Free State of Minnesota - Minnesota

State of Minnesota
County
Select County

District Court
Judicial District: Court File Number: Case Type: Civil

Plaintiff (Creditor/Debtor),

vs.

Request for Hearing and Notice for Hearing on Exemption Claim(s) (Minn. Stat. §§550.143, subd. 8; 551.05, subd. 6; 571.914, subd. 3)

Defendant (Creditor/Debtor).

Garnishee (Third Party)

I hereby request a hearing to resolve the exemption claim which has been made in this case regarding funds in the account of at the
Debtor Financial Institution ______________________________________________________________________________________________________________________________ Address City/State/Zip

I believe the property being held is exempt because:

Dated:
Debtor Address

Telephone Number

Hearing Date: Time: Hearing Place: ____________________________________

Note to both parties: Bring all documents and materials relevant to the exemption claim and objection to the hearing. Failure to do so could delay the court's decision.

JGM404

State

ENG

Rev 12/03

www.courts.state.mn.us/forms

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