US District Court - District of Colorado



IN THE UNITED STATES DISTRICT COURTFOR THE DISTRICT OF COLORADOCivil Action No.Plaintiff(s),v.Defendant(s).___________________________________________________________________________CLAIM OF EXEMPTION TO WRIT OF GARNISHMENT WITH NOTICE___________________________________________________________________________Instruction to Judgment Debtor: Use this form to claim your property is exempt from Garnishment.Name: __________________________________________ Phone Number ______________________Street Address: ______________________________________________________________________ Mailing Address, if different: ____________________________________________________________City:______________________________ State:________________________ Zip Code: ___________I believe the following property is exempt:Description of Property Being Held: _____________________________________________________Value of Property Being Held:$ _____________________Amount of Value I Claim is Exempt: $ _____________________I claim the Property is Exempt because (Please write the Exemption(s) listed in the Writ of Garnishment with Notice, if applicable):_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________I certify that the above is correct to the best of my knowledge and belief and that I sent a copy of this document by certified mail (return receipt requested) or by E-Service to both the Garnishee and to the Judgment Creditor, or if the Judgment Creditor is represented by Counsel, certified mail (return receipt requested) to the Judgment Creditor’s Attorney or E-Service to the Judgment Creditor’s Attorney. The person/place that was garnishedJudgment Creditor or AttorneyAddress: ________________________________________Address: ______________________________________________________________________________________________________________________________Subscribed under affirmation or oath ___________________________________________before me on ______________________(date)Signature of Judgment Debtor orJudgment Debtor’s Counsel and Reg. NumberMy commission expires: ____________________________________________________________________________Notary Public ................
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