Templates Bankruptcy Arizona Bankruptcy Exemption Worksheet

Arizona Bankruptcy Exemption Worksheet

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ARIZONA BANKRUPTCY EXEMPTION WORKSHEET

Part 1 — Debtor Identification

Field Entry
Debtor full legal name [________________________________]
Joint debtor (if any) [________________________________]
Last four digits of SSN [____] / [____]
Street address [________________________________]
City, AZ ZIP [________________________________]
County of residence [________________________________]
Bankruptcy chapter (☐ 7 ☐ 11 ☐ 13) [____]
Case number (if assigned) [________________________________]
Petition date [__/__/____]
Date debtor became AZ domiciliary [__/__/____]

☐ Debtor has been domiciled in Arizona for at least 730 days preceding the petition date and is required to use Arizona state exemptions per 11 U.S.C. § 522(b)(3)(A).

☐ Debtor has NOT met the 730-day rule. Apply 180-day look-back. Governing state: [________________________________]

☐ Debtor confirms that no federal § 522(d) exemptions are claimed (A.R.S. § 33-1133(B)).

Part 2 — Homestead Exemption Analysis (A.R.S. §§ 33-1101 to 33-1105)

2.1 Description of Homestead Property

Field Entry
Type of dwelling (☐ house ☐ condo ☐ co-op ☐ mobile home ☐ manufactured home ☐ houseboat ☐ travel trailer ☐ fifth wheel ☐ park model) [________________________________]
Property street address [________________________________]
County [________________________________]
Tax parcel / APN [________________________________]
Legal description (attach Exhibit A if lengthy) [________________________________]
Date debtor acquired interest [__/__/____]
Acquisition price $[____________]
Vesting (☐ sole ☐ community property ☐ JTWROS ☐ tenants in common ☐ trust) [________________________________]

2.2 Equity Computation

Item Amount
Current fair market value (☐ appraisal ☐ comparative market analysis ☐ Zillow/Redfin estimate; attach support) $[____________]
Less: First mortgage / deed of trust balance ($[____________])
Less: Second mortgage / HELOC balance ($[____________])
Less: Property tax liens ($[____________])
Less: Mechanics', HOA, or judgment liens (if any) ($[____________])
Less: Cost of sale (if liquidation analysis required) ($[____________])
Net equity $[____________]

2.3 Exemption Claimed

Item Amount
Statutory cap under A.R.S. § 33-1101(A) $400,000.00
CPI adjustment in effect on petition date (rounded to nearest $100) $[____________]
Exemption amount claimed on Schedule C $[____________]
Non-exempt equity (if any) $[____________]

☐ Debtor occupied the property as a primary residence on the petition date.

☐ Property has been the debtor's principal residence for at least 1,215 days preceding the petition date (11 U.S.C. § 522(p) cap of $189,050 inapplicable).

☐ Debtor (or debtor's family) claims only ONE homestead per A.R.S. § 33-1101(B). No spouse or family member is asserting a separate homestead.

☐ Recorded Declaration of Homestead attached as Exhibit B (optional but recommended).

Part 3 — Personal Property Exemptions (A.R.S. §§ 33-1123 to 33-1126)

3.1 Household Furniture, Furnishings, Goods, Electronics, and Appliances (§ 33-1123)

Item Description FMV
Living room furniture $[____________]
Bedroom furniture $[____________]
Dining/kitchen furniture $[____________]
Major appliances (refrigerator, washer, dryer, stove) $[____________]
Consumer electronics (TVs, stereo, gaming) $[____________]
Computers (household, non-business) $[____________]
Linens, dishware, kitchenware $[____________]
Decorative items, artwork $[____________]
Subtotal household goods $[____________]
Cap Amount
Aggregate FMV cap under § 33-1123 $15,000.00
CPI adjustment in effect on petition date $[____________]
Exemption claimed $[____________]
Non-exempt overage (if any) $[____________]

