1.1 A bill for an act
1.2 relating to commerce; modifying various statutory forms pertaining to garnishment;
1.3 amending Minnesota Statutes 2024, sections 550.136, subdivisions 6, 9; 550.143,
1.4 subdivisions 2, 3a, 3b, 3c; 551.05, subdivisions 1b, 1c, 1d; 551.06, subdivisions
1.5 6, 9; 571.72, subdivisions 8, 10; 571.74; 571.75, subdivision 2; 571.912; 571.914,
1.6 subdivision 2; 571.925; 571.931, subdivision 6; 571.932, subdivision 2.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2024, section 550.136, subdivision 6, is amended to read:
1.9 Subd. 6.Earnings exemption notice.Before the first levy on earnings under this chapter,
1.10the judgment creditor shall serve upon the judgment debtor no less than ten days before the
1.11service of the writ of execution, a notice that the writ of execution may be served on the
1.12judgment debtor's employer. The notice must: (1) be substantially in the form set forth
1.13below; (2) be served personally, in the manner of a summons and complaint, or by first
1.14class mail to the last known address of the judgment debtor; (3) inform the judgment debtor
1.15that an execution levy may be served on the judgment debtor's employer in ten days, and
1.16that the judgment debtor may, within that time, cause to be served on the judgment creditor
1.17a signed statement under penalties of perjury asserting an entitlement to an exemption from
1.18execution; (4) inform the judgment debtor of the earnings exemptions contained in section
1.19550.37, subdivision 14; and (5) advise the judgment debtor of the relief set forth in this
1.20chapter to which the debtor may be entitled if a judgment creditor in bad faith disregards a
1.21valid claim and the fee, costs, and penalty that may be assessed against a judgment debtor
1.22who in bad faith falsely claims an exemption or in bad faith takes action to frustrate the
1.23execution process. The notice requirement of this subdivision does not apply to a levy on
1Section 1.
S2847-1 1st EngrossmentSF2847 REVISOR RSI
SENATE
STATE OF MINNESOTA
S.F. No. 2847NINETY-FOURTH SESSION
(SENATE AUTHORS: BOLDON)
OFFICIAL STATUSD-PGDATE
Introduction and first reading93603/20/2025
Referred to Judiciary and Public Safety
Comm report: To pass as amended04/01/2025
Second reading 2.1earnings being retained by an employer pursuant to a garnishment previously served in
2.2compliance with chapter 571.
2.3 The ten-day notice informing a judgment debtor that a writ of execution may be used
2.4to levy the earnings of an individual must be substantially in the following form:
DISTRICT COURT2.5STATE OF MINNESOTA
................................ JUDICIAL DISTRICT2.6COUNTY OF .........................................
2.7............................... (Judgment Creditor)
EXECUTION EXEMPTION2.8against
NOTICE AND NOTICE OF INTENT TO2.9................................. (Judgment Debtor)
LEVY ON EARNINGS2.10and
2.11........................................... (Third Party)
District Court2.12State of Minnesota
Judicial District: ...........................................2.13County of: ...............................................
2.14 Court File Number: ......................................
2.15 Case Type: ...................................................
2.16Creditor's full name
Execution Exemption2.17.................................................................
Notice and Notice of2.18against
Intent to Levy on Earnings2.19Debtor's full name
2.20.................................................................
2.21and
2.22Third Party (bank, employer, or other)
2.23.................................................................
2.24 PLEASE TAKE NOTICE that a levy may be served upon your employer or other third
2.25parties, without any further court proceedings or notice to you, ten days or more from the
2.26date hereof. Your earnings are completely exempt from execution levy if you are now a
2.27recipient of relief based on need, if you have been a recipient of relief within the last six
2.28months, or if you have been an inmate of a correctional institution in the last six months.
2.29 Relief based on need includes Minnesota Family Investment Program (MFIP), Emergency
2.30Assistance (EA), Work First, Medical Assistance (MA), General Assistance (GA), Emergency
2.31General Assistance (EGA), Minnesota Supplemental Aid (MSA), MSA Emergency
2.32Assistance (MSA-EA), Supplemental Security Income (SSI), and Energy Assistance.
2.33 If you wish to claim an exemption, you should fill out the appropriate form below, sign
2.34it, and send it to the judgment creditor's attorney.
2Section 1.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 3.1 You may wish to contact the attorney for the judgment creditor in order to arrange for
3.2a settlement of the debt or contact an attorney to advise you about exemptions or other
3.3rights.
3.4 Notice: A levy may be served on your employer or other third parties. A levy means
3.5that part of your earnings can be taken to pay off debts that you owe. This can happen
3.6in 10 days or more after you get this notice. This can happen without any other court action
3.7or notice to you. But some of your money may be protected.
3.8 Your earnings cannot be taken if:
3.9 (i) you are getting government assistance based on need,
3.10 (ii) you got any government assistance based on need in the last 6 months, or
3.11 (iii) you were an inmate of a correctional institution in the last 6 months.
3.12 These are called exemptions. Your money is NOT protected unless you fill out the
3.13Exemption Claim Notice attached and send it back to the creditor or the creditor's
3.14lawyer. If you are not sure if you have any exemptions, talk to a lawyer.
3.15 You can also contact the creditor or their lawyer to talk about a settlement of the debt.
3.16 Examples of government assistance based on need:
3.17 (i) MFIP - Minnesota Family Investment Program
3.18 (ii) DWP - MFIP Diversionary Work Program
3.19 (iii) SNAP - Supplemental Nutrition Assistance Program
3.20 (iv) GA - General Assistance
3.21 (v) EGA - Emergency General Assistance
3.22 (vi) MSA - Minnesota Supplemental Aid
3.23 (vii) MSA-EA - MSA Emergency Assistance
3.24 (viii) EA - Emergency Assistance
3.25 (ix) Energy or Fuel Assistance
3.26 (x) Work Participation Cash Benefit
3.27 (xi) MA - Medical Assistance
3.28 (xii) MinnesotaCare
3.29 (xiii) Medicare Part B - Premium Payments help
3Section 1.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 4.1 (xiv) Medicare Part D - Extra
4.2 (xv) SSI - Supplemental Security Income
4.3 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), MN Working family
4.4credit
4.5 (xvii) Renter's Refund (also called Renter's Property Tax Credit)
4.6 PENALTIES
4.7 Warnings and Fines
4.8 (1) Be advised that Even if you claim an exemption, an execution a levy may still be
4.9 served on your employer. If your earnings are levied on they take money from you after
4.10 you claim an exemption, you may petition ask the court for a determination of to review
4.11 your exemption. If the court finds that the judgment creditor disregarded ignored your
4.12 claim of exemption in bad faith, you will be are entitled to costs, reasonable attorney
4.13 lawyer fees, actual damages, and an amount not a fine up to exceed $100. Bad faith is
4.14 when someone does something wrong on purpose.
4.15 (2) HOWEVER, BE WARNED BUT if you claim an exemption, the judgment creditor
4.16 can also petition ask the court for a determination of to review your exemption, and. If
4.17 the court finds that you claimed an exemption in bad faith, you will be assessed are
4.18 charged costs and reasonable attorney's lawyer fees plus an amount not and a fine up to
4.19 exceed $100.
4.20 (3) If after receipt of this notice, you in bad faith take action to frustrate the execution
4.21 levy, thus requiring the judgment creditor to petition the court to resolve the problem,
4.22 you will be liable to the judgment creditor for costs and reasonable attorney's fees plus
4.23 an amount not to exceed $100.
4.24 (3) If you get this notice, then do something in bad faith to try to block or stop the levy
4.25 and the creditor has to take you to court because of it, you will have to pay the creditor's
4.26 costs, and reasonable lawyer fees, and a fine up to $100.
.................................................................4.27DATED: ...........................
4.28 (Attorney for Judgment Creditor)
4.29 .................................................................
4.30 Address
4.31 .................................................................
4.32 Telephone
4Section 1.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 5.1Date: ....................................................................................
5.2Creditor's Signature: ............................................................
5.3(or creditor's lawyer's signature)
5.4Creditor's Name: ..................................................................
5.5(or creditor's lawyer's name)
5.6Street Address: ....................................................................
5.7City/State/Zip: .....................................................................
Fax: ....................................5.8Phone: ....................................
5.9Email: ..................................................................................
5.10 JUDGMENT Debtor's Exemption Claim Notice
5.11 I hereby claim that my earnings are exempt from execution because: (check all that
5.12apply)
5.13 (1) ... I am presently a recipient of relief getting government assistance based on need.
5.14 (Specify State the program, case number if you know it, and the county from which
5.15 relief is being received you got it from.)
.............................................................................................5.16..............................................
CountyCase Number (if known)5.17Program
County: ................................Case #: ..................................5.18Program: ..............................
County: ................................Case #: ..................................5.19Program: ..............................
County: ................................Case #: ..................................5.20Program: ..............................
5.21 (2) ... I am not now receiving relief getting assistance based on need right now, but I
5.22 have received relief did get government assistance based on need within the last six 6
5.23 months. (Specify State the program, case number if you know it, and the county you got
5.24 it from which relief has been received.)
.............................................................................................5.25..............................................
CountyCase Number (if known)5.26Program
County: ................................Case #: ..................................5.27Program: ..............................
County: ................................Case #: ..................................5.28Program: ..............................
County: ................................Case #: ..................................5.29Program: ..............................
5.30 (3) ... I have been was an inmate of a correctional institution within the last six 6 months.
5.31 (Specify State the correctional institution and location.)
......................................................................5.32......................................................................
Location .......................................................5.33Correctional Institution ................................
5Section 1.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 6.1 I hereby authorize any agency that has distributed relief to me or any correctional
6.2institution in which I was an inmate to disclose to the above-named judgment creditor or
6.3the judgment creditor's attorney only whether or not I am or have been a recipient of relief
6.4based on need or an inmate of a correctional institution within the last six months. I have
6.5mailed or delivered a copy of this form to the judgment creditor or judgment creditor's
6.6attorney.
......................................................................6.7......................................................................
6.8 Debtor
6.9 ......................................................................
6.10 Address
6.11 ......................................................................
6.12 Debtor Telephone Number
6.13 I give my permission to any agency listed above to give information about my benefits
6.14to the creditor named above, or to the creditor's lawyer. The information will ONLY be if
6.15I get assistance, or if I have gotten assistance in the past 6 months. If I was an inmate in the
6.16last 6 months, I give my permission to the correctional institution to tell the creditor named
6.17above or the creditor's lawyer that I was an inmate there.
6.18Date: ....................................................................................
6.19Debtor's Signature: ..............................................................
6.20Debtor's Name: ....................................................................
6.21Street Address: ....................................................................
6.22City/State/Zip: .....................................................................
6.23Phone: ..................................................................................
6.24Email: ..................................................................................
6.25 Sec. 2. Minnesota Statutes 2024, section 550.136, subdivision 9, is amended to read:
6.26 Subd. 9.Execution earnings disclosure form and worksheet.The judgment creditor
6.27shall provide to the sheriff for service upon the judgment debtor's employer an execution
6.28earnings disclosure form and an earnings disclosure worksheet with the writ of execution,
6.29that must be substantially in the form set forth below.
DISTRICT COURT6.30STATE OF MINNESOTA
..................... JUDICIAL DISTRICT6.31COUNTY OF ..............................
6.32 FILE NO. .........
(Judgment Creditor)6.33...........................................
EARNINGS6.34against
6Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI EXECUTION(Judgment Debtor)7.1...........................................
DISCLOSURE7.2and
(Third Party)7.3...........................................
District Court7.4State of Minnesota
Judicial District: ...........................................7.5County of: ...............................................
7.6 Court File Number: ......................................
7.7 Case Type: ...................................................
7.8Creditor's full name
Earnings Execution Disclosure7.9.................................................................
For Non-Child Support Judgments7.10and
7.11Debtor's full name
7.12.................................................................
7.13Third Party (bank, employer, or other)
7.14.................................................................
7.15 This form is called an "Earnings Execution Disclosure" or "Disclosure." It is for the
7.16employer to fill out. The "debtor" is the person who owes money. The debtor gets a copy
7.17of this form for their own information.
7.18 The employer is also called the "third party garnishee" or "third party." The debtor is
7.19also called a "judgment debtor." If the debtor asks how the calculations in this document
7.20were made, the employer must provide information about it.
7.21 "EARNINGS": For the purpose of execution, "earnings" means compensation paid or
7.22payable to an employee for personal services or compensation paid or payable to the producer
7.23for the sale of agricultural products; milk or milk products; or fruit or other horticultural
7.24products produced when the producer is operating a family farm, a family farm corporation,
7.25or an authorized farm corporation, as defined in section 500.24, subdivision 2, whether
7.26denominated as wages, salary, commission, bonus, or otherwise, and includes periodic
7.27payments pursuant to a pension or retirement.
7.28 "DISPOSABLE EARNINGS": Means that part of the earnings of an individual remaining
7.29after the deduction from those earnings of amounts required by law to be withheld. (Amounts
7.30required by law to be withheld do not include items such as health insurance, charitable
7.31contributions, or other voluntary wage deductions.)
7.32 DEFINITIONS
7.33 "Earnings": what is paid or payable to an employee, independent contractor, or
7.34self-employed person for personal services (a job). Also called compensation. Compensation
7Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 8.1can be wages, salary, commission, bonuses, payments, profit-sharing distributions, severance
8.2payment, fees, or other. It includes periodic payments from a pension or retirement. It can
8.3also be compensation paid or payable to a producer for the sale of agricultural products.
8.4This can be things like milk or milk products, or fruit or other horticultural products. Or
8.5things produced in the operation of a family farm, a family farm corporation, or an authorized
8.6farm corporation. This is defined in Minnesota Statutes, section 500.24, subdivision 2.
8.7 "Disposable Earnings": the part of a person's earnings that are left after subtracting
8.8the amounts required by law to be withheld. Note: Amounts required by law to be withheld
8.9do not include things like health insurance, charitable contributions, or other voluntary wage
8.10deductions.
8.11 "Payday": For the purpose of execution, "payday(s)" means the date(s) upon which
8.12the date when the employer pays earnings to the debtor in the ordinary course of business
8.13for doing their job. If the judgment debtor has no regular payday, payday(s) then "payday"
8.14means the 15th and the last day of each month.
8.15 The Third Party/Employer Must Answer The Following Questions:
8.16 (1) Right now, do you now owe, or within 90 days from the date the execution levy was
8.17served on you, will you or may you owe money to the judgment debtor for earnings?
No .....8.18 Yes .....
8.19 (2) Does the judgment debtor earn more than $... per week? (this amount is the greater
8.20of $9.50 per hour or the federal minimum wage per week)
8.21 (2) Within 90 days from the date you were served with the levy, will you or may you
8.22owe money to the debtor for earnings?
No .....8.23 Yes .....
8.24 (3) Does the debtor earn more than the current Minnesota or federal minimum wage per
8.25week? (use the number that is more)
No .....8.26 Yes .....
8.27 A. If you answer "No" to question 1, 2, or 3, you don't need to answer the rest of the
8.28questions. You don't have to do the Earnings Disclosure Worksheet. Sign the Earnings
8.29Disclosure Affirmation below and return this disclosure form to the sheriff. You must return
8.30it within 20 days after it was served on you.
8Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 9.1 B. If you answer "Yes" to question 1 or 2, and "Yes" to question 3, sign the Earnings
9.2Disclosure Affirmation below. You must return it to the sheriff within 20 days. You must
9.3also fill out the rest of this form. Read the instructions for the Earnings Disclosure Worksheet.
9.4 Earnings Disclosure Affirmation
9.5 I, ................... (person signing Affirmation), am the third party/employer or I am
9.6authorized by the third party/employer to complete this earnings disclosure and have done
9.7so truthfully and to the best of my knowledge.
9.8Date: ....................................................................................
9.9Third Party's Name: .............................................................
9.10Third Party's Signature: .......................................................
Fax: ....................................9.11Phone: ....................................
9.12Email: ..................................................................................
9.13 Instructions for Completing the Earnings Disclosure Worksheet
9.14 A. If your answer to either question 1 or 2 is "No," then you must sign the affirmation
9.15below and return this disclosure to the sheriff within 20 days after it was served on you,
9.16and you do not need to answer the remaining questions.
9.17 B. If your answers to both questions 1 and 2 are "Yes," you must complete this form
9.18and the Earnings Disclosure Worksheet as follows:
9.19 For each payday that falls within 90 days from the date the execution levy was served
9.20 on you, you must calculate the amount of earnings to be retained by completing steps
9.21 3 through 11 on page 2, and enter the amounts on the Earnings Disclosure Worksheet.
9.22 UPON REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH
9.23 INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS
9.24 DISCLOSURE WERE MADE withheld. Enter the amounts on the Earnings Disclosure
9.25 Worksheet.
9.26 You must:
9.27 (1) Withhold the amount of earnings listed in Column I on the Earnings Disclosure
9.28Worksheet each payday.
9.29 (2) After 90 days, return this Earnings Disclosure Worksheet to the sheriff. Include all
9.30the money withheld. Sign the Affirmation at the end of the worksheet before returning.
9.31 (3) Deliver a copy of the disclosure and worksheet to the debtor within 10 days after the
9.32last payday that falls within the 90-day period.
9Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 10.1 If the debt (judgment) is fully paid off or if the debtor's job ends before the 90-day period
10.2is over, you need to do the last disclosure and withholdings within 10 days of their last
10.3payday that you withheld money.
10.4 Each payday, you must retain the amount of earnings listed in column I on the Earnings
10.5 Disclosure Worksheet.
10.6 You must pay the attached earnings and return this earnings disclosure form and the
10.7 Earnings Disclosure Worksheet to the sheriff and deliver a copy of the disclosure and
10.8 worksheet to the judgment debtor within ten days after the last payday that falls within
10.9 the 90-day period. If the judgment is wholly satisfied or if the judgment debtor's
10.10 employment ends before the expiration of the 90-day period, your disclosure and
10.11 remittance should be made within ten days after the last payday for which earnings were
10.12 attached.
10.13 For steps 3 through 11, "columns" refers to columns on the Earnings Disclosure
10.14Worksheet.
Enter the date of judgment debtor's payday.COLUMN A.10.15(3)
Enter judgment debtor's gross earnings for each payday.COLUMN B.10.16(4)
Enter judgment debtor's disposable earnings for each
10.18 payday.
COLUMN C.10.17(5)
Enter 25 percent of disposable earnings. (Multiply
10.20 column C by .25.)
COLUMN D.10.19(6)
Enter here the greater of 40 times $9.50 or 40 times the
10.22 hourly federal minimum wage ($..........) times the
COLUMN E.10.21(7)
10.23 number of work weeks included in each payday. (Note:
10.24 If a payday includes days in excess of whole work
10.25 weeks, the additional days should be counted as a
10.26 fraction of a work week equal to the number of
10.27 workdays in excess of a whole work week divided by
10.28 the number of workdays in a normal work week.)
Subtract the amount in column E from the amount in
10.30 column C, and enter here.
COLUMN F.10.29(8)
Enter here the lesser of the amount in column D and the
10.32 amount in column F.
COLUMN G.10.31(9)
Enter here any amount claimed by you as a setoff,
10.34 defense, lien, or claim, or any amount claimed by any
COLUMN H.10.33(10)
10.35 other person as an exemption or adverse interest which
10.36 would reduce the amount of earnings owing to the
10.37 judgment debtor. (Note: Any indebtedness to you
10.38 incurred within ten days prior to your receipt of the first
10.39 execution levy on a debt may not be set off against the
10.40 earnings otherwise subject to this levy. Any wage
10.41 assignment made by the judgment debtor within ten
10.42 days prior to your receipt of the first execution levy on
10.43 a debt is void.)
10Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 11.1 You must also describe your claim(s) and the claims of
11.2 others, if known, in the space provided below the
11.3 worksheet and state the name(s) and address(es) of these
11.4 persons.
11.5 Enter zero in column H if there are no claims by you or
11.6 others which would reduce the amount of earnings
11.7 owing to the judgment debtor.
Subtract the amount in column H from the amount in
11.9 column G and enter here. This is the amount of earnings
COLUMN I.11.8(11)
11.10 that you must remit for the payday for which the
11.11 calculations were made.
11.12 AFFIRMATION
11.13 I, ................... (person signing Affirmation), am the third party/employer or I am
11.14authorized by the third party/employer to complete this earnings disclosure, and have done
11.15so truthfully and to the best of my knowledge.
...........................................................11.16DATED: .......................................................
11.17 Signature
11.18 ...........................................................
11.19 Title
11.20 ...........................................................
11.21 Telephone Number
...........................................................11.22EARNINGS DISCLOSURE WORKSHEET
11.23 Debtor's Name
11.24 Calculating Percentage of Disposable Earnings
11.25 Note to Creditor: You must fill out this chart before sending this form to the employer.
11.26Use the current minimum wage found online at: https://www.dli.mn.gov/minwage.
11.27 Minimum Wage = $MW/hour.
11.28 then this percentage of the disposable
earnings are withheld:11.29 if the weekly gross earnings are:
0%11.30 Less than [40 X MW]
10%11.31 [40 X MW + .01] to [60 X MW]
15%11.32 [60 X MW + .01] to [80 X MW]
25%11.33 [80 x MW + .01] or more
11.34 Employer: Use this creditor's calculation chart to know what percentage of earnings
11.35should be withheld.
11.36 Earnings Disclosure Worksheet
11Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 12.1......................................................................
12.2Debtor's name
C - Disposable
Earnings
12.3 B - Gross
Earnings12.4A - Payday Date
$.......................$................................................12.51.
...........................................................................12.62.
...........................................................................12.73.
...........................................................................12.84.
...........................................................................12.95.
...........................................................................12.106.
...........................................................................12.117.
...........................................................................12.128.
...........................................................................12.139.
...........................................................................12.1410.
12.15 Column A. Enter the debtor's payday.
12.16 Column B. Enter the debtor's gross earnings for each payday.
12.17 Column C. Enter the debtor's disposable earnings for each payday.
F - Column C
minus Column E
E - Greater of 40
X $9.50 or 40 X
12.18D 25 - % of
12.19withholding of
MN or Fed.
Min. Wage
12.20Column C (Use the
12.21creditor's calculation)
...........................................................................12.221.
...........................................................................12.232.
...........................................................................12.243.
...........................................................................12.254.
...........................................................................12.265.
...........................................................................12.276.
...........................................................................12.287.
...........................................................................12.298.
...........................................................................12.309.
...........................................................................12.3110.
12.32 Column D. Enter the percentage of disposable earnings that will be withheld. Get this
12.33number from the creditor's calculation chart.
12.34 Column E. Calculate 40 times the current MN minimum wage (or 40 times the current
12.35federal minimum wage) times the number of work weeks in each payday. Enter the bigger
12.36number here. Note: If a payday has extra days that are more than a full work week, count
12Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 13.1those extra days as part of a work week. Do this by dividing the number of extra workdays
13.2by the number of workdays in a normal week.
13.3 Column F. Subtract the amount in Column E from the amount in Column C and enter
13.4here.
