Free in PDF - Oklahoma

In the District Court of _______________________ County State of Oklahoma

__________________________
Plaintiff vs. ____________________________ Defendant and ____________________________ Garnishee

)
) ) ) ) ) ) ) ) ) ) )

Case No. _______________

Claim for Exemption and Request for Hearing 1. Funds sought in garnishment are exempt from execution because they are (check applicable box):

G G G G G G G G G G G G G G G G G G G G G G

A. B. C. D. E. F. G. H. I. J. K. L. M. N. O. P. Q. R. S. T. U. V.

Social Security benefits ­ 42 U.S.C. § 407. Supplemental security income ­ 42 U.S.C. §1383(d). Unemployment benefits ­ 40 O.S. §2-303. Workmen's Compensation benefits ­ 85 O.S. §48. Welfare benefits ­ 56 O.S. §173. Veterans' benefits ­ 38 U.S.C. §3101, 31 O.S. §7. Monies in Possession of Police Pensions ­ 11 O.S. §50-124. Monies in Possession of Firemen's Relief & Pension Fund ­ 11 O.S. §49-126. Monies in Possession of County Employee's Retirement System ­ 19 O.S. §959. Monies in Possession of Public Employee's Retirement Fund ­ 74 O.S. §923. Teacher's Annuities or Retirement Allowance ­ 70 O.S. §17-109. Annuities and pension payments under Railroad Retirement Act ­ 45 U.S.C. §231(m) United States Civil Service Retirement and Disability Pension Fund Payments ­ 5 U.S.C. §8346. United States Civil Service Survivor Annuities ­ 5 U.S.C. §8346. Interest in Retirement, Pension and Profit Sharing Plans ­ 60 O.S. §327, 60 O.S. §328. The Wages of Seamen ­ 46 U.S.C. §601. Funds vested in the Alien Property Custodian ­ 50 U.S.C. Appx. §9(f). Prepaid Burial Benefits ­ 36 O.S. §6125. Proceeds of Group-Life Insurance Policy ­ 36 O.S. 3632, and 36 O.S. §4026. Alimony, support, separate maintenance, or child support necessary for support of judgment debtor or dependent ­ 31 O.S. §1.1. Personal wage exemption because of undue hardship ­ 31 O.S. §1.1. Other ( please state ): ________________________________________________

2.

Check one box:

G G
3.

All funds are exempt, or, I believe the following amount of money is exempt: $__________________________ (Fill in the amount of funds to be exempt).

Check if applicable:

G
4.

I have attached copies of the documents that show that my money is exempt.

If garnishment is for wages, this claim and request is filed for the pay period _________________ through ________________, inclusive. I request that this matter be set for hearing.

5.

_________________________________________
Signature

Address for mailing of Court Hearing Notice _________________________________________ _________________________________________

Address for mailing a copy of Claim to Judgment Creditor's Attorney: _________________________________________ _________________________________________

You must mail the original to the Court Clerk of ____________________County at the following address: _________________________________________________________________ _________________________________________________________________________

AOC Form 22
Revised 8/05