3.2 Motor Vehicle (§ 33-1125(8))

Vehicle 1 Entry
Year / Make / Model / VIN [________________________________]
Title holder of record [________________________________]
FMV (☐ NADA ☐ Kelley Blue Book ☐ dealer offer; attach) $[____________]
Less: Loan/lien balance ($[____________])
Equity $[____________]
Vehicle 2 (if joint case) Entry
Year / Make / Model / VIN [________________________________]
FMV $[____________]
Less: Loan/lien balance ($[____________])
Equity $[____________]
Cap Amount
Standard exemption per debtor under § 33-1125(8) $15,000.00
Disability-enhanced exemption (debtor or dependent has physical disability) $25,000.00
CPI adjustment $[____________]
Exemption claimed (debtor) $[____________]
Exemption claimed (joint debtor, if any) $[____________]

☐ Debtor or dependent has a physical disability supporting the $25,000 cap. Documentation attached as Exhibit C.

3.3 Personal Items Schedule (§ 33-1125)

Category Statutory Cap FMV Claimed
All wearing apparel (§ 33-1125(1)) $500 $[________] $[________]
Musical instruments (§ 33-1125(2)) $400 $[________] $[________]
Domestic pets, horses, milk cows, poultry (§ 33-1125(3)) $1,000 $[________] $[________]
Engagement and wedding rings (§ 33-1125(4)) $2,000 $[________] $[________]
Library books and educational materials (§ 33-1125(5)) $250 $[________] $[________]
One watch (§ 33-1125(6)) $250 $[________] $[________]
Typewriter, computer, bicycle, sewing machine, family bible, burial lot (§ 33-1125(7)) — combined $2,000 $[________] $[________]
Professionally prescribed prostheses, wheelchair, mobility device (§ 33-1125(9)) unlimited $[________] $[________]
Firearms (§ 33-1125(10)) $2,000 $[________] $[________]

3.4 Tools of the Trade (§ 33-1130)

Item FMV
Trade tools and equipment $[____________]
Professional instruments $[____________]
Reference books $[____________]
Telephone numbers, client/customer lists, marketing assets, websites, domain names $[____________]
Subtotal tools of trade $[____________]
Cap Amount
Aggregate FMV cap under § 33-1130(1) $5,000.00
Exemption claimed $[____________]

☐ Items listed are primarily used in and necessary to the debtor's commercial activity, trade, business, or profession.

3.5 Money, Proceeds, and Insurance Benefits (§ 33-1126)

Category Cap FMV Claimed
Life insurance proceeds payable to surviving spouse/child (§ 33-1126(A)(1)) $20,000 $[________] $[________]
Health/accident/disability insurance proceeds (§ 33-1126(A)(4)) unlimited $[________] $[________]
Insurance on destroyed/damaged exempt property (§ 33-1126(A)(5)) tied to underlying exemption $[________] $[________]
Child support / spousal maintenance owed by court order (§ 33-1126(A)(2)) unlimited $[________] $[________]
Earnings of a minor child (§ 33-1126(A)(3)) unlimited $[________] $[________]
Annuity contract owned 2+ years (§ 33-1126(A)(7)) unlimited $[________] $[________]
Cash surrender value of life insurance owned 2+ years (§ 33-1126(A)(6)) unlimited (subject to non-debtor beneficiary rule) $[________] $[________]
Single financial-institution account (§ 33-1126(A)(9)) $5,000 $[________] $[________]

Part 4 — Wages and Earnings (A.R.S. § 33-1131)

Item Amount
Gross wages last pay period $[____________]
Statutory deductions (FICA, federal/state income tax, etc.) ($[____________])
Disposable earnings $[____________]
10% of disposable earnings (subject to garnishment under § 33-1131(B)) $[____________]
60 × applicable Arizona minimum hourly wage $[____________]
Excess over 60 × minimum wage $[____________]
Maximum garnishable amount (lesser of 10% or excess) $[____________]
Exempt portion of disposable earnings $[____________]

☐ Wages are post-petition; not property of the bankruptcy estate in a Chapter 7 (11 U.S.C. § 541(a)(6)).