I - Column G
minus Column
H
13.5 H - Setoff, Lien,
Adverse
Interest, or
Other Claims
13.6G - Lesser of
13.7Column D and
13.8Column F
...........................................................................13.91.
...........................................................................13.102.
...........................................................................13.113.
...........................................................................13.124.
...........................................................................13.135.
...........................................................................13.146.
...........................................................................13.157.
...........................................................................13.168.
...........................................................................13.179.
...........................................................................13.1810.
$ ......................13.19 TOTAL OF COLUMN I
13.20 Column G. Look at Column D and Column F. Enter the smaller amount of the two here
13.21in Column G.
13.22 Column H. Enter any amount claimed by you that would lower the amount of earnings
13.23that will go to the debtor. Things like:
13.24 (i) a setoff,
13.25 (ii) a defense,
13.26 (iii) a lien,
13.27 (iv) a claim, or
13.28 (v) any amount claimed by any other person as an exemption or adverse interest.
13.29 Note: You must describe your claim(s) and the claims of others, if known, in the spaces
13.30after this worksheet.
13.31 Enter zero in Column H if there are no claims by you or others which would lower the
13.32amount of earnings owed to the debtor.
13Sec. 2.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 14.1 Note: Any debt that happened within 10 days before you got the first levy on a debt
14.2may not be set off against the earnings that are affected by this levy. Any wage assignment
14.3made by the debtor within 10 days before you got the first levy on a debt is void. Wage
14.4assignment is when a debtor voluntarily agrees to money being taken out of their earnings.
14.5 Column I. Subtract the amount in Column H from the amount in Column G and enter
14.6here. This is the amount of earnings that go to the creditor.
14.7 *If you entered any amount in Column H for any payday(s) payday, you must describe
14.8those claims below either your claims, or the claims of others. It doesn't matter if they are
14.9your claims, or the claims of others. For amounts claimed claims by others, you must both
14.10state list the names and addresses of such persons each, and the nature of describe their
14.11claim claims, if known you know.
14.12................................................................................................................................................
14.13................................................................................................................................................
14.14................................................................................................................................................
14.15................................................................................................................................................
14.16 Earnings Worksheet Affirmation
14.17 I, ................. (person signing Affirmation), am the third party party/employer or I am
14.18authorized by the third party party/employer to complete this earnings disclosure worksheet,
14.19and have done so truthfully and to the best of my knowledge.
14.20 ..............................................
14.21 Signature
(...) ......................................................................................14.22Dated: ..................................
Phone Number14.23 Title
14.24Date: ....................................................................................
14.25Third Party's Name: .............................................................
14.26Third Party's Signature: .......................................................
Fax: ....................................14.27Phone: ....................................
14.28Email: ..................................................................................
14.29Sec. 3. Minnesota Statutes 2024, section 550.143, subdivision 2, is amended to read:
14.30 Subd. 2.Disclosure form.Along with the writ of execution, the notice, instructions,
14.31and the exemption notice described in subdivision 3, the sheriff shall serve upon the financial
14.32institution an execution disclosure form which must be substantially in the following form:
14Sec. 3.
S2847-1 1st EngrossmentSF2847 REVISOR RSI DISTRICT COURT15.1STATE OF MINNESOTA
.................................JUDICIAL DISTRICT15.2COUNTY OF .........................................
15.3................................(Judgment Creditor)
FINANCIAL INSTITUTIONS15.4against
EXECUTION15.5..................................(Judgment Debtor)
DISCLOSURE15.6and
15.7............................................(Third Party)
District Court15.8State of Minnesota
Judicial District: ...........................................15.9County of: ...............................................
15.10 Court File Number: ......................................
15.11 Case Type: ...................................................
15.12Creditor's full name
Execution Disclosure15.13.................................................................
15.14against
15.15Debtor's full name
15.16.................................................................
15.17and
15.18Third Party (bank, employer, or other)
15.19.................................................................
15.20 This form is called a "Non-Earnings Disclosure" or "Disclosure." It is being sent to you
15.21because you might be holding property that belongs to the debtor, or you might owe money
15.22to the debtor.
15.23 You are the "third party" or "garnishee." The "debtor" is the person who owes money.
15.24The debtor is also called the "judgment debtor." The creditor is the person the debtor owes
15.25money to. The creditor is also called the "judgment creditor." The debtor owes
15.26$....................... to the creditor.
15.27 You must list any money or property you owe the debtor on the lines below and sign
15.28the affirmation. Write "none" on the line if that is your answer. You must then return this
15.29disclosure to the creditor (or the creditor's lawyer) within 20 days after you got it.
15.30 On the ..... day of ............., ......., the time of service of execution herein, there was due
15.31and owing the judgment debtor from the third party the following:
15.32 Fill in the date you got this disclosure:
15.33 ..................... (month) ..................... (day), .......................... (year)
15.34 On the date you got this disclosure, you owed the debtor:
15Sec. 3.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 16.1 (1) Money. Enter on the line below any amounts due and owing the judgment debtor,
16.2except earnings, from the third party. Write down the amount of money you owe the debtor
16.3(except earnings).
16.4................................................................................................................................................
16.5 (2) Property. Write a short description of any personal property, instruments, or papers
16.6belonging to the debtor that you have in your possession. List the monetary value of each
16.7thing.
16.8................................................................................................................................................
16.9 (2) (3) Setoff. Enter on the line below the amount of any setoff, defense, lien, or claim
16.10which the third party claims against the amount set forth on line (1). State the facts by which
16.11such setoff, defense, lien, or claim is claimed. (Any indebtedness to a third party incurred
16.12by the judgment debtor within ten days prior to the receipt of the first execution levy on a
16.13debt is void as to the judgment creditor.) If you claim a setoff, defense, lien, or claim against
16.14the amount on lines (1) and (2) above, enter that amount on the line below. State the facts
16.15about your claim. Note: Any payment the debtor makes to the garnishee within the 10 days
16.16before they get the first garnishment order on that debt can't be used to lower the amount
16.17that is being garnished.
16.18................................................................................................................................................
16.19 (3) (4) Exemption. Enter any amounts or property that the debtor claims is exempt on
16.20the line below any amounts or property claimed by the judgment debtor to be exempt from
16.21execution.
16.22................................................................................................................................................
16.23 (4) (5) Adverse Interest. Enter on the line below any amounts claimed by other persons
16.24by reason of ownership or interest in the judgment of the debtor's property that other people
16.25claim they own or have interest in.
16.26................................................................................................................................................
16.27 (5) (6) Enter on the line below the total of lines (2), (3), and (4) (3), (4), and (5) on the
16.28line below.
16.29................................................................................................................................................
16.30 (6) (7) Enter on the line below the difference obtained (never less than zero) when line
16.31(5) (6) is subtracted from the amount on line sum of lines (1) and (2) on the line below.
16.32................................................................................................................................................
16Sec. 3.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 17.1 (7) Enter on the line below (8) Figure out 110 percent of the amount of the judgment
17.2creditor's claim which remains is still unpaid. Enter it on the line below.
17.3................................................................................................................................................
17.4 (8) Enter on the line below the lesser of line (6) and line (7). You are hereby instructed
17.5to remit this amount only if it is $10 or more.
17.6 (9) Look at (7) and (8). Put the smaller number on the line below. Hold this amount only
17.7if it is $10 or more.
17.8................................................................................................................................................
17.9 AFFIRMATION
17.10 I, ....................... (person signing Affirmation), am the third party garnishee or I am
17.11authorized by the third party garnishee to complete this nonearnings non-earnings
17.12garnishment disclosure, and have done so truthfully and to the best of my knowledge.
.................................................................17.13Dated: ..........................................
17.14 Signature
17.15 .................................................................
17.16 Title
17.17 .................................................................
17.18 Telephone Number
17.19Date: ....................................................................................
17.20Name: ..................................................................................
17.21Signature: ............................................................................
17.22Title: ....................................................................................
Email: ................................17.23Phone: ....................................
17.24Sec. 4. Minnesota Statutes 2024, section 550.143, subdivision 3a, is amended to read:
17.25 Subd. 3a.Form of notice.The notice required by subdivision 3 must be provided as a
17.26separate form and must be substantially in the following form:
DISTRICT COURT17.27STATE OF MINNESOTA
............................JUDICIAL DISTRICT17.28COUNTY OF ..............................
17.29......................................(Creditor)
17.30........................................(Debtor)
17.31.........................................(Financial institution)
17Sec. 4.
S2847-1 1st EngrossmentSF2847 REVISOR RSI District Court18.1State of Minnesota
Judicial District: ...........................................18.2County of: ...............................................
18.3 Court File Number: ......................................
18.4 Case Type: ...................................................
18.5Creditor's full name
Notice of Levied Funds18.6.................................................................
18.7Debtor's full name
18.8.................................................................
18.9Third Party (bank, employer, or other)
18.10.................................................................
18.11 IMPORTANT NOTICE
18.12 YOUR FUNDS HAVE BEEN LEVIED
18.13 Money in Your Account Has Been Frozen
18.14 The creditor has frozen money in your account at your financial institution bank.
18.15 Your account balance is $.......
18.16 The amount being held is $.......
18.17 The amount being held will be is frozen for 14 days from the date of this notice.
18.18 Some of your money in your account may be protected (the legal word is exempt).
18.19You may be able to get it sooner than 14 days if you act quickly and follow the
18.20instructions on the next page.
18.21 The attached exemption form lists some different sources of ways money in your account
18.22that may be protected. If your money is comes from one or more of these sources a benefit
18.23on this list, place put a check on the line on the form next to the sources of your money in
18.24the box next to it. If it is from one of these sources, The creditor cannot can't take it.
18.25 BUT, if you want the bank to unfreeze your money, you must follow the instructions
18.26and return the exemption form and with copies of your bank statements from the last
18.2760 days to have the bank unfreeze your money. Instructions and the form are attached. If
18.28you do not don't follow the instructions, your financial institution will give bank gives the
18.29money to the Sheriff your creditor. If your creditor gets an order from the court or writ of
18.30execution, your bank gives the money to them. If that happens and it your money is protected,
18.31you can still get it back from the creditor later, but that is not as easy to do as filling in the
18.32form now. But filling out the form now is easiest.
18.33 See next pages for instructions and the exemption form.
18Sec. 4.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 19.1See the attached Exemption Form Instructions and Exemption Form for your next steps.
19.2 Sec. 5. Minnesota Statutes 2024, section 550.143, subdivision 3b, is amended to read:
19.3 Subd. 3b.Form of instructions.The instructions required by this section must be in a
19.4separate form and must be substantially in the following form:
19.5 Exemption Form Instructions
19.6 Note: The creditor is who you owe the money to. You are the debtor.
19.7 1. Fill out both of the attached exemption forms in this packet.
19.8 If you check one of the lines, you should also give proof. Use proof that shows show
19.9that some or all of the money in your account is from one or more of the protected sources.
19.10This might be letters or account statements. Creditors may ask for a hearing if they question
19.11your exemptions.
19.12 To avoid a hearing:
19.13 (i) Case numbers should be added to the form.
19.14 (ii) Copies of documents should be sent with the form.
19.15 Notice: You must send to the creditor's attorney (or to the creditor, if no attorney) copies
19.16of your bank statements for the past 60 days before the levy garnishment. Send them to the
19.17creditor's lawyer (or to the creditor, if there isn't a lawyer). Keep a copy of your bank
19.18statements in case there are questions about your claim. If you do not don't send bank
19.19statements to the creditor's attorney lawyer (or to the creditor, if no attorney) bank statements
19.20along with your exemption claim, the financial institution may release give your money to
19.21the Sheriff creditor. They would do this once the creditor gives them a court order saying
19.22they have to turn over the funds.
19.23 2. Sign the exemption forms. Make one a copy to keep for yourself.
19.24 3. Mail or deliver the other copies of the form by (insert date).
19.25 Both Copies Must Be Mailed or Delivered the Same Day.
19.26 One copy of the form and the copies of your bank statements go to:
19.27................................................................................................................................................
19.28(Insert name of creditor or creditor's attorney)
19.29................................................................................................................................................
19.30(Insert address of creditor or creditor's attorney)
19Sec. 5.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 20.1 One copy goes to:
20.2................................................................................................................................................
20.3(Insert name of bank)
20.4................................................................................................................................................
20.5(Insert address of bank)
20.6Creditor's Name: ..................................................................
20.7(or creditor's lawyer's name)
20.8Street Address: ....................................................................
20.9City/State/Zip: .....................................................................
Fax: ....................................20.10Phone: ....................................
20.11Email: ..................................................................................
20.12 One copy goes to:
20.13Bank's Name: .......................................................................
20.14Street Address: ....................................................................
20.15City/State/Zip: .....................................................................
Fax: ....................................20.16Phone: ....................................
20.17Email: ..................................................................................
20.18 How The Process Works
20.19 If You Do Not Don't Send in the Exemption Form and Bank Statements:
20.20 14 days after the date of this letter some or all of your money may be turned over to the
20.21creditor or to the sheriff. This happens once they get an order from the court telling the bank
20.22to do this.
20.23 If You Do Send in the Exemption Form and Bank Statements:
20.24 Any money that is NOT protected can be turned over to the sheriff creditor once they
20.25get an order from the court.
20.26 If the Creditor Does Not Object to Your Claimed Exemptions:
20.27 The financial institution will bank should unfreeze your money six 6 business days after
20.28the institution gets they get your completed form. If they don't, ask the creditor or the
20.29creditor's lawyer to send a release letter to the bank.
20.30 If the Creditor Objects to Your Claimed Exemptions:
20Sec. 5.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 21.1 The money you have said is protected on the form will be is held by the bank. The
21.2creditor has six 6 business days to object (disagree) and ask the court to hold a hearing. You
21.3will receive get a Notice of Objection and a Notice of Hearing.
21.4 The financial institution will hold bank holds the money until a court decides whether
21.5if your money is protected or not. Some reasons a creditor may object are because you did
21.6not didn't send copies of your bank statements or other proof of the benefits you received
21.7got. Be sure to include these when you send your exemption form.
21.8 You may want to talk to a lawyer for advice about this process. If you are low income
21.9you can call Legal Aid statewide at 1(877) 696-6529.
21.10 PENALTIES:
21.11 Warnings and Fines
21.12 If you claim that your money is protected and a court decides you made that claim in
21.13bad faith, the court they can order you to pay costs, actual damages, attorney lawyer fees,
21.14and an additional amount of a fine up to $100. Bad faith is when someone does something
21.15wrong on purpose. For example, it may be bad faith if you claim you receive get government
21.16benefits that and you do not receive don't.
21.17 If the creditor made a bad faith objection to your claim that your money is protected,
21.18the court can order them to pay costs, actual damages, attorney lawyer fees, and an additional
21.19amount of a fine up to $100.
21.20Sec. 6. Minnesota Statutes 2024, section 550.143, subdivision 3c, is amended to read:
21.21 Subd. 3c.Form of exemption form.The exemption form required by this subdivision
21.22must be sent as a separate form and must be in substantially the following form:
DISTRICT COURT21.23STATE OF MINNESOTA
............................JUDICIAL DISTRICT21.24COUNTY OF ..............................
21.25......................................(Creditor)
21.26........................................(Debtor)
21.27.........................................(Financial institution)
District Court21.28State of Minnesota
Judicial District: ...........................................21.29County of: ...............................................
21.30 Court File Number: ......................................
21.31 Case Type: ...................................................
21.32Creditor's full name
Exemption Form21.33.................................................................
21Sec. 6.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 22.1against
22.2Debtor's full name
22.3.................................................................
22.4Bank's name
22.5.................................................................
22.6 EXEMPTION FORM
How Much Money is Protected (Exempt)22.7A.
I claim ALL of the money being frozen by the bank is protected.22.8.........
I claim SOME of the money is protected. The amount I claim is protected is $.......22.9.........
Why The Money is Protected22.10B.
22.11 My money is protected because I get it from one or more of the following places:
22.12 (Check all that apply)
22.13 Earnings (Wages)
22.14 ALL or SOME of my wages may be protected.
Some of my wages are protected because they were only deposited in my account
22.16 in the last 20 days.
22.15.........
22.17 For wages that were deposited in your account within the last 20 days, the amount
22.18 protected is whichever is more:
22.19 (i) 75% or more of your wages (after taxes are taken out), or
22.20 (ii) The current minimum wage times 40 per week. You can find the current minimum
22.21 wage here: https://www.dli.mn.gov/minwage.
22.22 All of my wages are protected because:
I get government benefits (a list of government benefits is on the next page)22.23.........
I am getting other assistance based on need22.24.........
I have gotten government benefits in the last 6 months22.25.........
I was in jail or prison in the last 6 months22.26.........
22.27 If you check one of these 4 boxes, your wages are only protected for 60 days after
22.28 they are deposited in your account. You MUST send the creditor copies of bank
22.29 statements that show what was in your account for the 60 days right before the
22.30 bank froze your money.
Government benefits22.31.........
22.32 Government benefits include, but are not limited to, the following can include many
22.33 things. For example:
22.34 MFIP - Minnesota Family Investment Program,
22.35 MFIP Diversionary Work Program,
22.36 Work participation cash benefit,
22.37 GA - General Assistance,
22.38 EA - emergency assistance,
22.39 MA - medical assistance,
22.40 EGA - emergency general assistance,
22Sec. 6.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 23.1 MSA - Minnesota Supplemental Aid,
23.2 MSA-EA - MSA Emergency Assistance,
23.3 Supplemental Nutrition Assistance Program (SNAP),
23.4 SSI - Supplemental Security Income,
23.5 MinnesotaCare,
23.6 Medicare Part B premium payments,
23.7 Medicare Part D extra help,
23.8 Energy or fuel assistance.
23.9 (i) MFIP - Minnesota Family Investment Program
23.10 (ii) DWP - MFIP Diversionary Work Program
23.11 (iii) SNAP - Supplemental Nutrition Assistance Program
23.12 (iv) GA - General Assistance
23.13 (v) EGA - Emergency General Assistance
23.14 (vi) MSA - Minnesota Supplemental Aid
23.15 (vii) MSA-EA - MSA Emergency Assistance
23.16 (viii) EA - Emergency Assistance
23.17 (ix) Energy or Fuel Assistance
23.18 (x) Work Participation Cash Benefit
23.19 (xi) MA - Medical Assistance
23.20 (xii) MinnesotaCare
23.21 (xiii) Medicare Part B - Premium Payments help
23.22 (xiv) Medicare Part D - Extra
23.23 (xv) SSI - Supplemental Security Income
23.24 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), MN Working family
23.25 credit
23.26 (xvii) Renter's Refund (also called Renter's Property Tax Credit)
23.27LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
23.28..............................................................................................................................................
23.29 List the case number and county for every box you checked:
23.30 Case Number: .............................................. County: ..............................................
23.31 Case Number: .............................................. County: ..............................................
23.32 Case Number: .............................................. County: ..............................................
23.33 County: .....................................................................................................................
23.34 Government benefits also include:
Social Security benefits23.35.........
Unemployment benefits23.36.........
Workers' compensation23.37.........
Veterans Veterans' benefits23.38.........
23Sec. 6.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 24.1 If you receive get any of these government benefits, include copies of any documents
24.2 you have that show you receive Social Security, unemployment, workers'
24.3 compensation, or veterans benefits get them.
Other assistance based on need24.4.........
I get other assistance based on need that is not on the list. It comes from: ..............24.5.........
24.6 ...................................................................................................................................
24.7 Make sure you include copies of any documents that show this.
24.8You may have assistance based on need from another source that is not on the list. If you
24.9do, check this box, and fill in the source of your money on the line below:
24.10Source:...................................................................................................................................
24.11 Include copies of any documents you have that show the source of this money.
24.12EARNINGS
24.13 ALL or SOME of your earnings (wages) may also be protected.
All of your earnings (wages) are protected if:24.14.........
You get government benefits (see list of government benefits)24.15.........
You currently receive other assistance based on need24.16.........
You have received government benefits in the last six months24.17.........
You were in jail or prison in the last six months24.18.........
24.19 If you check one of these lines, your wages are only protected for 60 days after
24.20 they are deposited in your account so you MUST send the creditor a copy of
24.21 BANK STATEMENTS that show what was in your account for the 60 days right
24.22 before the bank froze your money.
Some of your earnings (wages) are protected.24.23.........
24.24 If all of your earnings are not exempt, then some of your earnings are still protected
24.25 for 20 days after they were deposited in your account. The amount protected is the
24.26 larger amount of:
24.27 75 percent of your wages (after taxes are taken out); or
24.28 (insert the sum of the current federal minimum wage) multiplied by 40.
Other Exempt Protected Funds24.29C.
24.30 The money from the following these things are also completely protected after they
24.31 are deposited in your my account.
Child support24.32.........
An accident, disability, or retirement A retirement, disability, or accident pension
24.34 or annuity
24.33.........
Earnings of my child who is under 18 years of age24.35.........
Payments to you me from a life insurance policy24.36.........
Earnings of your child who is under 18 years of age24.37.........
Child support24.38.........
Money paid to you me from a claim for damage or destruction of property. Property
24.40 includes household goods, farm tools or machinery, tools for your my job, business
24.39.........
24Sec. 6.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 25.1 equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes,
25.2 furniture, or appliances.
Death benefits paid to you me25.3.........
25.4 I give my permission to any agency that has given me cash benefits to give information
25.5about my benefits to the above-named creditor, or its attorney named above or to the creditor's
25.6lawyer. The information will ONLY concern whether be if I get benefits or not assistance,
25.7or whether if I have gotten them assistance in the past six 6 months. If I was an inmate in
25.8the last 6 months, I give my permission to the correctional institution to tell the creditor
25.9named above or the creditor's lawyer that I was an inmate there.
25.10 If I was an inmate in the last six months, I give my permission to the correctional
25.11institution to tell the above-named creditor that I was an inmate there.
25.12 You must sign and send this form and send it back to the creditor's Attorney lawyer
25.13(or to the creditor, if there is no attorney lawyer) and the bank. Remember to include
25.14a copy of your bank statements for the past 60 days. Fill in the blanks below and go
25.15back to the instructions to make sure you do did it correctly.
25.16 I have mailed or delivered a copy of this form to: the creditor's lawyer (or to the creditor,
25.17if there is no lawyer) at the address listed below.
25.18................................................................................................................................................
25.19(Insert name of creditor or creditor's attorney)
25.20................................................................................................................................................
25.21(Insert address of creditor or creditor's attorney)
25.22Creditor's Signature: ............................................................
25.23(or creditor's lawyer's signature)
25.24Creditor's Name: ..................................................................
25.25(or creditor's lawyer's name)
25.26Street Address: ....................................................................
25.27City/State/Zip: .....................................................................
Fax: ....................................25.28Phone: ....................................
25.29Email: ..................................................................................
25.30 I have also mailed or delivered a copy of this exemption form to my bank at the address
25.31listed in the instructions. below:
........................................................................................................................25.32DATED: .....
25.33 DEBTOR
25Sec. 6.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 26.1 ........................................................................................................................
26.2 DEBTOR ADDRESS
26.3 ........................................................................................................................
