Debtor Exempt Property

CIRCUIT COURT OF KNOX COUNTY ___________________________________ VS. _______________________________ PLAINTIFF DEFENDANT _______________________ DOCKET NUMBER DEBTOR'S FILING OR EXEMPT PROPERTY (OR AMENDMENT TO DEBTOR'S FILING OF EXEMPT PROPERTY) I, the Judgment Debtor herein and a resident of Tennessee, claim and declare the following items, the value of which does not exceed $10,000.00, to be exempt from execution , seizure or attachment pursuant to the provisions of Tennessee Code annotated 26-2-102 and 26-2-114 (or to amend the previous list filed to assert such exemption). The Following is my list (or revised list) of claim exemptions, which I make oath, is true and correct to the best of my knowledge, information and belief; ITEM AUTOMOBILES : VALUE ________________________________ ________________________________ FURNITURE : ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ________________________________ ________________________________ ________________________________ HOUSEHOLD GOODS: ________________________________ ________________________________ ________________________________ OTHER (INCLUDING, BUT NOT LIMITED TO BANK ACCOUNTS, CASH, ETC.): ________________________________ ________________________________ TOTAL I further declare the following items, the value of which does not exceed $750, to be exempt tools of the trade: _______________________________ _______________________________ TOTAL ____________________ ____________________ ____________________ This personal property exemption right is in addition to certain items that are automatically exempt by law and do not need to be listed, including: 1. All necessary and proper wearing apparel for the actual use of the debtor and the debtor's family and the trunks pr receptacles necessary to contain them (T.C.A. 26-2103(a)(1)). 2. All family portraits and pictures (T.C.A. 26-2-102(a)(2)). 3. The family Bible and school books (T.C.A. 26-2-103(a)(3)). These items are in addition to other exemption rights that may be provided by state or federal law. Judgment Debtor's Signature ____________________________________ Sworn to and subscribed before me the _____ day of ___________, 20___ ______________________________________ Notary Public/Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE I (Judgment Debtor) hereby certify that a true and correct copy of this document has been mailed by first class mail, postage prepaid or personally delivered to: _______________ _________________________________ on this ______ day of __________, 20_____. (Judgment Creditor/ Creditor's Attorney) ____________________________________ Judgment Debtor American LegalNet, Inc. www.FormsWorkFlow.com