☐ Wages earned pre-petition but unpaid as of petition date are property of the estate; exemption claimed: $[____________].

Part 5 — Public Benefits, Retirement, and Other Statutory Exemptions

Asset Class Statutory Authority FMV Claimed
Social Security benefits 42 U.S.C. § 407 $[________] fully exempt
Veterans' benefits 38 U.S.C. § 5301 $[________] fully exempt
Unemployment insurance A.R.S. § 23-783(A) $[________] fully exempt
Workers' compensation A.R.S. § 23-1068(B) $[________] fully exempt
Welfare / TANF / SNAP A.R.S. § 46-208 $[________] fully exempt
ERISA-qualified retirement plans (401(k), pension) 11 U.S.C. § 522(b)(3)(C); A.R.S. § 33-1126(B) $[________] fully exempt
Traditional & Roth IRAs (federal cap) 11 U.S.C. § 522(n) (cap $1,512,350 aggregate, indexed) $[________] $[________]
Arizona State Retirement System A.R.S. § 38-792 $[________] fully exempt
Public Safety Personnel Retirement A.R.S. § 38-850 $[________] fully exempt
Education savings (529 plans) A.R.S. § 33-1126(A)(8) (subject to age-of-account rules) $[________] $[________]

Part 6 — Property NOT Exempt Under Arizona Law

Asset FMV
Cash on hand (beyond § 33-1126(A)(9) account exemption) $[____________]
Stocks, bonds, mutual funds (non-retirement) $[____________]
Cryptocurrency holdings $[____________]
Investment / non-homestead real estate $[____________]
Boats, RVs, aircraft (not qualifying as homestead) $[____________]
Collectibles, art, jewelry beyond § 33-1125 caps $[____________]
Tax refunds (pro rata pre-petition portion) $[____________]
Anticipated inheritance (within 180 days post-petition) $[____________]
Causes of action / lawsuits not personal-injury proceeds of personal property $[____________]
Business interests, partnership shares, LLC membership $[____________]
Accounts receivable (non-trade-of-tools) $[____________]
Total non-exempt property $[____________]

Part 7 — Summary of Exemptions Claimed

Schedule C Line Statute Exemption Amount
Homestead A.R.S. § 33-1101 $[____________]
Household goods A.R.S. § 33-1123 $[____________]
Motor vehicle A.R.S. § 33-1125(8) $[____________]
Wearing apparel A.R.S. § 33-1125(1) $[____________]
Musical instruments A.R.S. § 33-1125(2) $[____________]
Pets/livestock A.R.S. § 33-1125(3) $[____________]
Wedding/engagement rings A.R.S. § 33-1125(4) $[____________]
Books A.R.S. § 33-1125(5) $[____________]
Watch A.R.S. § 33-1125(6) $[____________]
Combined items (typewriter, computer, bicycle, etc.) A.R.S. § 33-1125(7) $[____________]
Prostheses/mobility device A.R.S. § 33-1125(9) $[____________]
Firearms A.R.S. § 33-1125(10) $[____________]
Tools of trade A.R.S. § 33-1130 $[____________]
Bank account A.R.S. § 33-1126(A)(9) $[____________]
Insurance proceeds (life) A.R.S. § 33-1126(A)(1) $[____________]
Health/disability insurance A.R.S. § 33-1126(A)(4) $[____________]
Annuity / cash value (2-year rule) A.R.S. § 33-1126(A)(6)–(7) $[____________]
Wages (pre-petition unpaid) A.R.S. § 33-1131 $[____________]
Retirement plans (ERISA-qualified) 11 U.S.C. § 522(b)(3)(C) $[____________]
IRAs (federal cap) 11 U.S.C. § 522(n) $[____________]
Social Security / Veterans' / public benefits various federal $[____________]
TOTAL EXEMPTIONS CLAIMED $[____________]

Part 8 — Strategic Considerations Checklist

☐ Confirmed 730-day domicile rule satisfied; AZ exemptions applicable.