26.4 DEBTOR TELEPHONE NUMBER
26.5Bank's Name: .......................................................................
26.6Street Address: ....................................................................
26.7City/State/Zip: .....................................................................
Fax: ....................................26.8Phone: ....................................
26.9Email: ..................................................................................
26.10Date: ....................................................................................
26.11Debtor's Signature: ..............................................................
26.12Debtor's Name: ....................................................................
26.13Street Address: ....................................................................
26.14City/State/Zip: .....................................................................
26.15Phone: ..................................................................................
26.16Email: ..................................................................................
26.17Sec. 7. Minnesota Statutes 2024, section 551.05, subdivision 1b, is amended to read:
26.18 Subd. 1b.Form of notice.The notice must be a separate form and must be substantially
26.19in the following form:
DISTRICT COURT26.20STATE OF MINNESOTA
......................JUDICIAL DISTRICT26.21COUNTY OF ..............................
(Creditor)26.22...........................................
(Debtor)26.23...........................................
26.24 (Financial
institution)26.25...........................................
District Court26.26State of Minnesota
Judicial District: .....................................26.27County of: ..............................................
26.28 Court File Number: ................................
26.29 Case Type: ..............................................
26.30Creditor's full name:
26.31.................................................................
26.32Debtor's full name:
26.33.................................................................
26.34Third Party (bank, employer, or other):
26.35.................................................................
26Sec. 7.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 27.1 IMPORTANT NOTICE
27.2 YOUR FUNDS HAVE BEEN LEVIED
27.3 Money in Your Account Has Been Frozen
27.4The creditor has frozen money in your account at your financial institution bank.
27.5 Your account balance is $.......
27.6 The amount being held is $.......
27.7The amount being held will be is frozen for 14 days from the date of this notice.
27.8Some of your money in your account may be protected (the legal word is exempt). You
27.9may be able to get it sooner than 14 days if you act quickly and follow the instructions
27.10on the next page.
27.11The attached exemption form lists some different sources of ways money in your account
27.12that may be protected. If your money is from one or more of these sources, place a check
27.13on the line on the form next to the sources of your money. If it is from one of these sources,
27.14the Creditor cannot take it comes from a benefit on this list, put a check on the line next to
27.15it. The creditor can't take it.
27.16BUT, if you want the bank to unfreeze your money, you must follow the instructions and
27.17return the exemption form and with copies of your bank statements from the last 60
27.18days to have the bank unfreeze your money. Instructions and the form are attached. If you
27.19do not don't follow the instructions, your financial institution will give bank gives the money
27.20to the your creditor. If your creditor gets an order from the court or writ of execution, your
27.21bank gives the money to them. If that happens and it your money is protected, you can still
27.22get it back from the creditor later, but that is not as easy to do as filling in the form now.
27.23But filling out the form now is easiest.
27.24 See next pages for instructions and the exemption form.
27.25Sec. 8. Minnesota Statutes 2024, section 551.05, subdivision 1c, is amended to read:
27.26 Subd. 1c.Form of instructions.The instructions required must be in a separate form
27.27and must be substantially in the following form:
27.28 INSTRUCTIONS
27.29 Note: The creditor is who you owe the money to. You are the debtor.
27.30 1. Fill out both of the attached exemption forms in this packet.
27Sec. 8.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 28.1If you check one of the lines, you should also give proof that shows that some or all of
28.2the money in your account is from one or more of the protected sources. Creditors
28.3may ask for a hearing if they question your exemptions. To avoid a hearing:
28.4 Case numbers should be added to the form. Copies of documents should be sent
28.5with the form.
28.6If you check one of the lines, you should also give proof. Use proof that shows that some
28.7or all of the money in your account is from one or more of the protected sources. This might
28.8be letters or account statements. Creditors may ask for a hearing if they question your
28.9exemptions.
28.10 To avoid a hearing:
28.11 (i) Case numbers should be added to the form.
28.12 (ii) Copies of documents should be sent with the form.
28.13 Notice: YOU MUST SEND TO THE CREDITOR'S ATTORNEY (OR TO THE
28.14CREDITOR, IF NO ATTORNEY) COPIES OF YOUR BANK STATEMENTS FOR
28.15THE PAST 60 DAYS BEFORE THE LEVY. Keep a copy of your bank statements in
28.16case there are questions about your claim. If you do not send to the creditor's attorney
28.17(or to the creditor, if no attorney) bank statements with your exemption claim, the
28.18financial institution may release your money to the creditor.
28.19 Notice: You must send copies of your bank statements for the past 60 days before the
28.20garnishment. Send them to the creditor (or to the creditor's lawyer). Keep a copy of your
28.21bank statements in case there are questions about your claim. If you don't send bank
28.22statements to the creditor (or to the creditor's lawyer) along with your exemption claim, the
28.23financial institution may give your money to the creditor. They would do this once the
28.24creditor gives them a court order saying they have to turn over the funds.
28.25 2. Sign the exemption forms. Make one copy to keep for yourself.
28.26 3. Mail or deliver the other copies of the form by (insert date).
28.27 Both Copies Must Be Mailed or Delivered the Same Day.
28.28 One copy of the form and the copies of your bank statements go to:
28.29Creditor's Name: ..................................................................................................................
28.30(Insert name of creditor or creditor's attorney) (or creditor's lawyer's name)
28.31Street Address: .....................................................................................................................
28.32(Insert address of creditor or creditor's attorney) City/State/Zip: ........................................
28Sec. 8.
S2847-1 1st EngrossmentSF2847 REVISOR RSI Fax: ..............................................................29.1Phone: ..........................................................
29.2Email: ...................................................................................................................................
29.3 One copy goes to:
29.4Bank's Name: ...............................................
29.5(Insert name of bank) Street Address: .........
29.6City/State/Zip: ..............................................
Fax: ..............................................................29.7(Insert address of bank) Phone: ...................
29.8Email: ...........................................................
29.9 How The Process Works
29.10 If You Do Not Don't Send in the Exemption Form and Bank Statements:
29.1114 days after the date of this letter some or all of your money may be turned over to the
29.12creditor pursuant to Minnesota statute. This happens once they get an order from the court
29.13telling the bank to do this.
29.14 If You Do Send in the Exemption Form and Bank Statements:
29.15Any money that is NOT protected can be turned over to the creditor once they get an order
29.16from the court.
29.17 If the Creditor Does Not Object to Your Claimed Exemptions:
29.18The financial institution will unfreeze your money six business days after the institution
29.19gets your completed form. The bank should unfreeze your money 6 business days after they
29.20get your completed form. If they don't, ask the creditor or the creditor's lawyer to send a
29.21release letter to the bank.
29.22 If the Creditor Objects to Your Claimed Exemptions:
29.23The money you have said is protected on the form will be is held by the bank. The creditor
29.24has six 6 business days to object (disagree) and ask the court to hold a hearing. You will
29.25receive get a Notice of Objection and a Notice of Hearing.
29.26The financial institution will hold bank holds the money until a court decides whether if
29.27your money is protected or not. Some reasons a creditor may object are because you did
29.28not didn't send copies of your bank statements or other proof of the benefits you received
29.29got. Be sure to include these when you send your exemption form.
29.30You may want to talk to a lawyer for advice about this process. If you are low income you
29.31can call Legal Aid statewide at 1(877) 696-6529.
29.32 PENALTIES Warnings and Fines:
29Sec. 8.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 30.1If you claim that your money is protected and a court decides you made that claim in bad
30.2faith, the court they can order you to pay costs, actual damages, attorney lawyer fees, and
30.3an additional amount of a fine up to $100. Bad faith is when someone does something wrong
30.4on purpose. For example, it may be bad faith if you claim you receive get government
30.5benefits that you do not receive and you don't.
30.6If the creditor made a bad faith objection to your claim that your money is protected, the
30.7court can order them to pay costs, actual damages, attorney lawyer fees, and an additional
30.8amount of a fine up to $100.
30.9 Sec. 9. Minnesota Statutes 2024, section 551.05, subdivision 1d, is amended to read:
30.10 Subd. 1d.Form of exemption form.The exemption form required by this subdivision
30.11must be a separate form and must be in substantially the following form:
DISTRICT COURT30.12STATE OF MINNESOTA
......................JUDICIAL DISTRICT30.13COUNTY OF ..............................
(Creditor)30.14...........................................
(Debtor)30.15...........................................
30.16 (Financial
institution)30.17...........................................
District Court30.18State of Minnesota
Judicial District: .....................................30.19County of: ..............................................
30.20 Court File Number: ................................
30.21 Case Type: ..............................................
30.22Creditor's full name:
Exemption Form30.23.................................................................
30.24against
30.25Debtor's full name:
30.26.................................................................
30.27Bank's name:
30.28.................................................................
30.29 EXEMPTION FORM
How Much Money Is Protected (exempt)30.30A.
... I claim ALL of the money being frozen by the bank is protected.30.31.......
... I claim SOME of the money is protected. The amount I claim is protected is $........30.32.......
Why The Money Is Protected30.33B.
30.34 My money is protected because I get it from one or more of the following places:
30.35 (Check all that apply)
30Sec. 9.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 31.1 Earnings (Wages)
31.2 ALL or SOME of my wages may be protected.
31.3 ... Some of my wages are protected because they were only deposited in my
31.4 account in the last 20 days.
31.5 For wages that were deposited in your account within the last 20 days, the amount
31.6 protected is whichever is more:
31.7 (i) 75% of your wages or more (after taxes are taken out), or
31.8 (ii) The current minimum wage times 40 per week. You can find the current
31.9 minimum wage here: https://www.dli.mn.gov/minwage.
31.10 All of my wages are protected because:
31.11 ... I get government benefits (a list of government benefits is on the next page)
31.12 ... I am getting other assistance based on need
31.13 ... I have gotten government benefits in the last 6 months
31.14 ... I was in jail or prison in the last 6 months
31.15 If you check one of these 4 boxes, your wages are only protected for 60 days
31.16 after they are deposited in your account. You MUST send the creditor copies
31.17 of bank statements that show what was in your account for the 60 days right
31.18 before the bank froze your money.
Government benefits31.19.......
31.20 Government benefits can include, but are not limited to, the following many things.
31.21 For example:
31.22 MFIP - Minnesota family investment program,
31.23 MFIP Diversionary Work Program,
31.24 Work participation cash benefit,
31.25 GA - general assistance,
31.26 EA - emergency assistance,
31.27 MA - medical assistance,
31.28 EGA - emergency general assistance,
31.29 MSA - Minnesota supplemental aid,
31.30 MSA-EA - MSA emergency assistance,
31.31 Supplemental Nutrition Assistance Program (SNAP),
31.32 SSI - Supplemental Security Income,
31.33 MinnesotaCare,
31.34 Medicare Part B premium payments,
31.35 Medicare Part D extra help,
31.36 Energy or fuel assistance.
31.37LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
31.38..............................................................................................................................................
31.39LIST THE CASE NUMBER AND COUNTY
31.40 Case Number: .............................................................................................................
31Sec. 9.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 32.1 County: .......................................................................................................................
32.2 Government benefits also include:
Social Security benefits32.3.......
Unemployment benefits32.4.......
Workers' compensation32.5.......
Veterans benefits32.6.......
32.7 If you receive any of these government benefits, include copies of any documents
32.8 you have that show you receive Social Security, unemployment, workers'
32.9 compensation, or veterans benefits.
Other assistance based on need32.10.......
32.11You may have assistance based on need from another source that is not on the list. If you
32.12do, check this box, and fill in the source of your money on the line below:
32.13Source:...................................................................................................................................
32.14 Include copies of any documents you have that show the source of this money.
32.15EARNINGS
32.16 ALL or SOME of your earnings (wages) may also be protected.
All of your earnings (wages) are protected if:32.17.......
You get government benefits (see list of government benefits)32.18.......
You currently receive other assistance based on need32.19.......
You have received government benefits in the last six months32.20.......
You were in jail or prison in the last six months32.21.......
32.22 If you check one of these lines, your wages are only protected for 60 days after they
32.23 are deposited in your account so you MUST send the creditor a copy of BANK
32.24 STATEMENTS that show what was in your account for the 60 days right before
32.25 the bank froze your money.
Some of your earnings (wages) are protected.32.26.......
32.27 If all of your earnings are not exempt, then some of your earnings are still protected
32.28 for 20 days after they were deposited in your account. The amount protected is the
32.29 larger amount of:
32.30 75 percent of your wages (after taxes are taken out); or
32.31 (insert the sum of the current federal minimum wage) multiplied by 40.
32.32 OTHER EXEMPT FUNDS
32.33 The money from the following are also completely protected after they are deposited
32.34 in your account.
An accident, disability, or retirement pension or annuity32.35.......
Payments to you from a life insurance policy32.36.......
Earnings of your child who is under 18 years of age32.37.......
Child support32.38.......
32Sec. 9.
S2847-1 1st EngrossmentSF2847 REVISOR RSI Money paid to you from a claim for damage or destruction of property Property
33.2 includes household goods, farm tools or machinery, tools for your job, business
33.1.......
33.3 equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes,
33.4 furniture, or appliances.
Death benefits paid to you33.5.......
33.6 (i) MFIP - Minnesota Family Investment Program
33.7 (ii) DWP - MFIP Diversionary Work Program
33.8 (iii) SNAP - Supplemental Nutrition Assistance Program
33.9 (iv) GA - General Assistance
33.10 (v) EGA - Emergency General Assistance
33.11 (vi) MSA - Minnesota Supplemental Aid
33.12 (vii) MSA-EA - MSA Emergency Assistance
33.13 (viii) EA - Emergency Assistance
33.14 (ix) Energy or Fuel Assistance
33.15 (x) Work Participation Cash Benefit
33.16 (xi) MA - Medical Assistance
33.17 (xii) MinnesotaCare
33.18 (xiii) Medicare Part B - Premium Payments help
33.19 (xiv) Medicare Part D - Extra
33.20 (xv) SSI - Supplemental Security Income
33.21 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
33.22 Family Credit
33.23 (xvii) Renter's Refund (also called Renter's Property Tax Credit)
33.24List the case number and county for every
33.25box you checked:
County: ........................................................33.26Case Number: ..............................................
County: ........................................................33.27Case Number: ..............................................
County: ........................................................33.28Case Number: ..............................................
33.29Government benefits also include:
33.30... Social Security benefits
33.31... Unemployment benefits
33.32... Workers' compensation
33.33... Veterans' benefits
33.34If you get any of these government benefits, include copies of any documents that show
33.35you get them.
33.36 ... I get other assistance based on need that is not on the list. It comes from:
33.37 ..........................................................................................................................................
33Sec. 9.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 34.1 Make sure you include copies of any documents that show this.
Other Protected Funds34.2C.
34.3 The money from these things are also completely protected after they are deposited
34.4 in my account.
34.5 ... Child Support
34.6 ... A retirement, disability, or accident pension or annuity
34.7 ... Earnings of my child who is under 18 years of age
34.8 ... Payments to me from a life insurance policy
34.9 ... Money paid to me from a claim for damage or destruction of property. Property
34.10 includes household goods, farm tools or machinery, tools for my job, business
34.11 equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes,
34.12 furniture, or appliances.
34.13 ... Death benefits paid to me
34.14 I give my permission to any agency that has given me cash benefits to give information
34.15about my benefits to the above-named creditor, or its attorney creditor named above or to
34.16the creditor's lawyer. The information will ONLY concern whether I get benefits or not, or
34.17whether I have gotten them in the past six months be if I get assistance, or if I have gotten
34.18assistance in the past 6 months. If I was an inmate in the last six 6 months, I give my
34.19permission to the correctional institution to tell the above-named creditor named above or
34.20the creditor's lawyer that I was an inmate there.
34.21 YOU MUST SIGN AND SEND THIS FORM BACK TO THE CREDITOR'S
34.22ATTORNEY (OR TO THE CREDITOR, IF NO ATTORNEY) AND THE BANK.
34.23REMEMBER TO INCLUDE A COPY OF YOUR BANK STATEMENTS FOR THE
34.24PAST 60 DAYS. FILL IN THE BLANKS BELOW AND GO BACK TO THE
34.25INSTRUCTIONS TO MAKE SURE YOU DO IT CORRECTLY.
34.26 You must sign this form and send it back to the creditor's lawyer (or to the creditor,
34.27if there is no lawyer) and the bank. Remember to include a copy of your bank
34.28statements for the past 60 days. Fill in the blanks below and go back to the instructions
34.29to make sure you did it correctly.
34.30 I have mailed or delivered a copy of this form to: the creditor (or creditor's lawyer) at
34.31the address listed below.
34.32Creditor's Signature: ............................................................................................................
34.33(Insert name of creditor or creditor's attorney lawyer's signature)
34.34Creditor's Name: ..................................................................................................................
34.35(Insert address of creditor or creditor's attorney lawyer's name)
34Sec. 9.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 35.1Street Address: .............................................
35.2City/State/Zip: ..............................................
Fax: ..............................................................35.3Phone: ..........................................................
35.4Email: ...........................................................
35.5 I have also mailed or delivered a copy of this exemption form to my bank at the address
35.6listed in the instructions. below:
..........................................................................................................35.7DATED: ...................
35.8 DEBTOR
35.9 ..........................................................................................................
35.10 DEBTOR ADDRESS
35.11 ..........................................................................................................
35.12 DEBTOR TELEPHONE NUMBER
35.13Bank's Name: .....................................................................
35.14Street Address: ...................................................................
35.15City/State/Zip: ....................................................................
Fax: .....................................35.16Phone: ..................................
35.17Email: .................................................................................
35.18Date: ...................................................................................
35.19Debtor's Signature: .............................................................
35.20Debtor's Name: ...................................................................
35.21Street Address: ...................................................................
35.22City/State/Zip: ....................................................................
35.23Phone: .................................................................................
35.24Email: .................................................................................
35.25Sec. 10. Minnesota Statutes 2024, section 551.06, subdivision 6, is amended to read:
35.26 Subd. 6.Earnings exemption notice.Before the first levy on earnings, the attorney for
35.27the judgment creditor shall serve upon the judgment debtor no less than ten days before the
35.28service of the writ of execution, a notice that the writ of execution may be served on the
35.29judgment debtor's employer. The notice must: (1) be substantially in the form set forth
35.30below; (2) be served personally, in the manner of a summons and complaint, or by first
35.31class mail to the last known address of the judgment debtor; (3) inform the judgment debtor
35.32that an execution levy may be served on the judgment debtor's employer in ten days, and
35.33that the judgment debtor may, within that time, cause to be served on the judgment creditor's
35.34attorney a signed statement under penalties of perjury asserting an entitlement to an
35.35exemption from execution; (4) inform the judgment debtor of the earnings exemptions
35Sec. 10.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 36.1contained in section 550.37, subdivision 14; and (5) advise the judgment debtor of the relief
36.2set forth in this chapter to which the judgment debtor may be entitled if a judgment creditor
36.3in bad faith disregards a valid claim and the fee, costs, and penalty that may be assessed
36.4against a judgment debtor who in bad faith falsely claims an exemption or in bad faith takes
36.5action to frustrate the execution process. The notice requirement of this subdivision does
36.6not apply to a levy on earnings being held by an employer pursuant to a garnishment
36.7summons served in compliance with chapter 571.
36.8 The ten-day notice informing a judgment debtor that a writ of execution may be used
36.9to levy the earnings of an individual must be substantially in the following form:
DISTRICT COURT36.10STATE OF MINNESOTA
......................JUDICIAL DISTRICT36.11COUNTY OF ..............................
(Judgment Creditor)36.12...........................................
36.13against
36.14 EXECUTION EXEMPTION
36.15 NOTICE AND NOTICE OF
INTENT TO LEVY ON EARNINGS(Judgment Debtor)36.16...........................................
WITHIN TEN DAYS36.17and
(Third Party)36.18...........................................
36.19 PLEASE TAKE NOTICE that A levy may be served upon your employer or other third
36.20parties, without any further court proceedings or notice to you, ten days or more from the
36.21date hereof. Your earnings are completely exempt from execution levy if you are now a
36.22recipient of relief based on need, if you have been a recipient of relief within the last six
36.23months, or if you have been an inmate of a correctional institution in the last six months.
36.24 Relief based on need includes the Minnesota Family Investment Program (MFIP),
36.25Emergency Assistance (EA), Work First Program, Medical Assistance (MA), General
36.26Assistance (GA), Emergency General Assistance (EGA), Minnesota Supplemental Aid
36.27(MSA), MSA Emergency Assistance (MSA-EA), Supplemental Security Income (SSI), and
36.28Energy Assistance.
36.29 If you wish to claim an exemption, you should fill out the appropriate form below, sign
36.30it, and send it to the judgment creditor's attorney.
36.31 You may wish to contact the attorney for the judgment creditor in order to arrange for
36.32a settlement of the debt or contact an attorney to advise you about exemptions or other
36.33rights.
36Sec. 10.
S2847-1 1st EngrossmentSF2847 REVISOR RSI District Court37.1State of Minnesota
Judicial District: ...........................................37.2County of: ....................................................
37.3 Court File Number: ......................................
37.4 Case Type: ...................................................
37.5Creditor's full name:
Execution Exemption Notice and Notice of37.6......................................................................
Intent to Levy on Earnings37.7against
37.8Debtor's full name:
37.9......................................................................
37.10and
37.11Third Party (bank, employer, or other):
37.12......................................................................
37.13Notice: A levy may be served on your employer or other third parties. A levy means that
37.14part of your earnings can be taken to pay off debts that you owe. This can happen in
37.1510 days or more after you get this notice. This can happen without any other court action
37.16or notice to you. But some of your money may be protected.
37.17 Your earnings cannot be taken if:
37.18 (i) you are getting government assistance based on need,
37.19 (ii) you got any government assistance based on need in the last 6 months, or
37.20 (iii) you were an inmate of a correctional institution in the last 6 months.
37.21These are called exemptions. Your money is NOT protected unless you fill out the
37.22Exemption Claim Notice attached and send it back to the creditor or the creditor's
37.23lawyer. If you are not sure if you have any exemptions, talk to a lawyer.
37.24You can also contact the creditor or their lawyer to talk about a settlement of the debt.
37.25 Examples of government assistance based on need:
37.26 (i) MFIP - Minnesota Family Investment Program
37.27 (ii) DWP - MFIP Diversionary Work Program
37.28 (iii) SNAP - Supplemental Nutrition Assistance Program
37.29 (iv) GA - General Assistance
37.30 (v) EGA - Emergency General Assistance
37.31 (vi) MSA - Minnesota Supplemental Aid
37.32 (vii) MSA-EA - MSA Emergency Assistance
37.33 (viii) EA - Emergency Assistance
37.34 (ix) Energy or Fuel Assistance
37Sec. 10.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 38.1 (x) Work Participation Cash Benefit
38.2 (xi) MA - Medical Assistance
38.3 (xii) MinnesotaCare
38.4 (xiii) Medicare Part B - Premium Payments help
38.5 (xiv) Medicare Part D - Extra
38.6 (xv) SSI - Supplemental Security Income
38.7 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
38.8 Family Credit
38.9 (xvii) Renter's Refund (also called Renter's Property Tax Credit)
38.10 PENALTIES Warnings and Fines
38.11 (1) Be advised that even if you claim an exemption, an execution levy may still be served
38.12 on your employer. If your earnings are levied on after you claim an exemption, you may
38.13 petition the court for a determination of your exemption. If the court finds that the
38.14 judgment creditor disregarded your claim of exemption in bad faith, you will be entitled
38.15 to costs, reasonable attorney fees, actual damages, and an amount not to exceed $100.
