Security Income 
 50.10  (SSI), and Energy Assistance. 
 50.11     If you wish to claim an exemption, you should fill out the 
 50.12  appropriate form below, sign it, and send it to the creditor's 
 50.13  attorney and the garnishee. 
 50.14     You may wish to contact the attorney for the creditor in 
 50.15  order to arrange for a settlement of the debt or contact an 
 50.16  attorney to advise you about exemptions or other rights. 
 50.17                             PENALTIES
 50.18     (1) Be advised that even if you claim an exemption, a 
 50.19     garnishment summons may still be served on your employer.  
 50.20     If your earnings are garnished after you claim an 
 50.21     exemption, you may petition the court for a determination 
 50.22     of your exemption.  If the court finds that the creditor 
 50.23     disregarded your claim of exemption in bad faith, you will 
 50.24     be entitled to costs, reasonable attorney fees, actual 
 50.25     damages, and an amount not to exceed $100. 
 50.26     (2) HOWEVER, BE WARNED if you claim an exemption, the 
 50.27     creditor can also petition the court for a determination of 
 50.28     your exemption, and if the court finds that you claimed an 
 50.29     exemption in bad faith, you will be assessed costs and 
 50.30     reasonable attorney's fees plus an amount not to exceed 
 50.31     $100. 
 50.32     (3) If after receipt of this notice, you in bad faith take 
 50.33     action to frustrate the garnishment, thus requiring the 
 50.34     creditor to petition the court to resolve the problem, you 
 50.35     will be liable to the creditor for costs and reasonable 
 50.36     attorney's fees plus an amount not to exceed $100. 
 51.1   DATED:  ............           ........................
 51.2                                  (Attorney for) Creditor
 51.3                                  ........................
 51.4                                  Address
 51.5                                  ........................
 51.6                                  Telephone
 51.7                   DEBTOR'S EXEMPTION CLAIM NOTICE
 51.8      I hereby claim that my earnings are exempt from garnishment 
 51.9   because: 
 51.10     (1) I am presently a recipient of relief based on need. 
 51.11     (Specify the program, case number, and the county from 
 51.12     which relief is being received.) 
 51.13  ................    ......................   ...............
 51.14  Program             Case Number (if known)   County
 51.15     (2) I am not now receiving relief based on need, but I have 
 51.16     received relief based on need within the last six months.  
 51.17     (Specify the program, case number, and the county from 
 51.18     which relief has been received.) 
 51.19  ................    ......................   ...............
 51.20  Program             Case Number (if known)   County
 51.21     (3) I have been an inmate of a correctional institution 
 51.22     within the last six months.  (Specify the correctional 
 51.23     institution and location.) 
 51.24  ...........................       ..........................
 51.25  Correctional Institution          Location
 51.26     I hereby authorize any agency that has distributed relief 
 51.27  to me or any correctional institution in which I was an inmate 
 51.28  to disclose to the above-named creditor or the creditor's 
 51.29  attorney only whether or not I am or have been a recipient of 
 51.30  relief based on need or an inmate of a correctional institution 
 51.31  within the last six months.  I have mailed or delivered a copy 
 51.32  of this form to the creditor or creditor's attorney. 
 51.33  ...........................          .........................
 51.34  Date                                 Debtor
 51.35                                       .........................
 51.36                                       Address
 52.1                                        .........................
 52.2                                        Debtor Telephone Number
 52.3      Sec. 25.  [REPEALER.] 
 52.4      Minnesota Statutes 1998, section 571.80, is repealed.