☐ Confirmed 1,215-day rule for full state homestead (avoids 11 U.S.C. § 522(p) cap).

☐ No transfers within 10 years preceding petition that could trigger 11 U.S.C. § 522(o) reduction of homestead for non-exempt-to-exempt asset conversion with intent to defraud.

☐ No pre-petition exemption planning that constitutes "extreme" pre-bankruptcy planning under In re Carey, 938 F.3d 1224 (11th Cir. 2019), or analogous Ninth Circuit authority.

☐ Considered timing of petition relative to anticipated tax refunds, bonuses, inheritances.

☐ Verified CPI-adjusted current dollar amounts for §§ 33-1101, 33-1123, 33-1125 with the Arizona Supreme Court Administrative Office or Bankruptcy Court website (annual adjustment effective January 1 of each year).

☐ Considered whether to record a Declaration of Homestead under A.R.S. § 33-1102 (not required but useful in creditor disputes).

☐ Reviewed whether any creditor has served a § 33-1102(B) demand triggering the 30-day designation rule.

☐ Identified all secured creditors with liens that survive bankruptcy (mortgages, auto loans, judgment liens that may be avoidable under 11 U.S.C. § 522(f)).

☐ Considered avoidance of judicial liens impairing exemptions under 11 U.S.C. § 522(f)(1)(A).

☐ Considered avoidance of non-purchase-money, non-possessory security interests in household goods under 11 U.S.C. § 522(f)(1)(B).

☐ Discussed objection deadlines under Fed. R. Bankr. P. 4003(b) with client (30 days after meeting of creditors concludes).

Part 9 — Debtor Verification

I, the undersigned debtor, declare under penalty of perjury under the laws of the United States and the State of Arizona that I have reviewed the foregoing exemption worksheet, that the values stated above reflect my good-faith estimate of fair market value as of the petition date, and that I claim the exemptions identified above as authorized by Arizona Revised Statutes Title 33, Chapter 8, and the federal non-bankruptcy exemptions cross-referenced herein. I understand that Arizona is an opt-out state under A.R.S. § 33-1133(B) and that I may not claim federal exemptions under 11 U.S.C. § 522(d).

Signature Block Entry
Debtor signature [________________________________]
Printed name [________________________________]
Date [__/__/____]
Joint debtor signature (if any) [________________________________]
Printed name [________________________________]
Date [__/__/____]

Prepared by Counsel:

Field Entry
Attorney name [________________________________]
State Bar of Arizona No. [________________________________]
Firm [________________________________]
Address [________________________________]
Phone [____________]
Email [________________________________]
Date [__/__/____]

Sources and References

  • A.R.S. Title 33, Chapter 8 (Homestead and Personal Property Exemptions): https://www.azleg.gov/arsDetail/?title=33
  • A.R.S. § 33-1101 (Homestead): https://www.azleg.gov/ars/33/01101.htm
  • A.R.S. § 33-1102 (Homestead acquisition): https://www.azleg.gov/ars/33/01102.htm
  • A.R.S. § 33-1123 (Household furniture): https://www.azleg.gov/ars/33/01123.htm
  • A.R.S. § 33-1125 (Personal items): https://www.azleg.gov/ars/33/01125.htm
  • A.R.S. § 33-1126 (Money, proceeds, benefits): https://www.azleg.gov/ars/33/01126.htm
  • A.R.S. § 33-1130 (Tools of trade): https://www.azleg.gov/ars/33/01130.htm
  • A.R.S. § 33-1131 (Wages): https://www.azleg.gov/ars/33/01131.htm
  • A.R.S. § 33-1133 (Federal exemption opt-out): https://www.azleg.gov/ars/33/01133.htm
  • 11 U.S.C. § 522 (Bankruptcy exemptions): https://www.law.cornell.edu/uscode/text/11/522
  • Arizona Proposition 209 (2022) summary (Ballotpedia): https://ballotpedia.org/Arizona_Proposition_209
  • U.S. Bankruptcy Court for the District of Arizona: https://www.azb.uscourts.gov/
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Last updated: May 2026