38.16 Even if you claim an exemption, a levy may still be served on your employer. If they
38.17 take money from you after you claim an exemption, you may ask the court to review
38.18 your exemption. If the court finds that the creditor ignored your claim of exemption in
38.19 bad faith, you are entitled to costs, reasonable lawyer fees, actual damages, and a fine
38.20 up to $100. Bad faith is when someone does something wrong on purpose.
38.21 (2) HOWEVER, BE WARNED if you claim an exemption, the judgment creditor can
38.22 also petition the court for a determination of your exemption, and if the court finds that
38.23 you claimed an exemption in bad faith, you will be assessed costs and reasonable
38.24 attorney's fees plus an amount not to exceed $100. BUT if you claim an exemption, the
38.25 creditor can also ask the court to review your exemption. If the court finds that you
38.26 claimed an exemption in bad faith, you are charged costs and reasonable lawyer fees,
38.27 and a fine up to $100.
38.28 (3) If after receipt of this notice, you in bad faith take action to frustrate the execution
38.29 levy, thus requiring the judgment creditor to petition the court to resolve the problem,
38.30 you will be liable to the judgment creditor for costs and reasonable attorney's fees plus
38.31 an amount not to exceed $100. If you get this notice, then do something in bad faith to
38.32 try to block or stop the levy and the creditor has to take you to court because of it, you
38.33 will have to pay the creditor's costs, and reasonable lawyer's fees, and a fine up to $100.
.................................................................38.34DATED: ......................................
38.35 (Attorney for Judgment Creditor)
38Sec. 10.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 39.1 .................................................................
39.2 Address
39.3 .................................................................
39.4 Telephone
39.5Date: .............................................................
39.6Creditor's Signature: ....................................
39.7(or creditor's lawyer's signature)
39.8Creditor's Name: ..........................................
39.9(or creditor's lawyer's name)
39.10Street Address: .............................................
39.11City/State/Zip: ..............................................
Fax: ..............................................................39.12Phone: ..........................................................
39.13Email: ...........................................................
39.14 JUDGMENT DEBTOR'S EXEMPTION CLAIM NOTICE
39.15 Debtor's Exemption Claim Notice
39.16 I hereby claim that my earnings are exempt from execution because: (check all that
39.17apply)
39.18 (1) ... I am presently a recipient of relief getting government assistance based on need.
39.19 (Specify State the program, case number if you know it, and the county from which
39.20 relief is being received you got it from.)
.............................................................................................39.21..............................................
CountyCase Number (if known)39.22Program
County: ................................Case #: .................................39.23Program: ..............................
County: ................................Case #: .................................39.24Program: ..............................
County: ................................Case #: .................................39.25Program: ..............................
39.26 (2) ... I am not now receiving relief getting assistance based on need right now, but I
39.27 have received relief did get government assistance based on need within the last six 6
39.28 months. (Specify State the program, case number if you know it, and the county from
39.29 which relief has been received you got it from.)
.............................................................................................39.30.............................................
CountyCase Number (if known)39.31Program
County: ................................Case #: .................................39.32Program: ..............................
County: ................................Case #: .................................39.33Program: ..............................
County: ................................Case #: .................................39.34Program: ..............................
39Sec. 10.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 40.1 (3) ... I have been was an inmate of a correctional institution within the last six 6 months.
40.2 (Specify State the correctional institution and location.)
......................................................................40.3......................................................................
Location........................................................40.4Correctional Institution.................................
40.5 I hereby authorize any agency that has distributed relief to me or any correctional
40.6institution in which I was an inmate to disclose to the above-named judgment creditor or
40.7the judgment creditor's attorney only whether or not I am or have been a recipient of relief
40.8based on need or an inmate of a correctional institution within the last six months. I have
40.9mailed or delivered a copy of this form to the creditor or creditor's attorney.
......................................................40.10DATE: .........................................
40.11 Judgment Debtor
40.12 ......................................................
40.13 Address
40.14I give my permission to any agency listed above to give information about my benefits to
40.15the creditor named above, or to the creditor's lawyer. The information will ONLY be if I
40.16get assistance, or if I have gotten assistance in the past 6 months. If I was an inmate in the
40.17last 6 months, I give my permission to the correctional institution to tell the creditor named
40.18above or the creditor's lawyer that I was an inmate there.
40.19Date: .............................................................
40.20Debtor's Signature: ......................................
40.21Debtor's Name: ............................................
40.22Street Address: .............................................
40.23City/State/Zip: ..............................................
40.24Phone: ..........................................................
40.25Email: ...........................................................
40.26Sec. 11. Minnesota Statutes 2024, section 551.06, subdivision 9, is amended to read:
40.27 Subd. 9.Notice of levy on earnings, disclosure, and worksheet.The attorney for the
40.28judgment creditor shall serve upon the judgment debtor's employer a notice of levy on
40.29earnings and an execution earnings disclosure form and an earnings disclosure worksheet
40.30with the writ of execution, that must be substantially in the form set forth below.
DISTRICT COURT40.31STATE OF MINNESOTA
......................JUDICIAL DISTRICT40.32COUNTY OF ..............................
40.33 FILE NO. .........
(Judgment Creditor)40.34...........................................
40Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI NOTICE OF LEVY ON41.1against
41.2 EARNINGS AND DISCLOSURE
(Judgment Debtor)41.3...........................................
41.4and
(Third Party)41.5...........................................
41.6 PLEASE TAKE NOTICE that pursuant to Minnesota Statutes, sections 551.04 and
41.7551.06, the undersigned, as attorney for the judgment creditor, hereby makes demand and
41.8levies execution upon all earnings due and owing by you (up to $10,000) to the judgment
41.9debtor for the amount of the judgment specified below. A copy of the writ of execution
41.10issued by the court is enclosed. The unpaid judgment balance is $.....
41.11 This levy attaches all unpaid nonexempt disposable earnings owing or to be owed by
41.12you and earned or to be earned by the judgment debtor before and within the pay period in
41.13which the writ of execution is served and within all subsequent pay periods whose paydays
41.14occur within the 90 days after the service of this levy.
41.15 In responding to this levy, you are to complete the attached disclosure form and worksheet
41.16and mail it to the undersigned attorney for the judgment creditor, together with your check
41.17payable to the above-named judgment creditor, for the nonexempt amount owed by you to
41.18the judgment debtor or for which you are obligated to the judgment debtor, within the time
41.19limits set forth in the aforementioned statutes.
41.20 ......................................................
41.21 Attorney for the Judgment Creditor
41.22 ......................................................
41.23 ......................................................
41.24 ......................................................
41.25 Address
41.26 (...) ...............................................
41.27 Phone Number
41.28 DISCLOSURE
41.29 DEFINITIONS
41.30 "EARNINGS": For the purpose of execution, "earnings" means compensation paid or
41.31payable to an employee for personal services or compensation paid or payable to the producer
41.32for the sale of agricultural products; milk or milk products; or fruit or other horticultural
41.33products produced when the producer is operating a family farm, a family farm corporation,
41.34or an authorized farm corporation, as defined in section 500.24, subdivision 2, whether
41Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 42.1denominated as wages, salary, commission, bonus, or otherwise, and includes periodic
42.2payments pursuant to a pension or retirement.
42.3 "DISPOSABLE EARNINGS": Means that part of the earnings of an individual remaining
42.4after the deduction from those earnings of amounts required by law to be withheld. (Amounts
42.5required by law to be withheld do not include items such as health insurance, charitable
42.6contributions, or other voluntary wage deductions.)
42.7 "PAYDAY": For the purpose of execution, "payday(s)" means the date(s) upon which
42.8the employer pays earnings to the judgment debtor in the ordinary course of business. If
42.9the judgment debtor has no regular payday, payday(s) means the 15th and the last day of
42.10each month.
District Court42.11State of Minnesota
Judicial District: .....................................42.12County of: ...............................................
42.13 Court File Number: ................................
42.14 Case Type: ..............................................
42.15Creditor's full name:
42.16 Notice of Levy on Earnings for
Non-Child Support Judgements42.17.................................................................
42.18against
42.19Debtor's full name:
42.20.................................................................
42.21and
42.22Third Party (Debtor's Employer):
42.23.................................................................
42.24 To the employer:
42.25An employee of yours owes a judgment (money) to a creditor. The creditor's lawyer is
42.26starting a levy on the earnings you owe the employee. A levy means that you might have
42.27to hold part of the employee's earnings and send it to the creditor. By law, you have to do
42.28this. The limit on the levy is $10,000. A copy of the writ of execution from the court is
42.29enclosed. The amount of the judgment is $........
42.30The levy applies to "nonexempt disposable earnings" that you owe the employee. There are
42.31definitions and instructions below on how to calculate the amount, if any, you have to hold.
42.32The levy starts with the pay period when you got this levy. It continues for all pay periods
42.33in the 90 days after you got this levy.
42Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 43.1You must complete the attached disclosure form and worksheet. Then mail it to the lawyer
43.2listed below. If any money is owed under the levy, you must also send a check payable to
43.3the creditor listed above. Follow the steps and the deadlines explained below.
43.4Creditor's Name: ..........................................
43.5Creditor's Lawyer's Name: ...........................
43.6Street Address: .............................................
43.7City/State/Zip: ..............................................
Fax: ..............................................................43.8Phone: ..........................................................
43.9Email: ...........................................................
District Court43.10State of Minnesota
Judicial District: .....................................43.11County of: ...............................................
43.12 Court File Number: ................................
43.13 Case Type: ..............................................
43.14Creditor's full name:
43.15 Earnings Disclosure and Worksheet
For Non-Child Support Judgements43.16.................................................................
43.17against
43.18Debtor's full name:
43.19.................................................................
43.20and
43.21Third Party (Debtor's Employer):
43.22.................................................................
43.23This form is called an "Earnings Execution Disclosure" or "Disclosure." It is for the employer
43.24to fill out. The "debtor" is the person who owes money. The debtor gets a copy of this form
43.25for their own information.
43.26The employer is the "third party." The debtor is also called a "judgment debtor." If the debtor
43.27asks how the calculations in this document were made, the employer must provide
43.28information about it.
43.29Definitions
43.30 "Earnings": what is paid or payable to an employee, independent contractor, or
43.31self-employed person for personal services (a job). Also called compensation. Compensation
43.32can be wages, salary, commission, bonuses, payments, profit-sharing distributions, severance
43.33payment, fees, or other. It includes periodic payments from a pension or retirement. It can
43.34also be compensation paid or payable to a producer for the sale of agricultural products.
43.35This can be things like milk or milk products, or fruit or other horticultural products. Or
43Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 44.1things produced in the operation of a family farm, a family farm corporation, or an authorized
44.2farm corporation. This is defined in Minnesota Statutes, section 500.24, subdivision 2.
44.3 "Disposable Earnings": the part of a person's earnings that are left after subtracting
44.4the amounts required by law to be withheld. Note: Amounts required by law to be withheld
44.5do not include things like health insurance, charitable contributions, or other voluntary wage
44.6deductions.
44.7 "Payday": the date when the employer pays earnings to the debtor for doing their job.
44.8If the debtor has no regular payday, then "payday" means the 15th and the last day of each
44.9month.
44.10 THE THIRD PARTY/EMPLOYER MUST ANSWER THE FOLLOWING
44.11QUESTIONS:
44.12 1. Do you now owe, or within 90 days from the date the execution levy was served on
44.13you, will you or may you owe money to the judgment debtor for earnings? Right now, do
44.14you owe money to the debtor for earnings?
No .....44.15 Yes .....
44.16 2. Does the judgment debtor earn more than $... per week? (This amount is the greater
44.17of $9.50 per hour of the federal minimum wage per week.) Within 90 days from the date
44.18you were served with the levy, will you or may you owe money to the debtor for earnings?
No .....44.19 Yes .....
44.20 3. Does the debtor earn more than the current Minnesota or federal minimum wage per
44.21week? (use the number that is more)
No .....44.22 Yes .....
44.23 INSTRUCTIONS FOR COMPLETING THE
44.24 EARNINGS DISCLOSURE
44.25 A. If your answer to either question 1 or 2 is "No," then you must sign the affirmation
44.26on page 2 and return this disclosure to the judgment creditor's attorney within 20 days after
44.27it was served on you, and you do not need to answer the remaining questions. If you answer
44.28"No" to question 1, 2, or 3, you don't need to answer the rest of the questions. You don't
44.29have to do the Earnings Disclosure Worksheet. Sign the Earnings Disclosure Affirmation
44.30below and return this disclosure form to the sheriff. You must return it within 20 days after
44.31it was served on you.
44Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 45.1 B. If your answers to both questions 1 and 2 are "Yes," you must complete this form
45.2and the Earnings Disclosure Worksheet as follows: If you answer "Yes" to question 1 or 2,
45.3and "Yes" to question 3, sign the Earnings Disclosure Affirmation below. You must return
45.4it to the sheriff within 20 days. You must also fill out the rest of this form. Read the
45.5instructions for the Earnings Disclosure Worksheet.
45.6 For each payday that falls within 90 days from the date the execution levy was served
45.7 on you, YOU MUST calculate the amount of earnings to be retained by completing steps
45.8 3 through 11 on page 2, and enter the amounts on the Earnings Disclosure Worksheet.
45.9 UPON REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH
45.10 INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS
45.11 DISCLOSURE WERE MADE.
45.12 Each payday, you must retain the amount of earnings listed in column I on the Earnings
45.13 Disclosure Worksheet.
45.14 You must pay the attached earnings and return this Earnings Disclosure Form and the
45.15 Earnings Disclosure Worksheet to the judgment creditor's attorney and deliver a copy
45.16 to the judgment debtor within ten days after the last payday that falls within the 90-day
45.17 period.
45.18 If the judgment is wholly satisfied or if the judgment debtor's employment ends before
45.19 the expiration of the 90-day period, your disclosure and remittance should be made
45.20 within ten days after the last payday for which earnings were attached.
45.21For steps 3 through 11, "columns" refers to columns on the Earnings Disclosure Worksheet.
Enter the date of judgment debtor's payday.COLUMN A.45.223.
Enter judgment debtor's gross earnings for each payday.COLUMN B.45.234.
Enter judgment debtor's disposable earnings for each
45.25 payday.
COLUMN C.45.245.
Enter 25 percent of disposable earnings. (Multiply
45.27 Column C by .25.)
COLUMN D.45.266.
Enter here the greater of 40 times $9.50 or 40 times the
45.29 hourly federal minimum wage ($.......) times the number
COLUMN E.45.287.
45.30 of work weeks included in each payday. (Note: If a pay
45.31 period includes days in excess of whole work weeks,
45.32 the additional days should be counted as a fraction of a
45.33 work week equal to the number of workdays in excess
45.34 of a whole work week divided by the number of
45.35 workdays in a normal work week.)
Subtract the amount in Column E from the amount in
45.37 Column C, and enter here.
COLUMN F.45.368.
Enter here the lesser of the amount in Column D and
45.39 the amount in Column F.
COLUMN G.45.389.
45Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI Enter here any amount claimed by you as a setoff,
46.2 defense, lien, or claim, or any amount claimed by any
COLUMN H.46.110.
46.3 other person as an exemption or adverse interest which
46.4 would reduce the amount of earnings owing to the
46.5 judgment debtor. (Note: Any indebtedness to you
46.6 incurred within ten days prior to your receipt of the first
46.7 execution levy on a debt may not be set off against the
46.8 earnings otherwise subject to this levy. Any wage
46.9 assignment made by the judgment debtor within ten
46.10 days prior to your receipt of the first execution levy on
46.11 a debt is void.)
46.12 You must also describe your claim(s) and the claims of
46.13 others, if known, in the space provided below the
46.14 worksheet and state the name(s) and address(es) of these
46.15 persons.
46.16 Enter zero in Column H if there are no claims by you
46.17 or others which would reduce the amount of earnings
46.18 owing to the judgment debtor.
Subtract the amount in Column H from the amount in
46.20 Column G and enter here. This is the amount of earnings
COLUMN I.46.1911.
46.21 that you must retain for the payday for which the
46.22 calculations were made. The total of all amounts entered
46.23 in Column I is the amount to be remitted to the attorney
46.24 for the judgment creditor.
46.25 Earnings Disclosure Affirmation
46.26 I, ................... (person signing Affirmation), am the third party/employer or I am
46.27authorized by the third party/employer to complete this earnings disclosure, and have done
46.28so truthfully and to the best of my knowledge.
......................................................46.29Dated: .....................................................
46.30 Signature
46.31 ......................................................
46.32 Title
46.33 ......................................................
46.34 Telephone Number
46.35 EARNINGS DISCLOSURE WORKSHEET
46.36 ...................
46.37 Judgment Debtor's Name
46.38Date: ....................................................................................
46.39Third Party's Name: .............................................................
46.40Third Party's Signature: .......................................................
Fax: ....................................46.41Phone: ....................................
46.42Email: ..................................................................................
46Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 47.1Instructions for Completing the Earnings Disclosure Worksheet
47.2 For each payday that falls within 90 days from the date the levy was served on you, you
47.3must calculate the amount of earnings to be withheld. Enter the amounts on the Earnings
47.4Disclosure Worksheet.
47.5 You must:
47.6 1. Withhold the amount of earnings listed in column I on the Earnings Disclosure
47.7Worksheet each payday.
47.8 2. After 90 days, return this Earnings Disclosure Worksheet to the sheriff. Include all
47.9the money withheld. Sign the Affirmation at the end of the worksheet before returning.
47.10 3. Deliver a copy of the disclosure and worksheet to the debtor within 10 days after the
47.11last payday that falls within the 90-day period.
47.12 If the debt (judgment) is fully paid off or if the debtor's job ends before the 90-day period
47.13is over, you need to do the last disclosure and withholdings within 10 days of their last
47.14payday that you withheld money.
47.15 Calculating Percentage of Disposable Earnings
47.16 Note to Creditor: You must fill out this chart before sending this form to the employer.
47.17Use the current minimum wage found online at: https://www.dli.mn.gov/minwage.
47.18 Minimum Wage = $MW/hour.
47.19 then this percentage of the disposable
earnings are withheld:47.20 if the weekly gross earnings are:
0%47.21 Less than [40 X MW]
10%47.22 [40 X MW + .01] to [60 X MW]
15%47.23 [60 X MW + .01] to [80 X MW]
25%47.24 [80 X MW + .01] or more
47.25 Employer: Use this creditor's calculation chart to know what percentage of earnings
47.26should be withheld.
47.27 Earnings Disclosure Worksheet
47.28......................................................................
47.29Debtor's Name
CB47.30A
Disposable
47.32 Earnings
Gross Earnings47.31Payday Date
47Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI $........................$..................................................48.11.
..............................................................................48.22.
..............................................................................48.33.
..............................................................................48.44.
..............................................................................48.55.
..............................................................................48.66.
..............................................................................48.77.
..............................................................................48.88.
..............................................................................48.99.
..............................................................................48.1010.
48.11 Column A. Enter the debtor's payday.
48.12 Column B. Enter the debtor's gross earnings for each payday.
48.13 Column C. Enter the debtor's disposable earnings for each payday.
FE48.14D
Column C
minus Column E
Greater of 40 X
$9.50 or 40 X
48.1525% of withholding
48.16of Column C
MN or Fed.
Min. Wage
48.17(Use the creditor's
48.18calculation chart)
...........................................................................48.191.
...........................................................................48.202.
...........................................................................48.213.
...........................................................................48.224.
...........................................................................48.235.
...........................................................................48.246.
...........................................................................48.257.
...........................................................................48.268.
...........................................................................48.279.
...........................................................................48.2810.
48.29 Column D. Enter the percentage of disposable earnings that will be withheld. Get this
48.30number from the creditor's calculation chart.
48.31 Column E. Calculate 40 times the current Minnesota minimum wage (or 40 times the
48.32current federal minimum wage) times the number of work weeks in each payday. Enter the
48.33bigger number here. Note: If a payday has extra days that are more than a full work week,
48.34count those extra days as part of a work week. Do this by dividing the number of extra
48.35workdays by the number of workdays in a normal week.
48Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 49.1 Column F. Subtract the amount in Column E from the amount in Column C and enter
49.2here.
IH49.3G
Column G
minus Column
H
49.4 Setoff, Lien,
49.5 Adverse
Interest, or
Other Claims
49.6Lesser of Column D
49.7and Column F
...........................................................................49.81.
...........................................................................49.92.
...........................................................................49.103.
...........................................................................49.114.
...........................................................................49.125.
...........................................................................49.136.
...........................................................................49.147.
...........................................................................49.158.
...........................................................................49.169.
...........................................................................49.1710.
$ ......................49.18 TOTAL OF COLUMN I
49.19 Column G. Look at column D and column F. Enter the smaller amount of the two here
49.20in column G.
49.21 Column H. Enter any amount claimed by you that would lower the amount of earnings
49.22that will go to the debtor. Things like:
49.23 (i) a setoff,
49.24 (ii) a defense,
49.25 (iii) a lien,
49.26 (iv) a claim, or
49.27 (v) any amount claimed by any other person as an exemption or adverse interest.
49.28 Note: You must describe your claim(s) and the claims of others, if known, in the spaces
49.29after this worksheet.
49.30 Enter zero in column H if there are no claims by you or others which would lower the
49.31amount of earnings owed to the debtor.
49.32 Note: Any debt that happened within 10 days before you got the first levy on a debt
49.33may not be set off against the earnings that are affected by this levy. Any wage assignment
49Sec. 11.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 50.1made by the debtor within 10 days before you got the first levy on a debt is void. Wage
50.2assignment is when a debtor voluntarily agrees to money being taken out of their earnings.
50.3 Column I. Subtract the amount in column H from the amount in column G and enter
50.4here. This is the amount of earnings that go to the creditor.
50.5 *If you entered any amount in Column H for any payday(s), you must describe below
50.6either your claims, or the claims of others. For amounts claimed by others, you must both
50.7state the names and addresses of these persons, and the nature of their claim, if known.
50.8payday, describe those claims below. It doesn't matter if they are your claims, or the claims
50.9of others. For claims by others, list the names and addresses of each, and describe their
50.10claims, if you know.
50.11................................................................................................................................................
50.12................................................................................................................................................
50.13................................................................................................................................................
50.14................................................................................................................................................
50.15 Earnings Worksheet Affirmation
50.16 I, ................. (person signing Affirmation), am the third party/employer or I am authorized
50.17by the third party/employer to complete this earnings disclosure worksheet, and have done
50.18so truthfully and to the best of my knowledge.
50.19 ..............................................
50.20 Title
(...) ......................................................................................50.21Dated: ...................................
Phone Number50.22 Signature
50.23Date: ....................................................................................
50.24Third Party's Name: .............................................................
50.25Third Party's Signature: .......................................................
Fax: ....................................50.26Phone: ....................................
50.27Email: ..................................................................................
50.28Sec. 12. Minnesota Statutes 2024, section 571.72, subdivision 8, is amended to read:
50.29 Subd. 8.Exemption notice.In every garnishment where the debtor is a natural person,
50.30the debtor shall be provided with a garnishment exemption notice. If the creditor is garnishing
50.31earnings, the earnings exemption notice provided in section 571.924 must be served ten or
50.32more days before the service of the first garnishment summons. If the creditor is garnishing
50Sec. 12.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 51.1funds in a financial institution, the exemption notice provided in section 571.912 must be
51.2served with the garnishment summons. In all other cases, the exemption notice must be in
51.3the following form and served on the debtor with a copy of the garnishment summons.
DISTRICT COURT51.4STATE OF MINNESOTA
............................JUDICIAL DISTRICT51.5COUNTY OF .........................................
51.6.................................................(Creditor)
51.7against
EXEMPTION NOTICE51.8...................................................(Debtor)
51.9and
51.10..............................................(Garnishee)
District Court51.11State of Minnesota
Judicial District: .....................................51.12County of: ...............................................
51.13 Court File Number: ................................
51.14 Case Type: ..............................................
51.15Creditor's full name
Exemption Notice51.16.................................................................
51.17against
51.18Debtor's full name
51.19.................................................................
51.20and
51.21Third Party (bank, employer, or other)
51.22.................................................................
51.23A Garnishment Summons is being served upon on you. This means a creditor with a court
51.24judgment against you wants to take some of your money or property to pay the judgment.
51.25Some of your property may be exempt and cannot can't be garnished taken. 'Exempt' means
51.26protected. The following is a list of some of the more common exemptions. It is not a
51.27complete and is subject to list. For full details and dollar amounts set by law see section
51.28550.37 of the Minnesota Statutes and other state and federal laws. The dollar amounts
51.29contained in this list are subject to the provisions of section 550.37, subdivision 4a, at the
51.30time of garnishment. If you have questions about an exemption, you should obtain contact
51.31a lawyer for legal advice.
51.32 These things you or your family might have are protected:
51.33 (1) a homestead or the proceeds from the sale of a homestead equity in your home, or
51.34money from recently selling your home - up to $510,000 total;
51.35 (2)(i) all clothing, one watch, utensils, and foodstuffs;
51Sec. 12.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 52.1 (ii) household furniture, household appliances, phonographs, radios, and computers,
52.2tablets, televisions up to a total current value of $5,850;, printers, cell phones, smart phones,
52.3and other consumer electronics up to $12,150 in all; and
52.4 (iii) jewelry - total value can't be more than $3,308;
52.5 (3) a manufactured (mobile) home used as your home you live in;
52.6 (4) one motor vehicle currently worth less than $2,600 after deducting any security
52.7interest;, counting only the amount you have paid off:
52.8 (i) $10,000;
52.9 (ii) $12,500 if it is necessary for your business, trade, or profession;
52.10 (iii) $25,000 if used by or to help someone with a disability that makes it hard to walk;
52.11or
52.12 (iv) $100,000 if designed or modified for someone with a disability that makes it hard
52.13to walk;
52.14 (5) farm machinery used by an individual principally engaged in farming, or if your
52.15main business is farming. Tools, machines, or office furniture used in your business or trade.
52.16This exemption is limited to - the total value can't be more than $13,000;
52.17 (6) relief based on need. This includes:
52.18 (i) MFIP - Minnesota Family Investment Program (MFIP) and Work First Program;
52.19 (ii) DWP - MFIP Diversionary Work Program;
52.20 (ii) Medical Assistance (MA);
52.21 (iii) SNAP - Supplemental Nutrition Assistance Program;
52.22 (iii) (iv) GA - General Assistance (GA);
52.23 (iv) (v) EGA - Emergency General Assistance (EGA);
52.24 (v) (vi) MSA - Minnesota Supplemental Aid (MSA);
52.25 (vi) MSA-Emergency (vii) MSA-EA - MSA Emergency Assistance (MSA-EA);
52.26 (vii) Supplemental Security Income (SSI);
52.27 (viii) Energy Assistance; and
52.28 (ix) (viii) EA - Emergency Assistance (EA);
52.29 (ix) Energy or Fuel Assistance;
52Sec. 12.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 53.1 (x) Work Participation Cash Benefit;
53.2 (xi) MA - Medical Assistance;
53.3 (xii) MinnesotaCare;
53.4 (xiii) Medicare Part B - Premium Payments help;
53.5 (xiv) Medicare Part D - Extra;
53.6 (xv) SSI - Supplemental Security Income;
53.7 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
53.8Family Credit; and
53.9 (xvii) Renter's Refund (also called Renter's Property Tax Credit);
53.10 (7) wages. 100% is protected if you get government assistance based on need. Otherwise,
53.11between 75-100% is protected depending on how much you earn;
53.12 (8) retirement benefits - the total interest under all plans and contracts can't be more than
53.13$81,000;
53.14 (7) (9) Social Security benefits;
53.15 (8) (10) unemployment benefits, workers' compensation, or veteran's veterans' benefits;
53.16 (9) an accident, disability, or retirement (11) a retirement, disability, or accident pension
53.17or annuity;
53.18 (10) (12) life insurance proceeds that are not more than $54,000;
53.19 (11) (13) earnings of your minor child; and
53.20 (12) (14) money from a claim for damage or destruction of exempt property (such as -
53.21like household goods, farm tools, business equipment, a manufactured (mobile) home, or
53.22a car). car;
53.23 (15) sacred possessions - like the Bible, Torah, Qur'an, prayer rug, and other religious
53.24items. Total value can't be more than $2,000;
53.25 (16) personal library - total value can't be more than $750;
53.26 (17) musical instruments - total value can't be more than $2,000;
53.27 (18) family pets - current value can't be more than $1,000;
53.28 (19) a seat or pew in any house or place of public worship and a lot in any burial ground;
53Sec. 12.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 54.1 (20) tools you need to work in your business or profession - the total value can't be more
54.2than $13,500;
54.3 (21) household tools and equipment - things like hand and power tools, snow removal
54.4equipment, lawnmowers, and more. Total value can't be more than $3,000; and
54.5 (22) health savings accounts, medical savings accounts - the total value can't be more
54.6than $25,000.
54.7 Sec. 13. Minnesota Statutes 2024, section 571.72, subdivision 10, is amended to read:
54.8 Subd. 10.Exemption notice for prejudgment garnishment.
54.9 Exemption Notice
54.10 Important Notice: A garnishment summons may be served on your employer, bank,
54.11or other third parties. This can happen without any further court proceeding or notice to
54.12you. See the attached Notice of Intent to Garnish for more information.
54.13 The following money and wages Some of your money in your account may be
54.14protected (the legal word is exempt) from garnishment:.
54.15 1. Financial institutions/bank
54.16 Some of the money in your account may be protected because you receive government
54.17benefits from one or more of the following places:
54.18 Earnings (Wages)
54.19 ALL or SOME of my wages may be protected.
54.20 ... Some of my wages are protected because they were only deposited in my account in
54.21the last 20 days.
54.22For wages that were deposited in your account within the last 20 days, the amount protected
54.23is whichever is more:
54.24 (i) 75 percent of your wages or more (after taxes are taken out), or
54.25 (ii) The current minimum wage times 40 per week. You can find the current minimum
54.26wage here: https://www.dli.mn.gov/minwage.
54.27 All of my wages are protected because:
54.28 ... I get government benefits (a list of government benefits is on the next page)
54.29 ... I am getting other assistance based on need
54Sec. 13.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 55.1 ... I have gotten government benefits in the last 6 months
55.2 ... I was in jail or prison in the last 6 months
55.3If you check one of these four boxes, your wages are only protected for 60 days after they
55.4are deposited in your account. You MUST send the creditor copies of bank statements
55.5that show what was in your account for the 60 days right before the bank froze your
55.6money.
55.7 Government Benefits
55.8 Government benefits can include many things. For example:
55.9 ... MFIP - Minnesota Family Investment Program,
55.10 ... DWP - MFIP Diversionary Work Program,
55.11 Work participation cash benefit,
55.12 ... SNAP - Supplemental Nutrition Assistance Program
55.13 ... GA - General Assistance,
55.14 ... EGA - Emergency General Assistance
55.15 ... MSA - Minnesota Supplemental Aid
55.16 ... MSA-EA - MSA Emergency Assistance
55.17 ... EA - Emergency Assistance,
55.18 ... Energy or Fuel Assistance
55.19 ... Work Participation Cash Benefit
55.20 ... MA - Medical Assistance,
55.21 EGA - emergency general assistance or county crisis funds,
55.22 MSA - Minnesota supplemental aid,
55.23 MSA-EA - MSA emergency assistance,
55.24 Supplemental Nutrition Assistance Program (SNAP),
55.25 SSI - Supplemental Security Income,
55.26 ... MinnesotaCare,
55.27 ... Medicare Part B - Premium Payments, help
55.28 ... Medicare Part D - Extra help,
55Sec. 13.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 56.1 ... SSI - Supplemental Security Income
56.2 Energy or fuel assistance,
56.3 ... Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working Family
56.4Credit
56.5 ... Renter's Refund (also called Renter's Property Tax Credit)
56.6 List the case number and county for every box you checked:
County: ........................................................56.7Case Number: ..............................................
County: ........................................................56.8Case Number: ..............................................
County: ........................................................56.9Case Number: ..............................................
56.10 Government benefits also include:
56.11 ... Social Security benefits,
56.12 ... Unemployment benefits,
56.13 ... Workers' compensation,
56.14 Veterans ... Veterans' benefits.
56.15 Sending the creditor's attorney (or creditor, if no attorney) a copy of BANK
56.16STATEMENTS that show what was in your account for the past 60 days may give the
56.17creditor enough information about your exemption claim to avoid a garnishment.
56.18 2. Earnings
56.19 All or some of your earnings may be completely protected from garnishment if:
56.20 All of your earnings (wages) may be protected if:
56.21 You get government benefits (see list of government benefits)
56.22 You currently receive other assistance based on need
56.23 You have received government benefits in the last six months
56.24 You were in jail or prison in the last six months
56.25 Your wages are only protected for 60 days after they are deposited in your account so
56.26it would be helpful if you immediately send the undersigned creditor a copy of BANK
56.27STATEMENTS that show what was in your account for the past 60 days.
56.28 Some of your earnings (wages) may be protected if:
56Sec. 13.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 57.1 If all of your earnings are not exempt, some of your earnings may still be protected for
57.220 days after they were deposited in your account. The amount protected is the larger amount
57.3of:
57.4 75 percent of your wages (after taxes are taken out); or
57.5 (insert the sum of the current federal minimum wage) multiplied by 40.
57.6 If you get any of these government benefits, include copies of any documents that show
57.7you get them.
57.8 ... I get other assistance based on need that is not on the list. It comes from:..................
57.9 ..........................................................................................................................................
57.10 Make sure you include copies of any documents that show this.
57.11 Other Protected Funds
57.12 The money from the following these things are also exempt for 20 days completely
57.13protected after they are deposited in your my account.
57.14 ... Child Support
57.15 An accident, disability, or retirement ... A retirement, disability, or accident pension
57.16or annuity
57.17 Payments to you from a life insurance policy
57.18 ... Earnings of your my child who is under 18 years of age
57.19 ... Payments to me from a life insurance policy
57.20 Child support
57.21 ... Money paid to you me from a claim for damage or destruction of property. Property
57.22includes household goods, farm tools or machinery, tools for your my job, business
57.23equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture,
57.24or appliances.
57.25 ... Death benefits paid to you. me
57.26 You WILL BE ABLE TO can claim these exemptions when you RECEIVE get a
57.27notice. You will get the notice at least ten 10 days BEFORE a wage garnishment. BUT if
57.28the creditor garnishes your bank account, you will not won't get the notice until AFTER the
57.29account has been frozen. If you believe the money in your bank account or your wages are
57.30exempt, YOU SHOULD IMMEDIATELY contact the person below right away. YOU
57Sec. 13.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 58.1SHOULD Tell them why you think your account or wages are exempt to see if you can
58.2avoid garnishment.
58.3Creditor ................................................................................................................................
58.4Creditor Address ..................................................................................................................
58.5Creditor telephone number ..................................................................................................
58.6Creditor's Name: ..................................................................
58.7(or creditor's lawyer's name)
58.8Street Address: ....................................................................
58.9City/State/Zip: .....................................................................
Fax: ....................................58.10Phone: ....................................
58.11Email: ..................................................................................
58.12Sec. 14. Minnesota Statutes 2024, section 571.74, is amended to read:
58.13 571.74 GARNISHMENT SUMMONS AND NOTICE TO DEBTOR.
58.14 The garnishment summons and notice to debtor must be substantially in the following
58.15form. The notice to debtor must be in no smaller than 14-point type.
58.16 GARNISHMENT SUMMONS
DISTRICT COURT58.17STATE OF MINNESOTA
........................... JUDICIAL DISTRICT58.18COUNTY OF .........................................
58.19................................................ (Creditor)
UNPAID BALANCE .............................58.20.................................................. (Debtor)
Date of Entry58.21.................................. (Debtor's Address)
of Judgment (or) Subject to Minnesota
58.23 Statutes, section 571.71, clause (2)
58.22............................................. (Garnishee)
District Court58.24State of Minnesota
Judicial District: .....................................58.25County of: ...............................................
58.26 Court File Number: ................................
58.27 Case Type: ..............................................
58.28Creditor's full name
Garnishment Summons58.29.................................................................
58.30and
58.31Debtor's full name
58.32.................................................................
58.33Third Party (bank, employer, or other)
58.34.................................................................
58.35Unpaid Balance: ...................................
58Sec. 14.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 59.1 GARNISHMENT SUMMONS
59.2The State of Minnesota
59.3To the Garnishee Third Party (garnishee) named above:
59.4 You are hereby summoned and required to serve upon the creditor's attorney (or the
59.5creditor if not represented by an attorney) and on the debtor within 20 days after service of
59.6this garnishment summons upon you, a written disclosure, of the nonexempt indebtedness,
59.7money, or other property due or belonging to the debtor and owing by you or in your
59.8possession or under your control and answers to all written interrogatories that are served
59.9with the garnishment summons. However, if the garnishment is on earnings and the debtor
59.10has garnishable earnings, you shall serve the completed disclosure form on the creditor's
59.11attorney, or the creditor if not represented by an attorney, within ten days of the last payday
59.12to occur within the 90 days after the date of the service of this garnishment summons.
59.13"Payday" means the day which you pay earnings in the ordinary course of business. If the
59.14debtor has no regular paydays, "payday" means the 15th day and the last day of each month.
59.15 Your disclosure need not exceed 110 percent of the amount of the creditor's claim that
59.16remains unpaid.
59.17 You shall retain garnishable earnings, other indebtedness, money, or other property in
59.18your possession in an amount not to exceed 110 percent of the creditor's claim until such
59.19time as the creditor causes a writ of execution to be served upon you, until the debtor
59.20authorizes you in writing to release the property to the creditor, or until the expiration of
59.21...... days from the date of service of this garnishment summons upon you, at which time
59.22you shall return the disposable earnings, other indebtedness, money, or other property to
59.23the debtor.
59.24 A court has ordered that you must serve a written statement to the creditor (or to the
59.25creditor's lawyer). You must do this within 20 days after you get this notice. Your written
59.26statement should include any money, or other property of the debtor that you have or owe
59.27to them. It should also include answers to any questions that are in this summons.
59.28 But, if the garnishment is on earnings and the debtor has earnings that can be garnished,
59.29fill out the completed disclosure form. Then serve it on the creditor (or the creditor's lawyer).
59.30It must be served within 10 days of the last payday within the 90 days after the date you
59.31got this summons. If the debtor has no regular paydays, "payday" means the 15th day and
59.32the last day of each month.
59Sec. 14.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 60.1 You don't have to disclose more than 110% of the unpaid amount that is owed to the
60.2creditor. Keep earnings that can be garnished, other indebtedness, money, or other property
60.3in your possession in an amount not to exceed 110 percent of the creditor's claim. Keep this
60.4until:
60.5 (i) the creditor has a writ of execution served on you;
60.6 (ii) the debtor gives you permission in writing to release the property to the creditor; or
60.7 (iii) it's been ... days from the day you got this garnishment summons.
60.8Then you give the debtor back the disposable earnings, other indebtedness, money, or other
60.9property.
60.10 Earnings
60.11 In the event If you are summoned as a garnishee because you owe "earnings" (as defined
60.12on the Earnings Garnishment Disclosure form attached to this Garnishment Summons, if
60.13applicable) to the debtor, then you are required to must serve upon the creditor's attorney,
60.14or the creditor if not represented by an attorney, a written an Earnings Disclosure Form
60.15within on the creditor (or the creditor's lawyer). The Earnings Disclosure Form must be in
60.16writing and must be served in the time limit set forth above. "Earnings" are defined on the
60.17Earnings Garnishment Disclosure Form attached to this Garnishment Summons.
60.18 In the case of earnings, you are further required to retain in your possession must keep
60.19all unpaid, nonexempt disposable earnings owed or to be owed by you and earned or to be
60.20earned that you owe or will owe to the debtor within during the pay period in which when
60.21this garnishment summons notice is served and within all subsequent pay periods whose
60.22paydays (defined above) occur within the 90 days after the date of service of this garnishment
60.23summons delivered and for all pay periods within 90 days after this notice is served.
60.24 Any assignment of earnings made by the debtor to any party within ten days before the
60.25receipt of the first garnishment on a debt is void. Any indebtedness to you incurred by the
60.26debtor within the ten days before the receipt of the first garnishment on a debt may not be
60.27set off against amounts otherwise subject to the garnishment.
60.28 Any transfer of earnings made by the debtor to someone else within 10 days before the
60.29first garnishment notice is invalid. Any debt the debtor owes you from within those 10 days
60.30can't be used to lower the amount that can be garnished.
60.31 You are prohibited By law from discharging or disciplining you can't fire or discipline
60.32the debtor because the debtor's their earnings have been subject to garnishment.
60Sec. 14.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 61.1 This Garnishment Summons includes:
61.2 (check applicable box the boxes that apply)
Earnings garnishment (see attached Earnings Disclosure Form)61.3...
Nonearnings garnishment (see attached Nonearnings Disclosure Form)61.4...
Both Earnings and Nonearnings garnishment (see both attached Earnings and
61.6 Nonearnings Disclosure Form)
61.5...
61.7 Notice to Debtor
61.8 You are being served copies of a Garnishment Summons, Earnings Garnishment
61.9Disclosure Form, Nonwage Garnishment Disclosure Form, Garnishment Exemption Notices
61.10and/or written Interrogatories (strike out if not applicable),. Copies of which are hereby
61.11served on you, were served upon the Garnishee by delivering copies these same documents
61.12were also delivered to the Garnishee. The Garnishee was paid $15.
..............................................................61.13Dated: ..................................................
61.14 Attorney for Creditor (or creditor)
61.15 ..............................................................
61.16 ..............................................................
61.17 ..............................................................
61.18 Address
61.19 ..............................................................
61.20 Telephone
61.21 ..............................................................
61.22 Attorney I.D. No
61.23Date: ...................................................................................
61.24Creditor's Signature: ...........................................................
61.25(or creditor's lawyer's signature)
61.26Creditor's Name: .................................................................
61.27(or creditor's lawyer's name)
61.28Street Address: ...................................................................
61.29City/State/Zip: ....................................................................
Fax: ......................................61.30Phone: ..................................
61.31Email: .................................................................................
61.32Sec. 15. Minnesota Statutes 2024, section 571.75, subdivision 2, is amended to read:
61.33 Subd. 2.Contents of disclosure.The disclosure must state:
61Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 62.1 (a) If an earnings garnishment disclosure, the amount of disposable earnings earned by
62.2the debtor within the debtor's pay periods as specified in section 571.921.
62.3 (b) If a nonearnings garnishment disclosure, a description of any personal property or
62.4any instrument or papers relating to this property belonging to the judgment debtor or in
62.5which the debtor is interested or other indebtedness of the garnishee to the debtor.
62.6 (c) If the garnishee asserts any setoff, defense, claim, or lien on disposable earnings,
62.7other indebtedness, money, or property, the garnishee shall disclose the amount and the
62.8facts concerning the same.
62.9 (d) Whether the debtor asserts any exemption, or any other objection, known to the
62.10garnishee against the right of the creditor to garnish the disposable earnings, other
62.11indebtedness, money, or property disclosed.
62.12 (e) If other persons assert claims to any disposable earnings, other indebtedness, money,
62.13or property disclosed, the garnishee shall disclose the names and addresses of these claimants
62.14and, so far as known by the garnishee, the nature of their claims.
62.15 (f) The garnishment disclosure forms and earnings disclosure worksheet must be the
62.16same or substantially similar to the following forms. If the garnishment affects earnings of
62.17the debtor, the creditor shall use the earnings garnishment disclosure form. If the garnishment
62.18affects any indebtedness, money, or property of the debtor, other than earnings, the creditor
62.19shall use the nonearnings garnishment disclosure form. Nothing contained in this paragraph
62.20limits the simultaneous use of the earnings and nonearnings garnishment disclosure forms.
62.21 EARNINGS DISCLOSURE FORM AND WORKSHEET
DISTRICT COURT62.22STATE OF MINNESOTA
........................... JUDICIAL DISTRICT62.23COUNTY OF .........................................
62.24................................................ (Creditor)
GARNISHMENT62.25.................................................. (Debtor)
EARNINGS DISCLOSURE62.26............................................. (Garnishee)
District Court62.27State of Minnesota
Judicial District: .....................................62.28County of: ...............................................
62.29 Court File Number: ................................
62.30 Case Type: ..............................................
62.31Creditor's full name
Garnishment Earnings Disclosure62.32.................................................................
For Non-Child Support Judgments62.33and
62.34Debtor's full name
62Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 63.1.................................................................
63.2Third Party (bank, employer, or other)
63.3.................................................................
63.4 This form is called a "Garnishment Earnings Disclosure" or "Disclosure." It is for the
63.5employer to fill out. The "debtor" is the person who owes money. The debtor gets a copy
63.6of this form for their own information. The debtor is also called a "judgment debtor."
63.7 The "creditor" is the party owed the money. The creditor is also called a "judgment
63.8creditor."
63.9 The "employer" is the "third party" or "garnishee." If the debtor asks how the calculations
63.10in this document were made, the employer must provide information about it.
63.11Definitions
63.12 "Earnings": For the purpose of garnishment, "earnings" means compensation what is
63.13paid or payable to an employee, independent contractor or self-employed person for personal
63.14services or (a job). Also called compensation. Compensation can be wages, salary,
63.15commission, bonus, payments, profit-sharing distributions, severance payment, fees or
63.16other. It includes periodic payments from a pension or retirement. It can also be compensation
63.17paid or payable to the a producer for the sale of agricultural products;. This can be things
63.18like milk or milk products;, or fruit or other horticultural products. Or things produced when
63.19the producer is operating in the operation of a family farm, a family farm corporation, or
63.20an authorized farm corporation, as. This is defined in section 500.24, subdivision 2, whether
63.21denominated as wages, salary, commission, bonus, or otherwise, and includes periodic
63.22payments pursuant to a pension or retirement.
63.23 "Disposable Earnings": Means that the part of the a person's earnings of an individual
63.24remaining after the deduction from those earnings of that are left after subtracting the
63.25amounts required by law to be withheld. (Amounts Note: Amounts required by law to be
63.26withheld do not include items such as things like health insurance, charitable contributions,
63.27or other voluntary wage deductions.)
63.28 "Payday": For the purpose of garnishment, "payday(s)" means the date(s) upon which
63.29the date when the employer pays earnings to the debtor in the ordinary course of business
63.30for doing their job. If the debtor has no regular payday, payday(s) then "payday" means the
63.31fifteenth 15th and the last day of each month.
63.32 The Employer/Garnishee Must Answer The Following Questions:
63Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 64.1 1. Do you Right now owe, or within 90 days from the date the garnishment summons
64.2was served on you, will you or, do you expect to owe money to the debtor for earnings?
No .....64.3 Yes .....
No .....64.4 Yes .....
64.5 2. Within 90 days from the date you were served with the garnishment, will you or may
64.6you owe money to the debtor for earnings?
No .....64.7 Yes .....
64.8 2 3. Does the debtor earn more than $........ per week? (This amount is the greater of
64.9$9.50 per hour or the current Minnesota or federal minimum wage per week.)? (use the
64.10number that is more)
No .....64.11 Yes .....
No .....64.12 Yes .....
64.13 INSTRUCTIONS FOR COMPLETING THE
64.14 EARNINGS DISCLOSURE
64.15 A. If your answer to either question 1 or 2 is "No," then you must sign the affirmation
64.16on Page 2 and return this disclosure to the creditor's attorney (or the creditor if not represented
64.17by an attorney) within 20 days after it was served on you, and you do not need to answer
64.18the remaining questions.
64.19 B. If your answers to both questions 1 and 2 are "Yes," you must complete this form
64.20and the Earnings Disclosure Worksheet as follows:
64.21 A. If you answer "No" to question 1, 2, or 3, you don't need to answer the rest of the
64.22questions. You don't have to do the Earnings Disclosure Worksheet. Sign the Earnings
64.23Disclosure Affirmation below and return this disclosure form to the creditor's attorney (or
64.24the creditor if not represented by an attorney). You must return it within 20 days after it
64.25was served on you.
64.26 B. If you answer "Yes" to question 1 or 2, and "Yes" to question 3, sign the Earnings
64.27Disclosure Affirmation below. You must return it to the creditor's attorney (or the creditor
64.28if not represented by an attorney) within 20 days. You must also fill out the rest of this form.
64.29Read the instructions for the Earnings Disclosure Worksheet.
64.30 Earnings Disclosure Affirmation
64Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 65.1 I, ........................ (person signing Affirmation), am the third party/employer or I am
65.2authorized by the third party/employer to complete this earnings disclosure and have done
65.3so truthfully and to the best of my knowledge.
65.4Date: ...............................................
65.5Signature of Third Party/Employer:
65.6.........................................................
65.7Title: ...............................................
65.8Phone: .............................................
65.9 Instructions for Completing the Earnings Disclosure Worksheet
65.10 For each payday that falls within 90 days from the date the garnishment summons was
65.11 served on you, you must calculate the amount of earnings to be retained by completing
65.12 Steps 3 through 11, and enter the amounts on the Earnings Disclosure Worksheet. UPON
65.13 REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH
65.14 INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS
65.15 DISCLOSURE WERE MADE. withheld. Enter the amounts on the Earnings Disclosure
65.16 Worksheet.
65.17 Each payday, you must retain the amount of earnings listed in Column I on the Earnings
65.18 Disclosure Worksheet.
65.19 You must return this Earnings Disclosure Form and the Earnings Disclosure Worksheet
65.20 to the creditor's attorney (or the creditor if not represented by an attorney) and deliver
65.21 a copy to the debtor within ten days after the last payday that falls within the 90-day
65.22 period.
65.23 If the claim is wholly satisfied or if the debtor's employment ends before the expiration
65.24 of the 90-day period, your disclosure should be made within ten days after the last payday
65.25 for which earnings were attached.
65.26For Steps 3 through 11, "Columns" refers to columns on the Earnings Disclosure Worksheet.
Enter the date of debtor's payday.COLUMN A.65.27 3.
Enter debtor's gross earnings for each payday.COLUMN B.65.28 4.
Enter debtor's disposable earnings for each payday.COLUMN C.65.29 5.
Enter 25 percent of disposable earnings. (Multiply
65.31 Column C by .25.)
COLUMN D.65.30 6.
Enter here the greater of 40 times $9.50 or 40 times the
65.33 hourly federal minimum wage ($..........) times the
COLUMN E.65.32 7.
65.34 number of work weeks included in each payday. (Note:
65.35 If a pay period includes days in excess of whole work
65.36 weeks, the additional days should be counted as a
65Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 66.1 fraction of a work week equal to the number of
66.2 workdays in excess of a whole work week divided by
66.3 the number of workdays in a normal work week.)
Subtract the amount in Column E from the amount in
66.5 Column C, and enter here.
COLUMN F.66.4 8.
Enter here the lesser of the amount in Column D and
66.7 the amount in Column F.
COLUMN G.66.6 9.
Enter here any amount claimed by you as a setoff,
66.9 defense, lien, or claim, or any amount claimed by any
COLUMN H.66.8 10.
66.10 other person as an exemption or adverse interest which
66.11 would reduce the amount of earnings owing to the
66.12 debtor. (Note: Any indebtedness to you incurred by the
66.13 debtor within the ten days before the receipt of the first
66.14 garnishment on a debt may not be set off against
66.15 amounts otherwise subject to the garnishment. Any
66.16 assignment of earnings made by the debtor to any party
66.17 within ten days before the receipt of the first
66.18 garnishment on a debt is void.)
66.19 You must also describe your claim(s) and the claims of
66.20 others, if known, in the space provided below the
66.21 worksheet and state the name(s) and address(es) of these
66.22 persons.
66.23 Enter zero in Column H if there are no claims by you
66.24 or others which would reduce the amount of earnings
66.25 owing to the debtor.
Subtract the amount in Column H from the amount in
66.27 Column G and enter here. This is the amount of earnings
COLUMN I.66.26 11.
66.28 that you must retain for the payday for which the
66.29 calculations were made.
66.30 AFFIRMATION
66.31 I, ...................... (person signing Affirmation), am the garnishee or I am authorized by
66.32the garnishee to complete this earnings disclosure, and have done so truthfully and to the
66.33best of my knowledge.
......................................................................66.34Dated: .....................................................
66.35 Signature
66.36 ......................................................................
66.37 Title
66.38 ......................................................................
66.39 Telephone Number
66.40 EARNINGS DISCLOSURE WORKSHEET
66.41 .............................
66.42 Debtor's Name
66Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 67.1 You must:
67.2 1. Withhold the amount of earnings listed in column I on the Earnings Disclosure
67.3Worksheet each payday.
67.4 2. After 90 days, return this Earnings Disclosure Worksheet to the creditor's attorney
67.5(or the creditor if not represented by an attorney). Include all the money withheld. Sign the
67.6Affirmation at the end of the worksheet before returning.
67.7 3. Deliver a copy of the disclosure and worksheet to the debtor within 10 days after the
67.8last payday that falls within the 90-day period.
67.9 If the debt (judgment) is fully paid off or if the debtor's job ends before the 90-day period
67.10is over, you need to do the last disclosure and withholdings within 10 days of their last
67.11payday that you withheld money.
67.12 Calculating Percentage of Disposable Earnings
67.13 Note to Creditor: You must fill out this chart before sending this form to the employer.
67.14Use the current minimum wage found online at: https://www.dli.mn.gov/minwage.
67.15 Minimum Wage = $MW/hour.
67.16 then this percentage of the disposable
earnings are withheld:67.17 if the weekly gross earnings are:
0%67.18 Less than [40 X MW]
10%67.19 [40 X MW + .01] to [60 X MW]
15%67.20 [60 X MW + .01] to [80 X MW]
25%67.21 [80 X MW + .01] or more
67.22 Employer: Use this creditor's calculation chart to know what percentage of earnings
67.23should be withheld.
67.24 Earnings Disclosure Worksheet
67.25......................................................................
67.26Debtor's Name
CB67.27A
Disposable
67.29 Earnings
Gross Earnings67.28Payday Date
$........................$..................................................67.301.
..............................................................................67.312.
..............................................................................67.323.
..............................................................................67.334.
67Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI ..............................................................................68.15.
..............................................................................68.26.
..............................................................................68.37.
..............................................................................68.48.
..............................................................................68.59.
..............................................................................68.610.
68.7 Column A. Enter the debtor's payday.
68.8 Column B. Enter the debtor's gross earnings for each payday.
68.9 Column C. Enter the debtor's disposable earnings for each payday.
FE68.10D
Column C minus
Column E
Greater of 40 X
$9.50 or 40 X
68.1125% of withholding
68.12of Column C
MN or Fed. Min.
Wage
68.13(Use the creditor's
68.14calculation chart)
..............................................................................68.151.
..............................................................................68.162.
..............................................................................68.173.
..............................................................................68.184.
..............................................................................68.195.
..............................................................................68.206.
..............................................................................68.217.
..............................................................................68.228.
..............................................................................68.239.
..............................................................................68.2410.
68.25 Column D. Enter the percentage of disposable earnings that will be withheld. Get this
68.26number from the creditor's calculation chart.
68.27 Column E. Calculate 40 times the current Minnesota minimum wage (or 40 times the
68.28current federal minimum wage) times the number of work weeks in each payday. Enter the
68.29bigger number here. Note: If a payday has extra days that are more than a full work week,
68.30count those extra days as part of a work week. Do this by dividing the number of extra
68.31workdays by the number of workdays in a normal week.
68.32 Column F. Subtract the amount in column E from the amount in column C and enter
68.33here.
68Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI IH69.1G
Column G minus
Column H
69.2 Setoff, Lien,
Adverse Interest,
or Other Claims
69.3Lesser of Column D
69.4and Column F
..............................................................................69.51.
..............................................................................69.62.
..............................................................................69.73.
..............................................................................69.84.
..............................................................................69.95.
..............................................................................69.106.
..............................................................................69.117.
..............................................................................69.128.
..............................................................................69.139.
..............................................................................69.1410.
$ .......................69.15 Total of Column I=
69.16 Column G. Look at column D and column F. Enter the smaller amount of the two here
69.17in column G.
69.18 Column H. Enter any amount claimed by you that would lower the amount of earnings
69.19that will go to the debtor. Things like:
69.20 (i) a setoff,
69.21 (ii) a defense,
69.22 (iii) a lien,
69.23 (iv) a claim, or
69.24 (v) any amount claimed by any other person as an exemption or adverse interest.
69.25 Note: You must describe your claim(s) and the claims of others, if known, in the spaces
69.26after this worksheet.
69.27 Enter zero in column H if there are no claims by you or others which would lower the
69.28amount of earnings owed to the debtor.
69.29 Note: Any debt that happened within 10 days before you got the first garnishment on a
69.30debt may not be set off against the earnings that are affected by this garnishment. Any wage
69.31assignment made by the debtor within 10 days before you got the first garnishment on a
69.32debt is void. Wage assignment is when a debtor voluntarily agrees to money being taken
69.33out of their earnings.
69Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 70.1 Column I. Subtract the amount in column H from the amount in column G and enter
70.2here. This is the amount of earnings that go to the creditor.
70.3 *If you entered any amount in Column H for any payday(s), you must payday, describe
70.4those claims below either. It doesn't matter if they are your claims, or the claims of others.
70.5For amounts claimed claims by others you must both state, list the names and addresses of
70.6these persons each, and the nature of describe their claim claims, if known you know.
70.7................................................................................................................................................
70.8................................................................................................................................................
70.9................................................................................................................................................
70.10 AFFIRMATION
70.11Earnings Worksheet Affirmation
70.12 I, ........................ (person signing Affirmation), am the third party party/employer or I
70.13am authorized by the third party party/employer to complete this earnings disclosure
70.14worksheet, and have done so truthfully and to the best of my knowledge.
70.15Dated: .............................................
70.16Signature .........................................
70.17Title .................................................
70.18Telephone Number (....) ..................
70.19Date: ....................................................................................
70.20Third Party's Name: .............................................................
70.21Third Party's Signature: .......................................................
Fax: ....................................70.22Phone: ....................................
70.23Email: ..................................................................................
70.24 EARNINGS DISCLOSURE FORM AND WORKSHEET
70.25 FOR CHILD SUPPORT DEBTOR
DISTRICT COURT70.26STATE OF MINNESOTA
........................... JUDICIAL DISTRICT70.27COUNTY OF .........................................
70.28................................................ (Creditor)
GARNISHMENT70.29.................................................. (Debtor)
EARNINGS DISCLOSURE70.30............................................. (Garnishee)
70.31 DEFINITIONS
70Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 71.1 "EARNINGS": For the purpose of execution, "earnings" means compensation paid or
71.2payable to an employee for personal services or compensation paid or payable to the producer
71.3for the sale of agricultural products; milk or milk products; or fruit or other horticultural
71.4products produced when the producer is operating a family farm, a family farm corporation,
71.5or an authorized farm corporation, as defined in section 500.24, subdivision 2, whether
71.6denominated as wages, salary, commission, bonus, or otherwise, and includes periodic
71.7payments pursuant to a pension or retirement, workers' compensation, or unemployment
71.8benefits.
71.9 "DISPOSABLE EARNINGS": Means that part of the earnings of an individual remaining
71.10after the deduction from those earnings of amounts required by law to be withheld. (Amounts
71.11required by law to be withheld do not include items such as health insurance, charitable
71.12contributions, or other voluntary wage deductions.)
71.13 "PAYDAY": For the purpose of execution, "payday(s)" means the date(s) upon which
71.14the employer pays earnings to the debtor in the ordinary course of business. If the judgment
71.15debtor has no regular payday, payday(s) means the 15th and the last day of each month.
71.16 THE GARNISHEE MUST ANSWER THE FOLLOWING QUESTION:
71.17 (1) Do you now owe, or within 90 days from the date the execution levy was served on
71.18you, will you or may you owe money to the debtor for earnings?
No ...............71.19 Yes ..............
71.20 INSTRUCTIONS FOR COMPLETING THE
71.21 EARNINGS DISCLOSURE
71.22 A. If your answer to question 1 is "No," then you must sign the affirmation below and
71.23return this disclosure to the creditor's attorney (or the creditor if not represented by an
71.24attorney) within 20 days after it was served on you, and you do not need to answer the
71.25remaining questions.
71.26 B. If your answer to question 1 is "Yes," you must complete this form and the Earnings
71.27Disclosure Worksheet as follows:
71.28 For each payday that falls within 90 days from the date the garnishment summons was
71.29 served on you, YOU MUST calculate the amount of earnings to be retained by completing
71.30 steps 2 through 8 on page 2, and enter the amounts on the Earnings Disclosure Worksheet.
71.31 UPON REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH
71.32 INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS
71.33 DISCLOSURE WERE MADE.
71Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 72.1 Each payday, you must retain the amount of earnings listed in column G on the Earnings
72.2 Disclosure Worksheet.
72.3 You must pay the attached earnings and return this earnings disclosure form and the
72.4 Earnings Disclosure Worksheet to the creditor's attorney (or the creditor if not represented
72.5 by an attorney) and deliver a copy to the debtor within ten days after the last payday
72.6 that falls within the 90-day period. If the claim is wholly satisfied or if the debtor's
72.7 employment ends before the expiration of the 90-day period, your disclosure should be
72.8 made within ten days after the last payday for which earnings were attached.
72.9 For steps 2 through 8, "columns" refers to columns on the Earnings Disclosure Worksheet.
72.10 (2) COLUMN A. Enter the date of debtor's payday.
72.11 (3) COLUMN B. Enter debtor's gross earnings for each payday.
72.12 (4) COLUMN C. Enter debtor's disposable earnings for each payday.
72.13 (5) COLUMN D. Enter either 50, 55, 60, or 65 percent of disposable earnings, based
72.14on which of the following descriptions fits the child support judgment debtor:
72.15 (a) 50 percent of the judgment debtor's disposable income, if the judgment debtor is
72.16supporting a spouse or dependent child and the judgment is 12 weeks old or less (12 weeks
72.17to be calculated to the beginning of the work week in which the execution levy is received);
72.18 (b) 55 percent of the judgment debtor's disposable income, if the judgment debtor is
72.19supporting a spouse or dependent child, and the judgment is over 12 weeks old (12 weeks
72.20to be calculated to the beginning of the work week in which the execution levy is received);
72.21 (c) 60 percent of the judgment debtor's disposable income, if the judgment debtor is not
72.22supporting a spouse or dependent child and the judgment is 12 weeks old or less (12 weeks
72.23to be calculated to the beginning of the work week in which the execution levy is received);
72.24or
72.25 (d) 65 percent of the judgment debtor's disposable income, if the judgment debtor is not
72.26supporting a spouse or dependent child, and the judgment is over 12 weeks old (12 weeks
72.27to be calculated to the beginning of the work week in which the execution levy is received).
72.28(Multiply column C by .50, .55, .60, or .65, as appropriate.)
72.29 (6) COLUMN E. Enter here any amount claimed by you as a setoff, defense, lien, or
72.30claim, or any amount claimed by any other person as an exemption or adverse interest that
72.31would reduce the amount of earnings owing to the debtor. (Note: Any assignment of earnings
72.32made by the debtor to any party within ten days before the receipt of the first garnishment
72Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 73.1on a debt is void. Any indebtedness to you incurred by the debtor within the ten days before
73.2the receipt of the first garnishment on a debt may not be set off against amounts otherwise
73.3subject to the garnishment.)
73.4 You must also describe your claim(s) and the claims of others, if known, in the space
73.5provided below the worksheet and state the name(s) and address(es) of these persons.
73.6 Enter zero in column E if there are no claims by you or others that would reduce the
73.7amount of earnings owing to the judgment debtor.
73.8 (7) COLUMN F. Subtract the amount in column E from the amount in column D and
73.9enter here. This is the amount of earnings that you must remit for the payday for which the
73.10calculations were made.
73.11 AFFIRMATION
73.12 I, ................... (person signing Affirmation), am the garnishee or I am authorized by the
73.13garnishee to complete this earnings disclosure, and have done so truthfully and to the best
73.14of my knowledge.
......................................................73.15Dated: .....................................................
73.16 Signature
73.17 ......................................................
73.18 Title
73.19 ......................................................
73.20 Telephone Number
......................................................
73.21EARNINGS DISCLOSURE
73.22WORKSHEET
73.23 Debtor's Name
CB73.24A
Disposable
73.26 Earnings
Gross Earnings73.25Payday Date
$........................$..................................................73.271.
..............................................................................73.282.
..............................................................................73.293.
..............................................................................73.304.
..............................................................................73.315.
..............................................................................73.326.
..............................................................................73.337.
..............................................................................73.348.
73Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI ..............................................................................74.19.
..............................................................................74.210.
FE74.3D
Column D minus
Column E
Setoff, Lien,
Adverse Interest,
74.6 or Other Claims
74.4Either 50, 55, 60, or
74.565% of Column C
..............................................................................74.71.
..............................................................................74.82.
..............................................................................74.93.
..............................................................................74.104.
..............................................................................74.115.
..............................................................................74.126.
..............................................................................74.137.
..............................................................................74.148.
..............................................................................74.159.
..............................................................................74.1610.
74.17 TOTAL OF COLUMN F $......................................
74.18 *If you entered any amount in column E for any payday(s), you must describe below
74.19either your claims, or the claims of others. For amounts claimed by others, you must both
74.20state the names and addresses of such persons, and the nature of their claim, if known.
74.21................................................................................................................................................
74.22................................................................................................................................................
74.23................................................................................................................................................
74.24 AFFIRMATION
74.25 I, ................. (person signing Affirmation), am the third party or I am authorized by the
74.26third party to complete this earnings disclosure worksheet, and have done so truthfully and
74.27to the best of my knowledge.
74.28 ..............................................
74.29 Signature
(....) .....................................................................................74.30Dated: ..................................
Phone Number74.31 Title
74.32 NONEARNINGS DISCLOSURE FORM
DISTRICT COURT74.33STATE OF MINNESOTA
........................... JUDICIAL DISTRICT74.34COUNTY OF .........................................
74Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 75.1................................................ (Creditor)
75.2against
NONEARNINGS DISCLOSURE75.3.................................................. (Debtor)
75.4and
75.5............................................. (Garnishee)
75.6 On the ......... day of .............., ............, the time of service of garnishment summons
75.7herein, there was due and owing the debtor from the garnishee the following:
District Court75.8State of Minnesota
Judicial District: .....................................75.9County of: ...............................................
75.10 Court File Number: ................................
75.11 Case Type: ..............................................
75.12Creditor's full name
Non-Earnings Disclosure75.13.................................................................
For Non-Child Support Judgments75.14against
75.15Debtor's full name
75.16.................................................................
75.17and
75.18Third Party (bank, employer, or other)
75.19.................................................................
75.20 This form is called a "Non-Earnings Disclosure" or "Disclosure." It is being sent to you
75.21because you might be holding property that belongs to the debtor, or you might owe money
75.22to the debtor.
75.23 You are the "third party" or "garnishee." The "debtor" is the person who owes money.
75.24The debtor is also called the "judgment debtor." The "creditor" is the person the debtor owes
75.25money to. The creditor is also called the "judgment creditor." The debtor owes $..................
75.26to the creditor.
75.27 You must list any money or property you owe the debtor on the lines below and sign
75.28the affirmation. Write "none" on the line if that is your answer. You must then return this
75.29disclosure to the creditor (or the creditor's lawyer) within 20 days after you got it.
75.30 Fill in the date you got this disclosure:
............................... (year)........................ (day),75.31.................... (month)
75.32 On the date you got this disclosure, you owed the debtor:
75Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 76.1 (1) Money. Enter on the line below any amounts due and owing the debtor, except
76.2earnings, from the garnishee Write down the amount of money you owe the debtor (except
76.3earnings).
76.4................................................................................................................................................
76.5 (2) Property. Describe on the line below Write a short description of any personal
76.6property, instruments, or papers belonging to the debtor and in the possession of the garnishee
76.7that you have in your possession. List the monetary value of each thing.
76.8................................................................................................................................................
76.9 (3) Setoff. Enter on the line below the amount of any If you claim a setoff, defense, lien,
76.10or claim which the garnishee claims against the amount set forth on lines (1) and (2) above
76.11enter that amount on the line below. State the facts by which the setoff, defense, lien, or
76.12about your claim is claimed. (Any indebtedness to a garnishee incurred by the debtor within
76.13the ten days before the receipt of the first garnishment on a debt may not be set off against
76.14amounts otherwise subject to the garnishment.) Note: Any payment the debtor makes to
76.15the garnishee within the 10 days before they get the first garnishment order on that debt
76.16can't be used to lower the amount that is being garnished.
76.17................................................................................................................................................
76.18 (4) Exemption. Enter on the line below any amounts or property claimed by the debtor
76.19to be exempt from execution that the debtor claims is exempt on the line below.
76.20................................................................................................................................................
76.21 (5) Adverse Interest. Enter on the line below any amounts claimed by other persons by
76.22reason of ownership or interest in the debtor's property of the debtor's property that other
76.23people claim they own or have interest in.
76.24................................................................................................................................................
76.25 (6) Enter on the line below the total of lines (3), (4), and (5) on the line below.
76.26................................................................................................................................................
76.27 (7) Enter on the line below the difference obtained (never less than zero) when line (6)
76.28is subtracted from the sum of lines (1) and (2) on the line below.
76.29................................................................................................................................................
76.30 (8) Enter on the line below Figure out 110 percent of the amount of the creditor's claim
76.31which remains is still unpaid. Enter it on the line below.
76Sec. 15.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 77.1................................................................................................................................................
77.2 (9) Enter on the line below the lesser of line Look at (7) and line (8). Retain Put the
77.3smaller number on the line below. Hold this amount only if it is $10 or more.
77.4................................................................................................................................................
77.5 AFFIRMATION
77.6 I, .......................... (person signing Affirmation), am the garnishee or I am authorized
77.7by the garnishee to complete this nonearnings garnishment disclosure, and. I have done so
77.8truthfully and to the best of my knowledge.
......................................................77.9Dated: .....................................................
77.10 Signature
77.11 ......................................................
77.12 Title
77.13 ......................................................
77.14 Telephone Number
77.15Date: ............................................................
77.16Name: ..........................................................
77.17Signature: ....................................................
77.18Title: ............................................................
Email: ...........................................................77.19Phone: ..........................................................
77.20Sec. 16. Minnesota Statutes 2024, section 571.912, is amended to read:
77.21 571.912 FORM OF NOTICE, INSTRUCTIONS, AND EXEMPTION NOTICE.
77.22 Subdivision 1.Form of notice.The notice, instructions, and exemption notice informing
77.23a debtor that a garnishment summons has been used to attach funds of the debtor to satisfy
77.24a claim must be a separate notice and must be substantially in the following form:
DISTRICT COURT77.25STATE OF MINNESOTA
......................JUDICIAL DISTRICT77.26COUNTY OF ...................................
77.27...........................................(Creditor)
77.28.............................................(Debtor)
77.29........................(Financial institution)
District Court77.30State of Minnesota
Judicial District: .....................................77.31County of: ...............................................
77.32 Court File Number: ................................
77.33 Case Type: ..............................................
77Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 78.1Creditor's full name
78.2.................................................................
78.3Debtor's full name
78.4.................................................................
78.5Third Party (bank, employer, or other)
78.6.................................................................
78.7 Important Notice
78.8 YOUR FUNDS HAVE BEEN GARNISHED
78.9 Money in Your Account Has Been Frozen
78.10 The Creditor has frozen money in your account at your financial institution bank.
78.11 Your account balance is $.......
78.12 The amount being held is $.......
78.13 The amount being held will be is frozen for 14 days from the date of this notice.
78.14 Some of your money in your account may be protected (the legal word is exempt).
78.15You may be able to get it sooner than 14 days if you act quickly and follow the
78.16instructions on the next page.
78.17 The attached exemption form lists some different sources of ways money in your account
78.18that may be protected. If your money is comes from one or more of these sources, place a
78.19benefit on the list, put a check on the line on the form next to the sources of your money.
78.20If it is from one of these sources, next to it. The creditor cannot can't take it.
78.21 BUT, if you want the bank to unfreeze your money, you must follow the instructions
78.22and return the exemption form and with copies of your bank statements from the last
78.2360 days to have the bank unfreeze your money. Instructions and the form are attached. If
78.24you do not don't follow the instructions or your Creditor gets an order from the court or writ
78.25of execution, your financial institution will give bank gives the money to your creditor. If
78.26your creditor gets an order from the court or writ of execution, your bank gives the money
78.27to them. If that happens and it your money is protected, you can still get it back from the
78.28creditor later,. But that is not as easy to do as filling in out the form now is easiest.
78.29 See next pages for instructions and the exemption form.
78.30 Subd. 2.Form of instructions.The instructions required must be in a separate form
78.31and must be substantially in the following form:
78.32 Instructions
78Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 79.1 Note: The creditor is who you owe the money to. You are the debtor.
79.2 1. Fill out both of the attached exemption forms in this packet.
79.3 If you check one of the lines, you should also give proof. Use proof that shows show
79.4that some or all of the money in your account is from one or more of the protected sources.
79.5This might be letters or account statements. Creditors may ask for a hearing if they question
79.6your exemptions.
79.7 To avoid a hearing:
79.8 (i) Case numbers should be added to the form.
79.9 (ii) Copies of documents should be sent with the form.
79.10 Notice: You must send to the creditor's attorney (or to the creditor, if no attorney) copies
79.11of your bank statements for the past 60 days before the garnishment. Send them to the
79.12creditor (or to the creditor's lawyer). Keep a copy of your bank statements in case there are
79.13questions about your claim. If you do not don't send bank statements to the creditor's attorney
79.14(or to the creditor, if no attorney) bank statements creditor (or to the creditor's lawyer) along
79.15with your exemption claim, the financial institution may release give your money to the
79.16creditor. They would do this once the creditor gives the financial institution them a court
79.17order directing it saying they have to turn over the funds.
79.18 2. Sign the exemption forms. Make one a copy to keep for yourself.
79.19 3. Mail or deliver the other copies of the form by (insert date).
79.20 Both Copies Must Be Mailed or Delivered the Same Day.
79.21 One copy of the form and the copies of your bank statements go to:
79.22..............................................................................................................................................
79.23(Insert name of creditor or creditor's attorney)
79.24..............................................................................................................................................
79.25(Insert address of creditor or creditor's attorney)
79.26Creditor's Name: .................................................................
79.27(or creditor's lawyer's name)
79.28Street Address: ...................................................................
79.29City/State/Zip: ....................................................................
Fax: ......................................79.30Phone: ..................................
79.31Email: .................................................................................
79.32 One copy goes to:
79Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 80.1..............................................................................................................................................
80.2(Insert name of bank)
80.3..............................................................................................................................................
80.4(Insert address of bank)
80.5Bank's Name: ......................................................................
80.6Street Address: ...................................................................
80.7City/State/Zip: ....................................................................
Fax: ......................................80.8Phone: ..................................
80.9Email: .................................................................................
80.10 How The Process Works
80.11 If You Do Not Don't Send in the Exemption Form and Bank Statements:
80.12 14 days after the date of this letter some or all of your money may be turned over to the
80.13creditor. This happens once they get an order from the court telling the financial institution
80.14bank to do this.
80.15 If You Do Send in the Exemption Form and Bank Statements:
80.16 Any money that is NOT protected can be turned over to the creditor once they get an
80.17order from the court.
80.18 If the Creditor Does Not Object to Your Claimed Exemptions:
80.19 The financial institution will bank should unfreeze your money six 6 business days after
80.20the institution gets they get your completed form. If they don't, ask the creditor or the
80.21creditor's lawyer to send a release letter to the bank.
80.22 If the Creditor Objects to Your Claimed Exemptions:
80.23 The money you have said is protected on the form will be is held by the bank. The
80.24creditor has six 6 business days to object (disagree) and ask the court to hold a hearing. You
80.25will receive get a Notice of Objection and a Notice of Hearing.
80.26 The financial institution will hold bank holds the money until a court decides whether
80.27if your money is protected or not. Some reasons a creditor may object are because you did
80.28not didn't send copies of your bank statements or other proof of the benefits you received
80.29got. Be sure to include these when you send your exemption form.
80.30 You may want to talk to a lawyer for advice about this process. If you are low income
80.31you can call Legal Aid statewide at 1(877) 696-6529.
80.32 PENALTIES:
80Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 81.1 Warnings and Fines
81.2 If you claim that your money is protected and a court decides you made that claim in
81.3bad faith, the court they can order you to pay costs, actual damages, attorney lawyer fees,
81.4and an additional amount of a fine up to $100. Bad faith is when someone does something
81.5wrong on purpose. For example, it may be bad faith if you claim you receive get government
81.6benefits that you do not receive and you don't.
81.7 If the creditor made a bad faith objection to your claim that your money is protected,
81.8the court can order them to pay costs, actual damages, attorney lawyer fees, and an additional
81.9amount of a fine up to $100.
81.10 Subd. 3.Exemption notice.The exemption notice must be a separate form and must
81.11be in substantially the following form:
DISTRICT COURT81.12STATE OF MINNESOTA
......................JUDICIAL DISTRICT81.13COUNTY OF ...................................
81.14...........................................(Creditor)
81.15.............................................(Debtor)
81.16........................(Financial institution)
District Court81.17State of Minnesota
Judicial District: .....................................81.18County of: ...............................................
81.19 Court File Number: ................................
81.20 Case Type: ..............................................
81.21Creditor's full name
Exemption Form81.22.................................................................
81.23vs.
81.24Debtor's full name
81.25.................................................................
81.26Bank's name
81.27.................................................................
81.28 EXEMPTION FORM
How Much Money is Protected (exempt)81.29A.
... I claim ALL of the money being frozen by the bank is protected.81.30......
... I claim SOME of the money is protected. The amount I claim is protected is $.......81.31......
Why The Money is Protected81.32B.
81.33 My money is protected because I get it from one or more of the following places:
81.34 (Check all that apply)
81.35 Earnings (Wages)
81Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 82.1 ALL or SOME of my wages may be protected.
82.2 ... Some of my wages are protected because they were only deposited in my account
82.3 in the last 20 days.
82.4 For wages that were deposited in your account within the last 20 days, the amount
82.5 protected is whichever is more:
82.6 (i) 75% of your wages or more (after taxes are taken out), or
82.7 (ii) The current minimum wage times 40 per week. You can find the current minimum
82.8 wage here: https://www.dli.mn.gov/minwage.
82.9 All of my wages are protected because:
82.10 ... I get government benefits (a list of government benefits is on the next page)
82.11 ... I am getting other assistance based on need
82.12 ... I have gotten government benefits in the last 6 months
82.13 ... I was in jail or prison in the last 6 months
82.14 If you check one of these 4 boxes, your wages are only protected for 60 days after
82.15 they are deposited in your account. You MUST send the creditor copies of bank
82.16 statements that show what was in your account for the 60 days right before the
82.17 bank froze your money.
Government Benefits82.18......
82.19 Government benefits can include, but are not limited to, the following many things.
82.20 For example:
82.21 ... MFIP - Minnesota Family Investment Program,
82.22 ... DWP - MFIP Diversionary Work Program,
82.23 ... SNAP - Supplemental Nutrition Assistance Program
82.24 Work participation cash benefit,
82.25 ... GA - General Assistance,
82.26 EA - emergency assistance,
82.27 MA - medical assistance,
82.28 ... EGA - Emergency General Assistance,
82.29 ... MSA - Minnesota Supplemental Aid,
82.30 ... MSA-EA - MSA Emergency Assistance,
82.31 ... EA - Emergency Assistance
82.32 ... Energy or Fuel Assistance
82.33 ... Work Participation Cash Benefit
82.34 ... MA - Medical Assistance
82.35 Supplemental Nutrition Assistance Program (SNAP),
82.36 SSI - Supplemental Security Income,
82.37 ... MinnesotaCare,
82.38 ... Medicare Part B - Premium Payments, help
82.39 ... Medicare Part D - Extra help,
82.40 Energy or fuel assistance.
82Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 83.1 ... SSI - Supplemental Security Income
83.2 ... Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
83.3 Family Credit
83.4 ... Renter's Refund (also called Renter's Property Tax Credit)
83.5LIST SOURCE(S) OF FUNDING IN YOUR ACCOUNT
83.6..............................................................................................................................................
83.7LIST THE CASE NUMBER AND COUNTY
83.8 Case Number: ...........................................................................................................
83.9 County: .....................................................................................................................
83.10 Government benefits also include:
Social Security benefits83.11......
Unemployment benefits83.12......
Workers' compensation83.13......
Veterans benefits83.14......
83.15 If you receive any of these government benefits, include copies of any documents
83.16 you have that show you receive Social Security, unemployment, workers'
83.17 compensation, or veterans benefits.
Other assistance based on need83.18......
83.19You may have assistance based on need from another source that is not on the list. If you
83.20do, check this box, and fill in the source of your money on the line below:
83.21Source:...................................................................................................................................
83.22 Include copies of any documents you have that show the source of this money.
83.23EARNINGS
83.24 ALL or SOME of your earnings (wages) may also be protected.
All of your earnings (wages) are protected if:83.25......
You get government benefits (see list of government benefits)83.26......
You currently receive other assistance based on need83.27......
You have received government benefits in the last six months83.28......
You were in jail or prison in the last six months83.29......
83.30 If you check one of these lines, your wages are only protected for 60 days after
83.31 they are deposited in your account so you MUST send the creditor a copy of
83.32 BANK STATEMENTS that show what was in your account for the 60 days right
83.33 before the bank froze your money.
Some of your earnings (wages) are protected.83.34......
83.35 If all of your earnings are not exempt, then some of your earnings are still protected
83.36 for 20 days after they were deposited in your account. The amount protected is the
83.37 larger amount of:
83.38 75 percent of your wages (after taxes are taken out); or
83.39 (insert the sum of the current federal minimum wage) multiplied by 40.
83Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 84.1 OTHER EXEMPT FUNDS
84.2 The money from the following are also completely protected after they are deposited
84.3 in your account.
An accident, disability, or retirement pension or annuity84.4......
Payments to you from a life insurance policy84.5......
Earnings of your child who is under 18 years of age84.6......
Child support84.7......
Money paid to you from a claim for damage or destruction of property Property
84.9 includes household goods, farm tools or machinery, tools for your job, business
84.8......
84.10 equipment, a mobile home, a car, a musical instrument, a pew or burial lot, clothes,
84.11 furniture, or appliances.
Death benefits paid to you84.12......
84.13List the case number and county for every
84.14box you checked:
County: ........................................................84.15Case Number: ..............................................
County: ........................................................84.16Case Number: ..............................................
County: ........................................................84.17Case Number: ..............................................
84.18Government benefits also include:
84.19... Social Security benefits
84.20... Unemployment benefits
84.21... Workers' compensation
84.22... Veterans' benefits
84.23If you get any of these government benefits, include copies of any documents that show
84.24you get them.
84.25 ... I get other assistance based on need that is not on the list. It comes from: .................
84.26 ..........................................................................................................................................
84.27 Make sure you include copies of any documents that show this.
84.28 C. Other Protected Funds
84.29 The money from these things are also completely protected after they are deposited in
84.30my account.
84.31 ... Child Support
84.32 ... A retirement, disability, or accident pension or annuity
84.33 ... Earnings of my child who is under 18 years of age
84.34 ... Payments to me from a life insurance policy
84Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 85.1 ... Money paid to me from a claim for damage or destruction of property. Property
85.2includes household goods, farm tools or machinery, tools for my job, business equipment,
85.3a mobile home, a car, a musical instrument, a pew or burial lot, clothes, furniture, or
85.4appliances
85.5 ... Death benefits paid to me
85.6 I give my permission to any agency that has given me cash benefits to give information
85.7about my benefits to the above-named creditor, named above or its attorney to the creditor's
85.8lawyer. The information will ONLY concern whether be if I get benefits or not, or whether
85.9I have gotten them assistance, or if I have gotten assistance in the past six 6 months. If I
85.10was an inmate in the last 6 months, I give my permission to the correctional institution to
85.11tell the creditor named above or the creditor's lawyer that I was an inmate there.
85.12 If I was an inmate in the last six months, I give my permission to the correctional
85.13institution to tell the above-named creditor that I was an inmate there.
85.14 You must sign this form and send THIS FORM it back to the creditor's
85.15ATTORNEY lawyer (or to the creditor, if there is no ATTORNEY lawyer) and the
85.16bank. Remember to include a copy of your bank statements for the past 60 days. Fill
85.17in the blanks below and go back to the instructions to make sure you do did it correctly.
85.18 I have mailed or delivered a copy of this form to: the creditor (or to the creditor's lawyer)
85.19at the address listed below.
85.20..............................................................................................................................................
85.21(Insert name of creditor or creditor's attorney)
85.22..............................................................................................................................................
85.23(Insert address of creditor or creditor's attorney)
85.24Creditor's Signature: ............................................................
85.25(or creditor's lawyer's signature)
85.26Creditor's Name: ..................................................................
85.27(or creditor's lawyer's name)
85.28Street Address: .....................................................................
85.29City/State/Zip: ......................................................................
Fax: ......................................85.30Phone: ..................................
85.31Email: ...................................................................................
85.32 I have also mailed or delivered a copy of this exemption form to my bank at the address
85.33listed in the instructions. below:
85Sec. 16.
S2847-1 1st EngrossmentSF2847 REVISOR RSI ..................................................................................................86.1DATED: ...........................
86.2 DEBTOR
86.3 ..................................................................................................
86.4 DEBTOR ADDRESS
86.5 ..................................................................................................
86.6 DEBTOR TELEPHONE NUMBER
86.7Bank's Name: .....................................................................
86.8Street Address: ...................................................................
86.9City/State/Zip: ....................................................................
Fax: .....................................86.10Phone: ..................................
86.11Email: .................................................................................
86.12Date: ...................................................................................
86.13Debtor's Signature: .............................................................
86.14Debtor's Name: ...................................................................
86.15Street Address: ...................................................................
86.16City/State/Zip: ....................................................................
86.17Phone: .................................................................................
86.18Email: .................................................................................
86.19Sec. 17. Minnesota Statutes 2024, section 571.914, subdivision 2, is amended to read:
86.20 Subd. 2.Form of Notice of Objection and Notice of Hearing.The Written Objection
86.21and Notice of Hearing must be in substantially the following form:
DISTRICT COURT86.22STATE OF MINNESOTA
............................JUDICIAL DISTRICT86.23COUNTY OF .........................................
86.24.................................................(Creditor)
CREDITOR'S NOTICE OF OBJECTION86.25...................................................(Debtor)
86.26 AND NOTICE OF HEARING ON
EXEMPTION CLAIM86.27..............................................(Garnishee)
86.28......................................................................
86.29......................................................................
86.30......................................................................
86.31(CREDITOR OR CREDITOR'S
86.32ATTORNEY)
86.33 NOTICE OF HEARING
86.34 The creditor objects to your exemption claim.
86.35 This hearing is to resolve your exemption
86.36 claim.
86Sec. 17.
S2847-1 1st EngrossmentSF2847 REVISOR RSI ......................................................................87.1Hearing Date:
......................................................................87.2Time:
......................................................................87.3Hearing Place:
District Court87.4State of Minnesota
Judicial District: .....................................87.5County of: ..............................................
87.6 Court File Number: ................................
87.7 Case Type: ..............................................
87.8Creditor's full name
Creditor's Notice of Objection and87.9.................................................................
Notice of Hearing on Exemption Claim87.10and
87.11Debtor's full name
87.12.................................................................
87.13Third Party (bank, employer, or other)
87.14.................................................................
87.15 Hearing Notice
87.16 The creditor objects to your exemption claim. This hearing is to decide if your exemption
87.17claim is valid.
87.18The hearing will be at:
Time: ...........................Date: ............................87.19Place: ......................................................
87.20 The creditor objects to your claim of exemption from garnishment for the following
87.21reason(s):
87.22..............................................................................................................................................
87.23..............................................................................................................................................
87.24..............................................................................................................................................
87.25 (Note: Bring with you to the hearing all documents and materials supporting your
87.26exemption claim. Failure to do so could delay the court's decision.)
87.27 If the creditor receives all documents and materials supporting your exemption claim
87.28before the hearing date, the creditor may agree with your claim and you can avoid a hearing.
87.29 Because a court hearing will be held on your claim that your funds are protected, your
87.30financial institution will retain the funds until it receives an order from the court.
87.31 Note: Bring all your documents and materials that support your exemption claim
87.32to the hearing. If you don't, the court's decision could be held up.
87Sec. 17.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 88.1 You can send your documents and materials to the creditor before the hearing. If they
88.2review them and agree with your claim, you can avoid a hearing.
88.3 Because there is a court hearing scheduled about your exemption claim, your bank will
88.4keep your funds until it gets an order from the court.
88.5Date: ...................................................................................
88.6Creditor's Signature: ...........................................................
88.7(or creditor's lawyer's signature)
88.8Creditor's Name: .................................................................
88.9(or creditor's lawyer's name)
88.10Street Address: ...................................................................
88.11City/State/Zip: ....................................................................
Fax: ......................................88.12Phone: ..................................
88.13Email: .................................................................................
88.14Sec. 18. Minnesota Statutes 2024, section 571.925, is amended to read:
88.15 571.925 FORM OF NOTICE.
88.16 The ten-day notice informing a debtor that a garnishment summons may be used to
88.17garnish the earnings of an individual must be substantially in the following form:
DISTRICT COURT88.18STATE OF MINNESOTA
............................JUDICIAL DISTRICT88.19COUNTY OF .........................................
88.20.................................................(Creditor)
88.21against
88.22 GARNISHMENT EXEMPTION
NOTICE AND NOTICE OF88.23...................................................(Debtor)
INTENT TO GARNISH EARNINGS88.24and
88.25..............................................(Garnishee)
88.26 PLEASE TAKE NOTICE that a garnishment summons or levy may be served upon
88.27your employer or other third parties, without any further court proceedings or notice to you,
88.28ten days or more from the date hereof. Some or all of your earnings are exempt from
88.29garnishment. If your earnings are garnished, your employer must show you how the amount
88.30that is garnished from your earnings was calculated. You have the right to request a hearing
88.31if you claim the garnishment is incorrect.
88.32 Your earnings are completely exempt from garnishment if you are now a recipient of
88.33assistance based on need, if you have been a recipient of assistance based on need within
88Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 89.1the last six months, or if you have been an inmate of a correctional institution in the last six
89.2months.
89.3 Assistance based on need includes, but is not limited to:
District Court89.4State of Minnesota
Judicial District: .....................................89.5County of: ..............................................
89.6 Court File Number: ................................
89.7 Case Type: ..............................................
89.8Creditor's full name
Garnishment Exemption Notice and89.9.................................................................
Notice of Intent to Garnish Earnings89.10and
89.11Debtor's full name
89.12.................................................................
89.13Third Party (bank, employer, or other)
89.14.................................................................
89.15 Notice: A garnishment may be served on your employer or other third parties.
89.16Garnishment means that part of your earnings can be taken to pay off debts that you
89.17owe. This can happen in 10 days or more after you get this notice. This can happen without
89.18any other court action or notice to you. But some of your money may be protected.
89.19 Your earnings cannot be taken if:
89.20 (i) you are getting government assistance based on need,
89.21 (ii) you got any government assistance based on need in the last 6 months, or
89.22 (iii) you were an inmate of a correctional institution in the last 6 months.
89.23 These are called exemptions. Your money is NOT protected unless you fill out the
89.24Exemption Claim Notice attached and send it back to the creditor or the creditor's
89.25lawyer. If you are not sure if you have any exemptions, talk to a lawyer.
89.26 You can also contact the creditor or their lawyer to talk about a settlement of the debt.
89.27 Examples of government assistance based on need:
89.28 (i) MFIP - Minnesota Family Investment Program,
89.29 (ii) DWP - MFIP Diversionary Work Program,
89.30 (iii) SNAP - Supplemental Nutrition Assistance Program
89.31 Work participation cash benefit,
89.32 (iv) GA - General Assistance,
89.33 EA - emergency assistance,
89.34 MA - medical assistance,
89Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 90.1 (v) EGA - Emergency General Assistance,
90.2 (vi) MSA - Minnesota Supplemental Aid,
90.3 (vii) MSA-EA - MSA Emergency Assistance,
90.4 Supplemental Nutrition Assistance Program (SNAP),
90.5 SSI - Supplemental Security Income,
90.6 (viii) EA - Emergency Assistance
90.7 (ix) Energy or Fuel Assistance
90.8 (x) Work Participation Cash Benefit
90.9 (xi) MA - Medical Assistance
90.10 (xii) MinnesotaCare,
90.11 (xiii) Medicare Part B - Premium Payments, help
90.12 (xiv) Medicare Part D - Extra help,
90.13 Energy or fuel assistance.
90.14 (xv) SSI - Supplemental Security Income
90.15 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
90.16 Family Credit
90.17 (xvii) Renter's Refund (also called Renter's Property Tax Credit)
90.18 If you wish to claim an exemption, you should fill out the appropriate form below, sign
90.19it, and send it to the creditor's attorney and the garnishee.
90.20 You may wish to contact the attorney for the creditor in order to arrange for a settlement
90.21of the debt or contact an attorney to advise you about exemptions or other rights.
90.22 PENALTIES
90.23 (1) Be advised that even if you claim an exemption, a garnishment summons may still
90.24 be served on your employer. If your earnings are garnished after you claim an exemption,
90.25 you may petition the court for a determination of your exemption. If the court finds that
90.26 the creditor disregarded your claim of exemption in bad faith, you will be entitled to
90.27 costs, reasonable attorney fees, actual damages, and an amount not to exceed $100.
90.28 (2) HOWEVER, BE WARNED if you claim an exemption, the creditor can also petition
90.29 the court for a determination of your exemption, and if the court finds that you claimed
90.30 an exemption in bad faith, you will be assessed costs and reasonable attorney's fees plus
90.31 an amount not to exceed $100.
90.32 (3) If after receipt of this notice, you in bad faith take action to frustrate the garnishment,
90.33 thus requiring the creditor to petition the court to resolve the problem, you will be liable
90.34 to the creditor for costs and reasonable attorney's fees plus an amount not to exceed
90.35 $100.
90Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI .................................................................91.1Dated: ................................................
91.2 (Attorney for) Creditor
91.3 .................................................................
91.4 Address
91.5 .................................................................
91.6 Telephone
91.7 Warnings and Fines
91.8 (1) Even if you claim an exemption, a levy may still be served on your employer. If they
91.9take money from you after you claim an exemption, you may ask the court to review your
91.10exemption. If the court finds that the creditor ignored your claim of exemption in bad faith,
91.11you are entitled to costs, reasonable lawyer fees, actual damages, and a fine up to $100. Bad
91.12faith is when someone does something wrong on purpose.
91.13 (2) BUT if you claim an exemption, the creditor can also ask the court to review your
91.14exemption. If the court finds that you claimed an exemption in bad faith, you are charged
91.15costs and reasonable lawyer fees, and a fine up to $100.
91.16 (3) If you get this notice, then do something in bad faith to try to block or stop the levy
91.17and the creditor has to take you to court because of it, you will have to pay the creditor's
91.18costs, and reasonable lawyer's fees, and a fine up to $100.
91.19Date: ...................................................................................
91.20Creditor's Signature: ...........................................................
91.21(or creditor's lawyer's signature)
91.22Creditor's Name: .................................................................
91.23(or creditor's lawyer's name)
91.24Street Address: ...................................................................
91.25City/State/Zip: ....................................................................
Fax: ......................................91.26Phone: ..................................
91.27Email: .................................................................................
91.28 DEBTOR'S EXEMPTION CLAIM NOTICE
District Court91.29State of Minnesota
Judicial District: .....................................91.30County of: ..............................................
91.31 Court File Number: ................................
91.32 Case Type: ..............................................
91.33Creditor's full name
Debtor's Exemption91.34.................................................................
Claim Notice91.35and
91Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 92.1Debtor's full name
92.2.................................................................
92.3and
92.4Third Party (bank, employer, or other)
92.5.................................................................
92.6 I hereby claim that my earnings are exempt from this garnishment because: (check all
92.7that apply)
92.8 (1) I am presently a recipient of relief based on need. (Specify the program, case number,
92.9 and the county from which relief is being received.)
.............................................................................................92.10..............................................
CountyCase Number (if known)92.11Program
92.12 (2) I am not now receiving relief based on need, but I have received relief based on need
92.13 within the last six months. (Specify the program, case number, and the county from
92.14 which relief has been received.)
.............................................................................................92.15..............................................
CountyCase Number (if known)92.16Program
92.17 (3) I have been an inmate of a correctional institution within the last six months. (Specify
92.18 the correctional institution and location.)
.................................................................92.19...........................................................
Location92.20Correctional Institution
92.21 I hereby authorize any agency that has distributed relief to me or any correctional
92.22institution in which I was an inmate to disclose to the above-named creditor or the creditor's
92.23attorney only whether or not I am or have been a recipient of relief based on need or an
92.24inmate of a correctional institution within the last six months. I have mailed or delivered a
92.25copy of this form to the creditor or creditor's attorney.
.................................................................92.26...........................................................
Debtor92.27Date
92.28 .................................................................
92.29 Address
92.30 .................................................................
92.31 Debtor Telephone Number
DISTRICT COURT92.32STATE OF MINNESOTA
............................JUDICIAL DISTRICT92.33COUNTY OF .........................................
92Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 93.1.................................................(Creditor)
93.2...................................................(Debtor)
93.3..............................(Financial institution)
93.4 ... I am getting government assistance based on need. (State the program, case number
93.5if you know it, and the county you got it from.)
County: ................................Case #: ..................................93.6Program: ..............................
County: ................................Case #: ..................................93.7Program: ..............................
County: ................................Case #: ..................................93.8Program: ..............................
93.9 ... I am not getting assistance based on need right now, but I did get government assistance
93.10based on need within the last 6 months. (State the program, case number if you know it,
93.11and the county you got it from.)
County: ................................Case #: ..................................93.12Program: ..............................
County: ................................Case #: ..................................93.13Program: ..............................
County: ................................Case #: ..................................93.14Program: ..............................
93.15 ... I was an inmate of a correctional institution within the last 6 months. (State the
93.16correctional institution and location.)
Location ..........................................................93.17Correctional Institution .............................
93.18 I give my permission to any agency listed above to give information about my benefits
93.19to the creditor named above, or to the creditor's lawyer. The information will ONLY be if
93.20I get assistance, or if I have gotten assistance in the past 6 months. If I was an inmate in the
93.21last 6 months, I give my permission to the correctional institution to tell the creditor named
93.22above or the creditor's lawyer that I was an inmate there.
93.23 Sign and send this form back to the creditor or the creditor's lawyer.
93.24 Fill in the blanks below.
93.25 I mailed or delivered a copy of this form to the creditor or to the creditor's lawyer if they
93.26have one, at the address listed below.
93.27Date: ...................................................................................
93.28Creditor's Signature: ...........................................................
93.29(or creditor's lawyer's signature)
93.30Creditor's Name: .................................................................
93.31(or creditor's lawyer's name)
93.32Street Address: ...................................................................
93.33City/State/Zip: ....................................................................
93Sec. 18.
S2847-1 1st EngrossmentSF2847 REVISOR RSI Fax: ......................................94.1Phone: ..................................
94.2Email: .................................................................................
94.3Date: ...................................................................................
94.4Debtor's Signature: .............................................................
94.5Debtor's Name: ...................................................................
94.6Street Address: ...................................................................
94.7City/State/Zip: ....................................................................
94.8Phone: .................................................................................
94.9Email: .................................................................................
94.10Sec. 19. Minnesota Statutes 2024, section 571.931, subdivision 6, is amended to read:
94.11 Subd. 6.Notice.The debtor shall be served with a copy of the prejudgment garnishment
94.12order issued pursuant to this section together with a copy of all pleadings and other documents
94.13not previously served, including any affidavits upon which the claimant intends to rely at
94.14the subsequent hearing and a transcript of any oral testimony given at the prejudgment
94.15garnishment hearing upon which the creditor intends to rely and a notice of hearing. Service
94.16must be in the manner prescribed for personal service of a summons unless that service is
94.17impracticable or would be ineffective and the court prescribes an alternative method of
94.18service calculated to provide actual notice to the debtor.
94.19 The notice of hearing served upon the debtor must be signed by the creditor or the
94.20attorney for the creditor and must be accompanied by an exemption notice. The notice of
94.21hearing must be accompanied by an exemption notice, and both notices must provide, at a
94.22minimum, the following information in substantially the following language:
94.23 NOTICE OF HEARING
94.24 Hearing Notice
94.25TO: ........................................................................................................................................
94.26 (the debtor) (debtor's full name)
94.27 The (insert the name of court) Court has ordered the prejudgment garnishment of some
94.28of your property in the possession or control of a third party. This is about property that a
94.29third party has or controls. Some of your property may be exempt from seizure and can't
94.30be taken. See the exemption notice below.
94.31 The Court issued this Order based upon the claim of because (insert name of creditor)
94.32that (insert name of creditor) is claims they are entitled to a court order for garnishment
94.33take some of your property to secure your payment of any money judgment that (insert
94Sec. 19.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 95.1name of creditor) may later be obtained against you and that immediate action was necessary.
95.2They do this to make sure you pay any money they might win in a future case against you.
95.3They felt immediate action was needed.
95.4 You have the legal right to challenge (insert name of creditor) claims at a court hearing
95.5before a judge.
95.6The hearing will be at:
Time: ...........................Date: ............................95.7Place: ......................................................
95.8 The hearing will be held at the (insert place) on (insert date) at (insert time). You may
95.9attend can go to the court hearing alone or with an attorney a lawyer. After you have
95.10presented your side of the matter, the court will decide You get to tell the court your side
95.11of the issue. Then the court decides what should be done with your property until the lawsuit
95.12against you is finally decided.
95.13 If you do not attend don't go to this hearing, the court may order garnishment of
95.14your property.
95.15 Exemption Notice
95.16 Some of your property may be exempt and cannot be garnished can't be taken. 'Exempt'
95.17means protected. The following is a list of some of the more common exemptions. It is not
95.18a complete and is subject to list. For full details and dollar amounts set by law see section
95.19550.37, and other state and federal laws of the Minnesota Statutes. If you have questions
95.20about an exemption, you should obtain competent contact a lawyer for legal advice.
95.21 These things you or your family might have are protected:
95.22 (1) a homestead or the proceeds from the sale of a homestead. equity in your home, or
95.23money from recently selling your home - up to $510,000 total;
95.24 (2)(i) all clothing, one watch, utensils, and foodstuffs;
95.25 (ii) household furniture, household appliances, phonographs, radios, and computers,
95.26tablets, televisions up to a total current value of $4,500 at the time of attachment., printers,
95.27cell phones, smart phones, and other consumer electronics up to $12,150 in all; and
95.28 (iii) jewelry - total value can't be more than $3,308;
95.29 (3) a manufactured (mobile) home used as your home. you live in;
95.30 (4) one motor vehicle currently worth less than $2,000 after deducting any security
95.31interest., counting only the amount you have paid off:
95Sec. 19.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 96.1 (i) $10,000;
96.2 (ii) $12,500 if it is necessary for your business, trade, or profession;
96.3 (iii) $25,000 if used by or to help someone with a disability that makes it hard to walk;
96.4or
96.5 (iv) $100,000 if designed or modified for someone with a disability that makes it hard
96.6to walk;
96.7 (5) farm machinery used by someone principally engaged in farming, or if your main
96.8business is farming. Tools, machines, or office furniture used in your business or trade. This
96.9exemption is limited to $10,000. - the total value can't be more than $13,000;
96.10 (6) relief based on need. This includes the:
96.11 (i) MFIP - Minnesota Family Investment Program (MFIP), Emergency Assistance (EA),
96.12Work First Program, Medical Assistance (MA),;
96.13 (ii) DWP - MFIP Diversionary Work Program;
96.14 (iii) SNAP - Supplemental Nutrition Assistance Program;
96.15 (iv) GA - General Assistance (GA),;
96.16 (v) EGA - Emergency General Assistance (EGA),;
96.17 (vi) MSA - Minnesota Supplemental Aid (MSA),;
96.18 (vii) MSA-EA - MSA Emergency Assistance (MSA-EA), Supplemental Security Income
96.19(SSI), and Energy Assistance.;
96.20 (viii) EA - Emergency Assistance;
96.21 (ix) Energy or Fuel Assistance;
96.22 (x) Work Participation Cash Benefit;
96.23 (xi) MA - Medical Assistance;
96.24 (xii) MinnesotaCare;
96.25 (xiii) Medicare Part B - Premium Payments help;
96.26 (xiv) Medicare Part D - Extra;
96.27 (xv) SSI - Supplemental Security Income;
96.28 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
96.29Family Credit; and
96Sec. 19.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 97.1 (xvii) Renter's Refund (also called Renter's Property Tax Credit);
97.2 (7) wages. 100% is protected if you get government assistance based on need. Otherwise,
97.3between 75-100% is protected depending on how much you earn;
97.4 (8) retirement benefits - the total interest under all plans and contracts can't be more than
97.5$81,000;
97.6 (7) (9) Social Security benefits.;
97.7 (8) (10) unemployment benefits, workers' compensation, or veterans' benefits.;
97.8 (9) An accident, disability or retirement (11) a retirement, disability, or accident pension
97.9or annuity.;
97.10 (10) (12) life insurance proceeds. that are not more than $54,000;
97.11 (11) The (13) earnings of your minor child.;
97.12 (12) (14) money from a claim for damage or destruction of exempt property (such as -
97.13like household goods, farm tools, business equipment, a manufactured (mobile) home, or
97.14a car). car;
97.15 (15) sacred possessions - like the Bible, Torah, Qur'an, prayer rug, and other religious
97.16items. Total value can't be more than $2,000;
97.17 (16) personal library - total value can't be more than $750;
97.18 (17) musical instruments - total value can't be more than $2,000;
97.19 (18) family pets - current value can't be more than $1,000;
97.20 (19) a seat or pew in any house or place of public worship and a lot in any burial ground;
97.21 (20) tools you need to work in your business or profession - the total value can't be more
97.22than $13,500;
97.23 (21) household tools and equipment - things like hand and power tools, snow removal
97.24equipment, lawnmowers, and more. Total value can't be more than $3,000; and
97.25 (22) health savings accounts, medical savings accounts - the total value can't be more
97.26than $25,000.
97.27Sec. 20. Minnesota Statutes 2024, section 571.932, subdivision 2, is amended to read:
97.28 Subd. 2.Service.The creditor's motion to obtain an order of garnishment together with
97.29the creditor's affidavit and notice of hearing must be served in the manner prescribed for
97.30service of a summons in a civil action in district court unless that service is impracticable
97Sec. 20.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 98.1or would be ineffective and the court prescribes an alternative method of service calculated
98.2to provide actual notice to the debtor. If the debtor has already appeared in the action, the
98.3motion must be served in the manner prescribed for service of pleadings subsequent to the
98.4summons. The date of the hearing must be fixed in accordance with rule 6 of the Minnesota
98.5Rules of Civil Procedure for the District Courts, unless a different date is fixed by order of
98.6the court.
98.7 The notice of hearing served upon the debtor shall be signed by the creditor or the
98.8attorney for the creditor and shall provide, at a minimum, the following information in
98.9substantially the following language:
98.10 NOTICE OF HEARING
98.11 Hearing Notice
98.12TO: ........................................................................................................................................
98.13 (the debtor) (debtor's full name)
98.14 A hearing will be held (insert place) on (insert date) at (insert time) to determine whether
98.15nonexempt property belonging to you will be garnished to secure a judgment that may be
98.16entered against you.
98.17 There will be a hearing to decide if your nonexempt property will be garnished to help
98.18pay a judgment that may be entered against you.
98.19The hearing will be at:
Time: ...........................Date: ............................98.20Place: ......................................................
98.21 You may attend can go to the court hearing alone or with an attorney a lawyer. After
98.22you have presented your side of the matter, the court will decide whether You get to tell
98.23the court your side of the issue. Then the court decides if your property should be garnished
98.24until the lawsuit which has been commenced against you is finally decided.
98.25 If the court directs the issuance of issues a garnishment summons while during the
98.26lawsuit is pending, you may still can keep the property until the lawsuit is decided if you
98.27file a bond in an amount. The amount of the bond is set by the court.
98.28 If you DO NOT ATTEND THIS don't go to this hearing, the court may order
98.29garnishment of your nonexempt property TO BE GARNISHED.
98.30 Exemption Notice
98.31 Some of your property may be exempt and cannot can't be garnished taken. 'Exempt'
98.32means protected. The following is a list of some of the more common exemptions. It is not
98Sec. 20.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 99.1a complete and is subject to list. For full details and dollar amounts set by law see section
99.2550.37, and other state and federal laws of the Minnesota Statutes. The dollar amounts
99.3contained in this list are subject to the provisions of section 550.37, subdivision 4a, at the
99.4time of the garnishment. If you have questions about an exemption, you should obtain
99.5competent contact a lawyer for legal advice.
99.6 These things you or your family might have are protected:
99.7 (1) A homestead or the proceeds from the sale of a homestead. equity in your home, or
99.8money from recently selling your home - up to $510,000 total;
99.9 (2)(i) all clothing, one watch, utensils, and foodstuffs;
99.10 (ii) household furniture, household appliances, phonographs, radios, and computers,
99.11tablets, televisions up to a total current value of $5,850., printers, cell phones, smart phones,
99.12and other consumer electronics up to $12,150 in all; and
99.13 (iii) jewelry - total value can't be more than $3,308;
99.14 (3) a manufactured (mobile) home used as your home. you live in;
99.15 (4) one motor vehicle currently worth less than $2,600 after deducting any security
99.16interests., counting only the amount you have paid off:
99.17 (i) $10,000;
99.18 (ii) $12,500 if it is necessary for your business, trade, or profession;
99.19 (iii) $25,000 if used by or to help someone with a disability that makes it hard to walk;
99.20or
99.21 (iv) $100,000 if designed or modified for someone with a disability that makes it hard
99.22to walk;
99.23 (5) farm machinery used by an individual principally engaged in farming, or if your
99.24main business is farming. Tools, machines, or office furniture used in your business or trade.
99.25This exemption is limited to - the total value can't be more than $13,000.;
99.26 (6) relief based on need. This includes the:
99.27 (i) MFIP - Minnesota Family Investment Program (MFIP), Emergency Assistance (EA),
99.28Work First Program, Medical Assistance (MA),;
99.29 (ii) DWP - MFIP Diversionary Work Program;
99.30 (iii) SNAP - Supplemental Nutrition Assistance Program;
99Sec. 20.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 100.1 (iv) GA - General Assistance (GA),;
100.2 (v) EGA - Emergency General Assistance (EGA),;
100.3 (vi) MSA - Minnesota Supplemental Aid (MSA),;
100.4 (vii) MSA-EA - MSA Emergency Assistance (MSA-EA), Supplemental Security Income
100.5(SSI), and Energy Assistance.;
100.6 (viii) EA - Emergency Assistance;
100.7 (ix) Energy or Fuel Assistance;
100.8 (x) Work Participation Cash Benefit;
100.9 (xi) MA - Medical Assistance;
100.10 (xii) MinnesotaCare;
100.11 (xiii) Medicare Part B - Premium Payments help;
100.12 (xiv) Medicare Part D - Extra;
100.13 (xv) SSI - Supplemental Security Income;
100.14 (xvi) Tax Credits - federal Earned Income Tax Credit (EITC), Minnesota Working
100.15Family Credit; and
100.16 (xvii) Renter's Refund (also called Renter's Property Tax Credit);
100.17 (7) wages. 100% is protected if you get government assistance based on need. Otherwise,
100.18between 75-100% is protected depending on how much you earn;
100.19 (8) retirement benefits - the total interest under all plans and contracts can't be more than
100.20$81,000;
100.21 (7) (9) Social Security benefits.;
100.22 (8) (10) unemployment benefits, workers' compensation, or veterans' benefits.;
100.23 (9) An accident, disability or retirement (11) a retirement, disability, or accident pension
100.24or annuity.;
100.25 (10) (12) life insurance proceeds. that are not more than $54,000;
100.26 (11) The (13) earnings of your minor child.;
100.27 (12) (14) money from a claim for damage or destruction of exempt property (such as -
100.28like household goods, farm tools, business equipment, a manufactured (mobile) home, or
100.29a car). car;
100Sec. 20.
S2847-1 1st EngrossmentSF2847 REVISOR RSI 101.1 (15) sacred possessions - like the Bible, Torah, Qur'an, prayer rug, and other religious
101.2items. Total value can't be more than $2,000;
101.3 (16) personal library - total value can't be more than $750;
101.4 (17) musical instruments - total value can't be more than $2,000;
101.5 (18) family pets - current value can't be more than $1,000;
101.6 (19) a seat or pew in any house or place of public worship and a lot in any burial ground;
101.7 (20) tools you need to work in your business or profession - the total value can't be more
101.8than $13,500;
101.9 (21) household tools and equipment - things like hand and power tools, snow removal
101.10equipment, lawnmowers, and more. Total value can't be more than $3,000; and
101.11 (22) health savings accounts, medical savings accounts - the total value can't be more
101.12than $25,000.
101.13Sec. 21. IMPLEMENTATION AND COMPLIANCE.
101.14 The forms in Minnesota Statutes, chapters 550, 551, and 571, as amended by this act
101.15must be active on the Minnesota courts website and in use by Minnesota courts on June 1,
101.162025. Notwithstanding Laws 2024, chapter 114, article 3, section 101, the effective date,
101.17garnishments governed by Minnesota Statutes, section 571.922, as amended by Laws 2024,
101.18chapter 114, article 3, section 101, are effective June 1, 2025. The failure to use revised
101.19forms before June 1, 2025, is not a basis for a complaint or violation of a federal statute,
101.20Minnesota Statutes, or the Minnesota Rules of Professional Conduct.
101.21Sec. 22. EFFECTIVE DATE.
101.22 This act is effective retroactively from January 1, 2025.
101Sec. 22.
S2847-1 1st EngrossmentSF2847 REVISOR RSI